Have your baby and get out. We need this bed for somebody else. Compassionate intrapartum communication : a discourse analysis of language use during labour in South African public and private maternity settings

Minnaar, Sulette (2020-03)

Thesis (MA)--Stellenbosch University, 2020.

Thesis

ENGLISH ABSTRACT: The intrapartum care received by a woman in labour critically influences her perceptions of the birth experience. At best, she can perceive the encounter as compassionate, retaining feelings of empowerment; at worst she can perceive the birth as obstetric violence, and be left feeling traumatised. Seeing that a significant portion of intrapartum care is delivered through communication, this study investigates the linguistic contribution that compassionate language makes in healthcare, specifically with regards to the discursive reconstruction of the memories of participants' recollections of their birth experiences, be it as birthing mothers or in their capacity as maternity care-providers. The main theoretical point of departure of this study constitutes a combination of two theoretical paradigms, namely Discourse Analysis (DA) and Interactional Sociolinguistics (IS), positioned within a health communication context. Aspects of Gee's (2014) theory of DA serves as the primary theoretical framework of this study. Gee's (2014) theory is enhanced by appropriate concepts taken from the field of IS, especially the approaches adopted by scholars such as Gumperz (2015) and Goffman (1974, 1981). In addition, the notion of identity formation in both DA and IS is expanded by Bucholtz & Hall's (2015) Sociocultural Linguistic approach to identity; and Pennycook (2005) and Butler's (1999) approaches to identity performativity. The key findings of this study are that i) through the discursive (re)construction of their birth experiences, participants have indicated that the manner of care which takes place in an intrapartum environment has a critical impact on not only mothers and babies/children, but, importantly, also on the care-providers themselves; ii) through these discursive (re)constructions, participants revealed that the realities of their birth experiences were not in line with their expectations of the communication during the intrapartum period in the instances where the births were perceived as negative or abusive; iii) in addition to describing the styles and strategies of compassionate intrapartum communication, care-provider participants, significantly, provided potential solutions to mitigate the traumas stemming from abusive intrapartum care, thereby benefitting both mothers and care-providers. This study makes a contribution by creating consciousness around obstetric violence, violence against women, and human rights violations in general.

AFRIKAANSE OPSOMMING: Die intrapartum sorg wat ’n vrou in kraam ontvang, het ’n kritieke invloed op haar persepsies van die geboortelike ervaring. Ten beste kan sy die gebeurtenis as deernisvol beskou, en gevoelens van bemagtiging behou; ten ergste kan sy die geboorte as obstetriese geweld beskou, en getraumatiseerd wees. Gegewe dat ’n beduidende deel van geboorte-sorg oorgedra word deur kommunikasie, bestudeer hierdie studie die linguistiese bydrae wat deernisvolle taalgebruik maak in gesondheidsorg, spesifiek m.b.t. die diskursiewe herkonstruksie van die herinneringe van deelnemers se herroepings van hulle geboortelike ervarings, hetsy as die moeder wat geboorte skenk of in die kapasiteit as kraamversorgers. Die hoof teoretiese vertrekpunt van hierdie studie beslaan ’n kombinasie van twee teoretiese paradigmas, naamlik Diskoersanalise (DA) en Interaksionele Sosiolinguistiek (IS), geposisioneer binne ’n gesondheidskommunikatiewe konteks. Aspekte van Gee (2014) se teorie van DA dien as die primêre teoretiese raamwerk vir hierdie studie. Gee (2014) se teorie word verryk deur toepaslike konsepte geneem uit die veld van IS, veral die benaderings wat aangeneem is deur academici soos Gumperz (2015) en Goffmann (1974, 1981). Verder word die nosie van identiteitvorming in beide DA en IS uitgebrei deur Bucholtz & Hall (2015) se Sosiokulturele Linguistiese benadering tot identiteit; en Pennycook (2005) en Butler (1999) se benaderings tot identiteitsperformatiwiteit. Die sleutelbevindinge van hierdie studie is: i) deelnemers het deur die diskursiewe (her)konstruksie van hulle geboortelike ervarings, aangedui dat die wyse waarop sorg plaasvind in ’n intrapartum omgewing, ’n kritiese impak het, nie net op ma’s en babas/kinders nie, maar, belangrik, ook op die versorgers self; ii) deur hierdie diskursiewe (her)konstruksies het deelnemers onthul dat die realiteite van hulle geboortelike ervarings nie ooreengestem het met hul verwagtinge tydens die geboorte-periode nie in die gevalle waar die geboortes beskou is as negatief of geweldadig; iii) versorgers het, bykomend tot hul beskrywing van die style en strategieë van deernisvolle intrapartum kommunikasie, ook potensiële oplossings verskaf om die traumas wat ontstaan weens geweldadige geboortelike sorg te verminder, en daardeur beide ma’s en versorgers te laat baat vind. Hierdie studie maak ’n bydrae deur bewustheid te skep rondom obstetriese geweld, geweld teen vroue, en menseregte-skendings oor die algemeen.

Please refer to this item in SUNScholar by using the following persistent URL: http://hdl.handle.net/10019.1/108148
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