Text box 3.

Vignette: Examples of tensions between different models of care.

A midwife and a physician had a discussion in the office concerning which method to use for inducing a woman’s labour. The midwife suggested a method having the drug already prepared in her hand. The physician instead pondered on different suggestions from colleague physicians. The discussion ended with the physician saying: “I will examine the patient and discuss the case with my colleague, and then I let you know what to do”. Despite the determined tone, the physician seemed unsure about the midwife’s suggestion and wanted to consult with a colleague, excluding the midwife from this talk. The midwives in turn tended to exclude physicians because they preferred to consult with each other before consulting the physicians. They felt that the morning rounds with physicians focused on the medical and organizational aspects of childbirth to the exclusion of midwives’ views on the normality of childbirth and caring issues. The midwives therefore discussed the need for a midwife-round before the ordinary round with the physicians where they could consider more midwifery caring issues and not just the medical and institutional aspects of childbirth as they usually did during the morning rounds.