Abstract
BackgroundHealth policy, guidelines, and standards advocate giving patients comprehensive information and facilitating their involvement in health-related decision-making. Routine assessment of patient reports of these processes is needed. Our objective was to examine decision-making processes, specifically information provision and consumer involvement in decision-making, for nine pregnancy, labour, and birth procedures, as reported by maternity care consumers in Queensland, Australia.MethodsParticipants were women who had a live birth in Queensland in a specified time period and were not found to have had a baby that died since birth, who completed the extended Having a Baby in Queensland Survey, 2010 about their maternity care experiences, and who reported at least one of the nine procedures of interest. For each procedure, women answered two questions that measured perceived (i) receipt of information about the benefits and risks of the procedure and (ii) role in decision-making about the procedure.ResultsIn all, 3,542 eligible women (34.2%) completed the survey. Between 4% (for pre-labour caesarean section) and 60% (for vaginal examination) of women reported not being informed of the benefits and risks of the procedure they experienced. Between 2% (epidural) and 34% (episiotomy) of women reported being unconsulted in decision-making. Over one quarter (26%) of the women who experienced episiotomy reported being neither informed nor consulted.ConclusionsThere is an urgent need for interventions that facilitate information provision and consumer involvement in decision-making about several perinatal procedures, especially those performed within the time-limited intrapartum care episode.
Highlights
Health policy, guidelines, and standards advocate giving patients comprehensive information and facilitating their involvement in health-related decision-making
In Australia, the National Maternity Services Plan 2010 recommended that maternity care services should enable women to access objective, evidence-based information that supports them to make informed choices in accordance with their individual needs [4]
We describe patterns in decision-making processes across the nine procedures studied and implications for both research and maternity care improvement
Summary
Guidelines, and standards advocate giving patients comprehensive information and facilitating their involvement in health-related decision-making. Our objective was to examine decision-making processes, information provision and consumer involvement in decision-making, for nine pregnancy, labour, and birth procedures, as reported by maternity care consumers in Queensland, Australia. Over the past two decades, health policy and legislation, clinical guidelines, and professional standards in several countries have increasingly emphasised patient participation in decision-making, alongside comprehensive information provision. This emphasis is evident in the maternity care sector. In the United Kingdom, the landmark Changing Childbirth report, published in 1993, advocated for the provision of woman-centred maternity care that supports consumers to make informed choices and exercise autonomy and control [3], and several subsequent documents have reinforced this objective.
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