What are the influences on women’s preferences and decision-making when planning mode of birth in high-income countries? A qualitative systematic review
Bibliographic record
Abstract
Objective: In antenatal care in the UK NHS, the concept of choice of mode of birth (MOB) has been recommended for some years but is still poorly operationalised. Proactive, routine provision of balanced and relevant information to women in antenatal care can be supported by using decision aids but such an aid does not currently exist. The objective of this qualitative systematic review was to identify the factors shaping women's MOB preference and the barriers and facilitators to supported MOB decision-making. Data sources: Seven major electronic databases were searched for articles published in English between 2011 and November 2022. Study eligibility criteria Eligible studies were of any design and provided qualitative data from currently or previously pregnant women in high-income countries, about reasons for MOB preference, and/or barriers or facilitators to women making supported MOB choices. Data were extracted into a pre-designed data extraction form. Identified subthemes were grouped and mapped onto two preestablished global themes. Study quality was assessed using the CASP tool for qualitative research. Confidence in the findings was assessed using GRADECERQual. Results: Women's preferences for MOB were shaped by perceptions of advantages or disadvantages of each MOB and their own or other women's previous birth experiences. Barriers to informed MOB decision-making were mainly relating to healthcare professionals' (HCPs') negative attitudes, which limited women's perceived options, and women's own strong personal beliefs and opinions. Facilitators included having time, support and information on which to make a robust decision. Conclusions: Barriers to supported decision-making about MOB still exist. HCPs are well placed to guide women through the decision-making process. Informed implementation of decision aids has the potential to address barriers in supported decision-making about MOB in routine NHS antenatal care.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.003 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".