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How to Support Birth Choices: A Student Explains Different Modes of Decision Making

Bias: A personal and sometimes unreasoned judgment.

Worldview:  The definition of a worldview is an overall way of looking at the world.

Most people will agree that supporting birth choices is important.  What we sometimes forget, is that our view of the world is often informed by biases we don’t even know we have.  So when we talk about birth choices, we usually only acknowledge the choices we are familiar with and which fit within our own defined worldview.  Decision making within the birth world is often made based on how we learned to make decisions in the first place.  Very often we make those decisions without even knowing that other people make decisions based off of a very different way of looking at the world.  This can lead to contention and misunderstanding among the birth team, and ultimately lead to distrust between clients, labor support professionals, and medical providers.  It helps to take a look at the different ways of making decisions in order to best support others choices in birth.  Below are a few ways that women and care providers make decisions.  Hopefully this will help open up your mind to the idea that in order to support women in labor, we need to understand why they are making the decisions they are making in the first place.

Critical Thinking: The objective analysis of facts to form a judgment.

Intuition:  A thing that one knows or considers likely from instinctive feeling rather than conscious reasoning (defined by Google).

Scientific Thinking: “The principles and empirical processes of discovery and demonstration considered characteristic of or necessary for scientific investigation, generally involving the observation of phenomena, the formulation of a hypothesis concerning the phenomena, experimentation to test the hypothesis, and development of a conclusion that confirms, rejects, or modifies the hypothesis.”

In an effort to help them think outside the box, our students are asked to think about this process and how different people may make decisions.  Below is an example of this assignment that will can help you begin thinking beyond your own worldview to better support your client’s birth choices.

Unit 2 Assignment 2: Decision Making by Amy Edge

“Three decisions in Homebirth in the hospital

1. Choosing IV pain med Nubain during labor/Intuition and Trial and error. She had used it before, and it worked for her during her previous pregnancy.  Plus she felt she only needed a small amount of pain relief to take the edge off.

2. Having a Doula in place/Trial and error plus Critical Thinking. She did not have a doula before, and realized she could have used one. She then researched and interviewed prospective doulas.

3. No epidural/Trial and error/Intuition. Had a previous epidural due to stalled labor, with next pregnancy she labored at home and progressed to the point that there was not time to get another. She realized she could get through with just the Nubain.

Three decisions in Case Study 3

1. Decrease Pitocin/Scientific and Critical Thinking. The doctor used medical knowledge to realize less was needed to remedy situation.

2. Provide oxygen/Scientific and Critical Thinking. Same reasoning a #1

3. Move mother to alternate side (left to right)/Scientific, Trial and Error and Intuition. The doctor was able to draw on his experience of what had worked previously, along with his medical knowledge.”

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Follow Rachel Leavitt:

Rachel has worked as a register nurse (BSN from University of Utah) since 2004 with a work history in Labor and Delivery, NICU and Postpartum Care. She is also the founder of New Beginnings Doula Training which she organized in 2011. When she's not busy being a mother and grandmother, she can be found reading research papers related to some aspect of childbirth.

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