Using a virtual platform for an asynchronous co-operative inquiry

Reflexivity and critical subjectivity

CI requires attention to reflexivity by the co-researchers because criticality – attention to meanings, values, patterns, relationships and contexts – is essential to making change. In the social sciences, reflexivity indicates intent to make change: examination of feeling, actions and motives, to consider how these might influence further behaviours, thoughts and feelings. Further, reflective practice informs much of health care, social care and educational understandings that promote health/wellbeing (Newman, 2018). In our inquiry, co-initiators SC and JH provided a scaffolding for reflexive processes (Heron and Reason, 1997), and met regularly to discuss and monitor progress of the inquiry. Their use of fieldnote diaries allowed documentation of emergent insights and areas of knowledge, and notation of divergent and convergent issues that arose. Any areas of ambiguity or tension were brought back to the online forum for further discussion. For example, if personal experiences were discussed too abstractly, an experiential example was encouraged, stimulating further personal memories/thoughts. Although each participant had their own concerns, biases, and histories, these were welcomed as groundings for our questionings (Gadamer, (2008/1967), and were a strength rather than a hindrance to our inquiry. Gadamer reminds us that there are no truly objective views. Instead he insists that we come to know anything through an ‘horizon of understanding’ – that is, a dialectical engagement between individuals’ understandings, creating a fusion of perspectives leading into fresh, more expansive horizons hitherto not grasped (Gadamer,1960/1975).

Critical subjectivity is key and challenges self and others to appraise and address assumptions and presuppositions. Thus, in our inquiry it was important to address terms such as ‘normal birth’ and ‘risk’. These highly charged terms could potentially dominate conversations, hindering the time to explore more hidden aspects of our topic. Yet such prevalent elements of childbirth discourse have impact on experiences (or absence) of spirituality in the birthplace/space. Reflecting upon and facilitating emergence of deeper wisdoms remained a core goal and value as we proceeded with the inquiry. The CI worldview is one in which human beings co-create new awareness and new activism through participatory research (Heron & Reason, 2006). CI enabled our conversations to go beyond disciplinary lexicons, biomedical perspectives and professional silos. It required collective commitment to critical subjectivity and further development of reflexivity, so that we were open to new horizons of understandings that could challenge and potentially transform dominant modes of thinking that often prevent spirituality and childbirth being spoken about together. Moreover, our purpose was not about widening polemic ways of knowing; it was more about inviting more partnership and shared knowing. This level of reflexivity invoked a depth of inquiry into our own (individual and collective) sense of power whilst acknowledging the power and influence of other(s) upon us historically and contextually – this attuned the group to an expanding sense of relational knowing.

Ethical principles

A formal ethics approval process was undertaken by SC at Robert Gordon University (RGU) adhering closely to the ethical principles of CI. It was important to be transparent and effective in ensuring that a focus on fairness and equity was core. Benefit and no-harm principles were foregrounded, through exploration of potential risks of engagement in the inquiry and the development of mutually agreed ground rules. These were posted online within the forum so all co-researchers would have access to them each time they logged on. The right to withdraw at any time was also emphasized. It was made explicit from the start that removing all content of a co-researcher from the discussion, once they left the inquiry, would not be feasible. However, if requested, all content would be made anonymous. Potential dissemination pathways (conferences, blogs, papers) were discussed with all co-researchers. The group was encouraged to discuss and be mutually accountable for how material/results/findings would be shared (and how individuals might be identified – or not). Access to email, Skype or telephone for SC and JH directly and individually was accessible and known to all co-researchers.

It is essential throughout any CI that unintended paternalism, manipulation or dominant interpersonal dynamics are addressed and mitigated as they arise. In our inquiry it was important to recognise that significant familiarity with the topic existed within previous work of co-researchers SC and JH. Moreover, SC had participated in, and knew how to utilise CI, creating potential for a power imbalance. SC and JH acknowledged these matters at the outset, informing co-researchers that any sense of conscious or unconscious coercion, in the direction/outcomes of the inquiry should be addressed, and that ongoing reflexive exploration of potential unintended manipulation was important.

As Tee and Lathlean (2004) note, researchers using participative approaches must develop a level of personal insight and self-awareness about the process of the inquiry. In our inquiry, individual autonomy was expressed in the self-creating and self-transfiguring activities of each of the co-researchers. Full engagement in an open and authentic manner was required, with an appropriate balance of the principles of hierarchy, collaboration, and autonomy – deciding for others, with others, and for oneself. The inquiry was attuned to the co-researchers’ creation of knowledge from/through their own lived experiences. The co-researchers discussed sensitivity and the role that language and tone plays in online discussion. This preparation and ongoing awareness clarified the import of ensuring collectively that no-one was undermined or disempowered by anyone within the group. All involved in the inquiry were professionals within their own country, where relevant associations and related support structures existed for counselling support if needed.

Developing co-researchers’ understanding of this evolving CI method took some time at the beginning, as did actuating participation in the virtual space. We were able to step into sensitive and tactful ways of being with one another and maintain a respectful attitude – built upon ethical principles and sympathetic relationships – while working in both synchronous and asynchronous online environments.

Scoping exercise

The inquiry began with a scoping exercise, a face to face in-person session at the International Normal Labour and Birth Research Conference in the UK (2017), with attendees from around the World (varying professions, cultures, languages and experiences related to childbirth). The session was titled ‘Spirituality and Childbirth: an initial co-operative inquiry’. Our session was advertised and those that attended (N: 17) came of their own volition. SC and JH discussed the purpose and format of the session. Attendees were free to leave if they wished at that stage. The stated purpose of this brief, introductory co-operative inquiry was to explore the topic of ‘Spirituality and Childbirth’. We posed two broad questions to the group: 1) ‘How is spirituality experienced by you, women and their families, in and around childbirth? and 2) ‘How does recognising spirituality in and around childbirth keep childbirth safe and normal?’ All attendees were well-educated professionals, sensitive and appreciative of the challenges and realities of contemporary childbirth.

The session commenced with participants working in pairs and small groups, responding to open questions posed by the leaders, and reporting back to the larger group. Various other activities to invoke emotional and relational responses were introduced, such as an invitation to hold hands, adopt silence and take on the gentle gaze of a partner. These exercises brought about a variety of responses in the co-researchers, including some discomfort, awkwardness or humour related to the personal and emotive quality of the exercises. Individual experiences of spirituality in childbirth were shared. At the end of the session the room resonated with a sense of calm and intimacy – rare at an international conference. This shift of mood was akin to Heidegger’s account of ‘mood’ and how different shared moods awaken new understandings and interpretations of the world in which we dwell together (Heidegger, 2008; Smith, 1981). The ‘mooded’ experience of the group provided the inspiration and energy to further the inquiry. At the end of the session, participants were presented with the possibility of extending the work to an online discussion group and seeking opportunities for dissemination. Participants seemed enthusiastic and were invited to provide contact information if they wished to participate further. Twelve individuals signed up and provided their contact details. This brief introductory session had explored practical and experiential knowing, through a variety of activities which generated flip chart diagrams, lists of words and mind-map explorations. These artefacts reflected the group’s interests, providing initial focal areas indicative of potential for further development in the next stages of the inquiry.

Following ethics approval, the twelve who signed up were sent a participant information sheet (PIS) by email and provided with a link to a virtual discussion board. It was made explicit that signing into the virtual platform was tantamount to providing informed consent (after reading the PIS), with opportunity to contact either of the initiators by phone or email with any questions. Three persons did not reply to this email invitation. A further two participants left the online inquiry during the process, leaving seven who continued through to dissemination of outcomes at the International Normal Labour and Birth Research Conference 2019, and subsequent publication of an article (Crowther et al., 2021). Participants from here on are referred to as co-researchers.

Phase 1 – Moving to virtual asynchronous

The first logistical challenge was deciding on the right virtual platform, seeking ease of access and usability. We eventually chose a university-based platform (^©Blackboard) with a secure discussion board, and ^© Skype video discussion and ^© Dropbox to share data. Technological support and security of the online discussion group remained the responsibility of SC. Co-researchers were situated around the world, creating what Blackford & Street (2012) have referred to as a ‘multi-site action research design’. At the beginning co-researchers introduced themselves by proffering their geographic, professional and personal information informing their perspectives on the topic. This created a space in which we could begin to know about and learn from one another. Napan (2016) suggests this phase of the inquiry forges links between co-researchers and helps build trust, cordiality and safety in the group. Heron and Reason (2008) caution that generating legitimate (new) knowledge is challenging when we consider what constitutes each co-researcher’s foundational ‘propositional knowledge’. Conversely, as discussed above, Gadamer (2008/1967) would maintain that our pre-understandings and experiences are what give strength to our inquiries because they are the impetus for beginning any inquiry. SC and JH initiated the asynchronous dialogue between co-researchers with discussion board entries: ‘Introducing ourselves to each other’ and ‘What do we mean when we say spirituality?’ From the responses, broad themes emerged that were gathered and reframed by the co-leaders into directions/questions. As the inquiry progressed further, emergent questions were posed, such as: ‘what is your relationship to spirituality in childbirth? and ‘what do we mean by the ‘intuition of midwives and women?’ Phase 1 established the relevance of the topic for each co-researcher and for the whole group. The early online questions/threads solidified the direction of the inquiry and opened up a conversation that was intriguing and engaging.

Phase 2 – Immersion in questioning and answering

Phase 2 was a stage in which co-researchers became fully immersed in and engaged with their experience of the inquiry over three-months. The intent was to deepen the experience so that initial points of understanding/questioning could be reflected upon and delved into, leading to new insights. This phase involved ‘experiential knowing’. In CI, the exploration can be enriched by inclusion of creative approaches such as art, photographs, stories or poetry. The asynchronous model offered the possibility of uploading work from other media/ways of knowing (beyond the usual verbal/textual). Several contributions from diverse perspectives and various media, brought more expressive, poignant, personal content, leading to a more poetic and existential discourse. Towards the end of this phase a final question was posed: ‘What has been your experience of undertaking the cooperative inquiry in this way?’ This generated an array of reflective insights and reports of transformative actions that had not yet been stated in the inquiry, helping move us into Phase 3.

Phase 3 – Moving to synchronous video meetings

In Phase 3 the seven remaining co-researchers re-assembled synchronously online, via Skype video/audio, to discuss the responses gained in earlier phases and consider their experiences within the asynchronous online inquiry. This phase involved development of outcomes (reflective and actional). Phase 3 privileged presentational and propositional knowing (although practical and experiential knowing continued to inform us). We developed or reframed ideas emerging from the online asynchronous inquiry and explored the notion of taking first order actions. For example, ‘I plan to discuss spirituality with student midwives’, and taking these into second order actions that transforms practice within one’s sphere of influence, for instance, ‘I have now implemented spirituality into the midwifery undergraduate curriculum to inform and transform teaching’.

‘Finishing’ the inquiry

In CI the above cycle may be repeated several times, so that ideas and discoveries tentatively reached in early phases can be further developed. Investigation of one aspect of the inquiry could be related to other parts, and new insights acquired as the group becomes more cohesive and self-critical. However, we felt that over the limited three-month timeframe, we had achieved a significant level of new insight, and, as this aspect of childbirth is obscured and development of awareness is lacking, but important to women, we were eager to share our work. The shared awareness and passionate call to action expressed in the inquiry reflected the significance and desire to improve the wellbeing of countless women, infants, families, caregivers and communities. Due to time constraints, but also to what we had discovered, the group decided to end the online, exploratory part of the inquiry and move to working with the data generated, and towards dissemination.

Phase 4 – Working with data

At the end of the online discussion group phase of the inquiry, co-researchers continued to work together in order to sift through generated data and draw out co-created new understandings. SC and JH remained immersed in the data by re-reading the transcripts, ensuring that the documents were comprehensible, and no further clarifications were needed. The discussion board data set and final discussion were downloaded by SC, who prepared charts grouping the textual quotes and image-based content into topical categories. The charts were shared (online, asynchronously) to the group, and co-researchers discussed patterns/relationships within and between the categories through a further online synchronous forum in which a group dialogue arrived at consensus on the naming of reflective themes.

Smaller groups (of two or three co-researchers) were formed, to consolidate a written summary for each identified theme. This was an asynchronous reflective exercise, as each contributor wrote individually, and an eventual amalgamation was created and agreed upon. Diagrammatic representations and mappings were co-created of the themes, and words, phrases, ideas, concepts and feelings that had emerged throughout the inquiry. As we passed images/diagrams within the group, the richness of our discourse became clearer and deeper. We met online synchronously several more times and reflected repeatedly upon the emergent outcomes. As our diagrams consolidated, SC suggested, and all agreed, that it was time to consider any transformative actions we had perhaps already taken, arising from the inquiry work, as well as future actions that everyone could imagine and commit to. These became a set of possible transformative actions (first order actions) we could share with others through our dissemination work. For example, this led to actions to speak out about spiritual themes in practice areas, inspiring others to change practice, and creative actions in both artistic reflection and practice areas (Crowther et al., 2021). In processing the work for dissemination, we continued to move through ‘representational’ and ‘propositional’ knowledge phases of the inquiry. We acknowledge that continuing the CI through several more iterative cycles would have brought deeper reflection and informed greater second order transformational changes.

Synchronous and asynchronous

This CI employed both synchronous and asynchronous modes of conversation. Rather than only working together in the same space and time synchronously, the group members were able to dip in and out of the discussion as circumstances allowed. The participants valued the convenience of participating in their own time and place, reporting that it allowed for a different quality of being together, in a way that enabled them to contribute as much or as little as they chose. It also meant that co-researchers felt comfortable enough to share relatively intimate experiences which they might have struggled to share in a more open forum.

The non-English speaker in our group was able to be less self-conscious and more confident about speaking out and had more time to think through her contributions. We all expressed that her poetic writing opened the conversation exquisitely. We might have missed the depth of her insight in a synchronous format. She might have felt intimidated, but instead she reported feeling empowered. The quieter co-researchers also could contribute more equally, without the pressure of communicating more performatively in a physical meeting.

It was difficult to work across time zones, and this contributed to some members being less able to engage/attend synchronous meetings. Hence the asynchronous method played an important role in enabling everyone to continue to engage, in their own workable space/time, but connected to the group though online materials. Co-researchers were able to decide when and how to participate and honour the demands of their individual lives. Kouppanou explains that in matters of closeness, what matters is the extent of the concern, as opposed to the physical distance between us (Kouppanou, 2017). As participants, we were moved closer by the personal and social significance we felt about our subject matter, and by what resonated for us within the discourse. Being able to reflect upon ideas and experiences in our own time and space added to our own capacities to engage deeply.

Difficulties included technical matters of access, how and where to archive the work for reference, and working with co-researchers with varying degrees of digital comfort level. Potentially the use of an asynchronous approach limited our ability as a group to be aware of body language, or facial expressions indicating emotions. Likewise, the mood and flow of our work was at times challenging to nurture and maintain. This is like Heidegger’s notion (2008) of a particularly absorbing mood that overcomes us and draws us in further as we make sense of the world that we find ourselves thrown into. As we experienced in our first conference encounter, a face-to-face group in a physical room can feel a flow of energy and emotion as an immersive and shared attunement. Sarker & Valacich (2010) contend that virtual meetings may miss the opportunity for co-researchers to engage fully in discussions, and that any changes in initial perspectives can occur more readily in the face-to-face format. However, our experience provided significant moments of engagement, as experiences recounted created moments of recognition, opened memories and connections to our own work (scholarly/practice-based) and co-created potent shared moods that hovered over us as our inquiry deepened. For example, Barbara shared her story of a fearful woman who she held in a deep relationship of trust, through soulful eye contact. The visceral power of her (poetical, emotive) written story allowed us to feel the strength of this relationship, validating what we knew from our own diverse experiences. Doreen then told a personal story of a nurse who gave simple but crucial guidance as she was leaving her shift, enabling a meditative, calm birth experience. Through many similar moments of revelation, we found that the spiritual energy of caregivers holds, affords and empowers women’s experiences of childbirth as deeply meaningful, emotionally resonant, and existentially significant life experience. On occasion, powerful emotional states surfaced that touched us deeply, as we told stories of birth moments, we had experienced that were spiritually moving. Poems, artworks, quotations and personal narratives emerged in this sharing that became more possible through our shared trust in one another. These embodied moments of revelation arose despite the technologies and physically separating media used. It is plausible that a co-researcher’s contribution in the online forum or document-sharing space proffered powerful responses because it could be viewed repeatedly, providing researchers a time for personal reflection, in a timeframe attuned to individual lives – thus allowing for profound internalised motivations and considered responses.

Managing distress and chaos in the virtual world

As a group, we managed a balance of chaos and order as we navigated our way through the unfolding multi-dimensional qualities of the inquiry. Technological challenges are a constant presence in the virtual world, ranging from inability to access online databases to trouble with internet bandwidth. Meetings can become stressful when a member cannot join, or other technical problems interfere with the flow. Working constantly towards consensus of themes though co-creation was time-consuming and required tact, patience and an honouring of idiosyncratic ways of expressing. Remaining openly engaged and providing each other with free attention and positive regard throughout the inquiry was key. We all remained open to the possibility of distress in the group. Some co-researchers were quiet for periods of time, due to technological issues and/or other demands on their time. Quiet co-researchers were asked by SC and JH if they needed help/support or were encountering difficulties preventing them from engaging. As noted, the asynchronous aspects of the inquiry enabled reflexivity, thus positively impacting experience by alleviating the pressures of time and quick responsivity.

Trust, sensitivity and loving concern for one another

One of the key goals of CI is to value engagement of all co-researchers in the study. It was especially important that SC and JH as initiators/facilitators employed and developed approaches that demonstrated a humanistic awareness – which, as Tee and Lathlean (2004) suggest, encourages engagement and ways of working with people respectfully over a period of time. This included building and maintaining trusting relationships, assessing competence of the co-researchers to participate in the virtual tools and CI process, managing interpersonal and group dynamics (for instance, by making sure that everyone had the opportunity to make a contribution) and making collaborative decisions about co-researchers’ participation (needs, capacities, interest).

The virtual asynchronous space became a site that supported self-expression and exploration. As contributions appeared on the online platform, a flurry of response would follow, often leading to further questions and insights. At times another thread of inquiry would emerge, as ideas connected to previous work by one of the researchers – e.g. the impact of memory/stories of childbirth experiences (Kay et al., 2017), or the role of environment (Balabanoff, 2019). While family concerns, professional pressures and other issues surfaced for members of the group, impinging on capacity to contribute, generosity of spirit and acceptance of each other’s needs (professional and personal) were continuously present.

Our loving concern and interest in one another revealed itself further when most of us met at the same International Normal Labour and Birth Research Conference two and a half years after the initial scoping exercise to present our completed inquiry. We were positively exuberant seeing each other in person – it was such a delight, and a feeling of coming home. We presented to a packed concurrent session and relished the process. We enabled one of the co-researchers, for whom English is a second language (BB), to present in English for the first time, showing full support as we stood together in a group presentation where all participated. Several members of the audience commented on the joy emanating from us as presenters – the joy of being together and the opportunity to share our inquiry with others was infectious.

Challenging the academy

CI represents a radical participatory research approach that is certainly not the norm in academic knowledge creation – arguably the contemporary academy norm aligns with competitive outcome driven approaches and attitudes (Harland et al., 2010; Spooner, 2018). The notion of the academy as a deeply thoughtful, conscious and moral compass for society is not a shared construct – indeed it is construed now, by many, as harbouring ‘subversive activity’ (Rolfe, 2013). Heidegger (1959/1969) warned the academy of undervaluing reflective and contemplative thinking. Rolfe (2013) warns that true scholarship must include diverse voices. Moreover, feminist ‘slow’ scholarship approaches are valuable in returning to depth of thought and creativity (Berg & Seeber, 2016; Bergland, 2018). The concepts of ‘taking time’ and ‘creating a safe environment’ for profundity of academic discussion is one we fostered and modelled within our inquiry. It does take time and sensitivity to unconceal ontological meaning and valuable ecological insights embodied in human experience (Gadamer,1960/1975). CI has been described as requiring modification to ‘fit’ academic needs/models (Knowles, 1986; Napan, 2009), and we acknowledge that this was our experience. In the purist sense a CI would evolve from each co-researcher’s commitment to a cause, from inception of the idea through to any final consensual outcomes. In reality, SC and JH, keen to bring this focus to a group, invited others in and wrote the study proposal and applied for ethics. Despite our CI orientation, the focus of the inquiry, and its technological logistics and ways of working were essentially decided upon by SC and JH. Although the intention was to ensure co-researchers experienced an emancipatory process, SC and JH, as initiators, were bound by various institutional requirements of the academy.

Moreover, CI is an egalitarian approach that is about opening up to non-hierarchical relationships enabling co-researchers to express their human wholeness (Heron, 1996). Casey & Fernandez-Rio (2019) note that CI can be hijacked when hierarchical demands intrude on the process. CI requires a radical extended epistemology which openly embraces the wholeness of persons as multi-dimensional beings – psycho-social, cultural, spiritual, emotional and political attributes – and their four ways of knowing – practical, experiential, presentational and propositional. All these are of equal significance in CI, representing a radically extended epistemic approach, infrequently honoured in academia. As Napan et al., (2018) suggests CI is an epistemic orientation that confronts the positivist academy. Our CI represents an epistemological and ontological counterpoint to childbirth scholarship and research that does not acknowledge the concept and experiential reality of spirituality as an aspect (important, real, meaningful) of childbirth.