title: At pains to consent: A narrative inquiry into women's attempts of natural childbirth.
abstract: BACKGROUND
  With only 1.2% of all annual U.S. births registered as out-of-hospital births, national trends show an increase in medicalised hospital births. Caesarean sections have become the most common surgical procedure in the U.S.; Caesarean section rates have increased from 20.6% in 1997 to 31.5% in 2009. Furthermore, in 2009, 67% of hospital births utilised epidural analgesia and 26% used oxytocin augmentation. In response to the increased medicalisation of childbirth within the U.S., some women resist standardised medical procedures and instead choose to labour and birth without medical intervention.
  
  
  OBJECTIVE
  The purpose of this study was to understand and contextualise the childbirth experiences of first-time mothers who planned to have a natural childbirth (without medical intervention) in the Midsouthern United States.
  
  
  METHODS
  Using narrative inquiry, we collected data from six participants through semi-structured life-story interviews.
  
  
  RESULTS
  Utilising thematic analysis, four recurring themes emerged: (1) benefits and limitations of pre-labour self-education; (2) labouring women's experiences of relationality; (3) the importance of birth stories and expectations; and (4) the creation of false dilemmas and complexities of "informed choice."
  
  
  CONCLUSIONS
  The women's stories suggest that U.S. medical establishments, the media, and society need to empower pregnant and birthing women by creating new narratives of labour and positive spaces of relationality. Furthermore, health care professionals need to critically examine their usage of the medical model of care while respecting women's choices and agency.
authors.affiliation: University of Memphis, USA. Electronic address: ahappel717@gmail.com.
authors.forename: Alison
authors.initials: A
authors.lastname: Happel-Parkins
authors.affiliation: University of Memphis, USA.
authors.forename: Katharina A
authors.initials: KA
authors.lastname: Azim
mesh_terms: D000328:Adult; D001294:Attitude to Health; D002585:Cesarean Section / Q000523:psychology; D002755:Choice Behavior; D003657:Decision Making; D036861:Delivery, Obstetric / Q000523:psychology*; D005260:Female; D006801:Humans; D009035:Mothers / Q000523:psychology*; D009321:Natural Childbirth / Q000523:psychology; D011247:Pregnancy; D014481:United States
keywords: Empowerment; Narrative inquiry; Natural childbirth; Pregnancy; Qualitative research