Coping with the stigma of home birth: Strategies of engagement and disengagement
Słowa kluczowe:
qualitative research, stigma, midwifery, coping with stress, childbirthAbstrakt
Background
Home birth in most developed countries is stigmatised. Negative discourses frame women planning home births as risk mothers who put their desire for a particular birthing experience above the health and safety of their children. As a result, one of the primary challenges home-birthing women face during pregnancy is how to cope with this stigma.
Participants and procedure
This study was conducted in the upper Midwest region of the United States with women who were planning home births with midwives. Eleven women participated in the study. Data included in-depth interviews, participant-observation field notes, and content from one participant’s blog. Data were analysed using inductive content analysis.
Results
Participants coped with home birth stigma in three ways: (1) avoidance, (2) engaging in an education campaign, and (3) focusing on a family tradition of home birth. These responses represent both disengagement and engagement approaches to coping. Nine participants exhibited one dominant coping strategy: three relied on avoidance, three on an education campaign, and three on family tradition. Two participants used more than one approach. Both of these participants used avoidance and family tradition.
Conclusions
Home birth stigma is a source of chronic stress for women who choose to give birth at home. Women cope with this stress in a number of ways. Interventions to increase women’s coping resources and processes may be helpful. Changing the environment through efforts to destigmatise home birth may reduce the overall stress experienced by home-birthing women and improve their wellbeing.
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Bibliografia
Antonovsky, A. (1979). Health, stress, and coping. San Francisco, CA: Jossey-Bass.
Antonovsky, A. (1996). The salutogenic model as a theory to guide health promotion. Health Promotion International, 11, 11–18.
Boucher, D., Bennett, C., McFarlin, B., & Freeze, R. (2009). Staying home to give birth: why women in the United States choose home birth. Journal of Midwifery & Women’s Health, 54, 119–126.
Carver, C. S., & Connor-Smith, J. (2010). Personality and coping. Annual Review of Psychology, 61, 679–704.
Chang, H. (2016). Autoethnography as method. New York: Routledge.
Chervenak, F. A., McCullough, L. B., Brent, R. L., Levene, M. I., & Arabin, B. (2013). Planned home birth: the professional responsibility response. American Journal of Obstetrics and Gynecology, 208, 31–38.
Church, S., Frith, L., Balaam, M., Berg, M., Smith, V., Van der Walt, C., Downe, S., & Van Teilingen, E. (2017). New Thinking on Improving Maternity Care: International Perspectives. London: Pinter and Martin.
Compas, B. E., Connor-Smith, J. K., Saltzman, H., Thomsen, A. H., & Wadsworth, M. E. (2001). Coping with stress during childhood and adolescence: problems, progress, and potential in theory and research. Psychological Bulletin, 127, 87.
Connor-Smith, J. K., Compas, B. E., Wadsworth, M. E., Thomsen, A. H., & Saltzman, H. (2000). Responses to stress in adolescence: Measurement of coping and involuntary stress responses. Journal of Consulting and Clinical Psychology, 68, 976–992.
Coxon, K., Sandall, J., & Fulop, N. J. (2014). To what extent are women free to choose where to give birth? How discourses of risk, blame and responsibility influence birth place decisions. Health, Risk & Society, 16, 51–67.
Ellis, C., Adams, T. E., & Bochner, A. P. (2011). Autoethnography: An overview. Historical Social Research, 36, 273–290.
Emerson, R. M., Fretz, R. I., & Shaw, L. L. (2011). Writing ethnographic field notes (2nd ed.). Chicago, IL: University of Chicago Press.
Epstein, A., Slotnick, A., Netto, P., Lake, R., Gavin, M., & Pluess, A. (2008). The business of being born. Burbank, CA: New Line Home Entertainment.
Fage-Butler, A. M. (2017). Risk resistance: constructing home birth as morally responsible on an online discussion group. Health, Risk & Society, 1–15.
Ferguson, S., Davis, D., & Browne, J. (2013). Salutogenesis and normal birth. Women and Birth, 26, S28.
Grigg, C. P., Tracy, S. K., Schmied, V., Daellenbach, R., & Kensington, M. (2015). Women’s birthplace decision-making, the role of confidence: part of the Evaluating Maternity Units study, New Zealand. Midwifery, 31, 597–605.
Hildingsson, I., Lindgren, H., Haglund, B., & Radestad, I. (2006). Characteristics of women giving birth at home in Sweden: A national register study. American Journal of Obstetrics and Gynecology, 195, 1366–1372.
Hildingsson, I., Radestad, I., & Lindgren, H. (2010). Birth preferences that deviate from the norm in Sweden: Planned home birth versus planned cesarean section. Birth, 37, 288–295.
Holten, L., & de Miranda, E. (2016). Women׳ s motivations for having unassisted childbirth or highrisk homebirth: An exploration of the literature on ‘birthing outside the system’. Midwifery, 38, 55–62.
Janssen, P. A., Henderson, A. D., & Vedam, S. (2009). The experience of planned home birth: views of the first 500 women. Birth, 36, 297–304.
Johnson, K. C., & Daviss, B. A. (2005). Outcomes of planned home births with certified professional midwives: Large prospective study in North America. British Medical Journal, 330, 1416–1419.
Leavitt, J. W. (1986). Brought to Bed: Childbearing in America 1750 to 1950. New York: Oxford University Press.
Lee, S., Ayers, S., & Holden, D. (2016). Risk perception and choice of place of birth in women with high risk pregnancies: A qualitative study. Midwifery, 38, 49–54.
Lindström, B., & Eriksson, M. (2005). Salutogenesis. Journal of Epidemiology and Community Health, 59, 440–442.
Lofland, J. & Lofland, L. H. (1995). Analyzing social settings: A guide to qualitative observation and analysis (3rd ed.). Belmont, CA: Wadsworth.
MacDorman, M. F., Declercq, E., & Menacker, F. (2011). Trends and characteristics of home births in the United States by race and ethnicity, 19902006. Birth, 38, 17–23.
MacDorman, M. F., Mathews, T. J., & Declercq, E. (2012). Home births in the United States, 19902009. NCHS Data Brief 84. Hyattsville, MD: National Center for Health Statistics.
Martin, J. A., Hamilton, B. E., Osterman, M. J., Driscoll, A. K., & Mathews, T. J. (2017). Births: Final data for 2015. National Vital Statistics Reports, 66. Hyattsville, MD: National Center for Health Statistics.
Martin, J. A., Hamilton, B. E., Sutton, P. D., Ventura, S. J., Menacker, F., Kirmeyer, S., & Munson, M. L. (2007). Births: Final data for 2005. National Vital Statistics Reports, 56. Hyattsville, MD: National Center for Health Statistics.
Miller, C. A. (2012). On the margins of the periphery: unassisted childbirth and the management of layered stigma. Sociological Spectrum, 32, 406–423.
Miller, C. T. (2006). Social psychological perspectives on coping with stressors related to stigma. In S. Levin & C. Van Laar (Eds.), Stigma and group inequality: Social psychological perspectives (pp. 21–44). Mahwah, New Jersey: Lawrence Erlbaum Associates.
Miller, C. T., & Kaiser, C. R. (2001). A theoretical perspective on coping with stigma. Journal of Social Issues, 57, 73–92.
Murray-Davis, B., McNiven, P., McDonald, H., Malott, A., Elarar, L., & Hutton, E. (2012). Why home birth? A qualitative study exploring women’s decision making about place of birth in two Canadian provinces. Midwifery, 28, 576–581.
Perez-Botella, M., Downe, S., Magistretti, C. M., Lindstrom, B., & Berg, M. (2015). The use of salutogenesis theory in empirical studies of maternity care for healthy mothers and babies. Sexual & Reproductive Healthcare, 6, 33–39.
Perined. (2016). Perinatale Zorg in Nederland 2015 [Perinatal Care in the Netherlands 2015]. Utrecht, The Netherlands: Perined.
Rooks, J. (1997). Midwifery and Childbirth in America. Philadelphia, PA: Temple University Press.
Skinner, E. A., Edge, K., Altman, J., & Sherwood, H. (2003). Searching for the structure of coping: a review and critique of category systems for classifying ways of coping. Psychological Bulletin, 129, 216.
Smith, V., Daly, D., Lundgren, I., Eri, T., Benstoem, C., & Devane, D. (2014). Salutogenically focused outcomes in systematic reviews of intrapartum interventions: A systematic review of systematic reviews. Midwifery, 30, e151–e156.
Snowden, J. M., Tilden, E. L., Snyder, J., Quigley, B., Caughey, A. B., & Cheng, Y. W. (2015). Planned out-of-hospital birth and birth outcomes. New England Journal of Medicine, 373, 2642–2653.
Swim, J. K., & Thomas, M. A. (2006). Responding to everyday discrimination: A synthesis of research on goal-directed, self-regulatory coping behaviors. In S. Levin & C. Van Laar (Eds.), Stigma and group inequality: Social psychological perspectives (pp. 105–126). Mahwah, New Jersey: Lawrence Erlbaum Associates.
Taylor, S. E., & Stanton, A. L. (2007). Coping resources, coping processes, and mental health. Annual Review of Clinical Psychology, 3, 377–401.
Viisainen, K. (2000). The moral dangers of home birth: parents’ perceptions of risks in home birth in Finland. Sociology of Health & Illness, 22, 792–814.
Wertz, R. W., & Wertz, D. C. (1989). Lying-In: A History of Childbirth in America. Expanded ed. New Haven, CT: Yale University Press.
Wrede, S. (1997). The notion of risk in Finnish prenatal care: Managing risk mothers and risk pregnancies. In E. Riska (Ed.), Images of Women’s Health: The Social Construction of Gendered Health (133180). Åbo, Finland: Institute of Women’s Studies at Åbo Akademi University.