Does maternity care decision-making conform to shared decision- making standards for repeat cesarean and labor induction after suspected macrosomia?

Birth ◽  
2018 ◽  
Vol 45 (3) ◽  
pp. 236-244 ◽  
Author(s):  
Eugene R. Declercq ◽  
Erika R. Cheng ◽  
Carol Sakala
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Maternity Care ◽  
Labor Induction ◽  
Shared Decision ◽  
Care Decision

scholarly journals Women’s Participation in Decision-Making in Maternity Care: A Qualitative Exploration of Clients’ Health Literacy Skills and Needs for Support

2021 ◽  
Vol 18 (3) ◽  
pp. 1130
Author(s):  
Laxsini Murugesu ◽  
Olga C. Damman ◽  
Marloes E. Derksen ◽  
Danielle R. M. Timmermans ◽  
Ank de Jonge ◽  
...  
Keyword(s):  
Decision Making ◽  
Health Literacy ◽  
Shared Decision Making ◽  
Maternity Care ◽  
General Information ◽  
Literacy Skills ◽  
Reliable Information ◽  
Functional Health ◽  
Shared Decision ◽  
Participation In Decision Making

Shared decision-making requires adequate functional health literacy (HL) skills from clients to understand information, as well as interactive and critical HL skills to obtain, appraise and apply information about available options. This study aimed to explore women’s HL skills and needs for support regarding shared decision-making in maternity care. In-depth interviews were held among women in Dutch maternity care who scored low (n = 10) and high (n = 13) on basic health literacy screening test(s). HL skills and perceived needs for support were identified through thematic analysis. Women appeared to be highly engaged in the decision-making process. They mentioned searching and selecting general information about pregnancy and labor, constructing their preferences based on their own pre-existing knowledge and experiences and by discussions with partners and significant others. However, women with low basic skills and primigravida perceived difficulties in finding reliable information, understanding probabilistic information, constructing preferences based on benefit/harm information and preparing for consultations. Women also emphasized dealing with uncertainties, changing circumstances of pregnancy and labor, and emotions. Maternity care professionals could further support clients by guiding them towards reliable information. To facilitate participation in decision-making, preparing women for consultations (e.g., agenda setting) and supporting them in a timely manner to understand benefit/harm information seem important.

scholarly journals Women’s traumatic childbirth experiences: Reflections and implications for practice

2018 ◽  
Vol 1 (1) ◽  
Author(s):  
Fontein-Kuipers Yvonne
Keyword(s):  
Decision Making ◽  
Informed Consent ◽  
Shared Decision Making ◽  
Maternity Care ◽  
Shared Decision ◽  
Intrapartum Care ◽  
Care Needs ◽  
Traumatic Birth ◽  
Traumatic Childbirth ◽  
Childbirth Experiences

Objective: This study aims to explore women’s traumatic childbirth experiences in order to make maternity care professionals more aware of women’s intrapartum care needs to prevent traumatic experiences. Methods: A qualitative exploratory study with a constant comparison/ grounded theory design was performed. Thirty-six interviews were conducted with women who had given birth in a Dutch birth setting. Findings: Four themes, playing a profound role in the occurrence of traumatic birth experiences, emerged: 1 Midwife-LED care – Maternity care professionals’ unilateral decision making during intrapartum care. 2. Alienation – Women’s experiences of feeling distant and estranged from the childbirth event and the experience. 3. Situatedness – The difference of the impact of interventions in situations when complications or emergencies are present in contrast to when interventions are performed without an emergency reason. 4. Discrepancies - Paradoxes between expectations (ought self) and reality (actual self) - on an interpersonal (woman) and intrapersonal (woman-midwife) level. Implications for practice: Intrapartum care needs to include informed-consent and shared-decision making. Practitioners need to continuously evaluate if the woman is consistently part of her own childbearing process. Practitioners need to provide personalised care, make an effort to explain (emergency) situations, be conscious of their non-verbal communication and maintain an ongoing dialogue with the woman. Conclusion: Intrapartum care can be adapted, adopting a woman-centred approach, in order to prevent women’s traumatic childbirth experiences. This study can serve as a valuable assistance for maternity services, midwifery practice, research and for developing guidance in the field of midwifery practitioners’ education. Keywords: Traumatic birth experience, Maternity care, Intrapartum care, Informed-consent, Shared-decision making, Woman-centred care, Qualitative research.

Needs of parents and professionals to improve shared decision-making in interprofessional maternity care practice: A qualitative study

Birth ◽  
2018 ◽  
Vol 45 (3) ◽  
pp. 245-254 ◽  
Author(s):  
Joyce Molenaar ◽  
Irene Korstjens ◽  
Marijke Hendrix ◽  
Raymond de Vries ◽  
Marianne Nieuwenhuijze
Keyword(s):  
Decision Making ◽  
Qualitative Study ◽  
Shared Decision Making ◽  
Maternity Care ◽  
Care Practice ◽  
Shared Decision

scholarly journals Shared decision‐making in maternity care: Acknowledging and overcoming epistemic defeaters

2019 ◽  
Vol 25 (6) ◽  
pp. 1113-1120 ◽  
Author(s):  
Keith Begley ◽  
Deirdre Daly ◽  
Sunita Panda ◽  
Cecily Begley
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Maternity Care ◽  
Shared Decision

scholarly journals Family health care decision making and self-efficacy with patients with ALS at the end of life

2008 ◽  
Vol 6 (3) ◽  
pp. 273-280 ◽  
Author(s):  
Marie T. Nolan ◽  
Joan Kub ◽  
Mark T. Hughes ◽  
Peter B. Terry ◽  
Alan B. Astrow ◽  
...  
Keyword(s):  
Health Care ◽  
Decision Making ◽  
End Of Life ◽  
Shared Decision Making ◽  
Family Members ◽  
Shared Decision ◽  
Health Care Decisions ◽  
The Family ◽  
Care Decision ◽  
Made In

ABSTRACTObjective:Persons with ALS differ from those with other terminal illnesses in that they commonly retain capacity for decision making close to death. The role patients would opt to have their families play in decision making at the end of life may therefore be unique. This study compared the preferences of patients with ALS for involving family in health care decisions at the end of life with the actual involvement reported by the family after death.Methods:A descriptive correlational design with 16 patient–family member dyads was used. Quantitative findings were enriched with in-depth interviews of a subset of five family members following the patient's death.Results:Eighty-seven percent of patients had issued an advance directive. Patients who would opt to make health care decisions independently (i.e., according to the patient's preferences alone) were most likely to have their families report that decisions were made in the style that the patient preferred. Those who preferred shared decision making with family or decision making that relied upon the family were more likely to have their families report that decisions were made in a style that was more independent than preferred. When interviewed in depth, some family members described shared decision making although they had reported on the survey that the patient made independent decisions.Significance of results:The structure of advance directives may suggest to families that independent decision making is the ideal, causing them to avoid or underreport shared decision making. Fear of family recriminations may also cause family members to avoid or underreport shared decision making. Findings from this study might be used to guide clinicians in their discussions of treatments and health care decision making with persons with ALS and their families.

Planned Home VBAC in the United States, 2004-2009: Outcomes, Maternity Care Practices, and Implications for Shared Decision Making

Birth ◽  
2015 ◽  
Vol 42 (4) ◽  
pp. 299-308 ◽  
Author(s):  
Kim J. Cox ◽  
Marit L. Bovbjerg ◽  
Melissa Cheyney ◽  
Lawrence M. Leeman
Keyword(s):  
United States ◽  
Decision Making ◽  
Shared Decision Making ◽  
Maternity Care ◽  
The United States ◽  
Shared Decision ◽  
Care Practices

Quantifying the Risks and Benefits of Continuing Labor Induction: Data for Shared Decision-Making

2020 ◽  
Author(s):  
Elizabeth Nicole Teal ◽  
Adam K. Lewkowitz ◽  
Sarah L. P. Koser ◽  
Carol B. N. Tran ◽  
Stephanie L. Gaw
Keyword(s):  
Decision Making ◽  
Cesarean Delivery ◽  
Shared Decision Making ◽  
Vaginal Delivery ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Neonatal Morbidity ◽  
Labor Induction ◽  
Shared Decision ◽  
Risks And Benefits

Abstract Objective To quantify the relative maternal and fetal risks and benefits of continuing labor induction. Study Design This retrospective cohort study included nulliparous women with nonanomalous, singleton, vertex, term pregnancies undergoing labor induction with intact membranes at a tertiary-care academic hospital from January 2015 to April 2017. The primary outcome was mode of delivery. Secondary outcomes included hemorrhage, transfusion, infection, and composite neonatal morbidity. The data were analyzed using chi-square and Fisher's exact tests. Multivariable regression was used to control for potential confounders. Results A total of 955 patients met the inclusion criteria. The median induction duration was 32.3 hours (interquartile range: 20.4–41 hours) and the vaginal delivery rate was 70.5% (n = 673). The chance of vaginal delivery at 12, 24, 36, 48, 60, and ≥60 hours was 76, 83, 77, 74, 72, and 48%, respectively. After controlling for confounders, there was a 20% decrease in chance of vaginal delivery with induction ≥ 24 hours compared with induction < 24 hours. The adjusted relative risks of hemorrhage, transfusion, and infection with induction ≥ 24 hours compared with induction < 24 hours were 1.9, 2.2, and 2.7, respectively (95% confidence interval [CI] of 1.4–2.5, 1.1–3.9, and 1.8–4.0, respectively). The relative risk for these outcomes remained stable or decreased at each subsequent time point. The increasing risks of hemorrhage and infection were primarily among patients who underwent cesarean delivery. There was no association between induction duration and neonatal morbidity. Conclusion In this cohort, the chance of vaginal delivery remained nearly 50% even when induction extended beyond 60 hours. Risks of hemorrhage and maternal infection rose modestly over time, but primarily in patients who underwent cesarean delivery. There was no difference in the risk of transfusion beyond 24 hours and no association between induction duration and neonatal morbidity. These findings may be useful when engaging patients in shared decision-making during labor induction.

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