Clues to judgment made by expert midwives in assisting labor

Abstract

Objective
The objective of this study is to investigate the characteristics of judgments made by expert midwives when assisting labor by describing their clues to judgment.
Subjects and methods
This study is designed as a qualitative and descriptive study. The definition of "expert midwives" in this study refers to those who have more than 20 years of experience and who have assisted in more than 1,000 labor cases. The participants in this study were four midwives with between 27 to 53 years of experience, some of whom assisted in over 1,000 labor cases and others in over 3,000 cases. Explanations about the study protocol were provided to the midwives and pregnant women, and then their consent to participate was obtained. A total of nine cases of assisted labor were observed and described in field notes, from which midwifery care episodes were distilled. Then, semi-structured interviews focusing on the care episodes were conducted with the midwives, and analyzed qualitatively.
Results
Analysis led to 5 categories and 15 subcategories of expert midwives' judgment clues in assisting labor. The five categories were as follows: "palpation," "reading body language," "having insight into progress," "following natural flow," and "trusting the pregnant woman's strength." From these categories, two themes of characteristics of expert midwives' judgment clues emerged: "making good use of knowledge based on experience," and "having faith in themselves."
Conclusion
Expert midwives made their judgments by using knowledge obtained through physical experience, and based on their own faith in natural childbirth.