Independent midwifery practice : a critical social approach : a thesis presented in partial fulfilment of the requirements for the degree of Master of Philosophy in Nursing at Massey University
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Date
1995
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Massey University
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Abstract
This study commenced three years after the passing of the. Nurses Amendment Act
1990 which gave midwives legal authority to practise without medical supervision.
It explored the social and political contexts of the work-lives of four independent
midwives in New Zealand. A critical social approach was used to examine how
midwives manage and negotiate their practice in an environment in which a dominant
medical discourse prevail. In-depth individual case studies were used for data
collection and reporting.
The research process provided an opportunity for participants to examine their takenfor-
granted work environments and consider those personal actions and hegemonic
structures which exist to constrain their practice. The participants surfaced those
actions which could be described as counter-hegemonic and resistant to the dominant
medical discourse. The study also illuminated those cognitive and physical actions
which demonstrated compliance with medicalised childbirth and thus maintained the
status quo. Midwives in this study used strategies of responsible subversion, the
generation of midwifery language and the presentation of an alternative midwifery
model of childbirth to contest medicalised childbirth. Within a context of assumed
authority by doctors over the midwives the dominance of medical discourse prevailed.
The participants were aware of the vulnerability of midwifery knowledge when it was
made visible. It ran the risk of being dismissed as unscientific by medicine, or being
incorporated into the dominant medical discourse on a superficial level. Conversely,
midwifery knowledge that was not made visible was likely to remain marginalised and
unrecognised.
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Keywords
Midwifery, Midwives, New Zealand, Nurses Amendment Act 1990