Being safe practitioners and safe mothers : a critical ethnography of continuity of care midwifery in Australia
Date
2014
Authors
Dove, S.
Muir Cochrane, E.
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Journal article
Citation
Midwifery, 2014; 30(10):1063-1072
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Abstract
Objective: to examine how midwives and women within a continuity of care midwifery programme in Australia conceptualised childbirth risk and the influences of these conceptualisations on women's choices and midwives' practice.
Design and setting: a critical ethnography within a community-based continuity of midwifery care programme, including semi-structured interviews and the observation of sequential antenatal appointments.
Participants: eight midwives, an obstetrician and 17 women
Findings: the midwives assumed a risk-negotiator role in order to mediate relationships between women and hospital-based maternity staff. The role of risk-negotiator relied profoundly on the trust engendered in their relationships with women. Trust within the mother–midwife relationship furthermore acted as a catalyst for complex processes of identity work which, in turn, allowed midwives to manipulate existing obstetric risk hierarchies and effectively re-order risk conceptualisations. In establishing and maintaining identities of ‘safe practitioner’ and ‘safe mother’, greater scope for the negotiation of normal within a context of obstetric risk was achieved.
Key conclusions and implications for practice: the effects of obstetric risk practices can be mitigated when trust within the mother–midwife relationship acts as a catalyst for identity work and supports the midwife's role as a risk-negotiator. The achievement of mutual identity-work through the midwives' role as risk-negotiator can contribute to improved outcomes for women receiving continuity of care. However, midwives needed to perform the role of risk-negotiator while simultaneously negotiating their professional credibility in a setting that construed their practice as risky.
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Link to a related website: https://dspace.flinders.edu.au/xmlui/bitstream/2328/36201/1/Dove_Being_AM2014.pdf, Open Access via Unpaywall
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Crown Copyright 2014 Elsevier