'Two's company-Three's a crowd':the collection of umbilical cord blood for commercial stem cell banks in England and the midwifery profession

Machin, Laura L. and Brown, Nik and McLeod, Danae (2012) 'Two's company-Three's a crowd':the collection of umbilical cord blood for commercial stem cell banks in England and the midwifery profession. Midwifery, 28 (3). pp. 358-365. ISSN 1532-3099

Abstract

OBJECTIVE: to explore how lay and professional stakeholders within umbilical cord blood banking discussed midwives' and privately employed phlebotomists' roles in light of commercial UCB collection, and what insights this offers of midwifery authority and power. DESIGN: qualitative study using face-to-face, semi-structured interviews that were digitally recorded, transcribed and coded according to themes relating to the research aims. SETTING: across England. PARTICIPANTS: 61 interviews were conducted between April 2009 and August 2010 with lay and professional stakeholders within umbilical cord blood banking. FINDINGS: the space and access requirements for privately employed phlebotomists to conduct their work were discussed and highlighted the discursive and spatial boundary-work conducted by, or on behalf of, midwives to retain their authority over the umbilical cord blood and labour rooms. KEY CONCLUSIONS: midwives were portrayed as accommodating privately employed phlebotomists to some extent. It was implied that midwives did so because phlebotomists conformed to implicit boundaries, which required respecting midwives' authority over the labour ward, room and the umbilical cord blood. In turn, midwives' power was protected. IMPLICATIONS FOR PRACTICE: the findings highlight the important role of spatial boundaries and the significance of the organisation of spaces when implementing Objective to explore how lay and professional stakeholders within umbilical cord blood banking discussed midwives’ and privately employed phlebotomists’ roles in light of commercial UCB collection, and what insights this offers of midwifery authority and power. Design qualitative study using face-to-face, semi-structured interviews that were digitally recorded, transcribed and coded according to themes relating to the research aims. Setting across England. Participants 61 interviews were conducted between April 2009 and August 2010 with lay and professional stakeholders within umbilical cord blood banking. Findings the space and access requirements for privately employed phlebotomists to conduct their work were discussed and highlighted the discursive and spatial boundary-work conducted by, or on behalf of, midwives to retain their authority over the umbilical cord blood and labour rooms. Key conclusions midwives were portrayed as accommodating privately employed phlebotomists to some extent. It was implied that midwives did so because phlebotomists conformed to implicit boundaries, which required respecting midwives’ authority over the labour ward, room and the umbilical cord blood. In turn, midwives’ power was protected. Implications for practice the findings highlight the important role of spatial boundaries and the significance of the organisation of spaces when implementing new services within health care.new services within health care.