Online health forums provide patients with important, relatively secure spaces for sharing narratives, raising concerns, asking questions, and advising and supporting one another (Sillence 2013), where both “experiential knowledge” (Caron-Flinterman et al. 2005) and shared scientific knowledge are considered valuable informational currency. An aspect raised on online patient forums where knowledge and support are very valuable relates to pregnant women’s decisions regarding the choice of homebirth as opposed to hospital birth, particularly due to women’s concerns that homebirths, while preferable for many personal reasons, may result in greater health risks to both self and baby. This paper contributes to current research into online patient communication by exploring the question: “How do pregnant women discuss the potential risks and benefits associated with homebirths on online patient forums?” It uses a combination of Foucauldian discourse analysis (Willig 2013) and Luhmannian semantic analysis (Andersen 2003) to explore the discursive construction of the risks and gains of homebirth on two open access online forums. Whilst the findings reflect women’s acknowledgement of ongoing political debates regarding health and safety, medicalization and patient empowerment, risks have also intensely personal meanings for women, amongst other things as they relate to the potentially serious impact of personal decisions and attendant culpability. This paper sheds important light on sociocultural debates which also reflect seasoned tensions in professional midwifery - the tensions between the natural and the scientific/medicalized, the normal and the abnormal, and the institutional and the private. It also provides important insights into women’s priorities which can support midwives counselling women, and can be considered an important study of how online forums provide discussion spaces where politically and personally sensitive issues are debated by the decision-makers themselves.
16 Apr 2016
Published - 16 Apr 2016
Online patient forums, homebirth, risks and benefits, decision-making, discourse analysis