Place of birth and concepts of wellbeing
Christine McCourt (City, University of London)
Juliet Rayment (City University London)
Jane Sandall (Women’s Health Academic Centre)
Susanna Rance (King's College London; Plymouth University)
Paper short abstract:
Based on a series of ethnographic case studies of birthcentres in the UK and Brazil, this paper discusses the conceptual and practical associations between place of birth and wellbeing in childbirth for women, families and professionals, as well as the use of place as a metaphor for wellbeing.
Paper long abstract:
This paper is based on analysis of a series of ethnographic case studies of birth centres in the UK and a cross-cultural case study in Brazil. Birthcentres are spaces that were developed to provide more homely and less medically oriented care for birth, run by midwives, either on a hospital site, proximate to an obstetric unit (AMU) or more remote from the hospital (FMU). Birthcentres have been designed and intended specifically as locations of wellbeing and this claim is supported by a large epidemiological study, which found that birthcentres provide safe care while reducing use of medical interventions. The birthcentre is intended as a protected space, one which uses domestic features as metaphors of home and contrasts these with the medical environment of most hospital births in order to promote a sense of wellbeing and to re-normalise concepts of birth, which had become inhabited by medical models and a preoccupation with risk. They also appear to function as protected spaces for midwives, intended to protect midwives' wellbeing following decades of professional struggles to maintain autonomy, midwife-led care and a professional identity founded on supporting normal, healthy birth. Comparisons are drawn between this recent development in UK policy and the creation of birthcentres as a major aspect of the Brazilian Ministry of Health's response to the 'rehumanisation of birth' (REHUNA) movement - the Rede Cegonha - which is focused on restoring wellbeing on individual, professional and community levels, particularly through a focus on the place of birth.
The place of 'place' in wellbeing scholarship