References

Back L, Hildingsson I, Sjoqvist C, Karlstrom A. Developing competence and confidence in midwifery-focus groups with Swedish midwives.. Women and Birth. 2015; 30:(1)e32-e38 https://doi.org/10.1016/j.wombi.2016.08.004

Ballou KA. A concept analysis of autonomy.. Journal of Professional Nursing. 1998; 14:(2)102-110 https://doi.org/10.1016/S8755-7223(98)80038-0

Baykara ZG, Sahinoglu S. An evaluation of nurses' professional autonomy in Turkey.. Nursing Ethics. 2014; 21:(4)447-460 https://doi.org/10.1177%2F0969733013505307

Beauchamp TI, Childress JF. Principles of biomedical ethics., 7th edn. New York, Oxford: Oxford University Press; 2012

Bedwell C, McGowan L, Lavender DT. Factors affecting midwives' confidence in intrapartum care: a phenomenological study.. Midwifery. 2015; 31:170-176 https://doi.org/10.1016/j.midw.2014.08.004

Catling CJ, Reid F, Hunter B. Australian midwives' experiences of their workplace culture.. Women and Birth. 2017; 30:(2)137-145 https://doi.org/10.1016/j.wombi.2016.10.001

Copeland F, Dahlen HG, Homer CSE. Conflicting contexts: midwives' interpretation of childbirth through photo elicitation.. Women and Birth. 2014; 27:126-131 https://doi.org/10.1016/j.wombi.2013.11.004

Creedy DK, Sidebotham M, Gamble J, Pallant J, Fenwick J. Prevalence of burnout, depression, anxiety and stress in Australian midwives: a cross-sectional survey.. BMC Pregnancy and Childbirth. 2017; 17:(13) https://doi.org/10.1186/s12884-016-1212-5

Davis DL, Homer CSE. Birthplace as the midwife's work place: how does place of birth impact on midwives?. Women and Birth. 2016; 29:407-415 https://doi.org/10.1016/j.wombi.2016.02.004

Dove ES, Kelly SE, Lucivero F, Machirori M, Dheensa S, Prainsack B. Beyond individualism: is there a place for relational autonomy in clinical practice and research?. Clinical Ethics. 2017; 12:(3)150-165 https://doi.org/10.1177%2F1477750917704156

Fleming VEM. Autonomous or automatons? An exploration through history of the concept of autonomy in midwifery in Scotland and New Zealand.. Nursing Ethics. 1998; 5:(1)43-51 https://doi.org/10.1177%2F096973309800500106

Harris FM, van Teijlingen E, Hundley V, Farmer J, Bryers H, Caldow J, Ireland J, Kiger A, Tucker J. The buck stops here: midwives and maternity care in rural Scotland.. Midwifery. 2011; 27:(3)301-307 https://doi.org/10.1016/j.midw.2010.10.007

Second report on the maternity services (Winterton report)..London: HMSO; 1992

Hunter B, Warren L. Midwives' experiences of workplace resilience.. Midwifery. 2014; 30:(8)926-934 https://doi.org/10.1016/j.midw.2014.03.010

Hyde A, Roche-Reid B. Midwifery practice and the crisis of modernity: implications for the role of the midwife.. Social Science and Medicine. 2004; 58:(12)2613-2623 https://doi.org/10.1016/j.socscimed.2003.09.014

International Confederation of Midwives. Core document: ICM international definition of the midwife.. 2011. https://www.internationalmidwives.org/assets/files/definitions-files/2018/06/eng-definition_of_the_midwife-2017.pdf (accessed 30 April 2018)

Kant I, Ellington JW. Grounding for the metaphysics of morals: on a supposed right to lie because of philanthropic concerns..Indianapolis: Hackett Pub. Co; 1993

Keenan J. A concept analysis of autonomy.. Journal of Advanced Nursing. 1999; 29:(3)556-562 https://doi.org/10.1046/j.1365-2648.1999.00948.x

Maier B. Is the narrow concept of individual autonomy compatible with or in conflict with evidence-based medicine in obstetric practice?: a philosophical critique on the misapplication of the value concept ‘autonomy’.. Woman –Psychosomatic Gynaecology and Obstetrics. 2014; 1:40-49 https://doi.org/10.1016/j.woman.2014.10.003

Mellado JM. Autonomy, consent and responsibility. Part 1: limitations of the principle of autonomy as a foundation of informed consent.. Radiología. 2016; 58:(5)343-351 https://doi.org/10.1016/j.rx.2016.06.009

Merriam-Webster Dictionary. Autonomy.. 2019. https://www.merriam-webster.com/dictionary/autonomy (accessed 9 December 2019)

Nieuwenhuijze MJ, Korstjens I, de Jonge A, de Vries R, Lagro-Janssen A On speaking terms: a delphi study on shared decision-making in maternity care.. BMC Pregnancy and Childbirth. 2014; 14:(223) https://doi.org/10.1186/1471-2393-14-223

Core of ethics for registered nurses and midwives in Brunei Darussalam..Brunei Darussalam: Ministry of Health; 2010

Core competency standards for registered nurses and midwives in Brunei Darussalam..Brunei Darussalam: Ministry of Health; 2013

Nursing and Midwifery Council. Practising as a midwife in the UK.. 2017. https://www.nmc.org.uk/globalassets/sitedocuments/nmc-publications/practising-as-a-midwife-in-the-uk.pdf (accessed 21 February 2018)

Stevenson A. Oxford Dictionary of English, 3rd edn. Oxford: Oxford University Press; 2010

Perdok H, Jans S, Verhoeven C, Henneman L, Wiegers T, Mol BW, Schellevis F, de Jonge A. Opinions of maternity care professionals and other stakeholders about integration of maternity care: a qualitative study in the Netherlands.. BMC Pregnancy and Childbirth. 2016; 16:(1) https://doi.org/10.1186/s12884-016-0975-z

Perdok H, Cronie D, van der Speld C, van Dillen J, de Jonge A, Rijnders M, de Graaf I, Schellevis FG, Verhoeven CJ. Experienced job autonomy among maternity care professionals in the Netherlands.. Midwifery. 2017; 54:67-72 https://doi.org/10.1016/j.midw.2017.07.015

Pollard K. Searching for autonomy.. Midwifery. 2003; 19:(2)113-124 https://doi.org/10.1016/S0266-6138(02)00103-1

Russell KE. Mad, bad or different? Midwives and normal birth in obstetric led units.. British Journal of Midwifery. 2007; 15:(3)128-131 https://doi.org/10.12968/bjom.2007.15.3.23032

Symon A. Midwives and professional status.. British Journal of Midwifery. 1996; 4:(10)543-550 https://doi.org/10.12968/bjom.1996.4.10.543

Thompson SM, Nieuwenhuijze MJ, Low LK, de Vries R. Exploring Dutch midwives' attitudes to promoting physiological childbirth: a qualitative study.. Midwifery. 2016; 42:67-73 https://doi.org/10.1016/j.midw.2016.09.019

United Nations Population Fund. The state of the world's midwifery 2011: delivering health, saving lives.. 2011. https://www.who.int/pmnch/media/membernews/2011/2011_sowmr_en.pdf (accessed 15 November 2019)

Wade GH. Professional nurse autonomy: concept analysis and application to nursing education.. Journal of Advanced Nursing. 1999; 30:(2)310-319 https://doi.org/10.1046/j.1365-2648.1999.01083.x

Warmelink JC, Hoijtink K, Noppers M, Wiegers TA, de Cock TP, Klomp T, Hutton EK. An explorative study of factors contributing to the job satisfaction of primary care midwives.. Midwifery. 2015; 31:482-488 https://doi.org/10.1016/j.midw.2014.12.003

Autonomy and its impact on midwifery practice

02 February 2020
Literature Review
02 February 2020
Volume 28 · Issue 2

Abstract

Objective

To explore the definition of autonomy, its significant features and impacts on midwifery practice.

Method

Combined keywords searched were performed on electronic databases: Scopus, Science Direct and Medline within EBSCOhost and Google Scholar. Data were extracted and analysed corresponding to the objectives of this review.

Findings

A total of eight studies (n=8) were included (one quantitative and seven qualitative). Autonomy is the central element in midwifery that is commonly linked with informed choices; decision-making and power to control over a situation. In order for a midwife to be autonomous, important attributes include knowledge and skills (being confident, and the ability to think critically). It was also found that infrastructure and culture at work impacts autonomy in midwifery practice.

Conclusion

Albeit a limited number of studies were included in the review, this review provides an important platform for understanding the principles and concepts that underpin autonomy in midwifery practice.

Autonomy is not a new concept in midwifery. Although not explicit, the term autonomy has been embedded in the definition of a midwife (International Confederation of Midwives [ICM], 2011). Reiterated in the core document of the ICM, autonomy may be identified, such as through the words: ‘responsible’, ‘accountable’ and ‘midwife's own responsibility’.

Like ICM (2011) and the Nursing and Midwifery Council ([NMC], 2017) in the UK, the United Nations Population Fund ([UNFPA], 2011) also reports that midwifery has been positioned and proclaimed as an autonomous profession within the national legislation of Indonesia, Myanmar, India and a few African countries. The concept of autonomy also resonates with the concept of midwifery-led care that was promoted more than 25 years ago in the UK with the publication of the Winterton report (House of Commons Health Committee, 1992). Despite the aforementioned, exercising autonomy in midwifery remains a global challenge and Brunei is no exception.

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Autonomy
Midwifery
Maternity care providers
Decision-making
Control