A Decision Aid for midwifery continuity of care: Development and pilot acceptability testing

Abstract

Background: Many maternity services in Australia offer women a variety of models of care including midwife led models. Childbearing women, however, need to understand the differences between these models if they are to make an informed decision about their choice of care. Decision Aids (DA) help people decide when there is not a single best option and the best decision will be based upon the values of the decision maker. There is no current tool that focuses on the choice of midwife led vs other models of maternity care. Aim: This research aimed to develop, and pilot test a Decision Aid focusing on the choice between midwife led and standard models of maternity care. Methods: The DA was developed using the International Patient Decision Aid Standards and pilot tested for acceptability with a group of clinicians who provide antenatal care in one jurisdiction in Australia. A posttest only study was conducted assessing knowledge, acceptability and decisional conflict, with a group of women of childbearing age living in the jurisdiction. Findings: A DA was developed and pilot acceptability testing with 14 women and 13 clinicians of Australian Capital Territory (ACT) health demonstrated its acceptability and highlighting areas for further development. Discussion: Some revisions may be needed to address issues of balance and bias toward midwife-led care identified by some recipients. Conclusion: Pilot acceptability testing with women and staff of ACT health provides a steppingstone to further research, development and evaluation of this DA.