Are women really at the centre of care in the modern maternity system? Dr Clare Davison investigates
Historically, during childbirth, women were cared for by known midwives within their own community (Donnison, 1988; Davison, 2020). Today, however, continuity of midwifery care has become increasingly difficult to find.
Following the move from the home to the hospital, pregnancy and childbirth have evolved into procedures that needs to be managed to reduce the ‘risks’ to mother and baby (Donnison, 1988; Jackson et al, 2012; Davis-Floyd, 2018; Davison, 2021). In this technocratic and obstetric-led model, the overuse of medical interventions has become routine and normalised (McDougal et al, 2016).
The medicalisation of birth has led to maternity care being provided within a technocratic, biomedical model, with most midwives now working in a fragmented hospital system where relationship-based care is often overlooked (Davison et al, 2015; Reed et al, 2017; Bradfield et al, 2018; Davison, 2019). This is not woman-centred care and contradictory to the advice from the World Health Organization (2016), that recommends that every childbearing woman, in settings with well-functioning midwifery programmes, is supported by a known midwife within a continuity of care model.
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