Dove, S.Muir Cochrane, E.2025-12-172025-12-172014Midwifery, 2014; 30(10):1063-10720266-6138https://hdl.handle.net/1959.8/158286Link to a related website: https://dspace.flinders.edu.au/xmlui/bitstream/2328/36201/1/Dove_Being_AM2014.pdf, Open Access via UnpaywallObjective: 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.enCrown Copyright 2014 Elseviermidwiferycontinuity of carechildbirth riskmother–midwife relationshipidentityJournal article10.1016/j.midw.2013.12.0162-s2.0-84907709781