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Challenging norms: Making non-normative choices in childbearing. Results of a meta ethnographic review of the literature

Madeley, A-M. ORCID: 0000-0003-0200-8834, Earle, S. & O'Dell, L. (2023). Challenging norms: Making non-normative choices in childbearing. Results of a meta ethnographic review of the literature. Midwifery, 116, article number 103532. doi: 10.1016/j.midw.2022.103532

Abstract

Objective: Women have the right to make choices during pregnancy and birth that sit outside clinical guidelines, medical recommendations, or normative expectations. Declining recommended place or mode of birth, routine intervention or screening can be considered 'non-normative' within western cultural and social expectations around pregnancy and childbirth. The aim of this review is to establish what is known about the experiences, views, and perceptions of women who make non-normative choices during pregnancy and childbirth to uncover new understandings, conceptualisations, and theories within existing literature. Methods: Using the meta-ethnographic method, and following its seven canonical stages, a systematic search of databases was performed, informed by eMERGe guidelines. Findings: Thirty-three studies met the inclusion criteria. Reciprocal translation resulted in three third order constructs - ‘influences and motivators’, ‘barriers and conflict and ‘knowledge as empowerment’. Refutational translation resulted in one third order construct – ‘the middle ground’, which informed the line of argument synthesis and theoretical insights. Key Conclusions and implications for practice: The findings of this review suggest that whilst existing literature from a range of high-income countries with similar healthcare systems to the UK have begun to explore non-normative decision-making for discrete episodes of care and choices, knowledge based, theoretical and population gaps exist in relation to understanding the experiences of, and wider social processes involved in, making non-normative choices across the UK maternity care continuum.

Publication Type: Article
Additional Information: This is an open access article distributed under the terms of the Creative Commons CC-BY license, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Publisher Keywords: Meta-ethnography, Qualitative, Home childbirth, Birth choice, Non-normative, Declining care
Subjects: R Medicine > RG Gynecology and obstetrics
Departments: School of Health & Medical Sciences
School of Health & Medical Sciences > Department of Nursing & Midwifery
SWORD Depositor:
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