Birthing change: an ethnographic study of the Alaska Family Health & Birth Center in Fairbanks, Alaska
AuthorBennett, Danielle M. Redmond
Alaska Family Health & Birth Center (Fairbanks, Alaska)
Maternal health services
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AbstractThis study examines the practices of the Alaska Family Health & Birth Center in order to understand how midwives help clients navigate the process of pregnancy, birth, and the postpartum period with a high rate of success, as defined by a low cesarean rate, low mortality and morbidity, and high maternal satisfaction. How do the midwives prepare mothers to navigate the transformation and how do they address failure to progress during birth? This study analyzes birth as a rite of passage, which incorporates a culture's worldview and its practices. These outcomes are achieved by employing a positive, holistic view of the natural, physiological process, by using practices that support the physiological process and minimize intervention, and by keeping the space in which out-of hospital birth takes place. The fact that parents are choosing an alternative ritual for birth at an increasing rate nationwide reflects a change happening in American culture.
DescriptionThesis (M.A.) University of Alaska Fairbanks, 2013
Table of ContentsChapter 1. Introduction -- 1.1. The Alaska Family Health & Birth Center (AFH & BC) -- 1.2. Controversy in American maternity care -- 1.3. Pregnancy and birth at AFH & BC as a rite of passage: research questions, hypothesis, and analysis -- 1.4. Rites of passage -- 1.5. Methods and methodology -- 1.6. Execution of research -- 1.7. Chapter summaries -- Chapter 2: The Alaska context -- 2.1. Geography, environment, and culture -- 2.2. Costs and insurance -- 2.3. Alaska native birthing traditions -- Chapter 3. The Alaska Family Health & Birth Center setting -- 3.1. The midwifery model of care -- 3.2. Different types of birth attendants -- 3.3. The legal context -- 3.4. Participant demographics -- 3.5. Study participants and what brought them to AFH & BC -- 3.6. AFH & BC statistics, legal status, and funding -- 3.7. Out-of-hospital and AFH & BC demographics -- Chapter 4. Prenatal care -- 4.1. A prenatal care appointment with Sienna -- 4.2. The childbirth preparation class with Deb -- 4.3. Additional notes on prenatal care -- 4.4. Conclusions about preparation for birth -- Chapter 5. Birth stories -- 5.1. Participant birth stories -- 5.2. Postpartum care -- 5.3. Conclusions about intrapartum care -- Chapter 6. The physiological process -- 6.1. Emotions and hormones -- 6.2. "Going deep within" -- 6.3. Authoritative knowledge: the knowledge -- 6.4. Conclusion -- Chapter 7. Failure to progress -- 7.1. Preventing failure to progress -- 7.2. Defining progress -- 7.3. Authoritative knowledge: the authority -- 7.4. Conclusion -- Chapter 8. AFH & BC and Fairbanks Memorial Hospital -- 8.1. Jane's birth story -- 8.2. The relationship between AFH & BC and Fairbanks Memorial Hospital -- 8.3. Crisis as normal -- Chapter 9. The role of the midwife -- 9.1. Guardians of birth -- 9.1.1. Holding the physical space by maintaining infrastructure -- 9.1.2. Holding the external space during birth -- 9.1.3. Holding the political space -- 9.2. Empowerment -- Chapter 10. Conclusion -- 10.1. Summary of findings -- 10.2. Epilogue -- References -- Participant interviews.
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