Midwives facilitating informed decision-making

Research Project

Midwives experiences of facilitating informed decision-making, a narrative literature review

About this project

Informed decision-making is a vital component of midwifery philosophy and a core recommendation of the global respectful maternity care charter; however, women and midwives report a lack of informed decision-making in actual practice. Midwifery philosophy aligns with facilitation of women’s informed decision-making during maternity care. Research reveals informed decision-making improves physical and mental health outcomes for women, regardless of childbearing experience, and is a protective factor for midwives’ job satisfaction. There is currently little known about midwives’ experiences of facilitating informed decision-making, and associated barriers.

Aim: To critically appraise and synthesize the best qualitative evidence exploring midwives’ experiences of facilitating women’s informed decision-making.

Methods: A narrative review was conducted after a systematic search of key databases and grey literature for qualitative research in English between 2010-2019 was undertaken. Quality assessment followed CASP guidelines and this review is reported in accordance with PRISMA guidelines. Thirteen studies were included in the final review.

Results: Midwives have a strong desire to facilitate informed decision-making, yet report a disparity between philosophy and practice due to multiple barriers. Barriers include; lack of specific knowledge and training, fear of blame and litigation, structural constraints including lack of time and fragmented models of midwifery care, and multidisciplinary philosophical disparities. Conclusion:

Existing literature identifies informed decision-making as the gold-standard in providing safe and respectful maternity care, yet this review demonstrates that it is not well executed in actual practice. Midwives recognise this disparity and identify barriers which require urgent education, research, policy and practice solutions.

Research team


  • Associate Professor Helen Hall