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'Just waiting to be hauled over the coals': Home birth midwifery in Ireland.
MedLine Citation:
PMID:  23415356     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE: to describe the context of Irish home birth midwives' practise experience. DESIGN: ethnography derived from participant observation, unstructured interview and documentary analysis. SETTING: women and midwives' homes and meeting places in Ireland. PARTICIPANTS: 21 self-employed community midwives. MEASUREMENTS AND FINDINGS: choice of place of birth is extremely limited in Ireland. Structural and professional supports for home birth and midwifery are lacking. Home birth midwives highly value midwifery professionalism but are professionally isolated. They promote women's birthing autonomy and choice of place of birth. However, they experience and anticipate negative, even punitive, responses from their own and other professions. This ethnography describes a particularly volatile period in Irish home birth midwifery practice. KEY CONCLUSIONS: Irish home birth midwives are professionally isolated which, given wider cultural antagonism to home birth, perfuses their practice with an element of defensiveness. Strong midwifery association is a key pillar of professionalism globally. In Ireland, the lack of a strong professional body undermines autonomous midwifery practice in all settings but particularly in the home. The midwifery philosophy of 'being with woman' appears to run contrary to professionalising discourses where the professional 'knows best'. Contemporary cultural expectations of professionalism such as clinical indemnification and risk averse practice protocols, bring challenges to autonomous midwifery practice. IMPLICATIONS FOR PRACTICE: place and context of birth effects not only the woman's birth experience but the midwife's professional autonomy. Without supports for autonomous midwifery, autonomous birthing is under threat. Place of birth effects birth experience and birth quality, not least because it is that context which also influences, for good or ill, midwifery autonomy.
Authors:
Colm Oboyle
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-2-14
Journal Detail:
Title:  Midwifery     Volume:  -     ISSN:  1532-3099     ISO Abbreviation:  Midwifery     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-2-18     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8510930     Medline TA:  Midwifery     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2013 Elsevier Ltd. All rights reserved.
Affiliation:
Trinity College Dublin, School of Nursing and Midwifery, 24 D'Olier Street, Dublin 2, Ireland. Electronic address: coboyle@tcd.ie.
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