Realizing shared decision making in everyday practice: the needs of parents and professionals in maternity care

Introduction: Shared decision making (SDM) is a critical component of high quality maternity care. However, due to the multidisciplinary character of maternity care, both parents and professionals experience challenges in... [ view full abstract ]

Introduction: Shared decision making (SDM) is a critical component of high quality maternity care. However, due to the multidisciplinary character of maternity care, both parents and professionals experience challenges in achieving SDM in everyday practice. Therefore, the objective of our study was to develop in co-creation with parents and maternity care professionals an intervention to support SDM throughout pregnancy, childbirth and postpartum care. This study details a needs-assessment conducted among professionals in maternity care and parents accessing maternity care provision.

Methods: A qualitative study using focus group discussions and content analysis was conducted in the South of the Netherlands in November and December 2016. Parents, primary care midwives, hospital-based midwives, obstetricians, obstetric nurses and maternity care assistants participated in eleven homogeneous focus group discussions. 

Results: Both parents and professionals disclosed various needs for SDM, which can be summarized in five themes: 1. Communication skills in SDM, 2. Knowledge and awareness of the different roles of parents and professionals in the SDM process, 3. Accessible, just in time, objective health information for parents to prepare for SDM, 4. Alignment and coordination between the different professionals in maternity care, 5. Decision aids and birth plans as tools to support SDM. According to parents and professionals, a feasible intervention to support SDM would focus on providing practical tools for everyday practice, focus on all professions and a variety in parents and would be online and interactive.

Discussion: In order to achieve SDM in everyday practice, both parents and professionals want to be prepared themselves. In addition to this, they need equally well-prepared counterparts. This needs assessment provides input for the first prototype of an intervention. This will be evaluated in heterogeneous focus group discussions, the next step in our process of co-creation. Conclusion: Collaboration of all parties involved amplifies the likelihood that a prototype intervention for SDM is feasible in everyday practice, and will meet the needs of parents and professionals in maternity care.