Paper short abstract:

Based on two ethnographic studies of midwifery units, this paper draws out how the embodiment is purposefully re-scripted and played out in everyday practices and the formal design and stated philosophies in order to re-establish ‘active birth’ in place of ‘active management of birth’.

Paper long abstract:

Midwifery units are more commonly known, in a range of countries as birth centres, and in some as 'home-from-home birth centres or birth-houses. They provide birth care to women who are categorised as having a healthy pregnancy without complications and can be remote from a hospital (Freestanding Midwifery Unit - FMU) or Alongside an obstetric hospital unit (AMU). The aims, material design and philosophy of such units are designed to underpin practices which support physiological birth, as well as, in some, a more social model of birth. Our studies of their operation suggest that this involves a process of re-scripting of the embodiment of what had become a more medicalised process where the bodies of women and midwives were framed in a more passive or defensive role. A regime of 'active management' of labour, which privileged technological interventions over the woman's body as active in giving birth is replaced in this 'active birth' model with a physiological management approach where the main agent is the 'woman in the body'. The midwives' embodiment in the form of manual skills and sensory observation techniques combined with low-technology interventions are used to facilitate rather than to 'actively manage' childbirth. Drawing on two ethnographic studies, we describe the evidence from observations of practices and environment and interviews with professionals and women and their birth partners to draw out how the theme of embodiment is purposefully re-scripted and played out in everyday practices as well as through the formal design and philosophies of midwifery units.