| Summary: | The history of midwifery has been a long struggle between a male dominated priesthood, then later a system of organised medicine (also controlled by men) and a women's community apprentice-led network of helping and healing. The advent of the National Health Service (NHS) in 1946 and subsequent reforms of the NHS confirmed medical power and hospital births were advocated as the safe option (Donnison, 1988; Tew, 1990) In 1992, the consumers of the maternity services and the midwives providing the majority of the care formed an alliance and petitioned the government of the day for a review of the service. This led to the publication of the 'Changing Childbirth' report (DoH, 1993) where continuity, choice and control were the fundamental principles. This ethnographic study follows the setting up of pilot teams as a result of 'Changing Childbirth' that then became fully established into the local maternity service. The focus is on one of the teams; their search for identity and the establishment of a Midwifery Group Practice. It explores the midwives struggles to develop as a team and the changing relationships with each other, their colleagues and management. This study also highlights the changing dynamics of the woman-midwife relationship for these midwives, their own personal development and the impact the new way of working had on family life. Using policy ethnography, this study sets out to observe how a national policy (DoH, 1993) was implemented by the midwives providing the local service. It documents the transformational journey undertaken as they moved from practising within the confines of the hospital to a community-based service underpinned by the trusting relationship with the women in their care.
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