Normal birth and its meaning: a discussion paper

Background. The importance of working in partnership with women to engender true ‘choice’ may be challenging for many midwives, but there is a need to confront those who promote authoritative knowledge within their own organisations if the profession is going to reclaim the fragile construct of normal birth as a physiological and social process in the future. Aim. Using Foucault’s (1976) concept of power and knowledge, this paper aims to explore how growth of authoritative knowledge and dominant discourse associated with medicine – in particular obstetrics – in the 20th century has transformed society’s view concerning ‘normal birth’. Discussion is placed within the context of recent NICE guidelines published in 2011, which afford women the choice of CS birth in the absence of clinical need. Key objectives. To understand how the use of authoritative knowledge and dominant discourse in obstetrics has influenced society’s view concerning the concept of ‘normal birth’. Findings. It is recognised as that which Foucault (1976) identified as the singular concept of power and knowledge has influenced society’s vision of ‘normal birth’ in the present day. Increasing medicalisation and pathologising of childbirth has led to the current practice of birth by CS in the absence of clinical need, as a genuine alternative birth choice available to all women in the UK. Implications. Midwives need to be mindful of how within the domain of present day maternity services in society, authoritative knowledge and dominant discourse surrounding ‘normal birth’, can influence women in their decision-making.