Perceived Reality and Subjective Importance of Shared Decision-Making During Perinatal Care

Aim: The aim of the study is to explore perceived reality and subjective importance of shared decision-making (SDM) during antenatal, intrapartum, and/or postpartum care, provided by the midwife and/or obstetrician. Methods: A cross- sectional study was conducted among women in Flanders, Belgium. SDM was measured with the Observing PatienT InvOlvemeNt scale. Tests examined the differences between perceived reality and subjective importance of SDM. A multivariate generalized linear model tested the main and interaction effects between SDM and the maternity care providers and the perinatal care periods. Bonferroni post hoc tests examined further significance. Results: A total of 1,216 pregnant and postpartum participants completed 1,987 self-reports of perceived reality and subjective importance of SDM. The community midwives' SDM was evaluated 924/1,987 times, the hospital midwives' SDM 309/1,987 times, and the obstetricians' SDM 754/1,987 times. Perceived reality and subjective importance of SDM showed significant differences between care professionals (p < .001; p < .001), explained by the differences between community and hospital midwives' SDM (p < .001, d85; p < .001; d28) and between community midwives and obstetricians' SDM (p < .001, d72; p < .001; d31). Conclusions: The findings indicate optimizing the decision-making process during perinatal care by aligning subjective importance and perceived reality of SDM throughout the perinatal care episodes. Community midwives seem to be benchmarkers of shared decision-making during perinatal care.