Shared Decision-Making Regarding Place of Birth–Mission Impossible or Mission Accomplished?

Yvonne Fontein-Kuipers*, Anouk Banda, Eline Oude Hassink, and Desirée de Ruiter

Shared Decision-Making Regarding Place of Birth–Mission Impossible or Mission Accomplished?

Women in the Netherlands with uncomplicated pregnancies receive midwife-led care and can
freely choose between birth at home, at a birth centre or at a short-stay hospital birthing unit.
Midwife-led antenatal care commences at approximately seven weeks of gestation. Within this physiological management of birth, midwives do not offer interventions such as medical pain relief, augmentation, or continuous fetal monitoring. If complications arise, interventions are needed, or when medical pain relief is requested or required, women are transferred to an obstetricled unit. The Dutch maternity care system and management of midwife-led care, specifically homebirth, has received a lot of negative criticism.

The first and main key point comprised: Mother and the (unborn) child at the centre of midwifery care,  including offering choices and information, and addressing the woman’s needs, preferences and choices regarding the place of birth. Midwives play an important role in offering women information and helping them to find, shift, and interpret information in order to make choices. Given the importance of this finding, midwives need to consider their role in women’s decision-making concerning the place of birth.

In this study, we aimed to explore and understand the process features of shared-decision making experiences about place of birth of pregnant women who receive midwifeled care in order to yield either a discussion or a propositional theory, building on Elwyn’s theory of shared-decision making. This qualitative exploratory study is based on a constant comparison/grounded theory design utilizing various methods for data collection, being focus groups and individual interviews.

Women Health Open J. 2017; 3(2): 36-44. doi: 10.17140/WHOJ-3-120