Midwifery directions: The Australian maternity services review

Australian midwifery is at a crossroads, and the 2009 Maternity Services Review and subsequent Report by the Australian federal government have revealed significant issues that were previously obscured. This article outlines the current position of Australian midwifery by examining the recently published Commonwealth Report of the Maternity Services Review, as well as looking at some South Australian Department of Health birth-related policies. The Report recommends important and positive changes for midwifery, but with caveats that may lead to greater restrictions on midwifery practice. The policies, while endorsing possible alternatives for women, also illustrate how birth options are 'problematised'. Relationships between government, medicine and midwifery are explored throughout the article, illuminating the tension for midwives between aligning with professional and scientific discourses, and those that are woman-centred. Free-standing birth-centres are presented as a possible way forward in order to ease the present dichotomy between 'scientific' and 'experiential' birthing care.