"Evidence" and midwifery practice.

Evidence-based care has become the new standard in the clinical disciplines. It represents a paradigm shift for clinicians, toward greater inclusion of research findings in patient care decisions. Randomized trials are the "gold standard" in clinical research and provide the strongest evidence for a treatment or intervention. But, randomized trials have limitations and cannot address all important clinical questions. Research using observational, descriptive, and qualitative methods also has a place in generating evidence for practice. Balancing the needs of individual women against what is learned from research with groups or populations is a challenge for midwives.