Discounting, reward and punishment sensitivity and decision-making by midwives

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Publication details

Mailey, SA, Provost, S & Jefford, E 2018, 'Discounting, reward and punishment sensitivity and decision-making by midwives', paper presented to the Southern Cross University 15th Annual Psychology Honours Research Conference, Coffs Harbour, NSW, 4-5 October.

Peer Reviewed



Aim: Discounting refers to the effect in which a delay or increased risk has on an individual’s preference for immediate reward. Differences in rates of discounting have been related to several problem behaviours involving impulsivity and risk-taking, such as drug use. However, little is known about whether these factors influence behaviour in other more every-day contexts. One such context is the childbirth environment, where midwives are faced with intricate and difficult decisions in a rapidly changing environment.
Method: Participants were 59 female midwives recruited through the Australian College of Midwives. They completed a survey which consisted of the Behavioural Inhibition and Behavioural Activation Scale (BIS/BAS), delay, probability and social discounting tasks, and three clinical childbirth scenarios for which they were asked to judge the quality of clinical reasoning and midwifery practice described.
Results: Delay, probability and discounting functions were obtained, and area under the curve was calculated. None of these tasks correlated with the judgements of clinical reasoning or midwifery practice. However, there was a correlation between the BAS and judgements of midwifery practice and clinical reasoning for a number of scenarios, and between the BIS and judgements of midwifery practice in one instance. Social discounting related to years of experience (r = .39).
Conclusions: Midwives’ judgements of the quality of decision-making and practice are influenced by their sensitivity to reward and possibly by their sensitivity to punishment, but not to levels of impulsivity and sensitivity to risk as measured by discounting tasks. Changes in social discounting with years of experience may be related to the development of “professional distance” between midwives and their patients, and although it may not impact decision-making, it may influence other aspects of midwives' relationship with mothers.