title: The struggle for contested boundaries in the move to collaborative care teams in Australian maternity care.
abstract: BACKGROUND
  the maternity services reforms announced by the Australian government herald a process of major change. The primary maternity care reforms requires maternity care professionals to work collaboratively as equals in contrast to the current system which is characterised by unequal relationships.
  
  
  OBJECTIVE
  critical discourse analysis (CDA) using neoliberalism as an interpretive lens was employed to determine the positions of the respective maternity care professionals on the proposed reform and what purpose was served by their representations to the national review of maternity services.
  
  
  METHODS
  a CDA framework informed by Fairclough, linking textual and sociological analysis in a way that foregrounds issues of power and resistance, was undertaken. Data were collected from selected written submissions to the 2008 national review of maternity services representing the position of midwifery, obstetrics, general practitioners including rural doctors and maternity service managers.
  
  
  RESULTS
  maternity care professionals yielded several discourses that were specific to the discipline with a number that were shared across disciplines. The rise in consumerism has changed historical positions of influence in maternity services policy. The once powerful obstetric position in determining the direction of policy has come under siege, isolated in the presence of a powerful alliance involving consumers, midwives, sympathetic maternity service managers and some medical professions. The midwifery voice has been heard, a historical first, supported by its presence as a member of the alliance.
  
  
  CONCLUSIONS
  the struggle for contested boundaries is entering a new phase as maternity care professionals struggle with different perceptions of what multidisciplinary collaboration means in the delivery of primary maternity care.
authors: School of Nursing & Midwifery, Monash University, Peninsula Campus, McMahons Road, Frankston, Victoria 3199, Australia. Meredith.McIntyre@monash.edu.au
authors: Meredith
authors: M
authors: McIntyre
authors: Karen
authors: K
authors: Francis
authors: Ysanne
authors: Y
authors: Chapman
mesh_terms: D001315:Australia; D003142:Communication; D003299:Cooperative Behavior; D005260:Female; D018166:Health Care Reform / Q000458:organization & administration*; D006801:Humans; D007400:Interprofessional Relations; D008427:Maternal Health Services / Q000458:organization & administration*; D008429:Maternal Welfare; D008880:Midwifery / Q000458:organization & administration*; D009313:National Health Programs / Q000458:organization & administration; D009775:Obstetrics and Gynecology Department, Hospital / Q000458:organization & administration; D057184:Practice Patterns, Nurses' / Q000458:organization & administration*; D011247:Pregnancy; D015397:Program Evaluation; D011785:Quality Assurance, Health Care