title: Risk and fear in the lived experience of birth without a midwife.
abstract: OBJECTIVE
  the broad aim of this study was to examine the lived-experience of women who birth without a midwife or other health-care professional in the United Kingdom; the specific purpose of this paper is to examine risk discourse as experienced by these women.
  
  
  METHODS
  reflective lifeworld research, a phenomenological approach was used in this study based on the philosophical writings of Husserl, Merleau-Ponty and Gadamer (Dahlberg et al., 2008). 10 in-depth interviews were conducted with women who had birthed without a midwife or other health-care professional present, interviews were transcribed and hermeneutically analysed.
  
  
  RESULTS
  women׳s lived-experiences of the maternity services in this study suggest a pervading mood of fear which finds voice in manipulative risk discourse and midwifery behaviours that can result in women avoiding maternity care. Fear based ׳risk-talk׳ is used as a scare tactic to coerce women into particular choices; if women do not comply they are labelled ׳risk-takers׳ and can become ostracised by the maternity care system.
  
  
  CONCLUSIONS
  risk discourse and its emphasis on mortality and morbidity raises awareness of death and creates important existential concerns for women which are unaddressed by health-care professionals. This can lead to a loss of trust in health-care professionals and women sourcing positive support and a salutogenic approach to childbirth from outside the system.
  
  
  CONCLUSIONS
  health-care professionals need to become aware of and address manipulative and coercive attitudes in risk discourse.
authors.affiliation: Graduate School [Interdisciplinary Faculties of Philosophy and Nursing], Marquette University, 1250 Wisconsin Avenue, Milwaukee, WI 53233, USA. Electronic address: mariamni.plested@marquette.edu.
authors.forename: Mariamni
authors.initials: M
authors.lastname: Plested
authors.affiliation: Graduate School [Interdisciplinary Faculties of Philosophy and Nursing], Marquette University, 1250 Wisconsin Avenue, Milwaukee, WI 53233, USA. Electronic address: maviskirkham@hotmail.com.
authors.forename: Mavis
authors.initials: M
authors.lastname: Kirkham
mesh_terms: D001291:Attitude of Health Personnel; D005239:Fear / Q000523:psychology*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007407:Interviews as Topic; D008880:Midwifery / Q000379:methods*; D009721:Nurse Midwives / Q000523:psychology*; D009723:Nurse-Patient Relations; D036801:Parturition / Q000523:psychology*; D011247:Pregnancy; D037841:Pregnant People / Q000523:psychology*; D012306:Risk; D006113:United Kingdom
keywords: Fear; Freebirth; Risk discourse; Salutogenesis; Unassisted birth