Dispatch from the quantitative | qualitative border

On Tuesday evening I attended my first WAPA meeting (Washington Association of Professional Anthropologists). This group meets monthly, first with a happy hour and then with a speaker. Because I have more of a quantitative background, the work of professional anthropologists really blows my mind. The topics are wide ranging and the work interesting and innovative. I’ve been sorry to miss so many of their gatherings.

This week’s topic was near and dear to my heart in two ways.

1. The work was done in a survey context as a qualitative investigation preceding the development of survey questions. As a professional survey methodologist, I have worked through the surprisingly complicated question writing process many hundreds of times, so this approach really fascinates me!

2. The work surrounded the topic of childbirth. As a mother of two and a [partially] trained birth assistant, I love to talk about childbirth.

The purpose of the study at hand was to explore infant mortality in greater depth by investigating certain aspects of the delivery process. The topics of interest included:

– whether the birth was attended by a professional or not
– whether the birth was at home or in a medical facility
– delivery of the placenta
– how soon after the birth the baby was wiped
– cord cutting and tying
– whether the baby was swaddled and whether the baby’s head was covered
– how soon the baby was bathed

The study was based on 80 respondents (half facility births, half homebirths) (half moms of newborns, half moms of 1-2 year olds) from each of two countries. The researchers collected two kinds of data: extensive unstructured interviews and survey questions. The interviews were coded using Atlas ti into specific, identifiable, repeated events that were relevant to infant mortality and then placed onto a timeline. The timeline guided the recommended order of the survey questions.

One audience member shared that she would have collected stories of “what is a normal childbirth?” from participants in addition to the women’s personal stories. Her focus with this tactic was to collect the language with which people usually discuss these events in childbirth. She mentioned that her field was linguistic anthropology. The language she was talking about is referred to by survey researchers as “native terms-” essentially the terms that people normally use when discussing a given topic. One of the goals of question writing is to write a question using the terms that a respondent would naturally use to classify their response, making the response process easier for the respondent and collecting higher quality data. The presenters mentioned that, although they did not collect normative stories, collecting native terms was a part of their research process and recommendations.

The topics of focus are problematic ones to investigate. Most women can tell whether or not they gave birth in a facility and whether or not the birth was attended by a professional. Women can usually remember their labor and delivery in detail (usually for the rest of their lives), as well as the first time they held and fed their babies. Often women can also remember the delivery of the placenta or whether or not they hemorrhaged or tore significantly during the birth process.

But other aspects of the birth, such as the cord cutting and tying and the first wiping and swaddling of the baby, are usually done by someone other than the mother (if there is someone else present). They often don’t command the attention of the mother, who is full of emotion and adrenaline and catching her breath from an all encompassing, life changingly powerful experience. These moments are often not as memorable as others, and the mothers are often not as fully aware of them or able to report them.

I wondered if the moms were able to use the same level of detail in retelling these parts of their stories? Was there any indication that these sections of the stories they told were their own personal stories and not a general recounting of events as they are supposed to happen? In survey research, we talk about satisficing, or providing an answer because an answer is expected, not because it is correct. In societies where babies are frequently born at home, people often grow up around childbirth and know the general, expected order of events. How would the results of the study have been different if the researchers had used a slightly different approach: instead of assuming that the mothers would be able to recount all of these details of their own experiences, the researchers could have taken a deeper look at who performed the target activities, how detailed an account of the activities the mothers were able to provide, and the nature of the mom’s involvement or role in the target activities.

I wondered if working with this alternative approach would have led to questions more like “The next few questions refer to the moments after your baby was born and the first time you held and nursed your baby. Was the baby already wiped when you first held and nursed them? Was the babies cord already cut and tied? Was the baby already swaddled? Was the baby’s head already covered?” Although questions like these wouldn’t separate out the first 5 minutes from the first 10, they would likely be easier for the mom to answer and yield more complete and accurate responses.

All in all, this event was a fantastic one. I learned about an area of research that I hadn’t known existed. The speaker was great, and the audience was engaged. If you have an opportunity to attend a WAPA event, I highly recommend it.

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