The experiences of shared decision-making of women who had an induction of labour.

2020 
Abstract Objectives The importance of shared decision-making (SDM) in relation to induction of labour (IOL) is recognised, little is known about women’s experiences of and satisfaction with decision-making and how this can be improved. The aim of this study was to 1) gain insight into women’s experiences of SDM in relation to IOL, 2) understand the factors associated with satisfaction versus dissatisfaction during SDM, and 3) identify recommendations for service improvement. Methods Qualitative semi-structured telephone interviews were conducted with 32 women who had a recent IOL at one of eight public hospitals in Sydney, Australia. An inductive approach to coding and categorisation of themes was used. Results While women reported varied experiences with SDM, many reported not feeling that they had a choice about IOL, not being presented with the risks and benefits of different birth options, and receiving insufficient information about the IOL process and methods. Satisfaction versus dissatisfaction with SDM appeared more closely related to a woman’s willingness to have an IOL and their willingness to defer decision-making, rather than the process of SDM. Recommendations for improvement included improved SDM practices, access to guidelines and continuity of care. Conclusion There is a need to improve SDM processes around IOL. Practice implications Particular areas for improvement include more comprehensive discussions surrounding the pros and cons of different birth methods and the IOL process. Decision aids and clinician training may assist with SDM.
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