Critical ethnography

Derived from the Greek Krites ("judge"), the Latin term criticus implies an evaluative judgment of meaning and method in research, policy, and human activity. A critical act begins with the recognition that ideas possess the capacity both to control and to liberate.

(Thomas 1983, p.148)

Malinowski (1967) advises that it is preferable to enter the research field with 'foreshadowed problems' rather than preconceived ideas that limit one's view. Given that my ‘foreshadowed problems’ consisted of an awareness, as discussed in the literature review (Chapter Two), of key issues and debates (Grbich 1999)

surrounding mental health and mental health promotion, my approach needed to be one that encapsulated these social, economic and political elements. My research aim to critically analyse how early parenting mental health promotion is understood and implemented by midwives and child health nurses in early parenting services, assumed an outcome of investing in and transforming the area of mental health promotion within early parenting in Tasmania. My research question of “what

creates mental health promotion?” was also, in itself, an ideological question in which social, political and power issues were at play (Antonovsky 1979). Thus, there was an evolving alignment with proponents of a ‘critical’ ethnography: Thomas (1993) and his writings on praxis-oriented ethnographic traditions with a goal of political action; Madison (2012) with her critical ethnographical writings on

performance; Giroux (1983;2014) whose works examine the construction of identity within educational contexts throughout the broader determinants of neoliberalism; and McLaren (1995;2010) whose critical ethnographical work is mainly situated in

critical pedagogy; and Street’s (1992) seminal work in nursing power relations. All were fundamental to my understanding of this critical ethnographic approach. In aligning my study with a critical ethnographic approach, I would be pursuing ethnography with a more direct style of thinking than classic ethnography (Madison 2012). Significantly, critical ethnography examines the relationships between knowledge, society, and political action (Thomas 1993). Health is political with policy makers seeking to maximise political support (Goddard et al. 2006, p.82). Therefore, critical ethnography could offer the appropriate methodological means by which to study a ‘political’ goal of supporting mental health promotion within the child health and maternity services in Tasmania.

Critical ethnography emerged from the ‘Chicago ‘School’, as opposed to Critical Social Theory which emanated from the Frankfurt School of Germany and had at its core an interest in liberating persons from domination and constraining conditions (Steven 1989, p.58). Chicago sociology referred to a particular worldview and fieldwork research method preferred by many of the Chicago analysts in the 1920s and 1930s, aligning with, amongst others, Mead philosophically and Sapir

anthropologically (Thomas 1983). This critical component or critical thought originated in a long tradition of intellectual rebellion in which rigorous examination of ideas and discourse constituted political challenge (Thomas 1983, p.146) and thus research becomes critical when theoretical and methodological approaches, such as ethnography, are re-examined for their critical component (p. 392).

A critical ethnographical approach to this study meant that mental health promotion might gain a greater voice, be less marginalised (Foley 2010), and in doing so would allow some form of ‘liberation’ to parents in their parenting experience. In choosing critical ethnography as my research methodology I was seeking to support action amongst midwives and child health nurses in early parenting and at the same time “provide rigorous and convincing evidence to those in decision-making positions” (Cook 2005, p. 131). Overall, I wanted to ensure that mental health promotion by midwives and child health nurses would serve parental interests in mental wellbeing. How do mental health promotion and critical ethnography intersect? Contemporary perspectives see health as a socio-political phenomenon influenced by issues of

power and dominance (Cook 2005). If health promotion is concerned with empowering individuals – and in this case I refer to empowerment as self-

actualisation or autonomy as discussed in Chapter Two and not an understanding of empowerment as compliance (Nyatanga & Dann 2002) – then it could be argued that both health promotion and critical ethnography aim to give more power, and thus control, to parents affected by funding allocation and health policies (Cook 2005). This would be so if knowledge were the vehicle through which parents were able to exert more control over the circumstances within the perinatal period

(Thomas 1993).

Of note is that critical ethnography emerges when a member of a culture becomes reflective and asks not only “what is this?” but also “what could this be?” (Thomas (1993, p.v).To this end, as a midwife and child health nurse, and as a member of the perinatal parenting culture, I saw this approach as supporting my ability to provoke reflection and facilitate change (De Laine 1997, p.127) in programs and services regarding early parenting mental health promotion. Furthermore, this critical

approach would have the potential of “forcing players” who decide about maternity

services “to act upon value commitments in the midst of political agendas” (Thomas 1993, p.ii) as commitments to invest in the early childhood years and in mental health services are politically determined.

3.3

Method

This section describes the strategies used to collect data for this study. The two main collection strategies were interviewing and document analysis. It is significant to note that I did not engage in participant observation as a major strategy for data collection, although this strategy is usually undertaken in ethnography. A

disadvantage to participant observation can include those being observed changing how they practise (Grbich 1999). I chose not to pursue this methodology as I considered my presence as an academic from the University of Tasmania in

midwifery and child health as too intrusive; that my ‘habitas’ of midwifery and child health academic capital, as Bourdieu (1991) defines it, would be too great an

I also considered that I would gather richer and more detailed data, a greater bricolage (Kinchloe, McLaren and Steinberg 2011), through mutualistic, co- constructed interviews. Through that approach it seemed likely that any perceived ‘outsider academic’ power would be diminished through my ‘interested’ – as

opposed to ‘disinterested’ (Merton 1973) – motivation. Through the methodology of interviewing, my roles of midwife and child health nurse engendered a mutual ‘discourse’, as described by Foucault (1993), with mutual power between me and the participants. In this way more rapport and disclosure occurred and my presence as academic researcher was seemingly less in the foreground and thus less intrusive. As a way of structuring my two methodological strategies, the interviewing process was based on Fontana and Frey’s (2008) framework and the process of document analysis on Bowen’s (2009) procedures.