'The Birth I Want': Negotiating the Ideal and the Practical in Natural Birth

This thesis explores the disjunction between a public, moralised discourse of natural birth and women's own more complex narratives of practical decision making and lived experience. I focus on women's negotiations of these two dimensions, which I term 'the work of birth', which includes the planning, preparation and practice in which some women are involved during their pregnancies. I argue that this work can be considered an ethical self-formation in which women work on the self in order to construct and present a particular subjectivity - of the good and responsible mother. I address questions which are not adequately answered in the sociology of childbirth literature, including how and why some women become involved in natural birth groups; why they consider investing time and money in antenatal education as a good thing to do; and why they report the need to practice for a natural birth. I approach their natural birth practices as things of 'value' or 'matter' (Bender and Taves 2012), as their search for meaning-making within a particular embodied event. As such, I argue that theoretical approaches from both cultural sociology and religious studies, including theories of lived religion and of ritual, can shed new light on the meanings and motivations of these practices. The thesis draws on analysis of primary materials, on observation of different antenatal groups and on over 40 interviews with pregnant women, new mothers, midwives and antenatal teachers, all of whom were involved in natural birth practices including Hypnobirth, home birth and using the services of a doula. I analyse the ideal of natural birth within the women's own narratives in order to understand the concept of the 'natural' in this particular context; what do women mean when they use this term and what work does it do here? I argue that the natural is not in a simple dichotomy with a medicalised birth and is not just the content of a particular type of birth but rather is intricately connected to the perception of choice, of having 'the birth I want'. I analyse the ideal in connection with the non-ideal or the 'profane'. Central to this is the constructed 'other' who does not do birth 'right', which reveals a changing location of expertise not only away from the medical establishment towards the birthing woman but also away from the midwife and towards the doula and other 'birth workers'. The interview narratives reveal a process of negotiation between the ideal birth and women's own practical considerations, including her embodied experiences (or lack thereof in first pregnancies) and her relationships with significant others (including her partner, baby and the expert). This negotiation takes the form of 'work'; of planning, preparation and practice for the ideal birth through the physical, mental and emotional working on the self. I suggest that this bears parallels to a western spiritual legacy of work on the self and shares its understandings of self-in-relation. As a result, I argue that the work should not be seen as a narcissistic pursuit of individualism, nor a futile practice which sets women up for failure. Rather, it can be seen as an expression of lived and embodied ethics, of attempting to make the best possible decisions in light of individual and relational circumstances within a plethora of choices in the field of consumption and a strong moral discourse in the public sphere. Through the performance of particular choices and practices, some women seek to demonstrate their good and responsible motherhood, regardless of whether the ideal birth is attained.