ABSTRACT
Beck’s (1992) concept of the Risk Society encapsulates a tectonic shift from a focus on class consciousness of the ‘first modernity’ to risk consciousness and individualisation of ‘the second modernity’. Specifically, the goal to eliminate scarcity under class society is substituted for the eradication of fear and risk caused by technological change under the risk society (Scott 2002). Within the health arena, medicalisation (a focus on illness and disease) is supplanted by biomedicalisation (a focus on health and risk). Health becomes an individual life project or achievement rather than a static physical state where the role of health professionals is to assist individuals to avoid and control potential risks, typically through technological surveillance (Clark et al. 2003). Within maternity care, for example, obstetricians and midwives base their professionalism on the successful anticipation of risk before it occurs. The contentious point is that these professions employ different models of birth and the body in their understanding of the sites of risk and its avoidance. The techno-rational/scientific (biomedical) model has assumed that the body itself is inherently risky. The role of the obstetrician, therefore, is to anticipate risk before it occurs typically intervening to avoid an adverse outcome. In reverse order, holistic midwifery regards medical interventions as the major source of risk to women and babies (Lane 1995) because for midwives, birth is a normal physiological and social event (Skinner 2006: 62); midwives avoid risk by avoiding medical intervention – that is, in facilitating a normal birth through ‘woman-centred’ care. Consumerism has thus traditionally formed the corner-stone of midwifery practice and professionalisation. However, while cognisant of the relationship between risk assessment and woman-centred care and the wider project of midwifery professionalisation, this chapter focuses primarily upon a critical examination of the rise of consumerism and risk cultures and how they relate to the growing support for complementary and alternative medicine (CAM) within midwifery.
