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New trial launched to help women make childbirth choices

Published: 06 October 2022

A new NIHR funded trial will evaluate how patient 'decision aids', can be used to inform pregnant women in making decisions about birth plans.

Childbirth is a safe and positive experience for most women in the UK, but it often involves intervention from doctors and midwives such as an unplanned caesarean section. This can be difficult for women, particularly those who were not expecting to need help, or those who are unaware of the possible risks.

Over the next two and a half years, researchers led by the University of Aberdeen, will develop an aid designed to guide discussion between pregnant women and health professionals during pregnancy appointments.

Decision aids are commonplace in healthcare settings, such as choosing between cancer treatments. But, no such aid exists for birth planning in routine maternity care.

Researchers aim to develop a ‘decision aid’ that will help pregnant women to make an informed choice between vaginal or caesarean birth.

Researchers will survey pregnant women, parents and healthcare staff to identify which outcomes of planned vaginal or caesarean birth are important to know about in advance. The results of these surveys will then be used to develop a decision aid to test in five UK maternity units.

In the last decade, national guidance from the National Institute of Health and Care Excellence has stated that the risks and benefits of both vaginal and caesarean birth should be discussed with women during pregnancy to help plan their birth.

However maternity services reported a £2 billion compensation bill in 2018/19, with lack of informed consent and failure to offer a caesarean birth listed as key reasons.

Dr Mairead Black, Senior Clinical Lecturer at the University, who is leading the research team,  said: “This is an important piece of work because it addresses a substantial gap in routine antenatal care in the UK at present.

“This work recognises that women, including those who do not identify as women, who are pregnant, should be the primary decision makers in their birth planning. It will help both maternity staff and those planning their birth by providing balanced information about the options of planning a vaginal or caesarean birth. It will support them to choose the option that fits best in the circumstances of the individual woman or family. 

“By working with members of the public, maternity staff and childbirth-related charities, we will develop a tool to help women decide between planning a vaginal or caesarean birth in routine antenatal care.

“We will also outline how the tool can best be embedded within routine NHS maternity care. Working alongside the NHS Maternity Transformation Programme, the Royal College of Midwives and the Royal College of Obstetricians and Gynaecologists, we ultimately aim to ensure that the final tool is accessible to all who would benefit from its use."

The study was funded by the NIHR Health and Social Care Delivery Research Programme.

More information about the study is available on the NIHR Funding & Awards Website. 


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