The thesis presents an empirical study that examines the birth experiences of women
who have given birth in Pakistan. It seeks to understand birth experiences from the
perspective of sixteen women - a sample of women recruited through acquaintances in
the Punjab district of Pakistan and a sample of Pakistani women living in the north of
England recruited through an over-50's club. It sets the interviewees accounts of the
pregnancies and birth within their accounts of their life stories. This material is
supplemented through observations collated during a number of visits to Pakistan over
several years: Human inquiry (Reason 1996) has underpinned a multi-method
approach. Two focus groups, participant observation and in-depth interviews were
the methods of choice.
The aims of the study were, to contribute to a growmg discourse on birth
internationally and to explore the life and birth experiences of a small number of
women who have experienced birth in Pakistan.
The methodology of choice was interpretive ethnography (Denzin 1997) with an
anthropological bias. This was in keeping with the developing relationship between
anthropology and midwifery. Reflection has been an important element of the
research methodology and a reflective diary was kept throughout. Analysis was
undertaken using adapted frameworks from Alasuutari's (1995), Polkinghorne's
(1995) and Childress (1998) analytic models. The findings are arranged around one
major theme, the dai (traditional birth attendant); her work, her life and her influence
on birth for women in Pakistan. Sub-themes include, boy preference, the omnipresent
medical model, birth systems, blood influences on life, shame and honour, and
specifically from the women interviewed in the UK - coming to England and
modernisation. Concepts that run through the whole are women's knowledge, the
place of birth, western medical influence on birth practice and colonialism. Rich,
thick, complex detail emerged from the women's stories and a dialectic framework
was used to resolve multiple contradictions, such as, how women could be strong in
the presence of adversity.
The thesis is written in the first person, which is a practice in keeping with my
personal philosophy and commonly accepted in qualitative work (Swanson-Kauffman
1986, Webb 1989, Binnie 1988).
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The fonnat is firstly to set the scene; then review some of the life influences for
women in Pakistan. A chapter follows on the rationale and methodology, including
the methods used. Thereafter, a chapter has been devoted to how, as a white western
woman I influenced the study, followed by an introduction to the women interviewed,
including some life and birth stories. It was decided not to put these into an appendix
due to the centrality of the women to the study.
To achieve the aim of the study, the final part of the thesis examines the findings
using a dialectical framework and concludes with the use of Plato's allegory of the
cave and the subsequent learning transformation that has taken place as a result of
undertaking the research.