Thesis
Optimal midwifery decision-making during 2nd stage labour: The integration of clinical reasoning into midwifery practice
Southern Cross University, School of Nursing and Midwifery
Doctor of Philosophy (PhD), Southern Cross University
2012
Metrics
244 File views/ downloads
515 Record Views
Abstract
Research Question:
What are the necessary and sufficient conditions for optimal midwifery decision-making during 2nd stage labour?
Thesis:
Good clinical reasoning and good midwifery practice are the necessary and sufficient conditions for optimal midwifery decision-making during 2nd stage labour.
Background Literature:
Previous research in decision-making primarily focussed on antenatal period. Literature on 2nd stage labour including the factors perceived to influence the midwife was extremely limited. No research has addressed the research question for this study.
Methodology:
Post-Structural Feminism provided the methodological foundations for this study. A modification of Denzin‟s Interpretative Interactionism was used as research design. Twenty-six midwives were interviewed and invited to give both a negative and a positive decision-making story.
Key Findings:
Collectively, good clinical reasoning and good midwifery practice produce optional midwifery decision-making during 2nd stage labour. Out of a total of 16 stories there were only five cases of optimal midwifery decision-making during 2nd stage labour. Second stage labour is a unique and rapidly changing situation and this research found that the woman being the final decision-maker was not essential to optimal decision-making during this time. Further, some midwives abdicated responsibility for decision-making to the women and/or their support people.
Conclusion:
Midwifery education and practice should be designed to build clinical reasoning skills to a high level of proficiency. Midwifery, as a woman-centred discipline, however, needs more than cognitive clinical reasoning to reach optimal decisions. Midwives take a woman-centred approach to care and need to be able to make an independent decision if and when the woman is unable to participate fully in decision-making.
Details
- Title
- Optimal midwifery decision-making during 2nd stage labour: The integration of clinical reasoning into midwifery practice
- Creators
- Elaine Jefford
- Contributors
- Kathleen M Fahy (Supervisor) - Southern Cross UniversityDeborah Sundin (Supervisor) - Southern Cross UniversityRobert Paul Weatherby (Supervisor) - Southern Cross University
- Awarding Institution
- Southern Cross University; Doctor of Philosophy (PhD)
- Theses
- Doctor of Philosophy (PhD), Southern Cross University
- Publisher
- Southern Cross University, School of Nursing and Midwifery
- Number of pages
- 278 pages
- Identifiers
- SCU1263; 991012821111602368
- Copyright
- © Elaine Jeffery 2012
- Academic Unit
- Allied Health and Midwifery; Faculty of Health
- Resource Type
- Thesis