In recent years, an intense and highly polarized debate has developed around the control of pregnancy and childbirth. The choice has been presented in terms of two opposing forms of maternity care: the medical model and its apparent antithesis, "natural" childbirth. Whilst the medical model is characterized as the active technicological management of pregnancy and childbirth controlled by obstetricians, natural childbirth is represented as low intervention in a biologically determined process supported by midwifery care (Annandale and Clarke, 1996). The controversy over maternity care intensified in the early 1990s as it became apparent that any policy change would determine the future direction of both obstetrics and midwifery (Martin, 1987). This came with the publication of the Winterton Report in 1992, and the Department of Health's subsequent response, Changing Childbirth, published in 1993, which were intended to settle the debate around maternity care. Both were acclaimed by the midwifery profession, consumer pressure groups and social policy analysts as heralding a new dawn in women-centred maternity care (Jackson, 1996; Pascall, 1997).