Effectiveness of shared decision‐making for mode of delivery after caesarean section: A systematic review and meta‐analysis of randomized controlled trials

Abstract

AimTo review the content, format and effectiveness of shared decision‐making interventions for mode of delivery after caesarean section for pregnant women.DesignSystematic review and meta‐analysis.MethodsSix databases (PubMed, Web of science Core Collection, Cochrance Network, Embase, CINAHL, PsycINFO) were searched starting at the time of establishment of the database to May 2023. Following the PRISMAs and use Review Manager 5.3 software for meta‐analysis. Two review authors independently assessed the quality of the studies using the risk of bias 2 tool. The protocol was registered in PROSPERO (CRD42023410536).ResultsThe search strategy obtained 1675 references. After abstract and full text screening, a total of seven studies were included. Shared decision‐making interventions include decision aids and counselling that can help pregnant women analyse the pros and cons of various options and help them make decisions that are consistent with their values. The pooled results showed that shared decision‐making intervention alleviated decisional conflicts regarding mode of delivery after caesarean section, but had no effect on knowledge and informed choice.ConclusionThe results of our review suggest that shared decision‐making is an effective intervention to improve the quality of decision‐making about the mode of delivery of pregnant women after caesarean section. However, due to the low quality of the evidence, it is recommended that more studies be conducted in the future to improve the quality of the evidence.Correlation with Clinical PracticeThis systematic review and meta‐analysis provides evidence for the effectiveness of shared decision‐making for mode of delivery after cesarean section and may provide a basis for the development of intervention to promote the participation of pregnant women in the decision‐making process.