Perceptions of the Midwife’s Role: A Technoscience Perspective.

Abstract

Different patterns of care and a range of lead professionals have influenced care provision in relation to childbirth. The role of a midwife has been influenced by historical factors, research and service changes within the National Health Service. Little is known about how the role of the midwife is perceived. This study explored the views of women and midwives relating to the role of the midwife.

Mixed methods of data collection were utilised. In the first phase of the study 4 focus groups (a total of 9 women) were performed. In the second phase of the study longitudinal interviews were conducted. A total of 10 women participated in this phase. The interviews were performed at 4 different time points of their childbearing experience. A total of 40 interviews were conducted. Additionally diaries from the 10 women were completed, to capture information between the interview time points. Following the initial exploratory phase , a postmodern feminist technoscience theoretical stance underpins the second phase of this study; in particular it draws on the work of Donna Haraway. Haraway’s notion of ‘situated knowledges’ provides the opportunity to locate the views of women and midwives. This provided the opportunity to utilise her notions of ‘modest witness’, ‘cyborg’, ‘goddess’, ‘material-semiotic’ and connect to their perceptions.
One facet of the study’s originality lies in matching the women’s and midwives’ ‘situated knowledges’, by interviewing the 10 midwives who were present at each of the 10 women’s birth experiences. Analysis using thematic networks was used to construct basic, organising and global themes.
The findings indicate that the use of technology has a powerful influence on women’s perceptions in relation to the role of the midwife. Women and midwives connected with technology through material-semiotic connections, which has led to cyborgification within a consultant led model of care and birth environment. Women overwhelmingly perceived that birth was safer in hospital, due to the presence of technology and doctors; doctors were perceived as the decision maker and the midwife as a ‘handmaiden’.
‘Being’ and ‘doing’ midwives were recognised. The midwives were all situated in a different place within these categories, depending on their values and experiences. Generally the ‘doing’ midwives were free to ‘do’, as they supported the biomedical culture of the environment they were working in. ‘Being’ midwives supported the natural elements of the birth process, they adapted to the role of a ‘hybrid’ midwife within a consultant led environment, interchanging their technological skills for normality skills when they were secluded from interferences of the medicalised culture.
This study provides evidence to inform practice developments within midwifery and makes a contribution to feminist theorising. It asserts that the culture of childbirth in contemporary society is technological, medically led and the normal birth process is not valued. This has contributed to cyborgification of women and midwives within a consultant led setting. An advancement of Haraway’s theory has been made from the emergence of the way in which the ‘being’ midwife morphs into a ‘doing’ midwife when she feels that she has to conform to the medicalised culture of the environment or from women’s expectations of their birth experience.