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“It's a Relief to Talk…”: Mothers' Experiences of Breastfeeding Recorded in Video Diaries

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“It's a Relief to Talk…”: Mothers' Experiences of Breastfeeding Recorded in Video Diaries “It’s a relief to talk…”: Mothers’ experiences of breastfeeding recorded in video diaries Alison Mary Taylor A thesis submitted in partial fulfilment of the requirements of Bournemouth University for the degree of Doctor of Philosophy 2015 This copy of the thesis has been supplied on condition that anyone who consults it is understood to recognise that its copyright rests with its author and due acknowledgement must always be made of the use of any material contained in, or derived from, this thesis. 2 Alison Mary Taylor Abstract: “It’s a relief to talk…”: Mothers’ experiences of breastfeeding recorded in video diaries Background: Despite breastfeeding providing maximum health benefits to mother and baby, many women in the UK do not breastfeed, or do so briefly. Using tenets of ethnography, this study aimed to explore the everyday experiences of first time breastfeeding mothers in the early weeks following birth. Methods: Using a camcorder, five mothers captured their real-time experiences in a video diary, until they perceived their infant feeding was established. A multi-dimensional approach involving thematic analysis was developed to ensure that both the audio and visual elements of the data were analysed. Findings: Three themes, significant to mothers were identified. First, how the camcorder empowered mothers to record their experiences ‘24/7’, providing audiovisual insights into the socio-cultural context and embodied nature of breastfeeding. Embodying the camcorder enabled mothers to offload their thoughts, feelings and experiences in real-time, revealing an emotional rollercoaster. The second theme showed how the video diary provided a platform for mothers to work out how to survive their ‘state of flux’ with their breastfeeding baby. Deep personal reflection involved identity work and plans to get back to ‘normal’. The third theme highlighted the complex nature of support including what mothers experienced when they felt under medicalised surveillance by the healthcare team, nurtured, influenced or undermined by family and friends, and when they sought information for themselves. Conclusions: For the first time, this thesis reports on the ‘unique presence of being there’ to observe mothers’ real-time everyday experiences of breastfeeding as recorded in their video diaries. It reveals the unique therapeutic role of the camcorder, the evolving nature of mothers’ identities in the first few weeks after birth, the impact of commercialisation on breastfeeding and the negative impact of medicalised surveillance when healthcare workers scrutinised rather than supported breastfeeding mothers. Recommendations are made for practice, education, policy and further research. 3 Contents 1 Introduction ............................................................................................... 14 1.1 Introduction ................................................................................ 14 1.2 Organisation of the thesis .......................................................... 14 2 Background and Context ......................................................................... 18 2.1 Introduction ................................................................................ 18 2.2 Breastfeeding as a public health issue ...................................... 18 2.3 Cultural norms for infant feeding in the UK ................................ 20 2.4 Political landscape, national, regional and local initiatives ......... 22 2.5 Early Breastfeeding Cessation................................................... 25 2.6 Enhancing new understanding................................................... 27 3 Literature Review ...................................................................................... 29 3.1 Introduction ................................................................................ 29 3.2 Search strategy .......................................................................... 29 3.2.1 Inclusion criteria and exclusion criteria ...................................... 29 3.2.2 Electronic search strategy ......................................................... 30 3.3 Critical appraisal of evidence ..................................................... 31 3.4 Findings ..................................................................................... 33 3.5 Themes ...................................................................................... 35 3.5.1 Emotional turmoil ....................................................................... 35 3.5.2 Producing a happy healthy baby................................................ 39 3.5.3 Negotiating a new identity .......................................................... 42 3.5.4 Fitting in or falling outside of cultural norms ............................... 46 3.6 Summing up the research .......................................................... 51 3.7 Research question ..................................................................... 57 4 4 Research Methodology and Methods ..................................................... 58 4.1 Introduction ................................................................................ 58 4.2 Outline of research design ......................................................... 58 4.3 Philosophical perspective .......................................................... 59 4.4 Theoretical Framework: Ethnography using video diaries ......... 62 4.5 Methods ..................................................................................... 71 4.5.1 Pilot study .................................................................................. 71 4.5.2 Participants and recruitment ...................................................... 74 4.5.3 Ethical considerations ................................................................ 79 4.5.4 Data collection ........................................................................... 90 4.5.5 Analysis ..................................................................................... 93 5 ‘But, what I really wanted to tell you’… … mothers using the camcorder .......................................... 102 5.1 Introduction .............................................................................. 102 5.2 Any time, any place ................................................................. 103 5.2.1 Breastfeeding and filming 24/7 ................................................ 103 5.2.2 Capturing the context ............................................................... 107 5.2.3 Capturing the embodied nature of breastfeeding ..................... 113 5.2.4 Summing up – any time, any place .......................................... 118 5.3 Embodying the camcorder ....................................................... 118 5.3.1 Self-portrayal ........................................................................... 118 5.3.2 Personifying the camcorder ..................................................... 128 5.3.3 Offloading in a rollercoaster of emotions ................................. 132 5.4 Conclusion – But what I really wanted to tell you… ................. 143 5 6 ‘Working it Out’ ....................................................................................... 145 6.1 Introduction .............................................................................. 145 6.2 Surviving .................................................................................. 146 6.2.1 Aaaaagh…I've got a baby attached to me! .............................. 146 6.2.2 Unprepared…fighting a battle .................................................. 147 6.2.3 Coping strategies ..................................................................... 150 6.2.4 Surviving the nights ................................................................. 151 6.2.5 What routine? .......................................................................... 154 6.2.6 Juggling work, rest and play .................................................... 155 6.2.7 Troubleshooting ....................................................................... 158 6.2.8 Determination with resilience ................................................... 160 6.2.9 “Essential” Paraphernalia ........................................................ 162 6.2.10 Summing up - surviving ........................................................... 169 6.3 A state of flux and getting back to ‘normal’ .............................. 171 6.3.1 Identity work...Only me! ........................................................... 171 6.3.2 Identity work…Giving up something of self to serve another ... 174 6.3.3 Getting back to ‘normal’…Logistics .......................................... 178 6.3.4 Getting back to ‘normal’…Going out ........................................ 181 6.3.5 Summing up............................................................................. 185 7 ‘The Support Conundrum’ ..................................................................... 187 7.1 Introduction .............................................................................. 187 7.2 Under surveillance ................................................................... 189 7.2.1 On the right track? ................................................................... 189 7.2.2 Scrutinised, judged and sabotaged.......................................... 192 7.2.3 Abandoned and alone .............................................................. 201 6 7.2.4 Summing up............................................................................
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