Negotiating control and meaning: home birth as a self-constructed choice in Finland

Each society has its own consensual understanding of birth and its determin ants: caregivers, location, participants and loci of decision-making, which in the Western world are based on biomedical knowledge. However, two compe ting cultural models or. childbirth, the biomedical/technocratic model and natural/holistic model, mediate women's choices and preferences for the pla ce and caregiver in childbirth. This article explores the way in which thes e cultural models of birth and the existing practical possibilities for cho ices shape women's and men's understanding of home birth. Based on intervie ws with 21 Finnish women and 12 Finnish men, the reasons for and experience s of planning and building toward a home birth are examined through an anal ysis of birth narratives. The analysis Focuses especially on the women's de finitions of what is 'natural' and their relationship with health services where biomedical practices and knowledge are the norm. The analysis shows t hat the notion of 'natural birth' holds various meanings in Finnish women's narratives namely self-determination, control, and trust in one's intuitio n. I seek to demonstrate that just as the biomedical management of childbir th exhibits distinct cross-cultural variation, so also does resistance to b iomedical hegemony. its such resistance is strongly embedded in the local s ocio-cultural situation. (C) 2001 Elsevier Science Ltd. All rights reserved .