Decisions, choice and shared decision making in antenatal clinics: An observational study

Area of Science:

• Maternal Health
• Healthcare Decision-Making
• Shared Decision Making (SDM)

Background:

• UK government prioritizes shared decision making (SDM) and patient choice in maternity services.
• Previous research has not explored the scope of antenatal decisions or the feasibility of SDM in this context.

Purpose of the Study:

• To describe decisions made during antenatal consultations.
• To investigate factors associated with patient choice.
• To explore the practice of SDM in UK maternity care.

Main Methods:

• Cross-sectional study involving audio-recording of consultations in a UK district general hospital.
• Multi-level regression models were employed to analyze associations between choice and various factors (doctor, patient, consultation, decision).

Main Results:

• A total of 585 decisions were documented, averaging 3.0 per consultation.
• No choice was offered in 75% of documented decisions.
• Decision topic, consultation length, Royal College membership, and specialist register status were associated with choice availability.

Conclusions:

• The absence of choice significantly hinders the ability of patients and healthcare professionals to engage in true shared decision-making.
• Achieving universal SDM necessitates further research into factors influencing choice and SDM, alongside professional development to support healthcare providers in offering options and facilitating shared decisions.