Risk and fear in the lived experience of birth without a midwife

Midwifery. 2016 Jul:38:29-34. doi: 10.1016/j.midw.2016.02.009. Epub 2016 Feb 17.


Purpose: the broad aim of this study was to examine the lived-experience of women who birth without a midwife or other health-care professional in the United Kingdom; the specific purpose of this paper is to examine risk discourse as experienced by these women.

Research design: reflective lifeworld research, a phenomenological approach was used in this study based on the philosophical writings of Husserl, Merleau-Ponty and Gadamer (Dahlberg et al., 2008). 10 in-depth interviews were conducted with women who had birthed without a midwife or other health-care professional present, interviews were transcribed and hermeneutically analysed.

Findings: women׳s lived-experiences of the maternity services in this study suggest a pervading mood of fear which finds voice in manipulative risk discourse and midwifery behaviours that can result in women avoiding maternity care. Fear based ׳risk-talk׳ is used as a scare tactic to coerce women into particular choices; if women do not comply they are labelled ׳risk-takers׳ and can become ostracised by the maternity care system.

Key conclusions: risk discourse and its emphasis on mortality and morbidity raises awareness of death and creates important existential concerns for women which are unaddressed by health-care professionals. This can lead to a loss of trust in health-care professionals and women sourcing positive support and a salutogenic approach to childbirth from outside the system.

Implications for practice: health-care professionals need to become aware of and address manipulative and coercive attitudes in risk discourse.

Keywords: Fear; Freebirth; Risk discourse; Salutogenesis; Unassisted birth.

MeSH terms

  • Attitude of Health Personnel
  • Fear / psychology*
  • Female
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Interviews as Topic
  • Midwifery / methods*
  • Nurse Midwives / psychology*
  • Nurse-Patient Relations
  • Parturition / psychology*
  • Pregnancy
  • Pregnant Women / psychology*
  • Risk
  • United Kingdom