The effect of a birthplace decision support tool on women’s decision-making and information gathering behaviours during pregnancy: mybirthplace study protocol

Abstract

The recent Maternity Review for England highlighted the need for more choice for women with more accessible information to support decisions. This study assesses the effect of an unique Decision Support Tool (DST) called MyBirthplace on decision making and information gathering behaviours of pregnant women regarding birth place choice. The study seeks to understand women's views and opinions about using the DST and their feelings about how well the DST supports them to make a decision. METHODS: A mixed method sequential exploratory design will be utilised to meet the above aim. This three phase study will involve a proposed sample of 169 women from a large maternity hospital in the United Kingdom. Phase one will be a questionnaire survey with women pre and post access to the DST, which is given to them by their midwife at the initial appointment. The questionnaire will look at baseline data, knowledge level and decision making using the Stages of Decision making scale (SDMS). A follow up questionnaire at 28 weeks (phase 2) will review the SDMS to enable the usefulness of Mybirthplace to be evaluated and to seek women's opinion on various aspects of MyBirthplace. The proposed sample size was determined by a power calculation based on changes attributed to the DST as measured by the SDMS. Phase three involves qualitative interviews with a minimum of 10 purposely chosen women at approximately 36 weeks gestation, and is followed by collating data on where the women actually give birth. DISCUSSION: This study is the first study to assess the effect of a DST in supporting women's choice of place of birth. It will add to current DST literature. It is also one of very few studies to utilise the stages of decision making scale with DST in pregnancy and thus will build on the existing literature; whilst broaching key concepts highlighted in the National Maternity Review.

In this issue – patient risks are ignored at organisation level

“…This letter is pertinent to our first paper which includes the call to focus on organisational learning to reduce risk 1. An effective LHS might know how to implement telemedicine too!5 Finally, Wiggins et al 13. present a protocol of how to undertake a mixed methods assessment of a decision support tool to improve decision making around a mother’s choice of place of birth.…”

Factors influencing referral to maternity models of care in Australian general practice

“…It is recognised that challenges navigating the referral system can act as a barrier to initiating antenatal care which is vital for the health and wellbeing of women and babies [34]. Finally, the literature overwhelmingly focusses on women's decision-making and neglects the gatekeeping role of the GP [35][36][37]. Given the established importance of GP referral to model of care and dearth of evidence regarding factors that influence referral, this study aimed to explore and describe the factors influencing Australian GPs' decision-making when referring pregnant women to maternity models of care.…”

Factors influencing referral to maternity models of care in Australian general practice

“…It is recognised that challenges navigating the referral system can act as a barrier to initiating antenatal care which is vital for the health and wellbeing of women and babies [28]. Finally, the literature overwhelmingly focusses on women's decision-making and neglects the gatekeeping role of the GP [29][30][31]. Given the established importance of GP referral to model of care and dearth of evidence regarding factors that influence referral, this study aimed to explore and describe the factors influencing Australian GPs' decision-making when referring pregnant women to maternity models of care.…”