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

Midwifery. 2010 Oct;26(5):488-96. doi: 10.1016/j.midw.2010.07.003. Epub 2010 Aug 17.


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

Objectives: 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.

Publication types

  • Review

MeSH terms

  • Female
  • Humans
  • Maternal Health Services / organization & administration*
  • Midwifery / organization & administration*
  • Models, Nursing*
  • Models, Organizational
  • Nurse's Role*
  • Nurse-Patient Relations
  • Outcome Assessment, Health Care
  • Pregnancy
  • Pregnancy Complications / prevention & control*
  • Quality Indicators, Health Care
  • Risk Management / organization & administration*
  • State Medicine
  • United Kingdom
  • United States