The Politics of Difficult Choices
Routledge – 2011 – 154 pages
The rhetoric of choice is much used in UK health policy and home birth is one of the three options that women are entitled to choose between when deciding where to have their baby. However, many women making this choice run into considerable opposition from the maternity service.
Home Birth: the politics of difficult choices focuses on the experiences of women whose choices were opposed by health professionals during their pregnancy journey. It confronts why and how women are being denied home birth and raises some challenging issues for current midwifery practice. Using ten women’s narratives, this important volume explores why women might want to give birth at home and considers ideas of risk and informed choice in pregnancy and birth. The book includes chapters on communication and language; fear and stress; advocacy and autonomy; fathers’ experience of contested place of birth and free birthing.
Pointers to best practice are presented whilst the text incorporates women’s narratives throughout, making this a practical and relevant read for midwifery students as well as practising midwives and childbirth educators, all of whom have a duty to make home birth a real option for women.
'This remains an invaluable resource for any student midwife learning how to best understnad and serve women, any midwife who wants to improve the pregnancy, birthing and mothering exerience of the women under their care…This book feeds fantastically into homebirth and service provision debates around the world and should not be overlooked by any health professional dedicated to supporting women and their families throughout pregnancy, birth and parenthood.' – Midwifery News
'Why do women choose to give birth at home, even in situations defined as medically risky? Are they ignorant? Irresponsible? Risking their babies' lives for their own good experience? Mary L. Nolan explores this uncharted territory with respect and intelligence, creating a fascinating and invaluable resource for carers involved with home birth and/or women with "high risk" pregnancies. Women and families choosing home birth will especially enjoy the voices of strong-minded women who are making their own choices.' – Dr Sarah J. Buckley, author of Gentle Birth, Gentle Mothering, www.sarahjbuckley.com
'I would strongly recommend it to anyone working in maternity services…These stories need to be heard if normality and choice in childbirth is to remain a real option' – MIDIRS
1. Policy – does it mean what it says? 2. Choosing Home Birth Against Medical Advice 3. Fear and Risk 4. Choice, Bullying and Coercion 5. Communication and Language 6. Avoidance, Subversion and Confrontation 7. Stress in Pregnancy and Birth 8. Men’s Experience of Home Birth Against Medical Advice 9. Free Birth: the end of the choice continuum 10. Advocacy, Empathy and Autonomy 11. The Dialectic between Possibilities and Limits
Mary L. Nolan is Professor of Perinatal Education at the University of Worcester, UK. She is also Senior Tutor at the National Childbirth Trust.