Understanding the Role and Experiences of Birth Centre Aides at the Ottawa Birth and Wellness Centre: Work, Leadership, and Reproductive Justice

Abstract

Free-standing birth centres (FSBCs) were formed in Ontario in 2014 and operate with the support of birth centre aides (BCAs), a novel birth worker role. As a recent introduction to the Ontario maternity care system, there have been no academic inquiries into BCAs and only a hand full of investigations on birth centres (Mattison, 2015; Mattison et al., 2020; Murray-Davis et al., 2014; Sprague et al., 2018). From a feminist perspective, an analysis of the BCA role offers a unique opportunity to conduct a feminist analysis of work in healthcare between largely women care providers (i.e., midwives and BCAs), leadership, and reproductive justice activism. My dissertation consists of three standalone papers based on empirical data gathered through in-depth semi-structured interviews and document analysis at the Ottawa Birth and Wellness Centre (OBWC). For my first paper, “Mapping the Development of Birth Centre Aides at the Ottawa Birth and Wellness Centre”, I applied a feminist sociology of professions framework (Davies, 1996; Witz, 1992) and employed an institutional ethnographic methodology (Smith, 1990) to understand how the BCA role was developed and operationalized in the OBWC. I mapped the development of the BCA role at the OBWC descriptively and visually using the documentary and interview data with key stakeholders from the OBWC (n=16), including BCAs, administrators, and midwives. In the second paper, “Feminist Leadership in Healthcare: The Case of Birth Centre Aides and the Ottawa Birth and Wellness Centre,” I integrated Tronto’s (1993) ethic of care with Dickson and Tholl’s (2014) LEADS in a Caring Environment leadership framework in an instrumental case study (Stake, 2005) to understand how BCAs lead from their position within the OBWC and how they experience feminist leadership practices in the OBWC. Finally, in my third paper, “Birth Work as Reproductive Activism: The Case of Birth Centre Aides at the Ottawa Birth and Wellness Centre,” I applied a reproductive justice theoretical framework (Ross, 2017; SisterSong, 2015) through an instrumental case study (Stake, 2005) to understand how BCAs undertake quiet reproductive activism at the OBWC. Taken together, my dissertation offers new knowledge on the role and development of BCAs in the OBWC and contributes to advancing feminist scholarship on healthcare leadership and reproductive justice activism.