Midwives and midwifery : the need for courage to reclaim vocation for respectful care

In maternal healthcare, structural patriarchy provides only a partial explanation for the violence that women are increasingly expressing, revealed in data showing that women are more likely to express abuse from female rather than male healthcare deliverers. To a large degree, the enforcement of standardised care has contributed to an increased disengagement between those delivering healthcare services and their clients. Personal relationships between midwives and the women they care for are strained, as the threat of litigation along with the intensification and acceptance of medicalised, standardised care focusing on risk has created an atmosphere of mistrust. Technological surveillance also further detaches midwives from their vocational roots, as their skills in supporting physiological pregnancy and birth diminish in favour of what is considered their professional duty: the monitoring of women. To reduce obstetric abuse, vocational practice that resists the 'othering' of childbearing women is needed to answer to the individual needs of women, improve outcomes, and create the circumstances at birth for women to have positive, safe, and profound experiences.