What is usual? Normality in maternity care

Abstract

Midwives have always been seen as the ‘guardians of normality’ (Rosser and Anderson, 1998) yet increasingly the limits for normality are changing. This paper explores the concepts of ‘normality’ and ‘usualness’ in the context of the midwifery role. The issues surrounding normality have been well researched yet their application to what is ‘usual’ in practice is harder to define. The skills and knowledge demanded by our consumers and colleagues have demonstrated the ability to adapt and be flexible across a variety of traditional definitions. There are many midwives pioneering ‘normal but not the usual’ within specific practice issues. What is ‘normal and usual’ for midwifery conduct is unclear and this article lists matters that demonstrate these in terms of the service provided. These areas of care are often ‘normal but not the usual’ yet they are the essence of what is termed midwifery care.