Professional autonomy for midwives in the contemporary UK maternity system: part 2
In this article, professionalisation, the midwifery profession and professional autonomy are explored from a sociological perspective to answer whether it is possible for a midwife to achieve professional autonomy within the contemporary UK system. Within part 1, obstetric influences and frictions, government policy and guidelines, risk, litigation and increasing managerialisation were considered, highlighting the complexities of professional midwifery and the challenges it faces. In part 2, choice, service pressures, evidence-based care, consumerism, leadership and reflexive practice are considered in the context of professional autonomy and the intention of retaining women's choice as the core belief of the profession. A conceptual framework has been devised to enable this, utilising the concept ‘New Professional Midwifery’.
There is a national ambition to provide women with the power and autonomy of choice; however, the development of the concept of New Professional Management is problematic for this ideal. Understanding how a midwife's professional status contributes to women's care is important for high-quality care provision. Considering contemporary practice and reviewing midwifery professional history sufficiently enough to ask ‘why have patterns persisted?’ enables understanding of wider professional structures and reduces the focus on individual milieu (Wright Mills, 2000). Sociological imagination and knowing oneself in the context of history and politics enables the individual to recognise what is happening and to contribute to society (Wright Mills, 2000). Through exploration of the organisational, national, and professional factors that affect midwifery, in addition to what women and their family's needs are, the question ‘can a midwife achieve professional autonomy in the contemporary UK maternity system?’ is answered. This attempts to prepare midwives for future practice with a conceptual framework to support new professional midwifery and professional imagination (Wright Mills, 2000; Power, 2008).
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