Flexible Therapeutic Lanscapes of Labour and the Place of Pain Relief

Flexibility in the design & enactment of spaces of healthcare is important in how providers respond to variations in patient expectations & experience. Health geographers have contributed to a wide body of literature concerning the therapeutic qualities of landscapes & the material, social & symbolic orderings of place & their uniqueness for individuals. In this paper, we draw upon these findings & a 'culture of place' approach to consider the complexities of maternity care & issues of pain relief. Given that pain is widely held to be a subjective experience & one that, in an era of patient decision making, increasingly demands discretionary approaches to its relief, we consider how medical professionals help to construct flexibility in healthcare & how this affects therapeutic landscapes. Drawing on analysis of four focus groups involving parent educators, midwives, health visitors, anaesthetists & obstetricians in the NE of England, we explore the material & discursive construction of flexible therapeutic landscapes & pain relief. Our findings suggest that flexibility is constrained & fashioned in association with health care professional's sense of place as already constituted. We propose that providing maternity care professionals with an explicit awareness of how places are relationally constructed, may help in expanding the therapeutic qualities of particular settings, & support a (more) flexible approach. References. [Copyright 2007 Elsevier Ltd.]