Journal of Women's Health Care
Open Access
ISSN: 2167-0420
ISSN: 2167-0420
Somphit Chinkam
Boston University School of Medicine, USA
Posters & Accepted Abstracts: J Women's Health Care
This study used a dyadic approach to explore decision making about birth after cesarean. We sought the perspectives of women and their providers on a shared decision making (SDM) toolkit to support their mode of birth discussions. Participants included women who had experienced one or two previous low transverse cesareans with a singleton pregnancy, and were eligible for labor after cesarean (LAC). Providers included certified-nurse midwives, nurse practitioners, obstetric residents and attending staff. Women were surveyed pre and post intervention to assess knowledge, preferences and satisfaction with decision making. Providers were surveyed regarding their use of the SDM toolkit. Twenty seven (27) women and 15 prenatal providers have participated from May 2016 to June 2017. Most women were: 26-35 years old, single, black, high school educated, unemployed, on Medicaid, and had one LTCS. Out of all, 59% of women planned and 37% attempted LAC. Overall, 22% achieved vaginal birth. After the intervention, women had increased knowledge about risks and benefits of LAC and elective repeat cesarean birth. Of all, 96% of women believed that the decision aid was important and 76% thought it helped them in making decisions. Women believed their providers listened to their concerns, and supported them in their decision making. Providers who used the toolkit thought it helped women understand mode of birth options and facilitated questions. The SDM toolkit was useful to prepare women for mode of birth discussions with their provider. After the intervention, most women found themselves as equal partners with providers. Providers were satisfied with the tools and thought they enabled SDM.
E-mail: somphit.chinkam@bmc.org