Vulnerability in birth: A negative capability.
MacLellan J.
AIM:This article explores the literature on women's expectations for birth, the sociocultural context from which these expectations originate and their impact on the interpretation of birth experience. BACKGROUND:Childbirth is associated with specific expectations from women with the potential for dissatisfaction if these expectations are not met. DESIGN:This paper presents a systematic analysis of the concept of vulnerability in childbirth. FINDINGS:A framework was extracted from the literature that linked the themes of a discourse of control, construction of inadequacy and shame of exposure to explain the sociocultural origin of dominant childbirth expectations in the literature. The experience of vulnerability unique to the birthing event is suggested as exposing the woman to this underlying contextual framework and impacting the interpretation of her birth. CONCLUSION:This synthesis has exposed the transient experience of vulnerability during birth as a significant contributor to the birthing woman's interpretation of the birth and her place within it. RELEVANCE TO CLINICAL PRACTICE:An explanatory framework is offered to clinicians that could increase their awareness of sociocultural and historical factors impacting a woman's expectations for birth. Appreciation of the woman's vulnerability in birth, exposing her to the influence of this framework, can assist clinicians to facilitate a quality birth experience for women. Furthermore, supporting women and midwives to accept this experience of birth vulnerability as a "negative capability," can facilitate an empowering birth experience.