Professional Care in Maternity Hospitals: Benefits and Challenges

Abstract

In sociological literature, midwifery is usually described as a ‘caring’ profession. This phrase is used to describe a profession that is based less on proficiency in some sphere of abstract scientific knowledge, and far more on building competency in the field of emotionally involved care. This article considers the case of the Russian Center for Midwifery Care in order to investigate what professional care means in practice. We intend to contextualize professional care and to show how Russian midwives employ care in order to secure their market niche. Healthcare in Russia is characterized by a lack of institutional trust between medical professionals and their clients. In this context, care becomes a basis for building personalized trust between a midwife and an expectant mother. However, this model of professional care frequently results in certain disadvantages for individual midwives. The ‘extensive’ nature of personalized care, as well as its tendency to exceed contractual obligations, create uncertainty in the responsibilities and work schedule of midwives. When we combine this with the 24-hour working shifts common in many maternity hospitals, we find the labour of midwives is being seriously exploited. Midwives who are also mothers find themselves in a particularly insecure position. For these midwives, the classic work-life balance is transformed into a balance between two kinds of care – caring for family members and caring for customers. This leads either to ‘care drain’ from the private to the public realm, or to the mother’s resigning due to the centre’s demanding working conditions. This article is based on the results of a qualitative sociological research project. Midwifery care is studied through interviews with the personnel and clients of a St. Petersburg midwifery care center that functions in as a subdivision of state maternity hospital.