title: Perspectives on midwifery power: an exploration of the findings of the inquiry into peripartum hysterectomy at Our Lady of Lourdes Hospital, Drogheda, Ireland.
abstract: The Lourdes Hospital Inquiry: An inquiry into peripartum hysterectomy at Our Lady of Lourdes Hospital, Drogheda, Ireland, of 2006 recounts in detail the circumstances within which 188 peripartum hysterectomies were carried out at the hospital between 1974 and 1998. The findings of the inquiry have serious ramifications for Irish healthcare delivery and have implications for many professional groups, including midwives. The findings prompt clear questions about the relative position or power of midwives within maternity care. These questions are examined in this article, through the analysis and application of various theoretical perspectives on power. Critical views of power focus on the socio-political nature of oppressive structures within society and seek mechanisms to address these. Stemming from structure versus agency debates, Giddens's structuration theory examines the agency-structure interaction and stresses the centrality of agents' roles in the social reproduction of structures. Postmodernism, particularly drawing on the work of Michel Foucault, focuses on a fluid conception of power while also describing the nature of disciplinary power. It offers midwives a way of viewing power as productive and dispersed. Drawing on different aspects of these perspectives on power, helps us to understand midwives' relative positions and power relations and how to enhance these to prevent future tragic outcomes such as those reported in the inquiry report.
authors.affiliation: School of Nursing, Dublin City University, Dublin, Ireland. anne.matthews@dcu.ie
authors.forename: Anne
authors.initials: A
authors.lastname: Matthews
authors.forename: P Anne
authors.initials: PA
authors.lastname: Scott
mesh_terms: D001242:Assertiveness; D001291:Attitude of Health Personnel; D001318:Authoritarianism; D002410:Catholicism; D016519:Hospitals, Religious; D006801:Humans; D007044:Hysterectomy / Q000451:nursing / Q000706:statistics & numerical data; D007494:Ireland; D008318:Malpractice; D009721:Nurse Midwives / Q000458:organization & administration / Q000523:psychology*; D024802:Nurse's Role / Q000523:psychology*; D015404:Nursing Methodology Research; D009742:Nursing Theory; D009774:Obstetrics; D015279:Organizational Culture; D010344:Patient Advocacy; D010558:Personnel Loyalty; D010687:Philosophy, Nursing; D019555:Physician-Nurse Relations; D033302:Postmodernism; D011209:Power, Psychological; D017009:Professional Autonomy; D020377:Self Efficacy