« BackMidwifery
Article in Press

Risk, theory, social and medical models: A critical analysis of the concept of risk in maternity care

  • Helen MacKenzie Bryers, RN, RM, BA, MM, PhD (Head of Midwifery, Honorary Research Fellow)


    • NHS Highland, Assynt House, Beechwood Park, Inverness IV2 3BW, UK
    • Centre for Rural Health, University of Aberdeen, Centre for Health Science, Inverness, UK
    • Corresponding Author InformationCorresponding author at: NHS Highland, Assynt House, Beechwood Park, Inverness IV2 3BW, UK.
  • ,
  • Edwin van Teijlingen, MA, MEd, PhD (Professor of Maternity and Perinatal Health)


    • Centre for Midwifery, Maternal & Perinatal Health, School of Health & Social Care, Royal London House, Christchurch Road, Bournemouth University, Bournemouth BU1 3LT, UK

Received 1 February 2010; received in revised form 18 June 2010; accepted 6 July 2010. published online 19 August 2010.
Corrected Proof



there is an on-going debate about perceptions of risk and risk management in maternity care.


to provide a critical analysis of the risk concept, its development in modern society in general and UK maternity services in particular. Through the associated theory, we explore the origins of the current preoccupation with risk Using Pickstone's historical phases of modern health care, the paper explores the way maternity services changed from a social to a medical model over the twentieth century and suggests that the risk agenda was part of this process.

Key conclusions

current UK maternity services policy which promotes normality contends that effective risk management screens women suitable for birth in community maternity units (CMUs) or home birth: however, although current policy advocates a return to this more social model, policy implementation is slow in practice.

Implications for practice

the slow implementation of current maternity policy in is linked to perceptions of risk. We content that intellectual and social capital remains within the medical model.

Keywords: Pickstone’s model of healthcare development, Clinical governance, Normality, Midwife-led care


PII: S0266-6138(10)00117-8


« BackMidwifery