In the beginning women supported women to birth.
Towards the end of the 19th century, male physicians evolved. And birth became more managed and systematic.
The modern maternity unit was modelled on a WWII weapons factory, and like an assembly line the focus was on being efficient and controlled!
Interventions began to rise…beyond the point of need and into an economic and insurance driven approach. These excess interventions have not improved mortality for women or babies…and we are seeing a rise in physical and emotional birth trauma and post natal depression. This medicalised approach is dehumanising. It disregards the unique nature of each woman, and the importance of the journey she is undertaking.
We often refer to birth as a journey, and yet we do not prepare for it as if it were a journey.
Instead, we process them in a standardised system, knowing they are assuming they are receiving the best possible information and know all their options.
For my PhD I am evaluating a potential universal approach to birth preparation I’ve developed called Birth Cartography.
As the name suggests, this process produces a Map. And a map is about a journey, with pathways and variability’s to consider.
I will use realist evaluation, as this places women squarely in the picture. It asks them what works for you, in what circumstances and why. Participants are given the resources to create a personal birth map, which should help them to step off the conveyor belt, and enable them to move through the maternity system feeling involved and confident.
The Birth Map process gives women a series of suggested questions to start conversations with their care providers, and draws in a birth partner. They can discuss the various scenarios and determine their personal if this – then that decision map to guide the labour and birth.
Throughout the study, women will provide feedback using an app for the smart phone to record reflections at key points during pregnancy and soon after birth. Focused interviews will follow to complete the experience.
A universal, consistent and woman-led process to enhance communication and decision making has the potential to revolutionise maternity care, improving the experience for women, their partners and the care providers.
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