I totally committed to having a trusting and respectful relationship with a woman that is underpinned by self-autonomy and informed choice. I also agree that partnership is a concept that midwifery should be based on at a professional and organisational level. In reality I don't know if partnership can be truly achieved because of inequities of power on both the part of the midwife and the woman, and other external factors impacting on health care practice. I also think that more research is needed to look at what women want from their midwives - do women want to be partners with midwives or are they looking for a respectful, professional relationship? And are we as midwives setting ourselves to fail if we are wanting to achieve partnership with every woman we work with?

On a personal level, I am thinking about how I can work with women as a locum midwife. The challenges for me are to develop a relationship and rapport in a very brief time, and building what the LMC has started. One of the things I have been conscious about is that I do not contradict the LMC or give conflicting advice and information. On the whole this has not been an issue, however, if it did eventuate I would present my opinion and explain why, but counsel the women to check back with her LMC. I also make sure I carefully feedback to the LMC what I have done and why.

Turanga kaupapa
The whanau is a vital part of the woman's context and I always acknowledge that. At the same time, it is important to acknowledge that not every woman wants her whole whanau involved - individual personalised care is vital at all times with all ethnicities.

Do I really know what's best for pregnant women?

I am a firm believer in the concept of partnership and continuity of carer. I did have a small glitch with one woman because I dithered about whether to renew my APC and organised for another midwife to carry out her post natal care because I went on 3 weeks holiday. This year I have made up my mind in advance and have organised the renewal of the APC.


I am a firm believer in the concept of partnership and continuity of carer. This was challenged to a degree by the woman who came from out of town to birth, with me as her LMC for birth only. She was determined that she was going to be induced and have an epidural, and that is contrary to my own philosophy of doing things. However, we met in the middle as far as decision marking was concerned, and were both happy in the end, which is what partnership is all about.
What I am interested in exploring further is the concept of choice for women – how much is woman’s choice and how much is standard midwifery practice? Do women get too much choice? Do we use women’s choice as a cop out for making midwifery decisions?

My philosophy of practice