'Safety' and 'respect' during labor and delivery.

The contribution of Spanish and Italian women and midwives from a non-medicalized care model.

Abstract

In this paper I analyze the experience and perspective of Italian and Spanish women who choose homebirth or a birth center to deliver and the independent midwives attending them. Data come from ethnographic research conducted in Italy, Spain, and the Netherlands between 2010 and 2015, as part of the European Marie Curie Grant research program. The concepts of «safety» and «respect» from their vision will be analyzed and relate to the official discourse proposed by biomedicine. Similarities and differences between the two concepts will be identified, also considering the different care practices implemented in both contexts (homebirth and hospitalized birth). The main objective of the paper is to discuss the contribution that the non-medicalized model of accompaniment in childbirth can offer in terms of better understanding and management of the reproductive process. A broader conception of «safety» that emerges from mothers who have given birth at home raises interesting questions about the need for critical revision of biomedical categories; categories that should be more inclusive of subjects' experiences -as recently indicated by WHO regarding childbirth- and not just clinical parameters. Including the perspectives of those who experience other models, could also offer opportunities to reflect on how to contain obstetric violence and avoid excessively medicalized practices that are detrimental to human rights in health and reproductive health. The proposal discussed in the paper is aimed at the dialogue between different models, based on the idea that marginal knowledge - precisely because of their being at the borders - allow a critical and constructive view.

KEY WORDS: homebirth; birth center; respectful birth; medicalization of birth; independent midwife.