Department of Obstetrics and Gynecology, Antwerp University Hospital UZA, ASTARC Antwerp University Wilrijk, Belgium.
Department of Global Health, Antwerp University, Wilrijk, Edegem, Belgium.
J Psychosom Obstet Gynaecol. 2021 Dec;42(4):328-334. doi: 10.1080/0167482X.2020.1765335. Epub 2020 Jun 15.
To describe the role of intuition for maternity care workers in deciding when a cesarean section should be advised during labor.
Focus group discussions with midwives and gynecologists, and nonparticipating observation at an obstetric ward.
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.
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.
描述直觉在产程中决定何时建议剖宫产时对助产士和妇产科医生的作用。
对助产士和妇产科医生进行焦点小组讨论，并在产科病房进行非参与性观察。
决定何时在产程中建议剖宫产是客观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、产程无进展、巨大儿或其他剖宫产指征；然而，随着经验的增加，非分析推理占据了主导地位。无论是有意识还是无意识地，产房外的其他活动似乎都会影响决策。在观察的 50 次分娩中，38 次自然分娩，12 次剖宫产。助产士显然有一种“直觉”，即产程正在向剖宫产发展。我们无法检测到从直觉到决策的转变有任何可预测的模式。
直觉在产程中决定建议剖宫产时起着尚未完全揭示的作用。专业人员在决策中使用直觉或本能的意识水平是可变的。随着经验水平的提高，直觉或本能似乎对决策过程的贡献更大。
