Freebirthing in the UK: A Narrative Study

Student thesis: Doctoral ThesisDoctor of Philosophy

Abstract

Background
Freebirth occurs when someone intentionally gives birth without healthcare professionals present in
societies where maternity services are available to assist them. Although the act is legal in England and Wales, it is a stigmatised birthing decision and an under-researched phenomenon. There is limited in-depth, empirical data on the subject although previous scholarship on the topic indicates women’s motivations are frequently linked to issues in state run maternity services.

Aims
The aim of this research was to understand women’s rationales and experiences of freebirthing in the UK. This incorporated a four-stage framework: 1. Pre-freebirth experiences; 2. The freebirthpregnancy; 3. The freebirth; and 4. The post-natal experience. It was envisaged that the findings from the study could be used to implement policy change.

Methods
The study was supported by AIMS (Association for Improvements in the Maternity Services), a national charity focussing on human rights in pregnancy and childbirth. This support greatly enhanced all aspects of the study and enabled meaningful public and patient involvement.
I undertook 16 face-to-face narrative interviews with women who had freebirthed in the UK. The data were analysed using the Voice Centred Relational Method or VCRM. This method consists of fourreadings: 1. The plot and the researcher’s response; 2. The “voice of the I” and the creation of I-poetry;3. Reading for relationships; and 4. The social, political, cultural and structural context. There is very limited guidance on how to present VCRM findings. I have therefore presented them as a Quest Narrative, relying on feminist literature pertaining to the so-called ‘heroine’s journey.’

Results
Women discussed varying motivations and experiences. Previous maternity experiences ranged from excellent to abusive. Women’s motivations were complex, including previous precipitous births, limitations on homebirths and prior experiences of obstetric violence. Participants were desirous of knowledge of pregnancy and birth that existed beyond the biomedical paradigm, particularly information on rights. Much of this knowledge was not provided by the National Health Service (NHS) and interviewees therefore sought this support elsewhere, for example, from online groups and charities such AIMS and Birthrights. Much of this knowledge base was shared within a Female Network.
Throughout the data there were indications that social norms pertaining to ‘Good Mother’ ideals dictated the ways in which women experienced their pregnancies and births. Interviewees recognisedthat they were expected to behave in certain ways, for example, to defer to the opinions of health care staff, and that failure to do so may result in suspicion and negative consequences. Some women reported health care staff acting in ways to bring them ‘back in line’ and enacting punishment when they were perceived to have transgressed social norms relating to ideal standards of maternal behaviour. Post-freebirth, many women gave back to the Female Network by sharing their lived experiences of freebirth in a variety of ways and via a range of platforms.
Results of the study were disseminated in several formats. These included academic publications, activist literature, blogs, an Economic and Social Research Council (ESRC) funded short video and a Wellcome, ESRC and King’s College London funded graphic zine.

Conclusion
This research contributes to the small but growing scholarship on freebirth and the wider area of reproductive rights, particularly that pertaining to obstetric violence, consent, and coercion. It provides a unique insight into the experiences of a marginalised group and illuminates highly problematic areas existing in UK NHS maternity provision. The thesis presents and develops the use of VCRM, applying the Quest Narrative as a useful framework for VCRM data presentation. In addition, this research furthers understanding of the Good Mother concept and how it impacts the lived experiences of women during their interactions with health care staff and other professionals.
Date of Award1 Sept 2023
Original languageEnglish
Awarding Institution
  • King's College London
SupervisorElsa Montgomery (Supervisor) & Glenn Robert (Supervisor)

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