Evidence based leaflets in maternity care

doi:10.1136/bmj.325.7354.43

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Compliance, coercion, and power have huge effect in maternity services

Barbara Vernon, national president (vernon@webone.com.au),
Sally Tracy, research midwife,
Tracy Reibel, administrator

Maternity Coalition, PO Box 269, Lyneham ACT 2602, Australia
Centre for Family Health and Midwifery, University of Technology Sydney, PO Box 123 Broadway, Sydney NSW 2007, Australia
Community Midwifery Program, East Fremantle WA 6158, Australia
Department of General Practice, University of Birmingham, Birmingham B17 0SN
James.Robins@irh.scot.nhs.uk

EDITOR—The midwives from Sheffield show the insight that a qualitative study can provide when coupled with a more controlled empirical investigation. 1 2 Both the studies and the accompanying editor's choice suggest that inequalities in power and status in the maternity services have a greater influence on what happens to women giving birth than either their hopes and dreams or the choices they feel informed to make.3

These studies are a powerful reminder that the physiological birth process without some degree of technological interference and tampering is rare. Midwives are portrayed in this hierarchical system as having little effect on the outcome of care. The authors suggest that when women can form a trusting relationship with a midwife they are more likely to ask questions and feel that they can make choices about their care, rather than simply being compliant.

As members of a national consumer movement in Australia, we consider it to be a violation of human rights for women …