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Understanding the Discourses of Traumatic Birth and the Transition to Motherhood Using Relational Dialectics Theory Valerie Fisher University of Wisconsin-Milwaukee

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Understanding the Discourses of Traumatic Birth and the Transition to Motherhood Using Relational Dialectics Theory Valerie Fisher University of Wisconsin-Milwaukee University of Wisconsin Milwaukee UWM Digital Commons Theses and Dissertations August 2018 Understanding the Discourses of Traumatic Birth and the Transition to Motherhood Using Relational Dialectics Theory Valerie Fisher University of Wisconsin-Milwaukee Follow this and additional works at: https://dc.uwm.edu/etd Part of the Communication Commons Recommended Citation Fisher, Valerie, "Understanding the Discourses of Traumatic Birth and the Transition to Motherhood Using Relational Dialectics Theory" (2018). Theses and Dissertations. 1799. https://dc.uwm.edu/etd/1799 This Dissertation is brought to you for free and open access by UWM Digital Commons. It has been accepted for inclusion in Theses and Dissertations by an authorized administrator of UWM Digital Commons. For more information, please contact [email protected]. UNDERSTANDING THE DISCOURSES OF TRAUMATIC BIRTH AND THE TRANSITION TO MOTHERHOOD USING RELATIONAL DIALECTICS THEORY by Valerie Cronin-Fisher A Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy in Communication at The University of Wisconsin-Milwaukee May 2018 ABSTRACT UNDERSTANDING THE DISCOURSES OF TRAUMATIC BIRTH AND THE TRANSITION TO MOTHERHOOD USING RELATIONAL DIALECTICS THEORY by Valerie Cronin-Fisher The University of Wisconsin-Milwaukee, 2018 Under the Supervision of Dr. Lindsay M. Timmerman The majority of existing research regarding birth and the transition to motherhood focuses on the physical health outcomes of mother and baby, often ignoring the social and emotional impact of the birth process (Leggett, 2014). The lack of focus on social and emotional outcomes for new mothers may be especially harmful for those who experience traumatic birth, as it is subjective in nature and is often overlooked as a routine birth by health professionals (Alder, Stadlmayr, Tschudin, & Bitzer, 2006; Beck, 2004a). Traumatic childbirth is defined as an event occurring during the labor and delivery process that involves actual or threatened serious injury or death to the mother or her infant (Beck, 2004a). Framed by relational dialectics theory (Baxter, 2011), the current investigation sought to understand women’s meaning making processes in publicly shared stories about birth trauma and transition to motherhood. Contrapuntal analysis (Baxter, 2011) was used to identify culturally dominant systems of meaning embedded in women’s talk about traumatic birth and their transition to motherhood. Forty-one women’s stories recounting traumatic births were analyzed within a variety of contexts (e.g., natural birth, cesarean, preemie). The dominant discourse of intensive motherhood informed much of women's talk about pregnancy, traumatic birth, and transition to motherhood. Discursive interplay was also identified during pregnancy, birth, and motherhood communication through the struggle between the discourse of intensive motherhood and the discourse of ii individualism through negating, countering, and entertaining. Mothers only distanced themselves from the discourse of intensive motherhood when they spoke about their traumatic birth on an individual level, outside their role as mother, as women were largely supported intensive motherhood. Keywords: relational dialectics theory, traumatic birth, transition to motherhood, contrapuntal analysis iii Ó Copyright by Valerie Cronin-Fisher, 2018 All Rights Reserved iv DEDICATION This dissertation is dedicated to my son, Stuart Cronin Fisher, who opened my eyes and heart to birth and motherhood. Thank you for helping me find my passion. v TABLE OF CONTENTS I. Introduction ......................................................................................................................1 II. Relevant Literature ..........................................................................................................5 History of Birth ................................................................................................................5 Communication During Birth ..........................................................................................8 Obstetricians ............................................................................................................9 Midwives..................................................................................................................9 Doulas ....................................................................................................................10 Close Others ...........................................................................................................11 Childbirth Trauma Minimization and Outcomes ...........................................................11 Discourse of Pregnancy .................................................................................................13 Discourse of Birth ..........................................................................................................15 Discourse of Motherhood ..............................................................................................17 Relational Dialectics Theory ..........................................................................................21 III. Method .........................................................................................................................27 Critical Rationale ..........................................................................................................29 Storytelling and Podcasts ...............................................................................................30 The Birth Hour Podcast .................................................................................................32 Data and Procedures ......................................................................................................33 Establishing Credibility .................................................................................................35 Theoretical Considerations and Contrapuntal Analysis .................................................36 IV. Findings ......................................................................................................................38 Discourses of Intensive Mothering During Pregnancy ..................................................39 Mothers should birth like the strong women before them .....................................39 Good pregnancies are natural and uneventful ........................................................40 Good births are a result of planning and control ....................................................41 Identifying interplay: Bad pregnancies are unplanned ..........................................43 Discourses of Intensive Mothering During Traumatic Birth ........................................45 Bad birth is something that happens to you ...........................................................46 Bad birth disconnects mind and body ....................................................................48 Bad birth is isolating and unnatural .......................................................................50 Identifying interplay: Birth isn’t all about the baby .............................................. 53 Discourses of Intensive Mothering During the Transition to Motherhood After a Traumatic Birth ...............................................................................................................................55 A good mother breastfeeds her baby .....................................................................56 A good mother puts complete focus her on baby ................................................. 58 Bad births result in difficult recoveries ................................................................. 59 Bad mothers have difficulty breastfeeding ........................................................... 61 Identifying interplay: Bad mothers dwell on negative birth experiences ..............64 Identifying interplay: Negating intensive motherhood through postpartum depression ............................................................................................................................................65 Other Findings ..................................................................................................................67 The influence of race on traumatic birth and the transition to motherhood. .........67 Fathers: a bystander during traumatic birth. .........................................................70 V. Discussion ....................................................................................................................72 vi Discourses of Intensive Motherhood During Pregnancy, Birth, and Motherhood ....... 73 Pregnancy ..........................................................................................................................73 Birth ..................................................................................................................................74 Motherhood .......................................................................................................................76 Interplay: Discourse of individualism ...............................................................................78 Theoretical Applications ...............................................................................................82 Practical Applications ...................................................................................................84 Applications for mothers and close others ........................................................................87
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