Choosing to Decline: Finding Common Ground through the Perspective of Shared Decision Making

Megregian, Michele; Nieuwenhuijze, Marianne

doi:10.1111/jmwh.12747

Cited by 17 publications

(21 citation statements)

References 28 publications

(36 reference statements)

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“…Immediate postpartum IUD insertion should be included among options discussed during the antenatal period and validated in the immediate postpartum period . Shared decision making can be a partnership in which the midwife has the ability to limit potential coercion and close gaps in comprehension or recall . Furthermore, Moniz et al suggest that immediate postpartum options should be presented even in the face of reimbursement or other challenges, including religious proscriptions, as a means to promote reproductive justice.…”

Section: Shared Decision Making and Mitigating Coercionmentioning

confidence: 99%

Immediate Postpartum Contraception: Intrauterine Device Insertion

Escobar

Shearin

2019

J Midwife Womens Health

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Insertion of an intrauterine device (IUD) in the immediate postpartum period is a safe, evidence-based form of contraception appropriate for most women. Despite the higher risk of expulsion as compared with interval insertion, the benefits of insertion in the immediate postpartum period are significant and include improved rates of contraception continuance and reduced instances of short interval birth. Through shared decision making, midwives and other clinicians can assist women in clarifying their reproductive goals and understanding of contraceptive options, including this method. In response to identified gaps in knowledge and insertion technique among midwives, this article provides an overview of immediate postpartum IUD insertion, risks and benefits, and eligibility criteria and describes preinsertion, insertion, and postinsertion care.

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Section: Shared Decision Making and Mitigating Coercionmentioning

confidence: 99%

Immediate Postpartum Contraception: Intrauterine Device Insertion

Escobar

Shearin

2019

J Midwife Womens Health

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“…This finding highlights the importance of enabling and encouraging women to actively participate in decisions regarding their care. This can be achieved through shared decision-making (SDM), which promotes open, honest and respectful communication and involves patients and HCP collaborating to make health care decisions that are based upon the best available evidence and patients' preferences, values and needs [40]. SDM is therefore argued to be "the pinnacle of patient-centred care" [41].…”

Section: Discussionmentioning

confidence: 99%

“We felt like part of a production system”: a qualitative study on women’s experience of mistreatment during childbirth in Switzerland

Meyer

Cignacco

Monteverde

et al. 2021

Preprint

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Introduction Mistreatment during childbirth is an issue of global magnitude that not only violates fundamental human rights but also seriously impacts women's well-being. The purpose of this study was to gain a better understanding of the phenomenon by exploring the individual experiences of women who reported mistreatment during childbirth in Switzerland. Materials and Methods This project used a mixed methods approach to investigate women's experiences of mistreatment during childbirth in general and informal coercion specifically: the present qualitative study expands on the findings from a nationwide online survey on childbirth experience. It combines inductive with theory-guided thematic analysis to study the 7753 comments women wrote in the survey and the subsequent interviews with 11 women who reported being mistreated during childbirth. Results The women described a wide range of experiences of mistreatment during childbirth in both the survey comments and the interviews. Out of all survey participants who wrote at least one comment (n = 3547), 28% described one or more experiences of mistreatment. Six of the seven types of mistreatment listed in Bohren and colleagues' typology of mistreatment during childbirth were found, the most frequent of which were ineffective communication and lack of informed consent. Five further themes were identified in the interviews: informal coercion, risk factors for mistreatment, consequences of mistreatment, examples of good care, and what's needed to improve maternity care. Conclusion The findings from this study show that experiences of mistreatment are a reality in Swiss maternity care and give insight into women's individual experiences as well as how these affect them during and after childbirth. This study emphasises the need to respect women's autonomy in order to prevent mistreatment and empower women to actively participate in decisions. Both individual and systemic efforts are required to prevent mistreatment and guarantee respectful, dignified, and high-quality maternity care for all.

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“…10,14-16 An important cause of this trauma reported by women is lack or loss of control, interventions being performed routinely without informed consent, and lack of support and communication by maternity care professionals. 20 In addition, recommendations in pregnancy are not a black and white matter, and are not consistent over time. Some women make extensive birth plans, to protect themselves from having this trauma repeated.…”

Section: Discussionmentioning

confidence: 99%

“…However, they are confronted with a growing number of professional guidelines, explained to them by care providers with an increasing fear of litigation, who are at the same time encouraged to practice shared decision making. 20 In addition, recommendations in pregnancy are not a black and white matter, and are not consistent over time. However, this relativity may sometimes be lost in translating a guideline into recommendations to a pregnant woman.…”

Section: Discussionmentioning

confidence: 99%

Women desiring less care than recommended during childbirth: Three years of dedicated clinic

Garde¹,

Hollander²,

Olthuis

et al. 2019

Birth

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Background: Some women decline recommended care during pregnancy and birth.This can cause friction between client and provider. Methods: A designated outpatient clinic was started for women who decline recommended care in pregnancy. All women who attended were analyzed retrospectively.The clinic used a systematic multidisciplinary approach. During the first visit, women told their stories and explained the reasoning behind their birth plan. The second visit was used to present the evidence underpinning recommendations and attempt to reach a compromise if care within recommendations was still not acceptable to the woman. During the third visit, a final birth plan was decided on. Results: From January 1, 2015, until December 31, 2017, 55 women were seen in the clinic, 29 of whom declined items of recommended care during birth and were included in the study. After discussions had been completed, 38% of birth plans were within recommendations, 38% were a compromise, in which both the woman and the care provider had made certain concessions, and 24% did not reach an agreement and delivered with another provider either at home or elsewhere. All maternal and perinatal outcomes were good. Conclusions: Using a respectful and systematic multidisciplinary approach, in which women feel heard and are invited to explain their motivations for their birth plans, we are able to arrive at a plan either compatible with or much closer to recommendations than the woman's initial intentions in most cases, thereby preventing negative choices.

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Choosing to Decline: Finding Common Ground through the Perspective of Shared Decision Making

Cited by 17 publications

References 28 publications

Immediate Postpartum Contraception: Intrauterine Device Insertion

Immediate Postpartum Contraception: Intrauterine Device Insertion

“We felt like part of a production system”: a qualitative study on women’s experience of mistreatment during childbirth in Switzerland

Women desiring less care than recommended during childbirth: Three years of dedicated clinic

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