Qualitative Research in Midwifery and Childbirth

Phenomenological Approaches

Gill Thomson, Fiona Dykes, Soo Downe

• Publisher: Routledge
• Year: 2012
• ISBN:
  9781136724855
• Edition: 1
• Topic: Medicine
• Subtopic: Gynecology, Obstetrics & Midwifery

Qualitative research, particularly phenomenology, is increasingly popular as a method for midwifery and health-related research. These approaches enable rich and detailed explanations to be uncovered and bring experience to life. Important recommendations and practice- based implications may then be raised and debated for future use. This book brings together a range of phenomenological methods and insights into one accessible text.

Illustrated with plenty of examples of successful phenomenological research, Qualitative Research in Midwifery and Childbirth keeps the focus applied to midwifery and childbirth and makes clear the links to practice throughout. The book introduces three key phenomenological approaches – descriptive, interpretive and the life world – and includes a comparative chapter which discusses the differences between these varied perspectives and methods. Each chapter focuses on how these approaches are used within midwifery research. The remaining chapters present a number of different research projects. These demonstrate how different phenomenological approaches have been used to explore and uncover experiences of childbirth and maternity as well as offering important insights into how women experience different facets of the birth experience during the antenatal, intra-partum and postnatal period.

Designed for researchers and students undertaking research projects on midwifery and childbirth, this text includes contributions from a range of international and highly regarded phenomenological authors and researchers.

1 Husserlian Phenomenology Reflected in Caring Science Childbearing Research

Terese Bondas

DOI: 10.4324/9780203816820-1

Introduction

Epistemology is the philosophical branch concerned with the theory of knowledge. Awareness and understanding of the epistemological roots of the method chosen in relation to the topic of interest may enhance the research process, and, ultimately the quality and depth of knowledge that is subsequently developed. The validity of the study may be distorted when the ontological (the conception of reality), and epistemological (nature of knowledge) starting points of the study are not explicated. Likewise, credible evidence for clinical practice suffers if the study is based on incompatible, incorrect or misleading interpretations and secondary or even tertiary references that have been far removed from the primary writings in philosophy, methods or research. A sound philosophical base is important for a discipline, enabling a scientific discussion and critique of the findings. Various methods that have been developed in a phenomenological tradition contribute to basic caring science research and knowledge through accurate and genuine description of phenomena. The overall aim of using a phenomenological perspective is not philosophical in caring science, but the development of knowledge within the disciplinary interest. Giorgi (1985) discusses the difference between a philosophical and a disciplinary knowledge development from the perspective of phenomenology. Thus, phenomenology as a philosophy is here viewed from an epistemological perspective. This provides a foundation for the different phenomenological methods that have been developed in different human science disciplines, and that continue to evolve in these contexts.

The findings from a phenomenological study also direct research in asking new questions, seeing the world through a phenomenological lens and finding phenomena that are relevant and meaningful to caring science. Phenomenology is in tune with caring science as a human science. There is always a perspective in research, otherwise phenomena would not be interesting or meaningful to study within a discipline, as opposed to taking a general once and for all approach across disciplines.

One note of caution: phenomenological methods should not be forced to fit circumstances where they are not appropriate. Unnecessary modifications of methods should not be developed that are inconsistent with phenomenological philosophy (Giorgi 1985). There are many valuable qualitative approaches based on other epistemologies that may be used if modifications are needed. It is not in the interest of science to force one single approach upon every research question.

The imperative of Edmund Husserl, who has been referred to as the father of (modern) phenomenology, is to return to the things themselves (1954/1970). The thing itself is the phenomenon and its structures and essence that are explored in a phenomenological attitude of bracketing previous knowledge, not a natural spontaneous lifeworld attitude. The Husserlian phenomenological foundation is based on constructs such as ‘intentionality’, ‘lifeworld’, ‘description’, and ‘epoché’. In this chapter, this foundation is outlined as the epistemological starting point for descriptive phenomenological caring science studies. This is exemplified below by the phenomenological method of Colaizzi (1978) to show one way of developing knowledge of lived experiences in childbearing and care (a pictorial representation of Colaizzi's method is provided in Chapter 11). The phases of deciding on the scope of the study, the aims, the data collection, the phenomenological intuiting and analysing, the reduction or bracketing, and the structure and essence, is described and discussed in relation to the epistemological starting points based on phenomenology. Examples are drawn from a caring science research programme (Bondas-Salonen 1998a,b, Bondas 2000a, Bondas and Eriksson 2001, Bondas 2002, 2005) of women's health and suffering, ante-natal and post-partum care, and the partner's presence during childbearing. Suffering was related to major changes in themselves and their life as a result of illness or violating and inhumane care. A meta-method study of phenomenological method articles and book chapters also emanated from the research programme (Bondas 2000b). The research has continued in the research network BFiN (www.uin.no/bfin) as a programme of qualitative research in evidence-based care, integrating studies and meta-synthesis of childbearing research (cf. Bondas and Hall 2007a,b, Berg et al. 2008, Lundgren et al. 2009, Wikberg and Bondas 2010).

This chapter uses some of the core ideas of Husserl's phenomenological philosophy and his followers that have developed phenomenological descriptive methods. These ideas serve as a departure to reflect on descriptive phenomenological research and heuristic synthesis in childbearing from a caring science perspective.

The Development of Husserlian Phemenology and its (Mis)use in Applied Science

Phenomenology as a philosophical movement began with Husserl's extensive writings (Giorgi 1985, Spiegelberg 1975). The history of phenomenology reveals endless variations due to continuous modifications and renewed interpretations, as described by Spiegelberg (1975) in ‘The phenomenological movement’. Husserl (1859–1938) developed a philosophy of phenomenology that lends itself to re-interpretation as a strict, rigorous and pure science through description of essential structures of consciousness (Spiegelberg 1975, p. 5). Husserl chose the term ‘phenomenology’ inspired by his professor of philosophy, Franz Brentano, who emphasized the intentionality of psychic phenomena.

Husserl was worried that human sciences uncritically borrowed its methods from the natural sciences, hence losing connection with people as living human beings (Husserl 1954/1970, p. 17). Husserl's (1954/1970, pp. 3, 17) answer was ‘epoché’, which means bracketing of the spontaneous attitude to the world, even if the world remains there for us (Husserl 1954/1970, p. 135ff.). Husserl neither denied nor doubted the material, so-called real world. Instead, he argued that all previous knowledge should be bracketed before new knowledge could be brought to the fore:

Thus I exclude all sciences relating to this natural world no matter how firmly they stand there for me…none is accepted by me; none gives me a foundation…I must not accept such a proposition until after I have put parenthesis around it. That signifies that I may accept such a proposition only in the modified consciousness, the consciousness of judgment-excluding, and therefore not as it is in science, a proposition which claims validity and the validity of which I accept and use.

(Husserl 1954/1970, pp. 61–62)

Husserl was not sure about the creation of knowledge based on the lifeworld; and he described the search for knowledge as ‘absolute beginners’ (1954/1970, p. 133). Merleau-Ponty (1962) continued this work in relation to the lifeworld and the connection of this concept to that which is experienced by the lived body. Other later phenomenological philosophers, such as Levinás, Ricoeur and Spiegelberg, all added their own nuances to phenomenological philosophy. Subsequent generations of phenomenologists developed methods in pedagogy, psychology and theology through the work of Colaizzi, Giorgi, Moustakas and van Kaam, among others. Duquesne University became the centre for a rich tradition of phenomenological studies. Researchers in human and social sciences, including nursing and caring sciences, could be seen as the fourth generation writing about phenomenological philosophy and applying these phenomenological methods. These researchers had one interest in common: to further a humanistic course of their discipline. Explorations and insights from phenomenology, which began to emerge in the late 1970s and early 1980s in nursing and caring sciences by researchers such as Paterson and Zderad (1976), Oiler (1982), Omery (1983), and Parse (1985), paved the way for experiential issues in childbearing research and phenomenological method applications. The various interpretations of phenomenological philosophy and methods are evident in these early interpreters. However, problems arose because, over time, applied researchers working in this field began to use methods based on mixing primary, secondary and even tertiary references and using other qualitative references that had nothing in common with phenomenology (Bondas 2000b). The critique had been raised already in the 1990s by researchers such as Crotty (1996), Paley (1997), Lawler (1998), and Porter (1998), among others. The recent development of meta-method in meta-synthesis (Paterson et al. 2001, Bondas and Hall 2007a,b) also confirms a mixed language use and methodological praxis in phenomenological studies. Phenomenological research has also been mixed with the methodological language and practice of grounded theory, ethnography and other qualitative descriptive studies. In some of the studies, the researcher's theoretical, clinical and/or his or her own lifeworld perspectives seem to dominate. The researcher has not accomplished the phenomenological task: deciding the phenomenon of interest for the study and uncovering the lived experience of the participating persons. In other studies, the research does not go beyond a thematic analysis; the essence of the phenomenon is not illuminated, or the challenge might not even have been recognized (cf. Bondas 2000b, Paterson et al. 2001, Bondas and Hall 2007a,b, Sandelowski and Barroso 2007).

In nursing and caring science literature, there are even different views of phenomenology as: a philosophy, a variety of philosophies, science, theory, method(s), modified methods and combined with an ontological position as lifeworld-led care and an attitude to life and care (Bondas 2000a,b). Phenomenology may be seen as an umbrella concept, and thus, the specific basis that is being used in any particular circumstance always needs to be explicated when this approach is used in writings and research.

What a Phenomenological Husserlian Epistemology can Offer Caring Science Childbearing Research

The Husserlian foundation includes phenomenological constructs such as ‘phenomenon’ and ‘intentionality’, ‘lifeworld’ ‘bracketing’, ‘description’ and ‘structure’ and ‘essence’, among others. These will be outlined in relation to the caring science research programme of Bondas that employed Colaizzi's descriptive phenomenological method, based on Husserl's philosophy.

Phenomenon and Intentionality

Husserl used the word phenomenon to denominate that which emerges in consciousness when we think, experience or imagine whether it exists in reality. In a study, this intuitive knowledge is data (‘inside-knowledge’) which appears in an immediate situation when collecting the data with the participant in the study. In Mohanty's (1987) words it is not a question of photographical resemblance: the phenomenon as revealed by the speaker is not necessarily the same as that seen by the observer. Understanding of the phenomena appears as it is given in the realm of the person's lifeworld which exists before interpretations or explanations. The intentionality of human consciousness is the primary phenomenological lens through which we view our lifeworld:

Consciousness is considered to be the principal realm since anything whatsoever that we can know or speak about must come through consciousness.

(Giorgi 1983, p. 134)

Intentional consciousness means that intentional objects do not necessarily exist, but when a person describes what s/he remembers, s/he refers to something that evokes an intentional phenomenological structure (Giorgi 1983). The meaning of time from a phenomenological perspective is the lived time in the person's unique lifeworld. The tempus of existence, that what once was, is and will be, is not differentiated but clustered together. A person may simultaneously think about w...

Table of contents

• Cover
• Half Title Page
• Title Page
• Copyright Page
• Table of Contents
• Contributors
• Foreword by Holly Powell Kennedy
• 1 Husserlian Phenomenology Reflected in Caring Science Childbearing Research
• 2 Lifeworld Phenomenology for Caring and Health Care Research
• 3 From beginning to end: how to do hermeneutic interpretive phenomenology
• 4 Phenomenological research approaches: mapping the terrain of competing perspectives
• 5 Lesbian Women's Experiences of Being Different in Irish Health Care
• 6 Women’s lived experiences of severe early onset preeclampsia: a hermeneutic analysis
• 7 The Meaning of Giving Birth from a Long-Term Perspective for Childbearing Women
• 8 ‘Abandonment of Being’ in Childbirth
• 9 Parents' Participation in the Care of Their Child in Neonatal Intensive Care
• 10 A Poetic Hermeneutic Phenomenological Analysis of Midwives ‘Being with Woman’ During Childbirth
• 11 Revealing the subtle differences among postpartum mood and anxiety disorders: phenomenology holds the key
• 12 Heidegger's Contribution to Hermeneutic Phenomenological Research
• 13 Authenticity and poetics: what is different about phenomenology?
• Index