A Shared Decision-Making Toolkit for Mode of Birth After Cesarean

Abstract

This study evaluated a shared decision-making (SDM) Toolkit (decision aid, counseling guide, and provider scripts) designed to prepare and engage racially diverse women in shared decision-making discussions about the mode of birth after cesarean. The pilot study, involving 27 pregnant women and 63 prenatal providers, assessed women's knowledge, preferences, and satisfaction with decision making, as well as provider perspectives on the Toolkit's acceptability. Most women experienced knowledge improvement, felt more in control and that providers listened to their concerns and supported them. Providers reported that the Toolkit helped women understand their options and supported their counseling. The SDM Toolkit could be used to help women and providers improve their SDM regarding mode of birth after cesarean.

The Perspectives of Women and Their Health-Care Providers Regarding Using an ECA to Support Mode of Birth Decisions

“…In response to these high and rising rates, the National Institutes of Health recommended shared decisionmaking to support women choosing mode of birth after cesarean options (Cunningham et al, 2011). Given the complexity of the choice between planning vaginal birth after cesarean (VBAC) and elective repeat cesarean birth (ERCB), women need effective ways to access evidence-based decision support and prepare for partnership with their health-care providers to make shared decisions based on values and preferences (Chinkam et al, 2020;Shorten et al, 2014).…”