Decision-making about mode of delivery after previous caesarean section: development and piloting of two computer-based decision aids

  1. Clare L. Emmett BSc MSc1,
  2. Deirdre J. Murphy MD MRCOG2,
  3. Roshni R. Patel MSc PhD MRCOG3,
  4. Tom Fahey MSc MD MFPH FRCGP4,
  5. Claire Jones BSc5,
  6. Ian W. Ricketts BSc PhD5,
  7. Peter Gregor BSc MA PhD5,
  8. Maureen Macleod BSc RGN SCM6,
  9. Alan A. Montgomery BSc MSc PhD1,
  10. On behalf of the DiAMOND Study Group†

Article first published online: 7 MAR 2007

DOI: 10.1111/j.1369-7625.2006.00429.x

Issue

Health Expectations

Health Expectations

Volume 10, Issue 2, pages 161–172, June 2007

Additional Information

How to Cite

Emmett, C. L., Murphy, D. J., Patel, R. R., Fahey, T., Jones, C., Ricketts, I. W., Gregor, P., Macleod, M., Montgomery, A. A. and On behalf of the DiAMOND Study Group (2007), Decision-making about mode of delivery after previous caesarean section: development and piloting of two computer-based decision aids. Health Expectations, 10: 161–172. doi: 10.1111/j.1369-7625.2006.00429.x

Author Information

  1. 1

    Academic Unit of Primary Health Care, University of Bristol, Bristol

  2. 2

    Academic Department of Obstetrics and Gynaecology, Trinity College, University of Dublin, Dublin

  3. 3

    Department of Obstetrics and Gynaecology, University of Bristol, Bristol

  4. 4

    Division of Community Health Sciences, University of Dundee, Dundee

  5. 5

    School of Applied Computing, University of Dundee, Dundee

  6. 6

    Department of Maternal and Child Health Sciences, University of Dundee, Dundee, UK

  1. †

    The Decision Aids for Mode Of Next Delivery (DiAMOND) Study Group comprises the following members: Clare Emmett, Tom Fahey, Julia Frost, Peter Gregor, Sandra Hollinghurst, Claire Jones, Beverley Lovering, Alan Montgomery, Irene Munro, Deirdre Murphy, Roshni Patel, Tim Peters, Ian Ricketts, Anne Schlegelmilch, Ali Shaw, Kav Vedhara, Kate Warren, Helen Watson.

*Clare L. Emmett Academic Unit of Primary Health Care University of Bristol 25–27 Belgrave Road Clifton BS8 2AA UK E-mail: clare.emmett@bristol.ac.uk

Publication History

  1. Issue published online: 22 MAY 2007
  2. Article first published online: 7 MAR 2007
  3. Accepted for publication 5 November 2006

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Keywords:

  • caesarean section;
  • childbirth;
  • decision aid;
  • patient involvement;
  • pilot study

Abstract

Objective  To develop and pilot two computer-based decision aids to assist women with decision-making about mode of delivery after a previous caesarean section (CS), which could then be evaluated in a randomized-controlled trial.

Background  Women with a previous CS are faced with a decision between repeat elective CS and vaginal birth after caesarean. Research has shown that women may benefit from access to comprehensive information about the risks and benefits of the delivery options.

Design  A qualitative pilot study of two novel decision aids, an information program and a decision analysis program, which were developed by a multidisciplinary research team.

Participants and setting  15 women who had recently given birth and had previously had a CS and 11 pregnant women with a previous CS, recruited from two UK hospitals. Women were interviewed and observed using the decision aids.

Results  Participants found both decision aids useful and informative. Most liked the computer-based format. Participants found the utility assessment of the decision analysis program acceptable although some had difficulty completing the tasks required. Following the pilot study improvements were made to expand the program content, the decision analysis program was accompanied by a training session and a website version of the information program was developed to allow repeat access.

Conclusions  This pilot study was an essential step in the design of the decision aids and in establishing their acceptability and feasibility. In general, participating women viewed the decision aids as a welcome addition to routine antenatal care. A randomized trial has been conducted to establish the effectiveness and cost-effectiveness of the decision aids.

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