Birth and the ‘reflexive consumer’: trust, risk and medical dominance in obstetric encounters

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Abstract
The doctor–patient relationship has come under considerable scrutiny in recent research as a ‘site’ for the analysis of consumerism in medical encounters. The research reported in this article examines consumerism in obstetric encounters through an analysis of the birthing narratives of 50 women. The analyses reveal that there are clear, socially patterned variations in the character of the relationships between birthing women and their doctors. There is considerable evidence to support the notion of childbearing women as both consumers and as ‘patients’ in a medicalized encounter. There is also strong evidence that women’s use of maternity services is highly reflexive, and characterized by conscious ‘risk assessment’. These findings have important implications for the analysis of trust, risk and medical dominance in obstetric encounters.