Creating ambiguity, creating social change

Current government policy in Victoria, as elsewhere, is seeking to change the provision of maternity care from an obstetric-led system to a flatter, more collaborative system that brings midwives to the front line as primary carers, at least in the public sector.<br /><br />However, dominant medical discourses continue to exert a sedimentary effect on contesting claims from midwives that deny the high-risk nature of the majority of births and which valorise the competence of the female body. Although there have been modifications in maternity arrangements (and the incumbent government is currently considering more), medical discourses continue to legitimate obstetric power via legal and professional structures, fortify the obstetric ‘habitus’, infect mainstream popular consciousness and undermine autonomous midwifery practice. Drawing from research material gleaned from in-depth interviews with nine obstetricians and thirty midwives conducted in 2004 and 2005, I argue that alternative discourses may strategically undermine obstetric dominance. Specifically, reversing stereotypes; inverting the binary opposition and privileging the subordinate term (or substituting the negative for positive); and defamiliarizing what is perceived to be fixed and given, all play on the ambiguities of representation and present social activists (midwives, childbirth educators and women) with valuable opportunities to challenge fundamentalist medical orthodoxies.<br />