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Shared Decision-Making on Late-Term Gestation Management (LATE-Study): A Cross-Sectional Survey Among Maternity Care
Anna E Seijmonsbergen-Schermers1,2,3,4, Kika Grosheide1,2,3,4, Fatima Hammiche5,6
1Amsterdam UMC Location Vrije Universiteit Amsterdam, Midwifery Science, Amsterdam, the Netherlands.
Birth (Berkeley, Calif.)
|August 3, 2026
Summary
Maternity care providers find late-term induction of labor guidelines helpful but don't always use shared decision-making (SDM) tools. Personal birth beliefs impact how SDM is practiced, with omissions in key elements.
Area of Science:
- Maternal Health
- Clinical Guidelines
- Shared Decision-Making
Background:
- A Dutch guideline (2021) recommends offering induction of labor (IOL) from 41 weeks + 0 days, alongside expectant management (EM), using shared decision-making (SDM).
- Understanding care providers' perspectives on these guidelines and their SDM tools is crucial for effective implementation.
Purpose of the Study:
- To examine maternity care providers' opinions and usage of SDM tools for late-term IOL guidelines.
- To assess self-reported adherence to SDM content recommendations and perspectives on SDM conversations.
- To investigate the association between providers' birth beliefs and their SDM practices.
Main Methods:
- A cross-sectional survey of 575 maternity care providers using an online questionnaire with Likert scale questions.
- Assessment of birth beliefs using the Birth Beliefs Scale.
- Uni- and multivariable regression analyses to explore associations between birth beliefs and SDM content/perspectives.
Main Results:
- High usage rates (63-72%) and positive helpfulness scores were reported for SDM tools among aware participants.
- Most providers addressed recommended SDM items, but fewer addressed outcome percentages (37%), parity differences (33%), or EM beyond 42 weeks (37%).
- Providers' birth beliefs influenced SDM content and perspectives, with those holding more natural views emphasizing women's preferences and alternatives.
Conclusions:
- Maternity care providers generally view the late-term management guideline tools positively, but consistent use is lacking.
- Key elements of SDM are frequently omitted in practice.
- Individual birth beliefs significantly shape the delivery and content of SDM conversations in late-term pregnancy management.