title: Gatekeeping access to the midwifery unit: Managing complaints by bending the rules.
abstract: While poor communication between service users and front-line staff causes many service user complaints in the British National Health Service, staff rarely reflect on the causes of these complaints. We discuss findings from an action research project with midwives which suggest that the midwives struggled to fully understand complaints from women, their partners and families particularly about restricted visiting and the locked door to the midwifery unit. They responded to individual requests to visit out of hours while maintaining the general policy of restricted visiting. In this way, the door was a gatekeeping device which allowed access to the unit within certain rules. The locked door remained a barrier to women and their families and as a result was a common source of informal complaints. We argue that the locked door and restricted visiting to the midwifery unit were forms of gatekeeping and boundary making by midwives which reveals a tension between their espoused woman-centred care and contemporary midwifery practice which is increasingly constrained by institutional values.
authors: Middlesex University, UK H.allan@mdx.ac.uk.
authors: Helen T
authors: HT
authors: Allan
authors: University of Surrey, UK.
authors: Anki
authors: A
authors: Odelius
authors: Cardiff University, UK.
authors: Billie J
authors: BJ
authors: Hunter
authors: Sheffield Hallam University, UK.
authors: Karen
authors: K
authors: Bryan
authors: University of Surrey, UK.
authors: Wendy
authors: W
authors: Knibb
authors: University of Surrey, UK.
authors: Jill
authors: J
authors: Shawe
mesh_terms: D005190:Family / Q000523:psychology; D005260:Female; D006302:Health Services Research; D006771:Hospitals, Maternity / Q000458:organization & administration*; D006801:Humans; D008297:Male; D008880:Midwifery; D011247:Pregnancy; D011340:Problem Solving; D013222:State Medicine; D006113:United Kingdom; D014789:Visitors to Patients
keywords: action research; maternity care; organisation of health services