“I no longer had a voice, I was just a vessel”: Birthing women’s experiences of information gathering, choice and dismissal

OBJECTIVE: To investigate pregnant people's lived experiences of attempted access to midwifery-led, out-of-hospital birth options within the public healthcare system in contemporary Ireland, during the implementation of the National Maternity Strategy 2016-2026. METHODS: The methodological approach employed in this qualitative study was hermeneutic phenomenology. Data was collected through interviews with 28 pregnant or postnatal participants who were attempting to give birth at home or in a birth centre. Van Manen's phenomenological approach to data analysis was employed to develop themes and facilitate trustworthiness. The first author repeatedly read and coded the transcripts, a process that was highly iterative. The themes were discussed amongst researchers, coded manually in the first instance and subsequently managed using NVivo software. RESULTS: Some participants experienced dismissal and dehumanisation during the births of their first children, which in turn led them to seek out information about midwifery-led, Out-of-Hospital models for subsequent pregnancies. However, information provided by healthcare professionals regarding the full range of birth options was inconsistent or non-existent. Those attempting to discuss their plans to step outside the medical model with healthcare professionals were again confronted with dismissal and prejudice. CONCLUSION: These finding regarding the experiences of information gathering and treatment during the antenatal and intrapartum periods are significant as they indicate that despite the nominal availability of alternative birth models, information regarding birth options and the knowledge exchanges between pregnant persons and healthcare professionals remains problematic, and those birthing outside the dominant medical paradigm are often dismissed or disregarded.