title: Tensions and conflicts in 'choice': Womens' experiences of freebirthing in the UK.
abstract: BACKGROUND
  the concept of choice is a central tenet of modern maternity care. However, in reality women's choice of birth is constrained by a paucity of resources and dominant medical and risk adverse discourses. In this paper we add to this debate through highlighting the tensions and conflicts that women faced when enacting a freebirthing choice.
  
  
  METHODS
  secondary analysis of data collected to explore why women choose to freebirth in the UK was undertaken. Ten women were recruited from diverse areas of the UK via invitations on freebirthing websites. Women provided a narrative and/or participated in an in-depth interview. A thematic analysis approach was used.
  
  
  RESULTS
  we present three key themes. First 'violation of rights' highlights the conflicts women faced from maternity care systems who were unaware of women's legal rights to freebirth, conflating this choice with issues of child protection. 'Tactical planning' describes some of the strategies women used in their attempts to achieve the birth they desired and to circumnavigate any interference or reprisals. The third theme, 'unfit to be a mother' describes distressing accounts of women who were reported to social services.
  
  
  CONCLUSIONS
  women who choose to freebirth face opposition and conflict from maternity providers, and often negative and distressing repercussions through statutory referrals. These insights raise important implications for raising awareness among health professionals about women's legal rights. They also emphasise a need to develop guidelines and care pathways that accurately and sensitively support the midwives professional scope of practice and women's choices for birth.
authors: University of Central Lancashire, School of Health, Flyde Road, Preston, Lancashire PR12HE, United Kingdom. Electronic address: clfeeley@uclan.ac.uk.
authors: Claire
authors: C
authors: Feeley
authors: University of Central Lancashire, School of Health, Brook Building, BB224, Flyde Road, Preston, Lancashire PR1 2HE, United Kingdom. Electronic address: gthomson@uclan.ac.uk.
authors: Gill
authors: G
authors: Thomson
mesh_terms: D000328:Adult; D002755:Choice Behavior; D005260:Female; D006801:Humans; D007603:Jurisprudence; D008016:Life Change Events; D009321:Natural Childbirth / Q000523:psychology*; D011247:Pregnancy; D036301:Qualitative Research; D012947:Social Work / Q000458:organization & administration
keywords: Autonomy; Childbirth; Choice; Freebirth; Legal; Unassisted birth