Woman centred maternity care and professional positioning: A response to Dornan

Abstract

In his editorial on childbirth in the UK, Dornan (2008) expresses his opinions on the structure of the medical and midwifery professions and the organisation of childbirth in the UK. While I would not wish to deny him the right to express these opinions, I feel that it is essential that the factual inaccuracies and the assumptions based on these inaccuracies are challenged. There was no UK Midwives Act in 1902 as Dornan asserts (Dornan, 2008). The 1902 Act related only to midwifery practice in England and Wales. Midwifery legislation for Scotland followed in 1917 and in Ireland in 1918 (Donnison, 1988). The various Midwives Acts enacted throughout the UK almost certainly protected the role of the midwife and ensured that midwifery practice continued, unlike the situation in many parts of the world notably North America, where midwifery practice has almost disappeared. The Central Midwives Board did have members of the medical profession but it was not comprised solely of doctors as Dornan states. Dornan (2008) declares that Changing Childbirth reflected the policy of the UK Department of Health. This is incorrect. Although the National Health Service exists in each of the 4 countries in the UK, there is no UK wide National Health Service. Each country devises its own health policy. Thus ‘Changing Childbirth’ was a policy devised by the Department of Health (DoH) in England for the NHS in England (DoH, 1993). Wales, Scotland and Northern Ireland all had and still have their own maternity policy strategies and documents.