Midwives' decision making about transfers for 'slow' labour in rural New Zealand

Patterson, J; Skinner, J; Foureur, M

Midwives' decision making about transfers for 'slow' labour in rural New Zealand

Patterson, J Skinner, J Foureur, M

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Publication Type:: Journal Article
Citation:: Midwifery, 2015, 31 (6), pp. 606 - 612
Issue Date:: 2015-01-01

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Field	Value	Language
dc.contributor.author	Patterson, J	en_US
dc.contributor.author	Skinner, J	en_US
dc.contributor.author	Foureur, M https://orcid.org/0000-0002-0454-0165	en_US
dc.date.available	2020-05-25T19:09:09Z
dc.date.issued	2015-01-01	en_US
dc.identifier.citation	Midwifery, 2015, 31 (6), pp. 606 - 612	en_US
dc.identifier.issn	0266-6138	en_US
dc.identifier.uri	http://hdl.handle.net/10453/34256
dc.description.abstract	© 2015 Elsevier Ltd. Midwives who provided Lead Maternity Care (LMC) to women in rural areas were invited to share their experiences of decision making around transfer in labour.Ethics approval was obtained from the NZ National Ethics Committee. Objective: to explore midwives' decision making processes when making transfer decisions for slow labour progress from rural areas to specialist care. Design: individual and group interviews were conducted with a purposive sample of rural midwives. The recalled decision processes of the midwives were subjected to a content and thematic analysis to expose experiences in common and to highlight aspects of probabilistic (normative), heuristic (behavioural), and group decision making theory within the rural context. Setting: New Zealand. Participants: 15 midwives who provided LMC services to women in their rural areas. Findings: 'making the mind shift', 'sitting on the boundary', 'timing the transfer' and 'the community interest' emerged as key themes. The decision processes were also influenced by the woman[U+05F3]s preferences and the distance and time involved in the transfer. Key conclusions and implications for practice: the findings contribute insights into the challenge of making transfer decisions in rural units; particularly for otherwise well women who were experiencing slow labour progress. Knowledge of the fallibility of our heuristic decision making strategies may encourage the practitioner to step back and take a more deliberative, probabilistic view of the situation. In addition to the clinical picture, this process should include the relational and aspirational aspects for the woman, and any logistical challenges of the particular rural context.	en_US
dc.relation.ispartof	Midwifery	en_US
dc.relation.isbasedon	10.1016/j.midw.2015.02.005	en_US
dc.subject.classification	Nursing	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Patient Transfer	en_US
dc.subject.mesh	Nurse-Patient Relations	en_US
dc.subject.mesh	Decision Making	en_US
dc.subject.mesh	Midwifery	en_US
dc.subject.mesh	Pregnancy	en_US
dc.subject.mesh	Labor Presentation	en_US
dc.subject.mesh	Qualitative Research	en_US
dc.subject.mesh	Rural Population	en_US
dc.subject.mesh	Rural Health Services	en_US
dc.subject.mesh	New Zealand	en_US
dc.subject.mesh	Female	en_US
dc.title	Midwives' decision making about transfers for 'slow' labour in rural New Zealand	en_US
dc.type	Journal Article
utslib.citation.volume	6	en_US
utslib.citation.volume	31	en_US
utslib.for	1110 Nursing	en_US
utslib.for	1114 Paediatrics and Reproductive Medicine	en_US
utslib.for	1117 Public Health and Health Services	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/Midwifery
pubs.organisational-group	/University of Technology Sydney/Strength - CHSP - Health Services and Practice
utslib.copyright.status	open_access
pubs.issue	6	en_US
pubs.publication-status	Published	en_US
pubs.volume	31	en_US

Abstract:

© 2015 Elsevier Ltd. Midwives who provided Lead Maternity Care (LMC) to women in rural areas were invited to share their experiences of decision making around transfer in labour.Ethics approval was obtained from the NZ National Ethics Committee. Objective: to explore midwives' decision making processes when making transfer decisions for slow labour progress from rural areas to specialist care. Design: individual and group interviews were conducted with a purposive sample of rural midwives. The recalled decision processes of the midwives were subjected to a content and thematic analysis to expose experiences in common and to highlight aspects of probabilistic (normative), heuristic (behavioural), and group decision making theory within the rural context. Setting: New Zealand. Participants: 15 midwives who provided LMC services to women in their rural areas. Findings: 'making the mind shift', 'sitting on the boundary', 'timing the transfer' and 'the community interest' emerged as key themes. The decision processes were also influenced by the woman[U+05F3]s preferences and the distance and time involved in the transfer. Key conclusions and implications for practice: the findings contribute insights into the challenge of making transfer decisions in rural units; particularly for otherwise well women who were experiencing slow labour progress. Knowledge of the fallibility of our heuristic decision making strategies may encourage the practitioner to step back and take a more deliberative, probabilistic view of the situation. In addition to the clinical picture, this process should include the relational and aspirational aspects for the woman, and any logistical challenges of the particular rural context.

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http://hdl.handle.net/10453/34256