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Open Access Highly Accessed Research article

Birth control: to what extent do women report being informed and involved in decisions about pregnancy and birth procedures?

Rachel Thompson12 and Yvette D Miller13*

Author Affiliations

1 School of Psychology, The University of Queensland, Brisbane, QLD 4072, Australia

2 The Dartmouth Center for Health Care Delivery Science, Dartmouth College, Hanover, NH 03755, USA

3 School of Public Health and Social Work, Queensland University of Technology, Kelvin Grove, QLD 4059, Australia

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BMC Pregnancy and Childbirth 2014, 14:62  doi:10.1186/1471-2393-14-62

Published: 7 February 2014

Abstract

Background

Health 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.

Methods

Participants 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.

Results

In 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.

Conclusions

There 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.

Keywords:
Decision-making; Maternity care; Paternalism; Patient participation; Patient-reported outcomes