Navigating Authoritative and Lived Knowledge: A Narrative Analysis of Epidural Use in Childbirth Among Ethnic Minority Malay Muslim Women in Singapore.

BACKGROUND: The dominant biomedical narrative on pain relief interventions—such as epidurals—as being "safe" often overshadows the lived experiences of women's perceptions and experiences of technology in childbirth. Although medicalized reproduction is the norm globally, some women value "natural" childbirth, while many use epidural analgesia. OBJECTIVE: This study explores how the perspectives of Malay/Muslim women in Singapore on epidural are shaped by biomedical authoritative knowledge, traditional knowledge, and lived knowledge. METHODS: Qualitative interviews were done with 35 self-identified Malay/Muslim middle class, and working-class women in Singapore, a high-resource setting. Data collection utilized snowball purposive sampling for a heterogeneous sample. All participants signed institutional review board-approved consent forms. Narrative analysis was applied to identify themes, and grounded theory analysis was applied to ensure data saturation. FINDINGS: Personal experiences with epidural use and health care workers, and anecdotal evidence from other women influence women's perceptions of epidural. Generally, Malay/Muslim women use lived knowledge to emphasize the medical risks associated with epidural. CONCLUSIONS: There are nuances to agency and values surrounding childbirth in a medicalized context. Conceptual approaches that focus only on affluent women or low-resource settings fail to fully explain the experiences of diverse groups.