Women's Decision-Making And Factors Affecting Their Choice Of ...

about how to use that treatment in caring for individual patients. On the other
hand, evidence without critical appraisal and application can lead to bad practice
(Naylor 1995). A conscientious practitioner is one who tries to understand the
complexities of medical or midwifery decision-making and appreciates the way in
which knowledge skills, values, and research evidence are integrated in each
patient-clinician encounter. The key is to use the available knowledge and
research evidence to provide individualised care.
Furthermore, systematic reviews, and therefore, the practice guidelines
based on them may require modification as new evidence continually emerges.
Multiple reviews may challenge guideline developers if they generate conflicting
conclusions (Cook, Crreengold, Ellrodt et al 1997), which would call for careful
critical appraisal of each review (Oxman, Cook, and Guyatt 1994), by considering
the focus of the individual review compared to the specific purpose of the
guideline to be developed. Particular emphasis should also be paid to issues of
clinical and statistical heterogeneity of the reviews (Jadad, Cook, and Browman
1997).
The present review was undertaken because although the topic of place of
birth is often written about as discussed in the introductory chapter, women's
views have not been made clear. It was therefore felt necessary to determine how
much research has dealt with women's views, and to determine whether there
were any gaps in knowledge about their views.
Methods
Before commencing the review, a check was made to determine whether a
similar up-to-date review already existed, or had been commissioned or was in the
process of being prepared. The verification was made in April 1999 in the
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