Perinatal and maternal outcomes by planned place of birth for healthy women with low risk pregnancies: the Birthplace in England national prospective cohort study. BMJ. 2011; 343

Davidson P, Halcomb E, Hickman L, Phillips J, Graham B Beyond the rhetoric: what do we mean by a ‘model of care’?. Aust J Adv Nurs. 2006; 23:(3)47-55

Deery R, Hunter B Emotion work and relationships in midwifery, 2nd edn. London: Palgrave Macmillan; 2010

Department of Health, Public Health England. 2014. (accessed 7 January 2016)

Dixon-Woods M, Baker R, Charles K, Dawson J, Jerzembek G, Martin G, McCarthy I, McKee L, Minion J, Ozieranski P, Willars J, Wilkie P, West M Culture and behaviour in the English National Health Service: overview of lessons from a large multimethod study. BMJ Qual Saf. 2013; 23:(2)106-15

Goodrich J, Cornwell JLondon: The King's Fund; 2008

HM Government. 2013. (accessed 7 January 2016)

Hicks N Evidence-based health care. Bandolier. 1997; 4:(39)

Hodnett ED, Downe S, Walsh D Alternative versus conventional institutional settings for birth. Cochrane Database Syst Rev. 2012; 8

Hunter B, Warren LCardiff: Cardiff University; 2013

Kirkham M, Morgan R, Davis CLondon: RCM; 2006

Kirkpatrick DH, Burkman RT Does standardization of care through clinical guidelines improve outcomes and reduce medical liability?. Obstet Gynecol. 2010; 116:(5)1022-6

2015. (accessed 7 January 2016)

McCourt C Supporting choice and control? Communication and interaction between midwives and women at the antenatal booking visit. Soc Sci Med. 2006; 62:(6)1307-18

Ménage D Part 1: A model for evidence-based decision-making in midwifery care. British Journal of Midwifery. 2016; 24:(1)44-9

Modder J, Fitzsimons KJLondon: Centre for Maternal and Child Enquiries and Royal College of Obstetricians and Gynaecologists; 2010

National Institute for Health and Care Excellence. Intrapartum care for healthy women and babies. 2014. (accessed 7 January 2016)

London: NMC; 2009

London: NMC; 2012

London: NMC; 2015

O’Neill OLondon: The Kings Fund; 2008

Porter S, Crozier K, Sinclair M, Kernohan WG New midwifery? A qualitative analysis of midwives’ decisionmaking strategies. J Adv Nurs. 2007; 60:(5)525-34

The home birth debate: rights and obligations. 2013. (accessed 7 January 2016)

London: RCM; 2012

London: RCOG; 2011

Sandall J The contribution of continuity of midwifery care to high quality maternity care.London: RCM; 2014

Part 2: A model for evidence-based decision-making in midwifery care

02 February 2016
Volume 24 · Issue 2


National and local health-care policies, along with professional standards and guidance, call for midwives to play a key role in delivering evidence-based, safe, personalised care in partnership with women. However, the tools to guide this complex process have been missing. This paper introduces, explains and demonstrates the utility of a model of evidence-based decision-making for midwifery. Uniquely, the model uses a very broad definition of evidence, which includes evidence from the woman, the midwife, research and resources, in an environmental context. The model addresses a gap in theory and practice about how partnership decision-making works within increasingly complex maternity services. Testing and evaluating the model in different maternity settings would assist in the development and refinement of this model.

This is the second part of a two-part paper in which a new model of evidence-based decision-making for midwifery is proposed. In part 1, the case was made for a fit-for-purpose decision-making model on which to base personalised care in increasingly complex maternity care systems (Ménage, 2016). Crucially, this model calls for a radical and far broader definition of the evidence on which to base decision-making. Part 2 introduces the new model and explains the different sources of evidence to be considered in partnership with women. A clinical scenario is used to show how this model can be used in practice. This paper argues that the model makes an important contribution to midwifery theory by providing a comprehensive framework on which to base decision-making that reflects the realities of modern midwifery care. In addition, it could be an important tool for use in midwifery education, ongoing professional development, supervision and change management.

Register now to continue reading

Thank you for visiting British Journal of Midwifery and reading some of our peer-reviewed resources for midwives. To read more, please register today. You’ll enjoy the following great benefits:

What's included

  • Limited access to our clinical or professional articles

  • New content and clinical newsletter updates each month