ArticleBMC pregnancy and childbirth2017
Factors influencing the clinical decision-making of midwives: a qualitative study.
Article in BMC pregnancy and childbirth, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 1 of them a synthesis that pooled it.
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Who cites it
31 citing papers in PubMed, 1 synthesis or guideline pooled it.
- A systematic review and meta-analysis of evidence-based practice and its associated factors among health professionals in Ethiopia.BMC health services research · 2024Pooled it
- From knowledge to action: understanding midwives' challenges in implementing delayed cord clamping in Northern Ghana.Maternal health, neonatology and perinatology · 2026Article
- Ready for change? The effect of profession and organization on patient safety culture and organizational readiness for change - a cross-sectional study.BMC health services research · 2026Article
- Factors Influencing Clinical Reasoning Among Clinical Nurses: An Integrative Review Using the Decision-Making Ecology Model.Journal of nursing management · 2026Review
- Article
- Patient and contextual factors influence clinicians' decision making regarding universal screening for gestational diabetes: results of a factorial survey set in rural and remote Western Australia.BMC pregnancy and childbirth · 2025Article
- The Cognitive Error Styles of Midwifery Students in Clinical Decision-Making: A Directed Qualitative Content Analysis Study.Journal of advances in medical education & professionalism · 2025Article
- Barriers to informed consent in obstetric care during childbirth from practitioner's perspective: a qualitative study.BMJ open · 2025Article
- Intersectional dynamics and care disparities in intrapartum electronic fetal monitoring: a socio-technical systems perspective.BMC pregnancy and childbirth · 2025Article
- Barriers and facilitators influencing midwives' implementation of South Africa's maternal care guidelines in postnatal health: a scoping review.Primary health care research & development · 2025Article
- Practice variation in induction of labour: women's role in the decision-making process.Research in health services & regions · 2025Article
- Moral judgment competence of midwifery students and its influencing factors: a cross-sectional study.Frontiers in public health · 2025Article
- Perspectives of midwives on respectful maternity care.BMC pregnancy and childbirth · 2024Article
- Association of personal and systemic factors on intrapartum risk perception and obstetric intervention rates: a cross-sectional study.BMC pregnancy and childbirth · 2024Article
- Digital Triage Tools for Sexually Transmitted Infection Testing Compared With General Practitioners' Advice: Vignette-Based Qualitative Study With Interviews Among General Practitioners.JMIR human factors · 2024Article
- Needs Assessment for the Development of a Leadership Course for Midwives: a Qualitative Study.Acta medica Philippina · 2024Article
- Evidence-based intrapartum care practice and associated factors among obstetrics workers in Ethiopia, systematic review and meta-analysis.SAGE open medicine · 2024Review
- Midwives' perceptions towards the ministry of health guidelines for the provision of immediate postpartum care in rural health facilities in Uganda.BMC pregnancy and childbirth · 2023Article
- Article
- A socioecological description of the influencing factors to midwives' management of preeclampsia in a Ghanaian tertiary hospital.PloS one · 2023Article
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAlthough midwives make clinical decisions that have an impact on the health and well-being of mothers and babies, little is known about how they make those decisions. Wide variation in intrapartum decisions to refer women to obstetrician-led care suggests that midwives' decisions are based on more than the evidence based medicine (EBM) model - i.e. clinical evidence, midwife's expertise, and woman's values - alone. With this study we aimed to explore the factors that influence clinical decision-making of midwives who work independently.
methodsWe used a qualitative approach, conducting in-depth interviews with a purposive sample of 11 Dutch primary care midwives. Data collection took place between May and September 2015. The interviews were semi-structured, using written vignettes to solicit midwives' clinical decision-making processes (Think Aloud method). We performed thematic analysis on the transcripts.
resultsWe identified five themes that influenced clinical decision-making: the pregnant woman as a whole person, sources of knowledge, the midwife as a whole person, the collaboration between maternity care professionals, and the organisation of care. Regarding the midwife, her decisions were shaped not only by her experience, intuition, and personal circumstances, but also by her attitudes about physiology, woman-centredness, shared decision-making, and collaboration with other professionals. The nature of the local collaboration between maternity care professionals and locally-developed protocols dominated midwives' clinical decision-making. When midwives and obstetricians had different philosophies of care and different practice styles, their collaborative efforts were challenged.
conclusionMidwives' clinical decision-making is a more varied and complex process than the EBM framework suggests. If midwives are to succeed in their role as promoters and protectors of physiological pregnancy and birth, they need to understand how clinical decisions in a multidisciplinary context are actually made.
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