Almost clandestine: Birth centers and the methodology of this research
As explained above, Mexico’s Ministry of Health does not grant a regulatory status to the country’s BCs. Since those spaces must therefore operate in semi-secrecy, it was of utmost importance for me to ensure their anonymity and confidentiality. To that end, I indicate the BCs by numbers, and give the interlocutors pseudonyms. During this research, I visited five BCs in five states, covering different parts of Mexico: the North, the Center, and the South. In this way, 1 obtained a broader, more complete picture of the formation and functioning of the BCs.
Given that the BCs cannot announce themselves as such even on websites, I found them via the snowball method. This non-probability sampling technique is adequate for finding people who are otherwise hard to find (Baltar and Gorjup 2012). 1 found a total of 11 BCs in the country. However, not all of them were suitable for this research. Two BCs declined to participate because their directors considered the risk to the spaces’ safety too great, should the anonymity protection fail. Three other BCs no longer operated as such because of threats of closure by the Secretary of Health. The threats were related to the service of attending births in these spaces. At the time when I contacted those BCs, their midwives or staff members were working independently, and only in homes (which is lawful). An additional BC was forced to close due to health problems among the leading staff just before the beginning of this research. Therefore, 1 carried out research on the remaining five BCs.
I scheduled our interviews in those five BCs between April 2015 and March 2016. The interviews included various visits to the facilities. The fieldwork was carried out on the basis of feminist ethnography and in the framework of gender and health studies, which emphasize that science is not objective, but partial, as it inevitably incorporates the researcher’s own “social values.” In other words, the researcher’s background plays a role even if the scientific method is followed. The effects of that background can be controlled only when acknowledged during the research: a situated knowledge that can be understood as a scientific epistemology with a gender perspective, partial but localized, and critical toward the attitude of androcentric science, which assumes itself to be universal (Ortiz 2006; Castañeda 2012).
During the research, the directors, collaborating midwives and some clients of the BCs were interviewed according to a previously designed guide. The final results consisted of ten interviews with midwives, two with doulas, and eight with clients (a total of 20). My interlocutors allowed me to use a recorder, and to enter all areas of the facilities. Afterwards, the interviews were transcribed and analyzed using Atlas T. The results presented in this chapter constitute only part of this previously published, broader research. A letter of informed consent was signed at the end of each interview (Sanchez-Ramirez 2016).
The research results presented in this chapter correspond to the experiences and perceptions of the clients of BCs, as follows: (1) saying “no” to hospitalized birth; (2) being subject to criticism for having chosen a midwife; (3) the integral support system of the BC model; and (4) empowerment through the process of birth. Before turning to these results, I briefly outline the characteristics of the visited BCs and the model of care provided by the interviewed heads of the BCs—the midwives.
