Making choices for childbirth: development and testing of a decision-aid for women who have experienced previous caesarean

Shorten, Allison; Chamberlain, Marie; Shorten, Brett; Kariminia, Azar

doi:10.1016/s0738-3991(03)00106-x

Cited by 34 publications

(50 citation statements)

References 25 publications

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“…It is known that women's decision making about mode of delivery may be influenced by cultural norms, family situation and the way risk information is presented to them by clinicians 31 32…”

Section: Resultsmentioning

confidence: 99%

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Helping pregnant women make better decisions: a systematic review of the benefits of patient decision aids in obstetrics

2011

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ObjectivesPatient decision aids can be used to support pregnant women engaging in shared decisions, but little is known about their effects in obstetrics. The authors aimed to evaluate the effects of patient decision aids designed for pregnant women on clinical and psychosocial outcomes.DesignSystematic review. Data on all outcomes were extracted and summarised. All studies were critically appraised for potential sources of bias and, when possible to obtain, the reported decision aids were evaluated. Meta-analysis was not possible due to the heterogeneity of outcomes in primary studies and the small number of studies.Data sourcesElectronic searches were performed using Medline, Embase, the Cochrane Library and Medion databases from inception until December 2010. Reference lists of all included articles were also examined and key experts contacted.Eligibility criteria for selecting studiesEligibility criteria included randomised controlled trials, which reported on patient decision aids for women facing any treatment decision in pregnancy published in English. Studies evaluating health education material that did not address women's values and preferences were excluded.ResultsPatient decision aids have been developed for decisions about prenatal testing, vaginal birth after Caesarean section, external cephalic version and labour analgesia. Use of decision aids is associated with a number of positive effects including reduced anxiety, lower decisional conflict, improved knowledge, improved satisfaction and increased perception of having made an informed choice.ConclusionsPatient decision aids have the potential to improve obstetric care. However, currently the evidence base is limited by the small number of studies, the quality of the studies and because they involved heterogeneous decision aids, patient groups and outcomes.

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“…It is known that women's decision making about mode of delivery may be influenced by cultural norms, family situation and the way risk information is presented to them by clinicians 31 32…”

Section: Resultsmentioning

confidence: 99%

“…Decision aids about mode of delivery may benefit women by presenting risk information in a clear and unbiased way and by eliciting women's values, helping them to make a decision consistent with their values 21 31…”

Section: Resultsmentioning

confidence: 99%

Helping pregnant women make better decisions: a systematic review of the benefits of patient decision aids in obstetrics

2011

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“…The questionnaire items were developed from reviewing the relevant literature. 24,30,[50][51] Part A involved demographic details. Part B concerned the nature of women's previous CSs and their intended birth options for a subsequent pregnancy.…”

Section: Participants and Methodsmentioning

confidence: 99%

Women's knowledge of options for birth after Caesarean Section

Chen

Hancock

2012

Women and Birth

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“…Two randomised controlled trials evaluating different antenatal education interventions designed to increase VBAC rates have been published and neither intervention altered VBAC rates [23,24]. One of the studies showed that consistent information using a decision-aid booklet reduced decisional conflict [25]. We plan to build on this evidence by providing consistent antenatal information from a small group of midwives, together with continuity of care in labour and birth.…”

Section: Introductionmentioning

confidence: 99%

Does continuity of care impact decision making in the next birth after a caesarean section (VBAC)? a randomised controlled trial

Homer

Besley

Bell

et al. 2013

BMC Pregnancy Childbirth

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BackgroundCaesarean section (CS) has short and long-term health effects for both the woman and her baby. One of the greatest contributors to the CS rate is elective repeat CS. Vaginal birth after caesarean (VBAC) is an option for many women; despite this the proportion of women attempting VBAC remains low. Potentially the relationship that women have with their healthcare professional may have a major influence on the uptake of VBAC. Models of service delivery, which enable an individual approach to care, may make a difference to the uptake of VBAC. Midwifery continuity of care could be an effective model to encourage and support women to choose VBAC.Methods/DesignA randomised, controlled trial will be undertaken. Eligible pregnant women, whose most recent previous birth was by lower-segment CS, will be randomly allocated 1:1 to an intervention group or control group. The intervention provides midwifery continuity of care to women through pregnancy, labour, birth and early postnatal care. The control group will receive standard hospital care from different midwives through pregnancy, labour, birth and early postnatal care. Both groups will receive an obstetric consultation during pregnancy and at any other time if required. Clinical care will follow the same guidelines in both groups.DiscussionThis study will determine whether midwifery continuity of care influences the decision to attempt a VBAC and impacts on mode of birth, maternal experiences with care and the health of the neonate. Outcomes from this study might influence the way maternity care is provided to this group of women and thus impact on the CS rate. This information will provide high level evidence to policy makers, health service managers and practitioners who are working towards addressing the increased rate of CS.Trial registrationThis trial is registered with the Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12611001214921

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Making choices for childbirth: development and testing of a decision-aid for women who have experienced previous caesarean

Cited by 34 publications

References 25 publications

Helping pregnant women make better decisions: a systematic review of the benefits of patient decision aids in obstetrics

Helping pregnant women make better decisions: a systematic review of the benefits of patient decision aids in obstetrics

Women's knowledge of options for birth after Caesarean Section

Does continuity of care impact decision making in the next birth after a caesarean section (VBAC)? a randomised controlled trial

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