Book Reviews

AIMS Journal, 2004, Vol 16 No 2

Redefining Motherhood: Changing Identities and Patterns edited by Sharon Abbey and Andrea O'Reilly

Second Story Press, 1998

reviewed by Nadine Edwards

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This book comprises three sections, each with several chapters by various authors. Many chapters deal with academic research, but a few are based on personal journeys, for example, the loss of a mother and what that means for a daughter.

This book explores how motherhood positions women "in a space between self and family", the tensions between "nurturing others and fulfilling the self", the tendency for motherhood to be equated with nurturing others and negating the self, and patriarchal assumptions surrounding motherhood.

The chapter on mothers' experiences of children in the educational system raises remarkably similar issues to those in maternity services: the realisation that power and knowledge are vested in professions and institutions, thus disempowering the individual.

Work on gender suggests that, while women tend to live in networks of relationships, "in a society that is phobic about intimacy and extols the virtues of independence, we mistakenly regard connection and closeness as dependency, fusion and merging". This is the kind of thinking that makes it difficult to challenge the facelessness in current maternity services based on continuity of care rather than carers.

Addressing gender equality, it's pointed out that the rhetoric of equality masks the reality of girls struggling to make personal gains within structures that systematically undermine their efforts, blaming the individual for failure. This echoes the rhetoric of choice and control in maternity services where responsibility is foisted upon women, but without the accompanying autonomy, to determine their own lives.

This isn't a quick read, though some chapters are more accessible than others, and it doesn't need to be read from cover to cover. It takes on board feminist contentions of diversity and looks at women's experiences of being mothers and daughters. One of the final paragraphs sums this up:

"There is no single meaning or given experience of motherhood. The very term 'motherhood' connotes a falsely static state of being rather than a socially and historically variable relationship. The experience of motherhood is highly complex and full of contradictions. It is not simply a biological phenomenon or the expression of nurturance and care. Motherhood is often a socially constructed identity. Ultimately, however, what being a mother means will depend upon a number of factors: socialisation; the conditions under which women become pregnant and give birth to children; the social and cultural context of child rearing; the beliefs and expectations that women hold about motherhood; the intersection of race, socioeconomic status, age, sexual orientation and culture on those beliefs and expectations. Motherhood shapes women's relationships with other people, their opportunities for paid employment, their leisure, their self-perceptions and their individual entities."

My concern about definitions of motherhood is that, in rightly criticising essentialist and traditionalist views of motherhood, we are in danger of creating equally oppressive definitions that are informed by patriarchal views of achievement, individualism and personhood, where motherhood is predicated onto and subjugated by other existing identities. The real needs of women and children often remain unaddressed as women, children and men suffer the punishing demands, costs and consequences of a mechanistic, capitalist view of the world.

To borrow Jeanette Winterston's wonderful phrase, "Let's tell more of the stories trapped inside our mouths about how it is to be mothers in a society that undermines motherhood."

Mothers and Midwives: The Ethical Journey, by Faye E. Thompson

Books for Midwives, 2004

reviewed by Nadine Edwards

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In the earlier chapters, the author explains the shortcomings of Western ethics based on Cartesian ideology, looking at their functionalist, disembodied, dispassionate, objectifying, abstract, impersonal, imperialist, utilitarian, disengaged and normative components. Thompson examines the birth ideology and discusses how current biomedical and other models of ethics have arisen, and why they are unhelpful to relationships between women and midwives, and unable to respond appropriately to women's needs and differences.

In the later chapters, the narratives of eight women and eight midwives in Australia open up issues of power and control, and the coercion of medical/institutional norms, and identify the broader ethical concerns of women and midwives. What is described here are real interactions between people with personalities, skills, knowledge, biases, histories and qualities. The rhetoric of facelessness, the pretence of equality and the adherence to rules and codes at best pose obstacles to the kind of relationships needed during the childbearing period; at worst, they cause untold harm.

Women and midwives describe ethical ways of relating that highlight the need for ethics based on feminist ideals and its principles of relationship, trust, knowledge sharing and empowerment: an ethical approach that protects women's vulnerabilities and fosters their autonomy.

In Australia, women giving birth and midwives attending them do so in constrained circumstances. Thompson identifies the same problems as in Britain-the dominance of obstetric ideology, limiting the possibilities for women and midwives to work together, and develop the knowledge and skills they need to strengthen the social/midwifery models of birth that provide such excellent outcomes.

These interviews confirm a growing body of literature (see the review of Mavis Kirkham's book on birth centres, AIMS Journal vol 15 no 4) showing that women and midwives are more able to be autonomous and knowledgeable in standalone birth centres and by independent practice at home compared with midwifery units and hospital practice.

The main message is that ethical decision-making occurs within relationships based on a broad congruence of values, trust, respect and honesty. In the words of Barbara Rothman: "Birth is not only about making babies. Birth is also about making mothers-strong, competent, capable mothers who trust themselves and know their inner strength." Current models of ethics appropriate the woman's right to be selfdetermining and to do what she believes is right for her baby, while preventing midwives from engaging with women to provide the positive support they need to do this.

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