Spoilt for choice: consuming maternity care

Medical care throughout the 19th and 20th centuries was characterized by a paternalistic approach to care. From the mid-20th century we began to see a shift in the way health was conceptualized and approached. Individuals demanded more control over their experiences, encouraging individual choice and responsibility. The emergence of the discourses of individual choice and responsibility has had a significant impact on midwifery practice. This article focuses on some of the consequences of these discourses, suggesting that it has submerged some other important professional imperatives such as promoting normal birth. It is suggested that midwives will need to take a more active approach. This article explores this issue within the context of midwifery practice in New Zealand. While some points of history and details of the maternity system or practice may be specific to New Zealand, the discourses explored and implications for practice are relevant to many other Western countries and their midwives.