The struggle for contested boundaries in the move to collaborative care teams in Australian maternity care

Meredith McIntyre, Karen Louise Francis, Ysanne Chapman

Research output: Contribution to journalArticleResearchpeer-review

17 Citations (Scopus)

Abstract

Background: the maternityservicesreformsannouncedbytheAustraliangovernmentheraldaprocess of majorchange.Theprimarymaternitycarereformsrequiresmaternitycareprofessionalstowork collaborativelyasequalsincontrasttothecurrentsystemwhichischaracterisedbyunequal relationships. Aim: criticaldiscourseanalysis(CDA)usingneoliberalismasaninterpretivelenswasemployedto determinethepositionsoftherespectivematernitycareprofessionalsontheproposedreformand what purposewasservedbytheirrepresentationstothenationalreviewofmaternityservices. Method: a CDAframeworkinformedbyFairclough,linkingtextualandsociologicalanalysisinaway that foregroundsissuesofpowerandresistance,wasundertaken.Datawerecollectedfromselected writtensubmissionstothe2008nationalreviewofmaternityservicesrepresentingthepositionof midwifery,obstetrics,generalpractitionersincludingruraldoctorsandmaternityservicemanagers. Findings: maternitycareprofessionalsyieldedseveraldiscoursesthatwerespecifictothediscipline with anumberthatweresharedacrossdisciplines.Theriseinconsumerismhaschangedhistorical positionsofinfluenceinmaternityservicespolicy.Theoncepowerfulobstetricpositionindetermining the directionofpolicyhascomeundersiege,isolatedinthepresenceofapowerfulallianceinvolving consumers,midwives,sympatheticmaternityservicemanagersandsomemedicalprofessions.The midwiferyvoicehasbeenheard,ahistoricalfirst,supportedbyitspresenceasamemberofthealliance. Conclusion: the struggleforcontestedboundariesisenteringanewphaseasmaternitycareprofes- sionals strugglewithdifferentperceptionsofwhatmultidisciplinarycollaborationmeansinthe deliveryofprimarymaternitycare.
Original languageEnglish
Pages (from-to)298 - 305
Number of pages8
JournalMidwifery
Volume28
Issue number3
DOIs
Publication statusPublished - 2012

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