Emotional labour in midwifery care: Balancing between woman’s autonomy and clinical control during childbirth through watchful attendance

Abstract

This article explores midwives' engagement with emotional labour. Drawing on theorisation first proposed by Arlie Hochschild, we investigate how midwives display emotions to induce certain emotional states in the birthing woman and, while doing so, simultaneously regulate their own emotions. Inspired by recent work from within the field of midwifery science on ‘watchful attendance’, we understand midwivery care as uniquely combining both clinical expertise and woman-centred support, particularly during childbirth. This perspective moves away from prevailing dichotomous views in the literature that tend to frame midwifery and technocratic models as oppositional, the former inspired by a natural and the latter by a pathological approach to birth. Ethnographic research we conducted in the Netherlands —including observations during childbirth and in-depth interviews with midwives and birthing women— confirms that midwives' work simultaneously responds to different care logics and that they deal with an inherent tension between promoting natural birth while ensuring clinical safety. We identify this tension as a key source of midwives' emotional labour, as they experience having to balance between the prioritization of women's autonomy, essential for natural birth, with the exercise of clinical control to monitor for and respond to potential risks. Our research highlights the emotional demands placed on midwives and calls for greater recognition of the emotional dimensions of their work.