The Tyranny of Time: Tensions between Relational and Clock Time in Community-Based Midwifery

Abstract

This paper focuses on eight National Health Service (NHS) community midwives' experience of linear time during the third phase of a 3-year action research study. Drawing on the words of the midwives, the paper seeks to compare and contrast the ways in which they experienced this temporal framework, individually and organizationally, in their clinical practice. Midwifery work was mostly described as being bound by a ‘technical administrative rationality’ that controlled the organization of paid employment, although this contradicted a cyclical, ‘nurturing rationality’ that was rooted in relational time. The midwives struggled with, and at times resisted, a more relational approach to working when the introduction of a supportive process called clinical supervision was introduced. This approach to working contested their existing temporal boundaries and imposed its own temporal framework. Despite all the midwives commenting on the importance of making time to meet as a group, clinical supervision was experienced as creating more work. There is, therefore, justification for acknowledging that in times of turbulent change and acute staffing crises, NHS community midwives preferred to prioritize work through assembly line production rather than investing time in nurturing, supportive client and colleague relationships.