What are pregnant women told about models of maternity care in Australia? A retrospective study of women's reports

Abstract

Objective: To describe women's reports of the model of care options General Practitioners (GPs) discussed with them at the first pregnancy consultation and women's self-reported role in decision-making about model of care.

Methods: Women who had recently given birth responded to survey items about the models of care GPs discussed, their role in final decision-making, and socio-demographic, obstetric history, and early pregnancy characteristics.

Results: The proportion of women with whom each model of care was discussed varied between 8.2% (for private midwifery care with home birth) and 64.4% (GP shared care). Only 7.7% of women reported that all seven models were discussed. Exclusive discussion about private obstetric care and about all public models was common, and women's health insurance status was the strongest predictor of the presence of discussions about each model. Most women (82.6%) reported active involvement in final decision-making about model of care.

Conclusion: Although most women report involvement in maternity model of care decisions, they remain largely uninformed about the breadth of available model of care options.

Practical implications: Strategies that facilitate women's access to information on the differentiating features and outcomes for all models of care should be prioritized to better ensure equitable and quality decisions.

Keywords: Decision support; Information provision; Informed decision-making; Maternity care; Models of care; Patient participation; Primary care.