Midwives' navigation and perceived power during decision-making related to augmentation of labour

Objective: to explore and understand how midwives perceive and experience decision-making about augmentation of tabour. Design: focus-group discussions. Setting: Stockholm, Sweden. Participants: 20 midwives experienced in working in tabour wards. Findings: five categories were identified that illustrate the factors considered by the midwives to influence decision-making during augmentation of tabour: 'regulations and guidelines'; 'shortage of delivery rooms'; 'influence of obstetricians'; 'women in labour'; and 'midwives' professional selves'. The theme identified was how midwives managed to 'navigate' these factors, which provided midwives with a decisive influence during the decision-making process. Key conclusions and implications: midwife job satisfaction can result from a sense of professional power over the possibility of navigating factors that influence decision-making during augmentation of tabour. This sense of power can subsequently influence co-operation with both obstetricians and women during tabour. (C) 2007 Elsevier Ltd. All rights reserved.