Risk and impulsivity factors influencing decision making during childbirth

Aim: Various factors have the potential to influence the decisions of health professionals during childbirth. Personality characteristics, level of education, experience, and training in childbirth delivery may influence the perception of clinical judgement and decision making in different childbirth scenarios. Method: Midwives responding to an email distributed by the Australian College of Midwives were surveyed. The survey was designed to assess risk sensitivity (probability discounting), impulsivity (delay discounting), sensitivity to reward (the Behavioural Activation System: BAS), sensitivity to punishment (the Behavioural Inhibition System: BIS) and decision making. Three birthing scenarios were presented to participants which differed in the quality of clinical decision making and good midwifery practice exhibited. Midwives decision making was assessed through participants’ responses on good clinical judgment and good midwifery practice scale for each of the scenarios. Results: Individual inconsistencies in identifying good clinical judgment and good midwifery practice through the scenarios were found, demonstrating differences in risk perception, risk sensitivity and decision making. Decision making in midwives correlated with factors influenced by the BIS and BAS. Risk sensitivity and impulsivity did not influence clinical judgement. Years of experience in midwifery practice influenced judgment on midwifery practice made in one birthing scenario. Conclusion: The importance of determining what factors influence decision making processes benefits the future of childbirth deliveries by enhancing the variables that best support the safest birthing plan for the pregnant woman and her child. Future research may expand by further assessing factors influencing decision making in different health professionals.