Middlesex University Research Repository An open access repository of Middlesex University research http://eprints.mdx.ac.uk MacLellan, Jennifer (2019) Vulnerability and identity negotiation in childbirth: a narrative approach. PhD thesis, Middlesex University. [Thesis] Final accepted version (with author’s formatting) This version is available at: https://eprints.mdx.ac.uk/28745/ Copyright: Middlesex University Research Repository makes the University’s research available electronically. Copyright and moral rights to this work are retained by the author and/or other copyright owners unless otherwise stated. The work is supplied on the understanding that any use for commercial gain is strictly forbidden. A copy may be downloaded for personal, non-commercial, research or study without prior permission and without charge. 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See also repository copyright: re-use policy: http://eprints.mdx.ac.uk/policies.html#copy Vulnerability and Identity Negotiation in Childbirth: A Narrative Approach. Jennifer MacLellan M00267405 A thesis submitted to Middlesex University in partial fulfilment of the requirements for the degree of PhD. School of Health & Education January 2019 1 Acknowledgements I would like to thank my project supervisors, without whom this piece of work would never have been completed: Professor Michael Traynor, whose encouragement, belief and support helped me throughout, but especially in the push for the final deadline and Dr Elena Vacchelli who helpfully corrected my grammar and offered some critical signposting that tied together the final stages of my work. I would also like to thank Associate Professor Carol Saunders, who encouraged me to undertake doctoral scholarship and gave me insightful feedback on an early draft of my proposal. To my husband Joseph who has kept the ship sailing over the past 6 years, endured my passionate revelations about philosophical theories and was an exceptional birth partner on both occasions, my sincere thanks from as deep as they come. Naturally I must also thank our sons, Benjamin and Samuel, for giving me the inside view on birth and reorienting my project! And to our attending Midwives: Anne – who told the medics I could do it, and Anna who had the grace to ask how she could fit into our home birthing family and give us support. My family and friends have travelled every step with me along this doctoral journey and I am so grateful for the support from Mum and Dad who always had an encouraging word and listening ear. Their pride in me has pushed me to succeed. Thanks to all my superb friends, especially to Emma for the theoretical debates, Vicky for the offer of a quiet room, Antara for being a role model by completing a Phd while becoming a Mother, and Jess for the references and virtual support. And lastly, I will unconventionally say thank you to myself, for managing to complete this piece of work despite all the stumbles along the road, for not taking the easy route but for following my passion and producing a thesis I hope can stimulate debate, and ultimately improvement in women’s experiences of childbirth in the UK. 2 Vulnerability and Identity Negotiation in Childbirth: A Narrative Approach J.MacLellan Abstract Despite knowledge and policy support of the positive contributors to a woman’s birth experience and awareness of the lasting impact of her interpretation of the event, there is a distinct lack of acknowledgment in the childbirth literature of the woman’s exposure to a vulnerability characteristic of birth. I feel that this transient experience of vulnerability exposes a woman’s identity to subliminal messages about her body, her competence and her social positioning, while the physicality of birth is foregrounded. I believe women use the telling of their birth stories to make meaning out of their experience. To analyse the identity work of the story, I selected 20 birth stories from a popular ‘mums’ internet forum. Using a multi component narrative analysis technique, comprising structural, thematic and discourse analyses, I have been able to explore the influence of competing discourses upon woman’s experience of birth in the UK. In complement I have woven my story of transition to motherhood into the project to chart my subjective position as it evolved with the development of this project. This project has contributed evidence to the discussion of women’s experiences of subjectivity in the discursive landscape of birth, while uncovering previously unacknowledged sites of resistance. The linguistic restrictions, sustained by the neoliberal control mechanisms on society and the self, act to shape the reality, feelings and expressions of birthing women. Naming these silencing strategies, as I have done through the findings of this project, and celebrating women’s discourse on birth as the explosion of birth stories across the internet are doing, offer bold moves to challenge the muting status quo of women in birth. Reclaiming women’s language for birth and working to create a new vocabulary encapsulating the experiences of birthing women, will also present opportunities for the issue of birth and women’s experiences of it to occupy greater political space with a confident and decisive voice. 3 Contents Acknowledgements ........................................................................................................................... 2 Abstract ................................................................................................................................................ 3 Chapter 1 Introduction ...................................................................................................................... 6 1.1 Background ........................................................................................................................... 6 1.2 Context for the study ................................................................................................................. 9 1.2.1 Historical Context of birth in the UK .............................................................................. 10 1.2.2 Current system of birth in the UK ................................................................................... 11 1.3 Analytical framework ............................................................................................................... 17 1.4 Outline of the thesis ................................................................................................................. 19 Chapter 2 Literature review ........................................................................................................... 23 2.1 Childbirth as an embodied experience ................................................................................. 24 2.2 Vulnerability in childbirth ......................................................................................................... 28 2.2.1 Birth as a rite of passage ................................................................................................ 32 2.2.2 Exposure and its link to birth vulnerability .................................................................... 34 2.2.3 The body in birth ............................................................................................................... 36 2.3 Storytelling and birth ............................................................................................................... 43 2.3.1 Memory and the story ...................................................................................................... 44 2.3.2 Social Task of storytelling ............................................................................................... 45 Chapter 3 Methodological approach ........................................................................................... 48 3.1 Research Question and Analysis Overview ........................................................................ 48 3.2 An Interdisciplinary Approach to Storytelling ....................................................................... 49 3.3 The Study Design .................................................................................................................... 54 3.3.1. Internet Based Media...................................................................................................... 54 3.3.2. An Alternative Communication System – The story .................................................. 55 3.4 The Data Collection Process ................................................................................................. 56