Midwives' coping methods for managing birth uncertainties

This article reports some of the findings from a larger study exploring the influence of uncertainty on the decision-making of midwives and doctors, and its potential as a contributory factor to the rising caesarean section rate. The specific focus of this paper is on the coping mechanisms used by midwives when dealing with uncertainty in childbirth and their attitude towards caesarean section. The findings indicate that midwives have ambivalent attitudes towards caesarean sections and rely on a range of strategies to cope with clinical uncertainty, such as the disclosure and non-disclosure of uncertainty with women, humour and adherence to clinical guidelines. However, the study did find that some midwives had poor coping responses to clinical uncertainty and spoke of considering other career options. The implications for practice suggest that the current emphasis on being certain and on specific time frames for women in labour threaten to obviate traditional midwifery skills.