The situational argument: do midwives agree or acquiesce with senior staff?

Abstract

This study concerns midwives' obedience/conformity to direction from a senior person. We sought to identify whether midwives just went along with what a midwife at management level suggested, or instead altered their views to match. In the first condition, a postal Social Influence Scale‐Midwifery (SIS‐M) measured and scored 209 midwives' private responses to 10 clinical questions. In a second condition, a senior midwife successfully influenced 60 of these midwives to alter their SIS‐M decisions to agree with her suggested correct responses. In a third condition, a postal condition again measured the midwives private SIS‐M responses. The aim was to elicit whether the midwives' simply complied with the senior midwife's suggestions during interview or actually changed their opinions to match hers. A 3 (E (lowest grade), F (middle grade) & G (sister grade)) × 3 (above conditions) ANOVA found a significant main effect for conditions (F(2, 94) = 151.87, p = 0.001) with higher scores in the interview condition when the senior midwife passively influenced participant responses. Results inform that the interview manipulation had no lasting social influence effect, consistent with Milgram's transient situational argument. That is, in the presence of senior staff, midwives' decisions are profoundly influenced.

Keywords:

• social influence
• conformity
• obedience
• midwives
• opinion

Notes

1. The scores are just for illustration and are not shown on the questionnaire.

2. Olsen (1997) carried out a meta‐analysis of the relative safety of homebirth compared to hospital birth. A total of 25,000 births from five different countries were studied. The results found no difference in survival rates between babies born at home and those born in hospital. However, there were several significant differences between the groups. Fewer medical interventions occurred in the homebirth group. Fewer home babies were born in poor condition. The homebirth mothers were less likely to have suffered lacerations during birth. They were less likely to have had their labours induced or augmented by medications or to have had caesarian sections, forceps or vacuum extractor deliveries. As for maternal deaths, there were none in either group.