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Decision-making in Swiss home-like childbirth: A grounded theory study. | LitMetric

AI Article Synopsis

  • Decision-making in midwifery is crucial for the health of mothers and babies, yet midwives often lack guidance on how to involve women in decision-making, particularly during complicated births.
  • The study aims to better understand decision-making in home-like birth settings by examining the perspectives of both midwives and women, ultimately creating a model for shared decision-making.
  • Findings showed that decision-making is viewed as a joint commitment, with both midwives and women applying different strategies to navigate choices, highlighting the need for midwives to enhance their shared decision-making skills for better care outcomes.*

Article Abstract

Background: Decision-making in midwifery, including a claim for shared decision-making between midwives and women, is of major significance for the health of mother and child. Midwives have little information about how to share decision-making responsibilities with women, especially when complications arise during birth.

Aim: To increase understanding of decision-making in complex home-like birth settings by exploring midwives' and women's perspectives and to develop a dynamic model integrating participatory processes for making shared decisions.

Methods: The study, based on grounded theory methodology, analysed 20 interviews of midwives and 20 women who had experienced complications in home-like births.

Findings: The central phenomenon that arose from the data was "defining/redefining decision as a joint commitment to healthy childbirth". The sub-indicators that make up this phenomenon were safety, responsibility, mutual and personal commitments. These sub-indicators were also identified to influence temporal conditions of decision-making and to apply different strategies for shared decision-making. Women adopted strategies such as delegating a decision, making the midwife's decision her own, challenging a decision or taking a decision driven by the dynamics of childbirth. Midwives employed strategies such as remaining indecisive, approving a woman's decision, making an informed decision or taking the necessary decision.

Discussion And Conclusion: To respond to recommendations for shared responsibility for care, midwives need to strengthen their shared decision-making skills. The visual model of decision-making in childbirth derived from the data provides a framework for transferring clinical reasoning into practice.

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Source
http://dx.doi.org/10.1016/j.wombi.2017.05.004DOI Listing

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