Case-loading midwifery in New Zealand: bridging the normal/abnormal divide 'with woman'

Objectives: to explore the way that case-loading midwives in New Zealand construct midwifery (and in so doing, the concepts of woman and childbirth). This paper illuminates the fundamental features of this construction (continuity and woman-centred care) and discusses this with regard to the role of midwives vis-a-vis normal/abnormal birth. Design: semi-structured interviews and official publications constituted the 'text' which was analysed using a poststructural approach that was informed by theorists Foucault, Grosz and Braidotti. Participants and setting: 48 case-loading midwives practising throughout New Zealand participated in this study. These included facility-employed and self-employed midwives and those from rural and urban settings. Findings: many midwives follow women through their maternity experience providing continuity of care regardless of whether the experience is considered 'normal' or 'abnormal'. Key conclusions: continuity and woman-centred care are fundamental features of the construction of midwifery in New Zealand. Implications for practice: a focus on the midwifery concept of 'with woman' can bridge the divide between the polarising concepts 'normal' and 'abnormal' and enable a more fluid and dynamic reading of midwifery.