title: 'How can we go on caring when nobody here cares about us?' Australian public maternity units as contested care sites.
abstract: BACKGROUND
  Provision of personalised, continuous care focused on 'well women' is now central to midwifery identity and work ideals, but it remains difficult in hospital contexts shaped by increased demand and by neoliberal policies. Previous accounts of occupational and work-family conflicts in midwifery and nursing have pointed to the 'moral distress' associated with managing conflicting expectations in health workplaces.
  
  
  OBJECTIVE
  This paper examines these issues in the Australian context and considers further the ethical implications of midwives not feeling 'cared for' themselves in health care organisations.
  
  
  METHODS
  Qualitative research in several Victorian maternity units included use of interviews and observational methods to explore staff experiences of organisational and professional change. Data were coded and analysed using NVivo.
  
  
  RESULTS
  Midwives reported frequent contestation as they sought to practice their ideal of themselves as caregivers in what they reported as often 'uncaring' workplaces. To interpret this data, we argue for seeing midwifery caring as embodied social practice taking place within 'organisation carescapes'.
  
  
  CONCLUSIONS
  Theoretical analysis of the moral and ethical dimensions of the contemporary organisational structure of maternity care suggests that a practice-based and dialogical ethic should form the core principle of care both for women in childbirth and for their carers.
authors.affiliation: School of Social Sciences, La Trobe University, 3086, Australia. k.reiger@latrobe.edu.au
authors.forename: Kerreen
authors.initials: K
authors.lastname: Reiger
authors.forename: Karen
authors.initials: K
authors.lastname: Lane
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D001315:Australia; D017028:Caregivers / Q000523:psychology*; D005260:Female; D006771:Hospitals, Maternity; D006801:Humans; D007407:Interviews as Topic; D009721:Nurse Midwives / Q000523:psychology*; D016272:Occupational Health; D011247:Pregnancy; D036301:Qualitative Research; D013315:Stress, Psychological; D011795:Surveys and Questionnaires; D016526:Workload; D017132:Workplace