New midwifery? A qualitative analysis of midwives’ decision‐making strategies

Abstract

Managers need to question whether the strategies they adopt hinder or support clinicians in their efforts to involve women in decisions. Clinicians need to consider whether they wish to be selective or universal in their use of new professional strategies.

How midwives’ discursive practices contribute to the maintenance of the status quo in English maternity care

“…For many of them, this was not consistent, a finding similar to that reported by Porter et al (2007) in their study of midwives' professional behaviour with respect to decision-making. In the study reported here, the midwives' professional identity, as demonstrated by their discursive practices, altered with areas of care.…”

“…Moreover, midwives as NHS employees are commonly constrained by practice guidelines based on medical or managerial, rather than midwifery, principles and priorities (Jowitt, 2001;Porter et al, 2007;Ali, 2008). However, UK midwives have a statutory duty to support women's choices regarding how and where they give birth, and to promote the midwifery approach to birth (Nursing and Midwifery Council (NMC), 2004).…”

“…Although there is a tendency to perceive professionalism as a neutral phenomenon, writers from various feminist traditions have pointed out that men have set the standards through which it is defined (Davies, 1992;Witz et al, 1996). Professional roles therefore have gender value (Porter et al, 2007); this regardless of the physical gender of individuals. Consequently, when women enter occupations originally reserved for men, they often become 'honorary' men to maintain occupational status (Gherardi, 1996).…”

“…The ascendancy of the marketplace ethos, the reshaping of power relationships between healthcare professionals and the public, and the regulation of medicine have also changed the constitution and representation of power in the NHS (Lissauer, 2003;Porter et al, 2007;Nettleton et al, 2008). Nevertheless, the reality of continuing medical control over both midwifery practice and childbirth belies the idea that roles based on traditional notions of gender attributes are yet fundamentally under threat in the NHS.…”

Meeting the health and social needs of pregnant asylum seekers: Midwifery students' perspectives. Part 2: Dominant discourses and approaches to care

“…Other studies reflect the idea of an underpinning managerial discourse influencing approaches to care of the pregnant woman seeking asylum, with a reliance on policies and guidelines (Nabb, 2006;Reynolds and White, 2010). This also extends to pregnant women more generally (Smith et al, 2009;Porter et al, 2007). In addition, there appears to be a lack of consensus in the literature around whether to approach care from an individual perspective (Schott andHenley, 1996b, Cowan andNorman, 2006) or if it is important to consider a person's context when making care decisions (Nairn et al, 2004;Squire and James, 2009).…”