The motherhood choice: a decision aid for women with multiple sclerosis

Abstract

Objective: This randomized controlled trial aimed to evaluate a decision aid for women with multiple sclerosis deciding whether to start or enlarge their families.

Method: Decision aid materials were mailed to participants, and their response materials returned by mail. One-hundred and ninety-four women with MS agreed to participate and were randomized to receive the DA or not. Participants completed questionnaires measuring decisional-conflict, self-efficacy, knowledge, depression and anxiety as well as their views regarding having children pre- and post-intervention.

Results: Women who received the DA had a significant decrease in decisional-conflict, increase in self-efficacy and knowledge of MS and pregnancy and more certainty in their choice than those in the control group. There were no adverse effects on depression or anxiety and women's decisions were not biased in either direction.

Conclusion: The DA is a useful tool that can be used by women with MS contemplating motherhood.

Practice implications: This DA is used as a resource by the MS Society illustrating how DAs may help with lifestyle choices complicated by illness. It represents a tool adaptable to suit other illnesses where reproductive decision-making may be compromised and should be of interest to health-care professionals who are consulted by women with family-planning concerns.