Doctoral Thesis Collection

This midwifery PhD thesis collection is an exciting new initiative for the RCM.

The aim of the collection is to provide a platform for midwives to showcase their academic work, and to inspire and support midwives who are considering or who are currently undertaking further academic study. Additionally, the collection will provide a source of open access midwifery generated evidence for everyone to use.

The opportunity for midwives to include details of the resultant publications and their social media details will hopefully also support the creation of professional networks related to their academic interests.

If you are a midwife and have a completed a PhD, and would like to include your thesis in this collection, please complete the online form below. 

If you would like to search the Thesis Collection, "Control+F" (or "Command+F" on a Mac) is the keyboard shortcut for the Find command. Pressing the Ctrl/Command key + the F key will bring up a search box in the top right corner of your screen. You can then use this to search the Collection for keywords

Submit details of your doctoral thesis to be included in the RCM collection

 

Author

Thesis and key words

Abstract

Dr Kirstie Coxon

[email protected]

Birth Place Decisions: A prospective qualitative study of how women and their partners make sense of risk and safety when choosing where to give birth

Full thesis

Place of birth, risk, narrative, longitudinal

 

For the past two decades, English health policy has proposed that women should have a choice of place of birth, but despite this, almost all births still take place in hospital. The policy context is one of contested evidence about birth outcomes in relation to place of birth, and of international debate about the safety of birth in non-hospital settings; partly as a consequence of this, ‘birth place decisions’ have become morally and politically charged. Given the perceived lack of consensus about birth place safety, this study sought to explore the experience of making birth place decisions from the perspectives of women and their partners, in the context of contemporary NHS maternity care.

Longitudinal narrative interviews were conducted with 41 women and 15 birth partners recruited from three English NHS trusts, each of which provided different birth place options. Initial interviews were conducted during pregnancy, and follow up interviews took place at the end of pregnancy and again up to three months after the birth. Altogether, 141 interviews were conducted and analysed using a thematic narrative approach.

This research contributes new knowledge about how birth place decisions are undertaken and negotiated, and about the extent to which some are excluded from these choices. Participants’ beliefs about birth place risk originated in upbringing and drew upon normative discourses which positioned hospital as an appropriate setting for birth. Individual worldviews informed conceptualisations of birth place risk, and these were premised upon prioritisation of medical risks of birth, perceived quality of the maternity service or the likelihood that medical intervention would interfere with birth. These beliefs were often enduring and the overall tendency was for women to be increasingly conservative about their birth place options over time, but during their first pregnancies, participants views were most fluid and open to change.

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