What features of the maternity unit promote obedient behaviour from midwives?

The aim of this paper was to present a comprehensive picture of characteristics within a maternity hospital which promote obedient behaviour from midwives. The overall objective was to assess midwives' views about their own acquiescent behaviour. A sensitive qualitative analysis appraised midwives' views gained from semi-structured interviews conducted within the seven maternity units of North Yorkshire in the UK. Participants included a stratified sample of 20 (7E, 7F, 6G grade) practicing midwives aged between 21-60 years. Taking a post-positivist approach, inductive thematic analysis was used to interpret the data. Two themes of "situational factors that promote obedient behaviour" were derived; "an obligation to follow hospital policies" and "fear of consequences from challenging senior staff". The key conclusion is that midwives are frequently placed in unenviable positions of relative powerlessness. It was clear that some actions and strategies that midwives use serve to reinforce the fundamental power structures and "status quo". Quite clearly, midwives are sometimes presented with conflict between a drive to agree with authority and supporting the safe, evidence-based choices of childbearing women in their care. Raising awareness of the processes involved in obedient behaviour and exercising sharing of power may be helpful to midwives in asserting not only their own professional capacity to influence, but also the autonomy of the women they seek to empower. © 2006 Elsevier Ltd. All rights reserved.