Journal
JOGNN-JOURNAL OF OBSTETRIC GYNECOLOGIC AND NEONATAL NURSING
Volume 43, Issue 5, Pages 568-579Publisher
ELSEVIER SCIENCE INC
DOI: 10.1111/1552-6909.12485
Keywords
VBAC; pregnancy; decision support techniques; decision aid; women's preferences
Categories
Funding
- OHSU Foundation
- NIH [5K12HD043488-04]
- Agency for Healthcare Research and Quality [1 R03 HS013959]
- National Institute of Child Health & Human Development [1 K08 HS11338-01]
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ObjectiveEvaluate tools to help pregnant women with prior cesareans make informed decisions about having trials of labor. DesignRandomized comparative trial. SettingA research assistant with a laptop met the women in quiet locations at clinics and at health fairs. ParticipantsPregnant women (N=131) who had one prior cesarean and were eligible for vaginal birth after cesarean (VBAC) participated one time between 2005 and 2007. MethodsWomen were randomized to receive either an evidence-based, interactive decision aid or two evidence-based educational brochures about cesarean delivery and VBAC. Effect on the decision-making process was assessed before and after the interventions. ResultsCompared to baseline, women in both groups felt more informed (F=23.8, p < .001), were more clear about their birth priorities (F=9.7, p=.002), felt more supported (F=9.8, p=.002, and overall reported less conflict (F=18.1, p < 0.001) after receiving either intervention. Women in their third trimesters reported greater clarity around birth priorities after using the interactive decision aid than women given brochures (F=9.8, p=.003). ConclusionAlthough both decision tools significantly reduced conflict around the birth decision compared to baseline, more work is needed to understand which format, the interactive decision aid or paper brochures, are more effective early and late in pregnancy.
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