Midwifery decision-making

Abstract

This chapter explores midwifery decision-making within the context of the socially and culturally constructed maternity care environment. It examines how midwives work with and support women in an attempt to facilitate choice within maternity services often focused on meeting institutionally required outcomes. The chapter discusses 'feeling valued' and 'feeling safe'. Doctors were seen to have more authoritative control over clinical decision-making than midwives, and midwives were seen to have greater control than women. Group pressure to voice a collective view can be strong in maintaining professional identity. Midwives who voice a different view to their localised professional group can be socially excluded and intimidated. Within midwifery literature, the terms 'safe' and 'safety' are primarily used to discuss the physical health of the woman and/or her baby. The term 'feeling safe' within this chapter describes a state within a maternity care encounter in which the woman and midwife can interact without fear of perceived or actual psychological harm.