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International Journal of Nursing Studies 44 (2007) 855–856

Commentary

Nursing and midwifery: Re-evaluating the relationship

Joan Camerona,�, Julie Taylorb

aUniversity of Dundee, School of Nursing and Midwifery, Ninewells, Dundee DD1 9SY, UKbUniversity of Dundee, School of Nursing and Midwifery, 11 Airlie Place, Dundee DD1 4HJ, UK

Received 7 February 2007; received in revised form 22 February 2007; accepted 22 February 2007

www.elsevier.com/locate/ijnurstu

Keywords: Midwifery; Nursing; Equality and diversity

The relationship between nursing and midwifery has

always been difficult. Thompson et al. (2007) used the

metaphor of marriage to describe the potential split

between nursing and midwifery. Marriage is usually

considered to be a partnership that is willingly

contracted by both partners, within a respectful relation-

ship. It is clear, that within the UK and North America

at least, the marriage between nursing and midwifery

was forced by prevailing social and political conditions

(Williams, 1997; DeVries and Barroso, 1997; Sandall

et al., 2001). Thompson et al. (2007) stated that

midwifery ‘routinely identifies with nursing to develop

career pathways, to exploit research and development

opportunities’. However, this statement fails to recog-

nise the lack of any alternatives as social, political and

economic structures are designed to consider the two as

inseparable.

Thompson (2007) argues that nursing and midwifery

should be considered together and cites the fact that

50% of the world’s midwives are also nurses. This fails

to reflect the tensions in countries where midwifery is

subsumed into a nursing culture (DeVries and Barroso,

1997). It is prevalent not only in anglo centric countries

but worldwide, where governments fail to invest in

midwifery—often to the detriment of the health of the

woman and her family (World Health Organization,

International Confederation of Midwives, and Interna-

e front matter r 2007 Elsevier Ltd. All rights reserve

urstu.2007.02.009

ing author. Tel.: +441382 632304;

42738.

esses: j.cameron@dundee.ac.uk (J. Cameron),

ee.ac.uk (J. Taylor).

tional Confederation of Obstetricians and Gynaecolo-

gists, 2004).

The argument that midwifery is now mature enough to

be able to exist independent of nursing is not new. In 1993,

Castledine suggested that midwives were now deemed to

be sufficiently mature to have a journal of their own

(Castledine, 1993). However, the argument that midwifery

lacks the maturity of nursing does not stand up to

scrutiny. As Thompson (2007) points out, midwifery has

enjoyed a separate existence from nursing in the past and

this is still the case in countries like the Netherlands.

The most problematical element of the argument put

forward by Thompson et al. is not the concept of a

divorce but the terms in which the need for separation is

couched. The minority position of midwifery within

nursing-dominated cultures can be compared to the

position of minority groups within a wider society.

Minority groups are criticised for failing to ‘fit in’ to the

dominant society; they are portrayed as being ‘difficult’

for refusing to adopt the mores of the dominant group;

and are depicted as taking more from the collective pot

than they contribute. This is language used by Thomp-

son et al. (2007). In a world that apparently endorses

equality and diversity, the lack of tolerance of ‘differ-

ence’ between the two professions is worrying.

Midwifery will almost certainly contract alliances—

with nursing, doctors and other health professionals—in

the future. These alliances will be equal partnerships

with respect and tolerance at their heart. What is more

concerning for the professions is the provocative stance

taken by Thompson et al. (2007). If nursing is to be so

dismissive of midwifery, than its ability to work co-

d.

ARTICLE IN PRESSJ. Cameron, J. Taylor / International Journal of Nursing Studies 44 (2007) 855–856856

operatively with any other group must also be ques-

tioned. In particular, the apparent lack of regard for

minority interests is not a positional statement nursing

should endorse.

References

Castledine, G., 1993. Maturity and interdependence. British

Journal of Midwifery 1 (1), 4.

DeVries, R.G., Barroso, R., 1997. Midwives among the

Machines. In: Marland, H., Rafferty, A.M. (Eds.), Mid-

wives, Society and Childbirth: Debates and Controversies in

the Modern Period. Routledge, London.

Sandall, J., Boureault, I.L., Meijer, W.J., Schuecking, B.E.,

2001. Deciding who cares: winners and losers in the late

twentieth century. In: DeVries, R., Benoit, C., Teijlingen,

E., Werde, S. (Eds.), Birth by Design: Pregnancy, Maternity

Care and Midwifery in North America and Europe.

Routledge, New York.

Thompson, DR., Watson, R., Stewart, S., 2007. Nursing and

midwifery: time for an amicable divorce?. International

Journal of Nursing Studies 44 (4).

Thompson, J.E., 2007. Commentary: ‘Nursing and midwifery:

time for an amicable divorce? Response to Thompson,

Watson and Stewart (2007). International Journal of

Nursing Studies 44 (4).

Williams, J., 1997. The controlling power of childbirth in

Britain. In: Marland, H., Rafferty, A.M. (Eds.), Midwives,

Society and Childbirth: Debates and Controversies in the

Modern Period. Routledge, London.

World Health Organization, International Confederation of

Midwives and International Federation of Obstetricians and

Gynaecologists, 2004. Making Pregnancy Safer: The Cri-

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