'Everybody expects the perfect baby...and perfect labour...and so you have to protect yourself ': discourses of defence in midwifery practice in Aotearoa/New Zealand.
Increasing fears of litigation among those involved in childbirth impact differently on the 40 midwives I interviewed and observed in the field during the course of my doctoral research. 'Defensive practice' within a culture of 'risk' was a theme that emerged strongly from the interview transcript data from this study, the primary aim of which was to analyse the actions between women and midwives that constitute midwifery partnerships. The context for the analysis was a large ethnographic study undertaken with a variety of midwives working in a main city in Aotearoa/New Zealand in 2003. Complex and contesting forms of knowledge production were analysed drawing on insights from Foucauldian-influenced discourse analysis. My work highlights the ways in which the practices of contemporary midwives in Aotearoa/New Zealand are caught within the intersection of an array of competing discourses. In the data from my study, the midwives talked of their complex negotiations of time and space, and their abilities to balance elements of risk within realms of restraint and responsibility in partnership with women. For the midwives I interviewed, 'keeping ourselves safe' takes place in different locations. Risk is located by some midwives as within the birthing body, and by some, within the spaces of labour ward itself. Both labouring bodies in the midwifery partnership, however, that of the pregnant body of the woman, and that of the working body of the midwife, together occupy spaces of risk/safety where they are amenable to various, and increasingly subtle, forms of governance.
The Princess Margaret Hospital, Christchurch, New Zealand. ruth.surtees@cdhb.govt.nz
Ruth
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Surtees
D000223:Adaptation, Psychological; D000884:Anthropology, Cultural; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D003675:Defensive Medicine / Q000458:organization & administration*; D005239:Fear; D005260:Female; D018594:Human Body; D006801:Humans; D007743:Labor, Obstetric / Q000523:psychology; D016365:Liability, Legal; D009520:New Zealand; D009721:Nurse Midwives / Q000458:organization & administration / Q000523:psychology; D024802:Nurse's Role / Q000523:psychology*; D009723:Nurse-Patient Relations; D015404:Nursing Methodology Research; D036801:Parturition / Q000523:psychology*; D010687:Philosophy, Nursing; D011247:Pregnancy; D012308:Risk Management / Q000458:organization & administration*; D011795:Surveys and Questionnaires