Is she allowed?
Dr Clare Davison discusses why midwives and other healthcare professionals need to acknowledge and support women's autonomy in maternity care
All women deserve access to a safe birth. All women, however, also deserve a positive and empowering birth experience and to be autonomous in their decision making. With the move from the community to the hospital, most women in the western world now give birth in large maternity hospitals, which need to be run efficiently. For the maternity service to run efficiently, it is deemed that midwifery care must be standardised, and tasks must be preformed. Kirkham (2018) states that ‘standardisation requires care to be defined as a series of tasks to be monitored rather than a continuing supportive relationship’.
Providing midwifery care in this way leads to midwives losing their autonomy and flexibility which is essential to woman-centred care. Polices, procedures and guidelines instead of ‘guiding’ the midwife's practice become rules that must be adhered to. With this policy driven practice comes the fear of deviating from the rules and the pressure for midwives to conform to them increases (Kirkham, 2018; Feeley et al, 2020). Providing true woman-centred care and upholding women's autonomy can be extremely challenging within this fragmented system, and this is the challenge that many midwives face on a daily basis.
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