2.4.d Impact of Conflict on Decision Making
Lack of role clarity and poor communication are primary determinants of preventable adverse neonatal and maternal outcomes, including death..."
- Guise & Segel, 2011 (16)
"The key sources of conflict among providers related to planned home birth are divergences in beliefs about safety and risk; lack of fluency with each other’s scope of practice, roles and responsibilities; and mismatched expectations about communication."
- Vedam et al., 2014b (17)
In Geeta’s case it is uncertain if there will be any conflict among the interprofessional team when everyone arrives at the hospital. A misunderstanding could occur. People may be saying or feeling these things:
Not all clients who opt for a planned home birth will necessarily decline all hospital procedures. That is an assumption that has no value."
"I believe some Midwives could make a greater effort to prepare their clients for the possibility of transfer, and explain to them what they could possibly expect from that process."
Cheyney et al., 2014a (1)
In Mee's case, Mee and Alang also may need to return to the hospital with their baby when Monica, the pediatrician, is no longer on shift. The next pediatrician may not have the same understanding about the plan that was made. In spite of good intentions and good communication skills, misunderstandings still do occur among team members.
When more people share in the decision making, there is likely to be more potential for disagreement. There are times when teams don’t communicate well and these are usually short lived moments that can be addressed and explored in a debrief. Yet, you still need to develop some good communication strategies to use in the moment. Sometimes the message you need to convey does not achieve the result that you expected. People can have differing professional opinions or priorities. In these circumstances a good communication tool is to use assertive language. Use stronger language and “I” statement such as “I am concerned.” In order for this to be effective and not misunderstood, awareness needs to be paid to your body language, tone of voice and posture. Stand tall, speak calmly and in a pronounced manner with steady eye contact.
It’s helpful and most safe when there is clear charting and documentation that accompanies a home birth transfer.”
“I should never be questioned about my skill set or management in front of a client, let alone during an event like a transfer. This could easily cause the woman to feel unsafe.”
Cheyney et al., 2014a (1)