Maternity healthcare professionals perspectives of decision-making in
the UK: a qualitative study.
Abstract
Objective To explore and characterise maternity healthcare
professionals’ (MHCPs) experience and practice of informed
decision-making (IDM), to inform policy, research and practice
development. Design Qualitative focus group study.
Setting Online with MHCPs from a single maternity unit in the
Southwest of England. Population MHCPs who give information
relating to clinical procedures and pregnancy care and are directly
involved in decision-making conversations purposively sampled from a
single National Health Service (NHS) Trust. Data collection: A
semi-structured topic guide was used. Data Analysis: Reflexive
thematic analysis . Results Twenty-four participants attended
seven focus groups. Two themes were developed: contextualising
decision-making and controversies in current decision-making.
Contextual factors that influenced decision-making practices included
lack of time, and challenges faced in intrapartum care. MHCPs reported
variation in how they approach decision-making conversations and asked
for more training on how to consistently achieve IDM. There were
communication challenges with women/birthing people who do not speak
English. Three controversies were explored in the controversies theme:
the role of prior clinical experience, the validity of informed consent
when women/birthing people were in pain and during emergencies, and
instances where women/birthing people declined medical advice.
Conclusions We found that MHCPs are committed to IDM but need
better support to deliver it consistently. Structured processes
including core information sets, communication skills training and the
decision support aids may help to standardise the information and better
support IDM.