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CONFERENCE PROCEEDING
Diagnostic algorithm development based on midwives’ clinical reasoning processes in situations involving preterm uterine contractions reported by pregnant women
1
Niigata Seiryo University, Faculty of Nursing, Niigata, Japan
2
Konan Women's University, Nursing, Kobe, Japan
3
Graduate School of Tenshi College, Midwifery, Sapporo, Japan
Eur J Midwifery 2026;10(Supplement 1):A696
ABSTRACT
BACKGROUND:
Midwives’ clinical reasoning processes—how they distinguish between normal and abnormal conditions and determine the need for intervention—remain poorly understood.
OBJECTIVES:
To clarify the midwifery diagnostic process and algorithmize midwives’ clinical reasoning process in situations where pregnant women report uterine contractions during the preterm period.
METHODS:
A survey targeting ten experienced midwives was conducted from January to March 2025. Semi-structured interviews were conducted based on simulated scenarios involving pregnant women experiencing prenatal uterine contractions. The interview content was qualitatively analyzed based on algorithm creation indicators to clarify the clinical reasoning process further, and was approved by the ethics committee of Niigata Seiryo University (Approval number 202406).
RESULTS:
The aim of this study was explained to ten midwives (mean years of experience = 21.6±9.44; number of deliveries assisted = 380±220); their consent for the survey was obtained. On average, the survey required 25.4±9.27 min to complete. The midwives were found to evaluate the urgency of uterine contractions in simulated pregnant women based on the presence or absence of labor onset signs and membrane rupture sensation, subsequently categorizing them as either “to be immediately reported to a physician for examination” or “physiological uterine contractions.” They conducted interviews regarding uterine contractions along with inquiries about the patients' lifestyle habits, minor issues, and self-care ability acquisition status. This information was utilized to provide health guidance tailored to the participants' lifestyle and readiness to prevent future deviations.
CONCLUSIONS:
After triaging, midwives evaluate the situation based on two factors: physical assessment of the pregnant woman, and her capacity for self-monitoring and self-care. Pregnant women with low self-monitoring and self-care ability are at an increased risk of uterine contractions. Health guidance is required to maintain and improve the normal course of pregnancy.
KEY MESSAGE:
We explored how midwives collect information and assess wellness. Poster session 2 (Group A)
Midwives’ clinical reasoning processes—how they distinguish between normal and abnormal conditions and determine the need for intervention—remain poorly understood.
OBJECTIVES:
To clarify the midwifery diagnostic process and algorithmize midwives’ clinical reasoning process in situations where pregnant women report uterine contractions during the preterm period.
METHODS:
A survey targeting ten experienced midwives was conducted from January to March 2025. Semi-structured interviews were conducted based on simulated scenarios involving pregnant women experiencing prenatal uterine contractions. The interview content was qualitatively analyzed based on algorithm creation indicators to clarify the clinical reasoning process further, and was approved by the ethics committee of Niigata Seiryo University (Approval number 202406).
RESULTS:
The aim of this study was explained to ten midwives (mean years of experience = 21.6±9.44; number of deliveries assisted = 380±220); their consent for the survey was obtained. On average, the survey required 25.4±9.27 min to complete. The midwives were found to evaluate the urgency of uterine contractions in simulated pregnant women based on the presence or absence of labor onset signs and membrane rupture sensation, subsequently categorizing them as either “to be immediately reported to a physician for examination” or “physiological uterine contractions.” They conducted interviews regarding uterine contractions along with inquiries about the patients' lifestyle habits, minor issues, and self-care ability acquisition status. This information was utilized to provide health guidance tailored to the participants' lifestyle and readiness to prevent future deviations.
CONCLUSIONS:
After triaging, midwives evaluate the situation based on two factors: physical assessment of the pregnant woman, and her capacity for self-monitoring and self-care. Pregnant women with low self-monitoring and self-care ability are at an increased risk of uterine contractions. Health guidance is required to maintain and improve the normal course of pregnancy.
KEY MESSAGE:
We explored how midwives collect information and assess wellness. Poster session 2 (Group A)
| eISSN: | 2585-2906 |
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