Review for The Practising Midwife on Promoting Equality by Neil Thompson

The basic premise of this book is that "contemporary western societies are characterised by inequality". The book is aimed at "people workers" including social workers, health workers and managers; the author intends to give such workers a theoretical and practical basis for countering inequality.

It is a basic text insofar as fundamental theoretical and political assumptions are very clearly outlined. It is written mainly with reference to sociological theory and Sartrean existentialism. I was surprised by this choice of philosophical orientation, which is not one much expressed in Britain. However, I think it does offer some useful tools, including the idea of dialectical reason which prevents theoretical concepts from solidifying into dogma. He also describes an approach which differentiates the personal, the cultural and the structural (PCS analysis) which is useful as an antidote to victim blaming. These basic theoretical assumptions are very clearly explained. His aim is political: to reduce inequality and power imbalances in the helping professions and he argues that such a reduction would be of benefit to both practitioners and clients.

The book includes three chapters which I think could be particularly relevant to midwives: one on power; another on health, which provides a critique of medicalisation; and a later chapter on the structure and nature of organisations. The relevance to midwives, especially those working in the NHS, lies in demystifying those circumstances in which midwives practise which are to the detriment of both midwives and clients. There is also a useful deconstruction of clichéd buzzwords such as "empowerment".

It is a very earnestly written book and I am impressed by its comprehensiveness. I would not wish to burden student midwives with it, but I think that midwife educationalists could find it very useful in informing their teaching on communication and cultural diversity.