Measuring social influence of a senior midwife on decision-making in maternity care: An experimental study

The document Changing Childbirth produced by the Department of Health (1993) requests provision of more choice, continuity and control for women during pregnancy and childbirth. In this context this study considers whether midwives'decisions are influenced by a senior midwife. A simple, valid and reliable scale - the Social Influence Scale for Midwifery (SIS-M) - was devised to measure and score midwives' private anonymous responses to 10 clinical decisions. The SIS-M was initially administered as a self-completed postal survey by 209 midwives. Following a 9-month time gap, a stratified sample of 60 (20 E, F, G grade midwives) were invited for interview in which a senior midwife attempted to influence SIS-M responses in a conformist direction. Overall, a 3 × 2 (E, F, G grade midwives x private and interview SIS-M scores) analysis of variance (ANOVA) revealed midwives were significantly more conformist when influenced by a senior midwife, in comparison to private anonymous responses. No significant interaction between groups was found. These findings indicate that there is influence of a senior midwife on clinical decisions that should be woman-centred, according to Changing Childbirth (1993). The implication is that this influence may remove choice from women. Copyright © 2005 John Wiley & Sons, Ltd.