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Self-care, midwifery and medicine : women's perspectives on negotiating a healthy reproductive experience

This thesis presents the results of a qualitative study of self-care in pregnancy,
birth and lactation within a non-random sample of 27 women in British Columbia,
Canada. The women were interviewed in the third trimester of pregnancy, and 23 of the
participants were re-interviewed post-partum. Interviews were tape recorded,
transcribed, and subjected to thematic analysis. Results were discussed in the context of
the social science literature on the medicalization of pregnancy and childbirth.
All but one woman used herbal medicine while pregnant. In the post-partum
interviews, nearly half reported using galactagogue herbs. The safety and efficacy of
each herbal remedy are discussed here. Most of the herbs are considered safe and
effective according to the herbal literature, but clinical reports are largely lacking.
While many of the women were cautious about using herbs during pregnancy, as
a general rule, they considered them to be safer than pharmaceutical drugs. In choosing
to self-medicate with herbs, the women said they were guided by prior knowledge (32%),
trusted sources of advice (56%), and intuition (12%). Trusted sources of advice included
books, friends, family members, maternity care providers, herbalists, herbal shops, and
internet. The majority of herbal advice (69%) was received by word-of-mouth.
Prolonged pregnancy also proved to be an interesting situation. Many women said they were opposed to labour induction at the time of the first interview, yet all but one woman who went beyond 40 weeks gestation used self-help measures to stimulate
labour. This appeared to be a response to pressure from maternity care providers, friends,
and family members. Though the medical definition of prolonged pregnancy is 42+
weeks gestation, in the social context, 40+ weeks was cause for concern.
Health care professionals, partners, family members, friends, and co-workers all
affected self-care behaviour, and their influence could be positive or negative. After an
overwhelmingly negative experience with a maternity care provider, over half of the
women went to another care provider, or forewent formal maternity care entirely.
These findings did not support the hypothesis that childbearing is almost
completely medicalized, at least for the sample population. Rather, women negotiated their maternity care within several frameworks, including the medical, midwifery, and self-care models. Medical language was used to describe birth stories, but only by women in physician care. There was an almost universal effort among the women to
normalize the childbearing experience.
The findings of this study point to a need for: (1) clinical investigation of herbal
medicines used in pregnancy, birth and lactation; (2) public and care-provider education
regarding social and psychological aspects of prolonged pregnancy; (3) broad-scale
inquiry into the phenomena of medicalization/normalization of the childbearing
experience, and (4) further investigation into women’s preferences for empowering styles of maternity care. / Graduate

Identiferoai:union.ndltd.org:uvic.ca/oai:dspace.library.uvic.ca:1828/8074
Date08 May 2017
CreatorsWestfall, Rachel Emma
ContributorsTurner, Nancy J., Glickman, Barry W.
Source SetsUniversity of Victoria
LanguageEnglish, English
Detected LanguageEnglish
TypeThesis
RightsAvailable to the World Wide Web

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