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Midwifery abdication – is it acknowledged or discussed
within the midwifery literature: An integrative review

Jefford, Elaine; Jomeen, Julie; Wallin, Margie


Elaine Jefford

Julie Jomeen

Margie Wallin


Aim: To explore the concept of ‘Midwifery Abdication’ and whether it is acknowledged or discussed within the midwifery literature.
Method:A modified Whittemore and Knafl (2005) integrative review framework enabled consideration of quantitative and qualitative literature. A total of 1508 papers were located. Duplicate records were removed, leaving 1197 records. All titles, abstracts, or case facts were reviewed using a framework derived from the definition of ‘Midwifery Abdication’. Three qualitative studies were selected for analysis; the NICE Quality Appraisal Checklist was used to determine study quality.
Key findings:Midwifery Abdication’ occurs within the wider midwifery literature as indicated in the three studies from different countries. However, the original constructs need to be widened to include: ‘external perceptions of midwifery practice’ and ‘how can reflection facilitate change?’ The extent of philosophy in these environments, lead to adoption of a midwifery philosophy failure. Such an environment impacts on a midwife’s ability to fully exercise their autonomy, and to advocate for normality and women. This renders ‘Midwifery Abdication’ almost inevitable or at least very difficult to stop. A midwife’s own midwifery identity, the environmental hierarchy and associated culture of social obedience, where acceptance and finding one’s place acted as an influential factor.
Midwifery education needs to ensure midwives are prepared and able to embrace their professional status as autonomous practitioners. Promotion of reflexive practice to facilitate personal and professional change is warranted. Practice policies that are not supportive of a midwife’s professional autonomy and scope of practice reinforce a technocratic work environment.


within the midwifery literature: An integrative review. European Journal of Midwifery, 2(June), Article 6.

Journal Article Type Article
Acceptance Date Jun 22, 2018
Online Publication Date Jun 27, 2018
Publication Date Jun 27, 2018
Deposit Date Aug 5, 2018
Publicly Available Date Aug 6, 2018
Publisher European Publishing
Peer Reviewed Peer Reviewed
Volume 2
Issue June
Article Number 6
Keywords Decision-making; Professionalism; Accountability; Midwifery practice; Midwifery; Abdication; Women-centred
Public URL
Publisher URL,92529,0,2.html


Article (182 Kb)

Copyright Statement
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

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