Power and Authoritative Knowledge: The Second OptiBIRTH Antenatal Class
Rebekah Maguire
Trinity College Dublin
My name is Rebekah Maguire. I graduated from UCD in 2011 with a degree in Social Science. I then moved on and completed my Master’s Degree in Applied Social Research in Trinity College Dublin in 2013. During the Master’s I worked as a research assistant on the MAMMI Study (Maternal Health and Maternal Morbidity in Ireland). My dissertation involved studying the considerations pregnant women take into account when they decided to participate in the MAMMI study. From then I successfully applied for the position of PhD student with the OptiBIRTH study. I have recently completed my doctoral studies on cultural change and VBAC. My research interests include pregnant women and their experiences of research, birth rituals and decision making around pregnancy and birth
Abstract
Background: The OptiBIRTH trial aims to improve maternal health service delivery, and optimise childbirth, by increasing vaginal birth after caesarean section (VBAC) through enhanced women-centred maternity care. Embedded... [ view full abstract ]
Background: The OptiBIRTH trial aims to improve maternal health service delivery, and optimise childbirth, by increasing vaginal birth after caesarean section (VBAC) through enhanced women-centred maternity care. Embedded within this trial is an ethnography of cultural change surrounding the OptiBIRTH intervention, which consists of two antenatal classes focusing on vaginal birth. Due to the nature of the trial, exploring the cultural elements surrounding the implementation of the OptiBIRTH intervention is crucial to understanding its efficacy.
Aims and objectives: To present the findings of an ethnography of one component of the OptiBIRTH trial complex intervention, the second antenatal class.
Methods: Using an ethnographic approach, encompassing participant and non-participant observation, in addition to field-notes from 14 antenatal classes, interview data collected from 15 women and 2 Opinion Leaders attending and participating in the OptiBIRTH antenatal class component in one hospital were analysed. Ethical approval was granted by the university and the study site.
Findings: For women participating in the intervention, the second OptiBIRTH antenatal class facilitates the construction of authoritative knowledge for them during their pregnancy. With their participation in OptiBIRTH, a transference of authoritative knowledge supported women to become more empowered and become legitimised in the decision-making hierarchy. The antenatal class provided a support structure for women that allows them to access clinicians’ authoritative knowledge so that they can make an informed decision based on knowledge that was deemed important and carried weight in the hospital.
Conclusion and Implications: By gaining knowledge and confidence through participation in the OptiBIRTH second antenatal class, VBAC become a tangible mode of birth that these women could see themselves achieving. Authoritative knowledge can re-frame vaginal birth in a positive light and present VBAC to women as being a viable option after a previous caesarean section. Clinicians can use these findings to assist women in decision-making around future births.
Authors
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Rebekah Maguire
(Trinity College Dublin)
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Valerie Smith
(Trinity College Dublin)
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Cecily Begley
(Trinity College Dublin)
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David Prendergast
(Intel)
Topic Area
Topics: Maternity Care
Session
MC2 » Maternity Care 2 (15:00 - Wednesday, 9th November, Lecture Theatre 0.32)
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