title: Using video in childbirth research.
abstract: BACKGROUND
  Conducting video-research in birth settings raises challenges for ethics review boards to view birthing women and research-midwives as capable, autonomous decision-makers.
  
  
  OBJECTIVE
  This study aimed to gain an understanding of how the ethical approval process was experienced and to chronicle the perceived risks and benefits.
  
  
  METHODS
  The Birth Unit Design project was a 2012 Australian ethnographic study that used video recording to investigate the physical design features in the hospital birthing space that might influence both verbal and non-verbal communication and the experiences of childbearing women, midwives and supporters. Participants and research context: Six women, 11 midwives and 11 childbirth supporters were filmed during the women's labours in hospital birth units and interviewed 6 weeks later. Ethical considerations: The study was approved by an Australian Health Research Ethics Committee after a protracted process of negotiation.
  
  
  RESULTS
  The ethics committee was influenced by a traditional view of research as based on scientific experiments resulting in a poor understanding of video-ethnographic research, a paradigmatic view of the politics and practicalities of modern childbirth processes, a desire to protect institutions from litigation, and what we perceived as a paternalistic approach towards protecting participants, one that was at odds with our aim to facilitate situations in which women could make flexible, autonomous decisions about how they might engage with the research process.
  
  
  CONCLUSIONS
  The perceived need for protection was overly burdensome and against the wishes of the participants themselves; ultimately, this limited the capacity of the study to improve care for women and babies.
  
  
  CONCLUSIONS
  Recommendations are offered for those involved in ethical approval processes for qualitative research in childbirth settings. The complexity of issues within childbirth settings, as in most modern healthcare settings, should be analysed using a variety of research approaches, beyond efficacy-style randomised controlled trials, to expand and improve practice-based results.
authors.affiliation: University of Technology, Sydney, Australia.
authors.forename: J Davis
authors.initials: JD
authors.lastname: Harte
authors.affiliation: University of Technology, Sydney, Australia.
authors.forename: Caroline Se
authors.initials: CS
authors.lastname: Homer
authors.affiliation: University of Technology, Sydney, Australia.
authors.forename: Athena
authors.initials: A
authors.lastname: Sheehan
authors.affiliation: University of Technology, Sydney, Australia.
authors.forename: Nicky
authors.initials: N
authors.lastname: Leap
authors.affiliation: University of Technology, Sydney, Australia.
authors.forename: Maralyn
authors.initials: M
authors.lastname: Foureur
mesh_terms: D001315:Australia; D003657:Decision Making; D059037:Doulas; D017041:Ethics Committees; D005260:Female; D006801:Humans; D007258:Informed Consent; D007407:Interviews as Topic; D007743:Labor, Obstetric; D008880:Midwifery; D036801:Parturition; D011247:Pregnancy; D018907:Privacy; D012107:Research Design; D014741:Video Recording / Q000941:ethics* / Q000331:legislation & jurisprudence
keywords: Australian ethical process; birth unit design; childbirth; ethical approval challenges; midwifery; video-ethnography; women’s experiences of labour and birth