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.
Decision-making about mode of delivery after previous caesarean section: development and piloting of two computer-based decision aids
Article first published online: 7 MAR 2007
Volume 10, Issue 2, pages 161–172, June 2007
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
- Issue published online: 22 MAY 2007
- Article first published online: 7 MAR 2007
- Accepted for publication 5 November 2006
- caesarean section;
- decision aid;
- patient involvement;
- pilot study
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.