Being safe practitioners and safe mothers : a critical ethnography of continuity of care midwifery in Australia

dc.contributor.authorDove, S.
dc.contributor.authorMuir Cochrane, E.
dc.date.issued2014
dc.descriptionLink to a related website: https://dspace.flinders.edu.au/xmlui/bitstream/2328/36201/1/Dove_Being_AM2014.pdf, Open Access via Unpaywall
dc.description.abstractObjective: 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.
dc.identifier.citationMidwifery, 2014; 30(10):1063-1072
dc.identifier.doi10.1016/j.midw.2013.12.016
dc.identifier.issn0266-6138
dc.identifier.urihttps://hdl.handle.net/1959.8/158286
dc.language.isoen
dc.publisherChurchill Livingstone
dc.rightsCrown Copyright 2014 Elsevier
dc.source.urihttps://doi.org/10.1016/j.midw.2013.12.016
dc.subjectmidwifery
dc.subjectcontinuity of care
dc.subjectchildbirth risk
dc.subjectmother–midwife relationship
dc.subjectidentity
dc.titleBeing safe practitioners and safe mothers : a critical ethnography of continuity of care midwifery in Australia
dc.typeJournal article
pubs.publication-statusPublished
ror.mmsid9915910287401831

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