From alchemy to epistemology : intuition and private midwifery in Australia

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Background Intuition entered the lexicon describing midwifery practice as early as the 14th Century and it has remained a component ever since. The Australian College of Midwives (2009) philosophical statement of midwifery identifies evidence, experience and intuition as the central responsibilities of the midwife. Many fields of science have investigated intuition however limited research has been undertaken with midwives. The aim of the study was to explore how midwives in private practice understand and use intuition in an Australian context. Method A qualitative, descriptive study was undertaken using a feminist framework. Ethical approval from UTS was sought and received prior to the study commencing. Twelve midwives in private practice were recruited using purposive and snowball sampling and advertisements were placed in two midwifery magazines. Data were collected using semi structured interviews and analysed using thematic analysis. Findings All the midwives used intuition in their practice. There were two themes, trust and knowledge, showing how the occurrence of intuition was influenced by relationships and environment. Issues related to trusting the relationship with women in their care, trusting the women and trusting themselves affected the use of intuition. Midwives also identified aspects of knowledge gained from environments that either enhanced or diminished their intuition. A lack of autonomy within institutions that are dominated by a biomedical hegemony that has become mainstream for the management of women with normal, low risk pregnancy and birth was described. Using Intuition was a fundamental part of this practice. Discussion Private midwives utilise skills that are relational, involve emotion work and use knowledge that is unique to midwifery, including intuition. This research describes private midwives’ understanding of intuition and explores their use of it by using a current neuroscience interpretation called Intelligent Memory. Midwives in private practice have often removed themselves from the governance of the institution and are more autonomous than midwives practising within hospitals. Issues about authoritative knowledge and feminist theory are discussed in light of the findings. Implications for practice The study raises implications for midwifery education and practice in light of the attributes and skills that were associated with the midwives use of intuition. Further research is required to confirm the findings of this study amongst a larger group of midwives but also to investigate midwives use of intuition within an institution. This study indicates that an understanding of intuition (Intelligent Memory) could enhance the analysis and use of intuition in midwifery training, curriculum and practice.
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