Power and political power positions in maternity care

Abstract

Power is not a new concept in relation to maternity care. However, discussion regarding the use and misuse of power is becoming high profile. Throughout history it is possible to trace the development of certain ‘power positions’ for obstetricians, midwives and women. This article discusses how socio-political developments and may have shaped the above ‘power positions’. The issue of obstetric and midwifery power reflects a historical power struggle for both ‘expert’ and ‘positional’ power status. The power position of women is more complex and this article highlights that a covert ‘third dimension of power’ may have been involved in shaping women's perception of their own needs. The implementation of Changing Childbirth (Department of Health, 1993) is challenging established positions and this explores how obstetricians, midwives and women are responding. Attitudes are changing and the ideology of women's empowerment is becoming accepted and valued. The challenge is now for women, midwives and obstetricians to re-examine power positions, abandon the power struggle and to work together in creating a positive climate for change.