Perceived Reality and Subjective Importance of Shared Decision-Making During Perinatal Care

Aim: The aim of the study is to explore the perceived reality and subjective importance of shared decision-making (SDM) during antenatal, intrapartum, and/or postpartum care, provided by the midwife and/or obstetrician. Methods: A cross-sectional study was conducted among women in Flanders, Belgium. SDM was measured with the Observing PatienT InvOlvemeNt scale. The differences between perceived reality and subjective importance of SDM were examined using t tests. A multivariate generalized linear model tested the main and interaction effects between SDM and the maternity care providers and the perinatal care periods. Bonferroni post hoc tests examined further significance. Results: A total of 1,216 pregnant and postpartum participants completed 1,987 self-reports of perceived reality and subjective importance of SDM. The community midwives' SDM was evaluated 924/1,987 times, the hospital midwives' SDM 309/1,987 times, and the obstetricians' SDM 754/1,987 times. Perceived reality and subjective importance of SDM showed significant differences between care professionals (p < .001; p < .001), explained by the differences between community and hospital midwives' SDM (p < .001, d .85; p < .001; d .28) and between community midwives and obstetricians' SDM (p < .001, d .72; p < .001; d .31). Conclusions: The findings indicate optimizing the decision-making process during perinatal care by aligning subjective importance and perceived reality of SDM throughout the perinatal care episodes. Community midwives seem to be benchmarkers of shared decision-making during perinatal care.