Great expectations: Legitimacy and emotions among out of hospital midwives

In this article we examine the process by which a group of marginal health-care professionals portray the legitimacy of their skills and services to potential clients. While extensive attention has been devoted to this construal of legitimacy through such affinitive alignments, much less attention has been given to elucidating the factors shaping how marginal social groups construct alternative professional legitimacy frameworks with which to contest dominant competitors. Drawing on qualitative content analysis of direct entry midwives’ (DEMs) online descriptions of their practices and in-depth interviews, we explain how DEMs construe professional legitimacy through alternative cultural understandings of maternity care and experience. Our study highlights three key components of DEMs’ professional legitimation: midwives’ alignment with professional associations and scientific research, the creation of new understandings of care relationships and space, and the role of emotions in defining the optimal birth experience. We argue that the positive emotions associated with direct entry midwifery care become critical mechanisms for redefining both professionalism and the experience of birth within the boundaries of alternative practice.