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

• Published in: Patient education and counseling Vol. 52; no. 3; pp. 307 - 313
• Main Authors: Shorten, Allison, Chamberlain, Marie, Shorten, Brett, Kariminia, Azar
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier Ireland Ltd 01.03.2004
• Subjects: Australia; Birth choice; Caesarean section; Cesarean Section - psychology; Cesarean Section - utilization; Decision Making; Decision support; Decision-aid; Evidence-Based Medicine; Female; Humans; Nursing; Patient education; Patient Education as Topic - methods; Patient Satisfaction - statistics & numerical data; Pilot Projects; Pregnancy; Risk Assessment; Trial of Labor; Vaginal Birth after Cesarean - psychology; Vaginal Birth after Cesarean - utilization; Australia; Patient education; Caesarean section; Decision-aid; Birth choice; Decision support
• ISSN: 0738-3991; 1873-5134
• DOI: 10.1016/S0738-3991(03)00106-X

This paper presents the development and pilot testing of an evidence-based decision-aid for pregnant women who have experienced previous caesarean section and who are considering options for birth in a subsequent pregnancy. The Ottawa Decision Support Framework (DSF) has been utilised and modified in the development of a tailored booklet entitled “Birth Choices: What is best for you …vaginal or caesarean birth?” Development included a review by women who had experienced previous caesarean birth as well as obstetric, midwifery and educational experts. The booklet was also reviewed for acceptability by 21 pregnant women who were facing this birth decision. Pre- and post-booklet preferences for birth were elicited and compared to actual birth outcomes. This decision-aid shows promise in facilitating informed decision-making in pregnancy. It is currently undergoing an evaluation in a multi-centre randomised controlled trial.