How do risk management principles fit in with the reality of clinical midwifery?

Abstract

Background Risk assessment and management has become a key focus in midwifery practice, in light of failings in maternity care. Whilst studies have explored risk management within healthcare, it has not looked at its impact on normal midwifery practice. Aim To review the literature exploring how risk management principles fit with clinical midwifery. Methods A literature search was undertaken electronically as well as a search by hand. Nine papers were identified as suitable for the literature review. Data was extracted and used to inform the themes. Findings Three themes were identified: midwives being with women; midwives and normality, and increased sensitivity to risk; and organisational risk technologies and blame. Conclusion There is a mismatch between clinical midwifery culture and risk management. Risk categorisation and increasing risk surveillance clearly have an impact on midwifery practice. However, more research is needed to explore how midwives navigate around these systems.