Maternity care and the perception of risk: the impact on midwifery's professional boundaries

Although maternal and infant mortality rates are reassuringly low in high-income countries, there is a growing perception that childbirth is inherently risky. Women are surrounded by an amplified risk discourse from healthcare professionals, sensationalist media reporting and societal views. This hyper-focus on risk places many obstacles between women and physiological birth, with over-medicalisation initiating unnecessary interventions. Women find themselves in a system where risk management takes precedence over holistic, individualised care. While policy and governance focus on minimising risk, it remains unclear whether this benefits the woman or the organisation. As a result of the hegemonistic medical model of care, midwifery itself faces the threat of deprofessionalisation through the erosion of skills and knowledge. Midwives must assert their expertise of physiological birth and reclaim their role as guardians of physiology while working within evidence-based guidelines to provide safe, effective and woman-centred care.