Abstract

EBM generates a proliferation of guidelines and recommendations targeting health practitioners that are expected to “apply” them. There is a valorisation of standardization of care. In their daily practice midwives are facing two different important professional paradoxical injunctions:  following guidelines/protocols and also providing a woman centered individualized care. Midwives are in a field of ethical tensions. How to take the most appropriate decision for the patient? How can we demonstrate a good quality of care? In the past years there was a number of publications promoting the importance of more practical wisdom or “phronesis” in health care practices. A review of the literature on the subject was undertook and 37 papers were selected to answer the main question: how can we understand the meaning of practical wisdom (or phronesis) and its place healthcare practice? Can practical wisdom be learned, taught, developed and cultivated? We will develop the mean findings of our review, highlighting the fundamental place of professional judgement in midwifery profession. It is a question of using discernment and deliberation in order to decide the best action for the good of a unique person in a context of care.  We will see the importance of a reflexive practice in clinical places as well as using narratives of experiences to learn discussion and reflection during the undergraduate period. In all context of care practical wisdom can help midwives to use the strengths of EBM and also to have a woman centered care. Practical wisdom is also seen as a mean to flourish as professional.