Women's views on the use of decision aids for decision making about the method of delivery following a previous caesarean section: qualitative interview study

Abstract

Objective: To obtain the views of women on their experiences of decision making about the method of delivery following a previous caesarean section and the role of decision aids in this process.

Design: Qualitative study nested within a randomised controlled trial, using repeat semi-structured interviews conducted pre- and postnatally. Data were analysed using a framework approach.

Setting: Three maternity units in south-west England and Scotland.

Sample: Purposive sample of 30 women participating in a randomised controlled trial of two decision aids for women making a decision about mode of next delivery following a previous caesarean section (Decision Aids for Mode of next Delivery).

Results: Thirty women were interviewed during pregnancy about their experience of decision making about the mode of delivery and 22 were re-interviewed postnatally. Key themes were: role of decision aids in reducing decisional conflict and uncertainty during the pregnancy; impact of decision aids on knowledge and anxiety; the relationship between prior preferences, decisions and actual outcome; and the mediating role of decision aids.

Conclusions: Women making a decision about mode of delivery following previous caesarean section value some form of structured information to help reduce decisional conflict. Information provision for women making this decision needs to be relevant to their individual needs. Decision analysis may help reconcile prior preferences and the actual mode of delivery.