The logics of planned birthplace for remote Australian Aboriginal women in the northern territory: A discourse and content analysis of clinical practice manuals

Abstract

Objective: the aim of this research is to review the content, and describe the structural and contextual discourse around planned birthplace in six clinical practice manuals used to care for pregnant Aboriginal women in Australia's remote Northern Territory. The purpose is to better understand where, how and why planned birthplaces for Aboriginal women have changed over time. Methods: content and discourse analysis was applied to the written texts pertaining to maternal health care and the results placed within a theoretical framework of Daviss's Logic. Findings: the manuals demonstrate the use of predominantly scientific and clinical logic to sanction birthplace. Planned birthplace choices have declined over time, with hospital now represented as the only place to give birth. This is in opposition to Aboriginal women's longstanding requests and is not supported by robust scientific evidence. Conclusions: despite scientific and clinical logics dominating the sanctioning of birthplace for Aboriginal women, conjecture is apparent between assumed logics and evidence. There needs to be further critical reflection on why Aboriginal women do not have planned birthplace choices, and these reasons, once identified, debated and addressed both in research agendas and policy re-development.