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This chapter draws on empirical research exploring whether certain personality characteristics moderate the quality of clinical decision-making made by midwives and if that influences their midwifery practice. It suggests that irrespective of where in the world a midwife is located or in which model of care she works, further examination of the role played by temperamental characteristics of midwives may help them to identify and reflect on the factors influencing their decisions and practice. In terms of midwifery, this offers a way of understanding the role played by delay discounting in a midwife’s decision-making processes and how she enacts/reacts to an individual woman. Although the exact mechanism by which sensitivity to punishment is having an effect in the Henri scenario is unknown, the presence of this effect encourages the view that ‘personality’ factors have a role to play in the clinical decision-making process.

This chapter presents the theoretical constructs and influencing variables identified within midwifery abdication. It provides evidence of how midwifery abdication was enacted when a practising midwife was caring for a woman. The international validation of this influencing variable identified midwives feeling ‘powerless’ and ‘intimidated’ as a result of the medicalisation of childbirth, often characterised by frequent interventions. Externalised perceptions contribute to or influence internalised perceptions. One antecedent of externalised perceptions may be the environment within which a midwife undertook her midwifery education. Globally, many midwives and the women they work with experience a fragmented model of care, sometimes meeting each other for the first time during the birth. Midwives, in addition, need to be given the support and time to reflect safely and meaningfully and to develop skills which allow them to feel empowered to challenge appropriately and lead practice and culture changes.

This chapter explores the aim of facilitating the midwife to provide information when engaging in a shared decision-making approach with women. Stress urinary incontinence (SUI) is defined as the involuntary loss of urine on effort or physical exertion, or on sneezing or coughing. For women around the world, SUI is more common than urgency incontinence. Approximately 80% of pregnant women, primigravidae and multigravidae, experience increased micturition frequency at some time during pregnancy. In general, incontinence in women is typically related to dysfunction of the bladder or pelvic floor muscles. Such dysfunction often arises during pregnancy or childbirth, or during menopause. A model of decision-making that might help facilitate this is the Three-Talk Model for Shared Decision-Making. Women need to be the final decision-makers in their care, and to enable these midwives need to engage in shared decision-making and provide evidence-informed information so an informed choice can be made.

Decision-making pervades all aspects of midwifery practice across the world. Midwifery is informed by a number of decision-making theories, but it is sometimes difficult to marry these theories with practice. This book provides a comprehensive exploration of decision-making for midwives irrespective of where in the world they practice or in which model of care. The first part critically reviews decision-making theories, including the Enhancing Decision-making Assessment in Midwifery (EDAM) tool, and their relevance to midwifery. It explores the links between midwifery governance, including professional regulation and the law, risk and safety and decision-making as well as how critical thinking and reflection are essential elements of decision-making. It then goes on to present a number of diverse case studies, demonstrating how they interrelate to and impact upon optimal midwifery decision-making. Each chapter presents examples that show how the theory translates into practice and includes activities to reinforce learning points. Bringing together a diverse range of contributors, this volume will be essential reading for midwifery students, practising midwives and midwifery academics.

Objective and background: The 10-item Birth Satisfaction Scale-Revised (BSS-R) has recently been endorsed by international expert consensus for global use as the birth satisfaction outcome measure of choice. English-language versions of the tool include validated UK and US versions, however the instrument has not to date, been contextualised and validated in an Australian English-language version. The current investigation sought to develop and validate an English-language version of the tool for use within the Australian context. Methods: A two-stage study. Following review and modification by expert panel, the Australian BSS-R (A-BSS-R) was (Stage 1.) evaluated for factor structure, internal consistency, known-groups discriminant validity and divergent validity. Stage 2. directly compared the A-BSS-R dataset with the original UK dataset to determine the invariance characteristics of the new instrument. Participants were a purposive sample of Australian postnatal women (n=198). Results: The A-BSS-R offered a good fit to data consistent with the BSS-R tri-dimensional measurement model and was found to be conceptually and measurement equivalent to the UK version. The A-BSS-R demonstrated excellent known-groups discriminant validity, generally good divergent validity and overall good internal consistency. Conclusion: The A-BSS-R represents a robust and valid measure of the birth satisfaction concept suitable for use within Australia and appropriate for application to International comparative studies.