Abstract

Purpose

To describe the role of intuition for maternity care workers in deciding when a cesarean section should be advised during labor.

Material and methods

Focus group discussions with midwives and gynecologists, and nonparticipating observation at an obstetric ward.

Results

The decision about when to propose a cesarean section during labor is the result of interaction between objective and intuitive factors. Junior delivery ward workers report that they use more analytic reasoning for objective diagnosis of fetal distress, non-progressive labor, macrosomia or other indications for cesarean section; with increasing experience, however, non-analytic reasoning takes the overhand. Both consciously and unconsciously, other activities going on outside the individual delivery room seem to influence the decision. Out of the 50 deliveries observed, 38 births occurred through vaginal deliveries and 12 through cesarean sections. Maternity care workers clearly have “gut feelings” that the course of labor is moving toward a cesarean section. We were unable to detect any predictable pattern in the transition from gut feeling to decision.

Conclusion

Intuition plays a still not completely uncovered role in the decision to advise cesarean section during labor. The level of consciousness at which professionals use intuition or gut feeling and are aware of it in decision making is variable. Intuition or gut feelings seem to contribute more to the decision process as the level of experience increases.

中文翻译：

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产科和助产士的直觉：直觉在决定分娩时何时进行剖宫产中的作用

摘要

目的

描述产科护理人员的直觉在决定何时应在分娩期间建议剖宫产时的作用。

材料与方法

与助产士和妇科医生进行焦点小组讨论，并在产科病房进行非参与式观察。

结果

分娩时何时建议剖宫产的决定是客观因素和直觉因素相互作用的结果。初级产房工作人员报告说，他们使用更多的分析推理来客观诊断胎儿窘迫、非进行性分娩、巨大儿或其他剖宫产指征；然而，随着经验的增加，非分析推理占了上风。有意识和无意识地，在个体产房外进行的其他活动似乎会影响这一决定。在观察到的 50 例分娩中，38 例通过阴道分娩进行，12 例通过剖宫产分娩。产妇护理人员显然有“直觉”，即分娩过程正在走向剖宫产。

结论

直觉在分娩期间建议剖宫产的决定中发挥着尚未完全揭示的作用。专业人员使用直觉或直觉并在决策中意识到它的意识水平是可变的。随着经验水平的提高，直觉或直觉似乎对决策过程的贡献更大。