The limits of choice : how community midwives negotiate choice in and of their practice
type: CreativeWork
description: This study explored the ways in which community midwives negotiate competing discourses when supporting choice in pregnancy and birth. The ways in which choice was presented to pregnant women by NHS Trusts providing maternity services, via their information leaflets and the websites that host them, offered an indication of how such organisations conceptualised pregnancy and birth, providing the context in which the community midwives practised. Foucauldian discourse analysis was undertaken of the leaflets and websites, illustrating the discursive structures in which community midwives worked. Interviews with community midwives explored the ways in which they negotiated competing discourses when supporting women to make choices in their pregnancy and birth. In Leaflet 1 and its host website, a dominant medical discourse was identified. The power/knowledge of this discourse could be traced to a medical philosophy that believed that pregnancy and birth are risk laden activities, that women’s bodies are likely to fail and therefore require medical input to manage. In this discourse women are discursively constructed as patients, which repeats and renews medical dominance. Leaflet 2 and the associated website demonstrated a midwifery discourse, which recognised pregnancy and birth as a social as well as a biological construct. In this discourse, the community midwife is discursively constructed as one who understands and supports physiologically normal pregnancy and birth and takes responsibility for recognising any departure from the norm and advising and referring on as required. Crucially in this discourse the woman’s autonomy is recognised and her choices, based on her perceptions of risk, respected. The discursive construction of the leaflet and website place the midwife in the community, not just the spaces of the home, but the wider geographical community. The interviews with the community midwives illustrated the challenges and barriers they encountered in provid…
abstract: This study explored the ways in which community midwives negotiate competing discourses when supporting choice in pregnancy and birth. The ways in which choice was presented to pregnant women by NHS Trusts providing maternity services, via their information leaflets and the websites that host them, offered an indication of how such organisations conceptualised pregnancy and birth, providing the context in which the community midwives practised. Foucauldian discourse analysis was undertaken of the leaflets and websites, illustrating the discursive structures in which community midwives worked. Interviews with community midwives explored the ways in which they negotiated competing discourses when supporting women to make choices in their pregnancy and birth. In Leaflet 1 and its host website, a dominant medical discourse was identified. The power/knowledge of this discourse could be traced to a medical philosophy that believed that pregnancy and birth are risk laden activities, that women’s bodies are likely to fail and therefore require medical input to manage. In this discourse women are discursively constructed as patients, which repeats and renews medical dominance. Leaflet 2 and the associated website demonstrated a midwifery discourse, which recognised pregnancy and birth as a social as well as a biological construct. In this discourse, the community midwife is discursively constructed as one who understands and supports physiologically normal pregnancy and birth and takes responsibility for recognising any departure from the norm and advising and referring on as required. Crucially in this discourse the woman’s autonomy is recognised and her choices, based on her perceptions of risk, respected. The discursive construction of the leaflet and website place the midwife in the community, not just the spaces of the home, but the wider geographical community. The interviews with the community midwives illustrated the challenges and barriers they encountered in provid…
author: Cameron, H
language: en
date published: 2020
date modified: 2026-07-24T04:26:17Z
provider: U. of Salford
publisher: Networked Digital Library of Theses and Dissertations
type: WebPage
source organization: U. of Salford