Evidence suggests that black and minority ethnic (BME) nurses and midwives are more likely to face fitness to practice hearings and less likely to be in managerial positions than white registrants (Gillen, 2012;Kline, 2014) The literature also describes experiences of covert as well as overt racism between the white majority and BME staff as well as 'horizontal racism' between BME staff of differing ethnicities (Smith et al., 2006).
Midwifery is an ancient profession that continues to be practiced almost exclusively by women. This paper explores the role that millennia of gender exclusivity has had in shaping the knowledge that informs the profession. Prior to the Renaissance this knowledge was exclusively female, largely oral, tacit and intuitive whilst recognising childbearing as an important transformative period in a woman's lifecycle. Male scientific enquiry in the seventeenth century into human anatomy extended to women's bodies and childbirth and disrupted the female ways of knowing. Their positivist ontology focussing on the mechanics of childbirth created an opportunity for intervening in a normal process and receiving payment for it. The perceived structural superiority of a male obstetric ontology of childbirth has posed an existential threat to the midwifery profession. This paper concludes by discussing how 20 th century professional regulation of midwifery has encouraged midwives to use patriarchal structures and frameworks of knowledge to co-exist within the hegemonic biomedical model advocated by the majority of their obstetric colleagues.
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