Medical and midwifery boundaries: patterns of formal and informal persistence and change

The professional boundaries between medical practitioners and midwives have traditionally been characterized as a gendered opposition between medical men and oppressed female midwives. Sociological analysis of the professional boundary suggests that there is increasing subtlety and change in this relationship. This paper, based on interviews with Australian midwives and doctors about their work and their views of each other, provides evidence of complexity in the operation of gender and professional power. Boundaries are managed on the basis of age, seniority, previous experience and philosophy as well as gender and profession. While medical specialists are described as holding traditional patriarchal views senior midwives increasingly demand their respect. Junior doctors and midwives have the potential to form more collegial relationships despite being ‘in competition’ for patients, but this varies with the philosophical stance of the individuals concerned. Registrars varied in their sympathy towards midwifery claims of autonomy and midwives themselves varied in the way they conceptualized their professional identity. Female medical practitioners are potentially more sympathetic but they are relatively few. The study demonstrates both positive and negative inter-professional interaction and shows that despite differences in power and gender, the possibility of future multidisciplinary cooperation is at least present.