Midwifery and decision-making theories

Abstract

This chapter presents decision-making theories/models and frameworks/tools: medical clinical reasoning, a non-midwifery specific shared decision-making model, a midwifery-specific decision-making model, decision-making tool, decision-making flowchart and Page's several steps of evidence-based midwifery. Medical clinical reasoning derives from the analytical or rational approach to decision-making – hypothetico-deductive theory. The three-talk model for shared decision-making has three key steps embedded within an active listening and deliberation ethos: Team Talk, Option Talk and Decision Talk. Enhancing Decision-making and Assessment in Midwifery has two domains: Clinical Reasoning and Midwifery Practice. The rationale is that in order to provide evidence-informed care, a midwife must enter into a relationship whereby a sharing of information occurs, thus enabling the woman to be the decision-maker about her care. Decision-making is complex, multi-dimensional and influenced by multiple factors. The evidence from research area, within the Ménage model, relies upon midwives having the capability to seek and critically analyse both quantitative and qualitative research.