Professional autonomy for midwives in the contemporary UK maternity system: part 1

02 December 2020
12 min read
Volume 28 · Issue 12


The history and professionalisation of midwifery has travelled through turbulent times to arrive at an opportunity for transformation in the contemporary UK maternity system. This professionalisation, the midwifery profession and professional autonomy are explored in this article from a sociological perspective, to answer the question of whether a midwife can achieve professional autonomy within the UK system. This is a two-part article. Part one has a strong focus on the historical context of midwifery, government policy and guidelines, risk, litigation and increasing managerialisation to frame the discussion in part two. The second part provides a discussion of autonomy, choice, managerialisation and reflexive practice, to create a conceptual framework utilising the concept New Professional Midwifery. This is to centralise a core belief in midwifery autonomy and women's choice facilitation. This paper is part one of two.

Midwifery in the UK is underpinned by the Nursing and Midwifery Council's (NMC, 2018) ‘The code: professional standards of practice and behaviour for nurses, midwives and nursing associates’. ‘The code’ presents the standards and behaviours expected of midwifery professionals (NMC, 2018). Autonomy and the ability to act on one's professional judgement are integral to midwifery education and professional practice (NMC, 2018; 2019). As educated, competent professionals, midwives are known to reduce global maternal and neonatal mortality, and improve quality of care (Renfrew et al, 2014); thus, demonstrating the value of the profession to society.

The professionalisation of midwifery has followed a complex, turbulent course of development, which forms the sociological basis for contemporary care in pregnancy and childbirth. An exploration of the historical context of midwifery, government policy, risk, managerialisation, litigation and social media help provide a fundamental basis for sociological imagination.

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