Dr Sascha Callaghan1, Dr Liz Sutton
1University Of Sydney
This paper presents a high level discourse analysis of the major midwifery textbooks used in Australian midwifery training. The analysis uses grounded theory to identify the key themes and values evident in the midwifery materials used to prepare Australian students to enter the profession. Among the values of care for women, and the need to provide a safe and supportive environment for women in labour, there appears to also be a strong emphasis on the role of midwife as “guardian of normal childbirth”. In shaping this role, midwifery texts emphasise both the utility of pain as a transformative experience; and a commitment to avoiding medical or technological interference in labour wherever possible, including for pain relief and for assistance in the birthing process.
We reflect on how well (or otherwise) these themes match women’s clinical experiences and needs. The most recent Australian Institute of Health and Welfare data indicates that over 78.5% of women having their first baby receive medical pain relief, and just under half will have either an instrumental birth or a cesarean section. Of those who have a non-instrumental, “normal” vaginal birth, 40% will have significant physical damage to the pelvic floor or anal sphincter, the risks of which are rarely mentioned in midwife training. The data raises questions about whether the themes evident in midwifery education materials, adequately reflects most women’s experiences and needs. This is an important issue when the majority of women giving birth in Australia will do so at last partly under the care of Australian midwives, both in the pre-natal period and in the process of giving birth.
Biography:
Dr Sascha Callaghan is a lawyer and research affiliate at the University of Sydney. She is currently researching consent and risk communication in vaginal birth. This discourse analysis was undertaken jointly with Dr Liz Sutton at the Monash Bioethics Centre for Bioethics. It is part of a wider program of research exploring risk communication, preference shaping and consent in child birth.