Hub of medical expertise or medicalised conveyor-belt? Sharing meanings online on the hospital birth setting

Abstract

In 2014, the official risk advice in the UK regarding birth setting was altered given scientific evidence that for low-risk groups, home births are safer than hospital births. As hospital births were previously the de facto recommendation, and pregnant women in the UK now need to consider their birth setting options carefully, many go online, seeking advice about birth setting options from their peers. In this paper, I investigate how the hospital birth setting is constructed on an online forum where women seek advice on the relative merits of various birth settings, analysing posters’ constructions of the hospital birth setting using Foucauldian discourse analysis. Findings reveal that the hospital birth setting is characterised either as the best and safest place to ensure safe delivery due to on-site biomedical experts and technology, or it is constructed as dehumanising, involving unnecessary intervention-related risks to mother and baby. The majority of the threads are critical of the hospital birth setting. Besides these findings, this paper contributes methodologically to the study of birth settings as it adopts a cultural approach supported by discourse analysis, illustrating the metapragmatic context within which birth setting decisions are made. As women’s perspectives on the birth setting issue are in focus, findings regarding women’s satisfaction with the various options are valuable for healthcare professionals who support women with birth setting decisions, as well as obstetric and maternity practitioners in the hospital setting. The extent of posters’ critique of the hospital birth setting suggests the need for further research.