This dissertation draws on feminist theory and ecofeminist philosophy to examine the connections between understandings of women and nature and the construction of pervasive conceptualizations and practices of childbirth. It also examines the relationship between conceptualizations of men and masculinity, culture and nature, and childbirth. In order to conduct such an examination, this study explores the dominant Western discourse around gender and childbirth. Specifically, the work aims to identify prominent characteristics and themes related to childbirth in both popular culture, such as Hollywood films (Knocked Up, The Backup Plan), documentaries (The Business of Being Born), birth guides, magazines, news articles, websites, and scholarly, medical and alternative healthcare discourse. This work seeks to consider how various conceptualizations of childbirth are used to legitimate, or, alternately, to undermine, patriarchal gender norms such as emphasized femininity and patriarchal (hegemonic) masculinity and, more generally, what ecofeminist philosopher Val Plumwood calls "master consciousness" (Val Plumwood 1993), a way of understanding the world that is reliant on an unjustifiably dualistic thinking and that is responsible for fostering social practices of domination. In particular, this work seeks to determine to what extent is our conceptualization of childbirth, and subsequent practice, based on potentially erroneous presumptions about the hierarchical division between the realms of culture and nature and masculinity and femininity? Perhaps most importantly, this dissertation sets out to consider the implications of alternative conceptualizations of childbirth emerging in the context of the natural birth movement. Specifically, I aim to determine whether or not these alternatives interpretations of childbirth counteract patriarchal gender categories and the culture/nature dualism. / Jeff Nall. / Thesis (Ph.D.)--Florida Atlantic University, 2011. / Includes bibliography. / Electronic reproduction. Boca Raton, Fla., 2011. Mode of access: World Wide Web.

The appropriate oral intake for labouring women has long been a controversial issue among midwives and anaesthetists. Anaesthetists argue that any type of food and, to some extent, fluid consumption during labour, will increase a woman’s risk of gastric content aspiration if general anaesthesia is required. Many midwives believe that aspiration, being such a rare event with contemporary medical practice, is unlikely in the hands of a skilled obstetric anaesthetist. These midwives believe that labouring without any form of sustenance other than water or clear fluids may be detrimental for the woman, her baby and the progress of labour. To date, research has been unable to provide reliable information to support either side of this debate. This thesis presents a series of studies (three surveys and a comparative trial) designed to enhance the body of knowledge available for decisions about labouring women’s oral requirements. The surveys were conducted to describe the policies of hospitals in New South Wales, Australia, and the views and practices of anaesthetists and midwives regarding the oral intake of labouring women. The main findings of this thesis come from a comparative study conducted to explore the effect of eating or not eating food on labour and birth outcomes of 217 nulliparous women with low risk pregnancies, (Eating group = 123; Non-eating group = 94). The study employed a naturalistic approach to its design in order to capture the actual eating behaviour of labouring women rather than the manipulated approach used in a randomised control trial. The findings from this series of studies suggest women should be informed of the lack of evidence to support any dietary regime for labour, along with the possible risks and benefits, and allowed to make their own decisions about their oral intake needs for labour. Although this thesis has augmented knowledge, it has been unable to demonstrate that eating food during labour improves labour and birth outcomes. However, it did not find this practice to be harmful for mothers or babies. The lack of reliable research evidence on which to base practice decreases the ability of midwives to be assured of the ‘best practice’ for labouring women’s oral intake. Further research is essential to ascertain ‘best practice’ for this aspect of care. / Doctor of Philosophy (PhD)

The overall aim of this thesis was to examine what experiencing childbirth-related fear may imply for women and for men. The thesis compromises four studies with the following specific aims: I) to investigate the extent and level of childbirth-related fear in women and men, and to identify and compare experiential factors associated with childbirth-related fear in relation to level of fear. II) To describe the contents of childbirth-related fear in women and men, and to investigate whether the contents differed in relation to level of fear. III) To illuminate experiences of intense childbirth-related fear from the perspective of the women, and IV) of the men themselves. The studies were carried out using a combination of postal questionnaires and open interviews. The questionnaire was answered by 410 (74%) women and 329 (60%) men who prior to the study had had a baby at Norrlands university hospital, Sweden. Twenty women and 20 men who in the questionnaire had assessed their fear related to childbirth as intense were interviewed about what this experience had meant to them. The questionnaires were analyzed by factor analyses and quantitative content analysis. When analyzing the open interviews an approach based on the similarity-difference method in Grounded Theory were used. The results showed that the large majority of women (80%) and men (72%) had some experiences of fear related to childbirth. For 94 (23%) women and 43 (13%) men the fear was defined as intense. Among the factors identified as being involved in the experience of childbirth-related fear, 'exposedness and inferiority' had the greatest explanatory power in women, while 'communicative difficulties' had the greatest power in men. The contents of fear were fairly similar in both women and men, but the relative importance fo the fear categories differed. Among women fears related to 'the labour and delivery process' were ranked highest, while the uppermost category among the men were fears related to 'the health and life of the baby'. The comparison of the contents in relation to level of fear revealed that fears related to 'own capabilities and reactions' were significantly more common in women with experiences of intense fear than in women with mild to moderate fear. Among the men fears related to 'the health and life of the baby' and 'the health and life of the woman' were significantly more common in men with intense fear than in men with mild to moderate fear. In addition the open interviews indicated that socially constructed norms and beliefs about being happy and expectant influenced the women's perceptions of themselves and of what is considered as appropriate to feel and talk about during pregnancy. Many women judged themselves as different and inferior to others because of their fear, and described difficulties in expressing their fears due to expectations or experiences of not being taken seriously, being neglected or given misguided consolation. For the interviewed men, wishes to contribute and not causing trouble for the woman, as well as strives to adhere to prevailing norms about "masculinity" impled difficulties to disclose and talk about the fear, and look for support.

Bakgrund: Av alla gravida kvinnor räknas omkring 5 % lida av svår förlossningsrädsla. Kvinnor med förlossningsrädsla löper högre risk för komplikationer under och efter graviditeten. I Sverige läggs idag mycket resurser på Auroraverksamhet för att hjälpa kvinnor med förlossningsrädsla. Det saknas omfattande utvärdering av Auroraverksamheten. Syfte: Syftet med detta fördjupningsarbete var att undersöka upplevelse och effekt av Aurorasamtal inför förlossning samt upplevelse av den efterföljande förlossningen bland först- och omföderskor. Metod: Studien har en retrospektiv studiedesign där datainsamling skedde via en enkätundersökning. Datamaterialet sammanställdes därefter i SPSS. Resultat: Majoriteten av kvinnorna upplevde att samtalen hjälpte dem till en mer positiv förlossningsupplevelse. Fler förstföderskor än omföderskor önskade planerat kejsarsnitt när de kom till Auroramottagningen. De flesta kvinnor som önskade vaginal förlossning blev vaginalt förlösta. Över hälften av kvinnorna som deltog i studien var mindre rädda för förlossning 1 – 2 år efter förlossningen än de upplevde att de var innan Aurorasamtalet och förlossningen. Konklusion: Aurorasamtal förefaller ha störst betydelse för omföderskor och för de kvinnor som önskar vaginal förlossning. / Background: About 5 % of all pregnant women suffer from severe fear of childbirth. Women with fear of childbirth are at higher risk for complications during and after pregnancy. In Sweden a lot of resources are being spent on Aurora counselling to help women with fear of childbirth. There is no comprehensive evaluation of Aurora counselling though. Aim: The aim of this study was to examine the experience and impact of Aurora counselling for childbirth as well as the experience of the following birth among primipara and multipara women. Method: The study had a retrospective study design in which data was collected through a survey. The data was compiled in SPSS. Results: The majority of women felt that the Aurora counselling has helped them to experience a more positive birth experience. More primipara than multipara desired an elective caesarean section when they came to Aurora Clinic. Most of the women who desired to have a vaginal birth became vaginally delivered. More than half of the women who participated in the study were less afraid of childbirth 1 - 2 years after the birth than they estimated they were before the Aurora counselling and childbirth. Conclusion: Aurora counselling seems to have the greatest impact on multipara women as well as on women who desire vaginal birth.

Thesis (M.S.)--University of Michigan, 1980.

Thesis (Ph. D.)--University of Washington, 1985. / Vita. Bibliography: leaves [507]-538.

A Marcha do Parto em Casa foi uma passeata ocorrida em junho de 2012 em 31 cidades brasileiras motivada por declarações do Conselho Regional de Medicina do Rio de Janeiro de que entraria com processo ético-disciplinar contra um médico que declarou em entrevista veiculada num programa de televisão que o parto é um ato natural, que pode ocorrer no local de escolha da mulher, inclusive em casa. Posteriormente, este conselho profissional publicou duas resoluções: uma impedindo os médicos de participarem de partos domiciliares e obrigando os plantonistas das emergências obstétricas a reportarem quaisquer intercorrências assistidas por eles de mulheres oriundas de partos domiciliares ou Casas de Parto; e outra impedindo a entrada de doulas, obstetrizes e parteiras nas maternidades do estado do Rio de Janeiro, responsabilizando o diretor técnico da instituição caso isto ocorresse. A partir do conceito-ferramenta formulado por Felix Guattari, este trabalho analisa a Marcha do Parto em Casa como analisador dos movimentos pela humanização do parto, a partir de seis entrevistas realizadas com organizadoras e participantes da Marcha em diferentes cidades do país. Estuda os atores e suas ações para a realização desta mobilização, as ações do Conselho Regional de Medicina e coloca a questão do parto como um mercado em disputa.

A Marcha do Parto em Casa foi uma passeata ocorrida em junho de 2012 em 31 cidades brasileiras motivada por declarações do Conselho Regional de Medicina do Rio de Janeiro de que entraria com processo ético-disciplinar contra um médico que declarou em entrevista veiculada num programa de televisão que o parto é um ato natural, que pode ocorrer no local de escolha da mulher, inclusive em casa. Posteriormente, este conselho profissional publicou duas resoluções: uma impedindo os médicos de participarem de partos domiciliares e obrigando os plantonistas das emergências obstétricas a reportarem quaisquer intercorrências assistidas por eles de mulheres oriundas de partos domiciliares ou Casas de Parto; e outra impedindo a entrada de doulas, obstetrizes e parteiras nas maternidades do estado do Rio de Janeiro, responsabilizando o diretor técnico da instituição caso isto ocorresse. A partir do conceito-ferramenta formulado por Felix Guattari, este trabalho analisa a Marcha do Parto em Casa como analisador dos movimentos pela humanização do parto, a partir de seis entrevistas realizadas com organizadoras e participantes da Marcha em diferentes cidades do país. Estuda os atores e suas ações para a realização desta mobilização, as ações do Conselho Regional de Medicina e coloca a questão do parto como um mercado em disputa.

D.Cur. / The primary objective of the study was to ascertain the effects of the use of water during birth on maternal outcomes. The main maternal outcomes evaluated were maternal experience of the second stage of labour, and trauma to the birth canal. The second objective was to set guidelines for midwives whether or not to conduct deliveries under water.

The purpose of this study was to determine whether the wives' perceptions of personal control over the process of childbirth were related to couples' choices and utilization of three birthing alternatives (home birth, unmedicated hospital birth, and medicated hospital birth). The wives' perceived control over the childbirth process was expected to vary inversely with the level of medical intervention in the birthing alternative chosen. The home birth mothers were expected to perceive themselves as having more control over childbirth than were the unmedicated hospital group mothers, and the unmedicated hospital group mothers more than the medicated hospital group mothers. The husbands' perception of their wives' perceived control in childbirth and their participation was also measured.