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Midwives' decision-making process when a non-vigorous neonate is born - a Swedish qualitative interview study
Manuela Isacson1, Ola Andersson2, Li Thies-Lagergren3
1Sachs' Children and Youth Hospital, Stockholm, Sweden; Department of Clinical Sciences, Lund, Pediatrics, Lund University, Sweden.
Midwifery
|September 14, 2022
Summary
Midwives balance clinical reasoning with intuition when deciding when to clamp the umbilical cord for non-vigorous newborns. This decision-making process involves assessing the neonate and valuing experience.
Area of Science:
- Neonatal resuscitation
- Midwifery practice
- Decision-making in obstetrics
Background:
- Midwives are primary decision-makers for non-vigorous newborns.
- Current practice links early cord clamping to resuscitation needs.
- Understanding the initial minutes of a non-vigorous neonate's life is crucial.
Purpose of the Study:
- To explore midwives' reasoning and experiences in managing non-vigorous neonates.
- To understand the decision-making process regarding umbilical cord clamping in critical situations.
- To investigate factors influencing midwives' timing of cord clamping for non-vigorous neonates.
Main Methods:
- Qualitative study using Critical Incident Technique.
- Semi-structured interviews with 14 midwives in Swedish labor wards.
- Thematic analysis of interview data.
Main Results:
- A central theme of "The balancing act of clamping the umbilical cord" emerged.
- Key themes included assessing neonate resuscitation needs, valuing midwife knowledge/experience, and influencing factors.
- Midwives' decisions were influenced by clinical reasoning, feelings, intuition, and experience.
Conclusions:
- Midwives' decisions on cord clamping for non-vigorous neonates involve a complex interplay of factors.
- Intuition and experience significantly influence clinical judgment in these critical situations.
- Further research can refine protocols for managing non-vigorous neonates.
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