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

Meyer, Y, Frank, F, Muntwyler, FS, Fleming, V and Pehlke-Milde, J (2017) Decision-making in Swiss home-like childbirth: A grounded theory study. Women and Birth, 30 (6). pp. 272-280. ISSN 1871-5192

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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.

Item Type: Article
Uncontrolled Keywords: 11 Medical and Health Sciences
Subjects: R Medicine > RA Public aspects of medicine
R Medicine > RG Gynecology and obstetrics
R Medicine > RJ Pediatrics
Divisions: Public Health Institute
Publisher: Elsevier
Related URLs:
Date Deposited: 02 Oct 2020 12:41
Last Modified: 02 Oct 2020 12:45
DOI or Identification number: 10.1016/j.wombi.2017.05.004
URI: https://researchonline.ljmu.ac.uk/id/eprint/13785

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