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Regime change in Australian maternity hospitals

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Abstract

Contemporary attempts to ‘organise’ risk and manage uncertainty are remaking many ‘industrial-era’ institutions – including maternity hospitals. Health policies are encouraging a shift away from hierarchical, medically dominated structures towards new governance systems and ‘women-centred’ care, often led by midwives. To understand the resulting contestation, in this article we argue for a wider conceptual frame than a focus on neo-liberal state regulation of the professions. We utilise theories of the ‘second modernity’, in particular those concerning socio-cultural changes associated with shifts in risk regimes, to interpret findings from qualitative research studies undertaken in Australian maternity hospitals. Whereas analysis confined to macro or institutional levels emphasises stability and hegemony, we demonstrate that when cultural and interactional levels are examined, considerable fluidity and uncertainty in the identification and negotiation of risk is evident, resulting in new work practices with inevitable shifts in professional identities and allegiances.

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Acknowledgements

The research for this article was funded by Deakin University Arts Faculty and by collaborative grants between La Trobe University and the tertiary and rural hospitals. We have appreciated the support of our research assistants, notably Bonnie Simons, and feedback from colleagues at conferences and reviewers’ suggestions for refining the argument developed here.

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Authors and Affiliations

  1. School of Heritage, History and Society, Deakin University, Victoria, Australia

    Karen Lane

  2. School of Social Sciences, La Trobe University, 3086, Victoria, Australia

    Kerreen Reiger

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  1. Karen Lane
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Correspondence to Karen Lane.

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Lane, K., Reiger, K. Regime change in Australian maternity hospitals. Soc Theory Health 11, 407–427 (2013). https://doi.org/10.1057/sth.2013.7

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