Respectful witness : a midwife adopts an anthropological view on her practice

Abstract

This thesis explores midwifery in the United Kingdom (UK) from my perspective both as a midwife and a member of the Association of Radical Midwives (ARM). The rhetoric of contemporary midwifery and the ARM speaks to a relational and social model of care which focusses on the pregnant woman, her baby, and her family. However, childbirth in the UK is increasingly complex and there are tensions between the provision of care in a medically dominated health care system and the ability of midwives to work as advocates for women. Central to this tension is the self-perception of midwives as a professional group, and their position in a care hierarchy. The majority of midwifery care in the UK is provided through the NHS, although a minority of midwives work outside but alongside the NHS maternity care system. The ARM was founded in the late 1970s in the UK as a support group for midwives who were concerned about the erosion of their professional role and identity. It remains active and has evolved into a grassroots midwifery organisation which has been influential on the development of UK midwifery over the last forty years. Focussing on the ARM provided me with the lens to examine the challenges that have shaped midwifery and therefore influenced my own practice experiences. To achieve this, I have taken a historical perspective, critically reflecting back on my own practice, the writings of the ARM and a range of ethnographic observations and interviews with midwives who were members of the ARM.