Evidence-Based Paradigms and Contemporary Midwifery
Midwifery and maternity care are fields of community health where the use of evidence is, at best, contested and at worst highly divisive. The process of childbearing elicits strong opinions and views within Australian communities and in popular culture and there is often little evidence per se underpinning such debates. As a profession, midwifery is traditionally dominated by women and has strong links with feminist thought and community activism. At various points in time midwifery has had an antagonistic relationship with medicine, a profession historically dominated by men. This has resulted in a long period of inter-professional negotiation and conflict, although in more recent times there has been some convergence. Despite the increasing prominence and legitimacy of midwifery in maternity care, questions around what is safe, and who should provide care in the context of birthing, remains contentious. The evidence-based paradigm is influential in delineating what is safe and risky in the context of maternity care and thus shapes the relationship between midwifery and medicine.