A descriptive phenomenological study of independent midwives' utilisation of intuition as an authoritative form of knowledge in practice.

Abstract

Out of the diversity of possible ways of knowing in maternity and health care, there has emerged a hegemonic emphasis on knowledge that is based on scientific principles. Arguably, there is also a role for intuition in healthcare. Indeed, leading midwives, educationalists and researchers in related fields have hailed the important role of intuition in advancing midwifery practice and education. A review of the literature shows that there is a dearth of research exploring the nature and use of intuition in midwifery practice. This descriptive phenomenological study explores the experiences and use of intuition in a cohort of seven independent midwives across the South and Midlands area of the United Kingdom. The study explores what midwifery intuition is for them and how they incorporate this form of knowing into the complexity of their midwifery practice. The study found that the experience and utilisation of the independent midwives’ intuition is a complex phenomenon that included the reception of subtle cues, own emotions, bodily-felt sensations, images and dreams. Such ways of knowing provided practice-relevant knowledge that can be either specific or non-specific and can serve various levels and kinds of use (for example, from directly increasing generalised alertness to specific directions for treatment). The findings result in a novel typology of the essence of midwifery intuition and the different nuanced ways it comes to be utilised, developed, and confirmed or disconfirmed within the holistic trajectory of practice. The study concludes with a consideration of how the findings contribute to existing scholarship in the area as well as the implications for practice and education. This comprises how the identification of the salient elements of the midwives’ intuition has contributed to the understanding of the phenomenon and may aid other midwives and students in developing and enhancing their own intuition. This will provide assistance in enabling intuition to be recognised as a first person rational form of authoritative knowledge to be utilised, and at times, prioritised alongside other forms of practice knowledge. Recognising intuition as part of a holistic knowing will enhance individualised, safe, maternity care for women and autonomous, transparent decision making for midwives. It is recommended that the provision of reflective workshops and reflection during revalidation will enable clarification of the phenomenon and enable other practitioners to develop this form of artistry. It is also recommended that models of care that promote this intimate way of knowing are utilised in maternity provision.