A qualitative study of childbirth as spoken about in midwives' ante- and postnatal consultations

Objective: to describe conversational topics concerning childbirth and illuminate the meanings of childbirth within the discourse of ante- and postnatal midwifery consultations. Design: video-recordings of midwives' consecutive encounters with women/couples;, from early pregnancy until after birth. The encounters were analysed using content analysis and a phenomenological hermeneutic approach. Setting: Swedish midwifery clinics at primary health care centres. Participants: five midwives, five women and three men. Findings: bio-medical aspects of childbirth were given much importance in the consultations relative to the activities and lived experiences of the women and their partners. Two main features of the meanings of childbirth were found in the consultations; one in which childbirth was understood as a spontaneous and risky process needing to be controlled and to which the woman had to adapt; the other was characterised by being woman centred, pointing to her power and abilities in a process during which she is cared for and which leads to a satisfying result. Key conclusions and implications for practice: a mechanistic and medicalised understanding of childbirth seems to dominate this discourse but the 'natural childbirth perspective' also appears. This study could serve as a basis for reflection on the content and meanings of childbirth in ante- and postnatal midwifery care. (C) 2000 Harcourt Publishers Ltd.