Choosing mode of birth

How medical and cultural discourses on vaginal births and caesarean sections shape pregnant women's knowledge of and plans for giving birth

Project Description

Despite the fact that the proportion of serious vaginal tearing injuries has decreased, the incidence of childbirth-related injuries is high in Sweden, higher than the OECD average (OECD 2015). It has recently been established that more knowledge is needed to prevent, diagnose and treat this type of injuries more effectively (SBU 2021). In addition, there is a scarcity of research on how childbirth-related injuries are experienced. How are decisions about potential future pregnancies and childbirths affected? And not least, how is the image created of what are acceptable/unacceptable injuries or consequences of childbirth?

In parallel with an increased focus on the shortcomings of maternity care, the proportion of women who want to have a caesarean section without a medical reason has increased. There are indications that the reasons have changed from a fear of childbirth and child injuries, to a fear of getting childbirth-related injuries that lead to reduced bodily ability. However, this needs to be investigated in more detail. In addition, more research is needed on the interaction between women who are to give birth and the healthcare services. How is vaginal delivery versus caesarean section described? How do so-called delivery contracts, which mean that women who are afraid to give birth are encouraged to start a vaginal delivery, which can transition into a caesarean section if the woman so wishes, affect the options available to the pregnant woman?

This project aims to investigate how medical and cultural discourses about childbirth are shaped as a knowledge field. The field includes conflicting discourses about women's experiences of birth related injuries and women's wishes to give birth via caesarean section without medical reasons. Childbirth, no matter the mode, is paradoxical in its position as being both private and public as well as naturalized and medicalized. Questions that are explored within the project are how information about the different modes of childbirth is constructed and presented by the care providers regarding choices and risks, how those who choose/undergo different types of childbirths experience the caregivers' information, and their own reasons for choosing a specific mode of birth. The project leads to a multidisciplinary initiative where gender studies, caring sciences, ethical and reproductive policy perspectives meet to analyse discourses about childbirth and decision making about childbirth.