Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK
Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK.
Med Humanit. 2020 Dec;46(4):512-524. doi: 10.1136/medhum-2019-011786. Epub 2020 May 2.
Freebirthing is a clandestine practice whereby women intentionally give birth without healthcare professionals (HCPs) present in countries where there are medical facilities available to assist them. Women who make this decision are frequently subjected to stigma and condemnation, yet research on the phenomenon suggests that women's motivations are often complex. The aim of this review was to explore how freebirth has been conceptualised over time in the English-language academic and grey literature. The meta-narrative methodology employed enables a phenomenon to be understood within and between differing research traditions, as well as against its social and historical context. Our research uncovered nine research traditions (nursing, autobiographical text with birthing philosophy, midwifery, activism, medicine, sociology, law and ethics, pregnancy and birth advice, and anthropology) originating from eight countries and spanning the years 1957-2018. Most of the texts were written by women, with the majority being non-empirical. Empirical studies on freebirth were usually qualitative, although there were a small number of quantitative medical and midwifery studies; these texts often focused on women's motivations and highlighted a range of reasons as to why a woman would decide to give birth without HCPs present. Motivations frequently related to women's previous negative maternity experiences and the type of maternity care available, for example medicalised and hospital-based. The use of the meta-narrative methodology allowed the origins of freebirth in 1950s America to be traced to present-day empirical studies of the phenomenon. This highlighted how the subject and the publication of literature relating to freebirth are embedded within their social and historical contexts. From its very inception, freebirth aligns with the medicalisation of childbirth, the position of women in society, the provision of maternity care and the way in which women experience maternity services.
“自由分娩”是一种秘密的做法，指的是在有医疗设施可以帮助她们的国家，妇女故意在没有医疗保健专业人员（HCPs）在场的情况下分娩。做出这种决定的妇女经常受到污名化和谴责，但对这一现象的研究表明，妇女的动机往往是复杂的。本综述的目的是探讨“自由分娩”在英语学术和灰色文献中是如何随着时间的推移而被概念化的。采用元叙述方法可以使人们在不同的研究传统中理解一个现象，也可以在其社会和历史背景下理解。我们的研究发现了九个研究传统（护理、带有分娩哲学的自传体文本、助产、行动主义、医学、社会学、法律和伦理、怀孕和分娩建议以及人类学），这些传统来自八个国家，跨越了 1957 年至 2018 年的时间。大多数文本都是由女性撰写的，其中大多数是非实证的。关于“自由分娩”的实证研究通常是定性的，尽管也有少数定量的医学和助产研究；这些文本通常侧重于妇女的动机，并强调了妇女决定在没有 HCPs 在场的情况下分娩的一系列原因。动机通常与妇女以前的负面孕产经历和可用的孕产护理类型有关，例如医疗化和基于医院的。使用元叙述方法可以追溯到 20 世纪 50 年代美国“自由分娩”的起源，以及目前对这一现象的实证研究。这突显了主题和与“自由分娩”相关的文献的出版如何嵌入到它们的社会和历史背景中。从一开始，“自由分娩”就与分娩的医疗化、妇女在社会中的地位、孕产护理的提供以及妇女体验孕产服务的方式相一致。
