The paradox of success and the challenge of change : home birth associations of Aotearoa/New Zealand (1999)
AuthorsDaellenbach, Reashow all
This thesis is a social and political analysis of the home birth associations of Aotearoa/New Zealand. These consumer groups were formed in late 1970s and over the last twenty years have responded to significant changes in the health sector, some of which are the outcome of home birth political activism. Like many other grass roots movements attempting to achieve change, activists have constantly been challenged to re-create ‘collective identities’ and re-position themselves with respect to various sets of ‘allies’, ‘opponents’, and ‘bystanders’. The thesis examines how home birth associations in Aotearoa/New Zealand have responded in various ways to the radical changes in the professional status of midwifery and the restructuring of the health sector in the 1990s. This analysis draws on theorising about social movements, feminist activism, professionalising strategies and the impact of neoliberal policy projects in the health sector. Home birth association newsletters, the print media, one to one interview, focus group discussion and participant observation are used in this feminist qualitative project. The contradictory positioning of home birth as simultaneously part of and marginalised within New Zealand's state funded maternity service drew home birth advocates into conflicts and compromises with the state. Activists from the home birth associations prioritised a ‘rights’ claim over a home birth advocacy frame and succeeded in effecting significant changes to maternity services as more choices were made available to women. This, however, has not necessarily lead to corresponding changes in the balance of power between consumers and professional experts in policy making and knowledge production. The New Zealand College of Midwives, which grew out of home birth networks, attempts to address power relations through a discourse of ‘partnership’. However, the asymmetrical dependence of home birth associations on midwives to link new members to local networks, and for activists to have a voice in policy making, creates new challenges and strains for home birth activists. A number of home birth associations have attempted to gain contracts with state health funding authorities as a means to exercise more consumer control over home birth services. This raises a new problems for activists as they renegotiate their relationships with state agencies, midwives and women choosing to birth at home.