The rhetoric of informed choice: perspectives from midwives on intrapartum fetal heart rate monitoring.

OBJECTIVE: To investigate midwives' attitudes, values and beliefs on the use of intrapartum fetal monitoring. DESIGN: Qualitative, semi-structured interviews. SUBJECTS AND SETTING: Fifty-eight registered midwives in two hospitals in the North of England. RESULTS: In this paper two main themes are di...

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Publicado en:Health Expectations Vol. 8; no. 4; pp. 306 - 315
Autores principales: Hindley C, Thomson AM
Formato: research Journal Article
Publicado: Wiley-Blackwell Dec2005
Acceso en línea:Ver este registro en EBSCOhost
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        10.1111/j.1369-7625.2005.00355.x
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        atl: The rhetoric of informed choice: perspectives from midwives on intrapartum fetal heart rate monitoring.
      aug:
        au:
          Hindley C
          Thomson AM
        affil: Lecturer Midwifery, Midwifery and Social Work; carol.hindley@manchester.ac.uk
      sug:
        subj:
          Consent
          Decision Making, Clinical
          Fetal Monitoring, Electronic Psychosocial Factors
          Certified Nurse Midwives Psychosocial Factors
          Power
          Female
          Fetus
          Pregnancy
          Qualitative Studies
          Semi-Structured Interview
          Thematic Analysis
          United Kingdom
          Funding Source
          Human
          Fetus, conception to birth
          Female
      ab: OBJECTIVE: To investigate midwives' attitudes, values and beliefs on the use of intrapartum fetal monitoring. DESIGN: Qualitative, semi-structured interviews. SUBJECTS AND SETTING: Fifty-eight registered midwives in two hospitals in the North of England. RESULTS: In this paper two main themes are discussed, these are: informed choice, and the power of the midwife. Midwives favoured the application of informed choice and shared a unanimous consensus on the definition. However, the idealistic perception of informed choice, which included contemporary notions of empowerment and autonomy for women expressing an informed choice, was not reportedly translated into practice. Midwives had to implement informed choice on intrapartum fetal monitoring within a competing set of health service agendas, i.e. medically driven protocols and a political climate of actively managed childbearing. This resulted in the manipulation of information during the midwives' interactions with women. This ultimately meant that the women often got the choice the midwives wanted them to have. CONCLUSIONS: The information that a midwife imparts may consciously or subconsciously affect the woman's uptake and understanding of information. Therefore, the midwife has a powerful role to play in balancing the benefits and risk ratios applicable to fetal heart rate monitoring. However, a deeply ingrained pre-occupation with technological methods of intrapartum fetal monitoring over many years has made it difficult for midwives to offer alternative forms of monitoring. This has placed limits on the facilitation of informed choice and autonomous decision making for women.
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      doctype:
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        Journal Article
      ougenre: Article
    language: English
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