Caesarean section or vaginal delivery for low-risk pregnancy? Helping women make an informed choice in low- and middle-income countries.
Women's fear and uncertainty about vaginal delivery and lack of empowerment in decision-making generate decision conflict and is one of the main determinants of high caesarean section rates in low- and middle-income countries (LMICs). This study aims to develop a decision analysis tool (DAT) to...
Saved in:
| Main Authors: | , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2022-01-01
|
| Series: | PLOS Global Public Health |
| Online Access: | https://doi.org/10.1371/journal.pgph.0001264 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849337118731534336 |
|---|---|
| author | Alexandre Dumont Myriam de Loenzien Hung Mac Quo Nhu Marylène Dugas Charles Kabore Pisake Lumbiganon Maria Regina Torloni Celina Gialdini Guillermo Carroli Claudia Hanson Ana Pilar Betrán QUALI-DEC consortium |
| author_facet | Alexandre Dumont Myriam de Loenzien Hung Mac Quo Nhu Marylène Dugas Charles Kabore Pisake Lumbiganon Maria Regina Torloni Celina Gialdini Guillermo Carroli Claudia Hanson Ana Pilar Betrán QUALI-DEC consortium |
| author_sort | Alexandre Dumont |
| collection | DOAJ |
| description | Women's fear and uncertainty about vaginal delivery and lack of empowerment in decision-making generate decision conflict and is one of the main determinants of high caesarean section rates in low- and middle-income countries (LMICs). This study aims to develop a decision analysis tool (DAT) to help pregnant women make an informed choice about the planned mode of delivery and to evaluate its acceptability in Vietnam, Thailand, Argentina, and Burkina Faso. The DAT targets low-risk pregnant women with a healthy, singleton foetus, without any medical or obstetric disorder, no previous caesarean scarring, and eligibility for labour trials. We conducted a systematic review to determine the short- and long-term maternal and offspring risks and benefits of planned caesarean section compared to planned vaginal delivery. We carried out individual interviews and focus group discussions with key informants to capture informational needs for decision-making, and to assess the acceptability of the DAT in participating hospitals. The DAT meets 20 of the 22 Patient Decision Aid Standards for decision support. It includes low- to moderate-certainty evidence-based information on the risks and benefits of both modes of birth, and helps pregnant women clarify their personal values. It has been well accepted by women and health care providers. Adaptations have been made in each country to fit the context and to facilitate its implementation in current practice, including the development of an App. DAT is a simple method to improve communication and facilitate shared decision-making for planned modes of birth. It is expected to build trust and foster more effective, satisfactory dialogue between pregnant women and providers. It can be easily adapted and updated as new evidence emerges. We encourage further studies in LMICs to assess the impact of DAT on quality decision-making for the appropriate use of caesarean section in these settings. |
| format | Article |
| id | doaj-art-204413d865ef4e5cb4cf96ceac4406a3 |
| institution | Kabale University |
| issn | 2767-3375 |
| language | English |
| publishDate | 2022-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLOS Global Public Health |
| spelling | doaj-art-204413d865ef4e5cb4cf96ceac4406a32025-08-20T03:44:47ZengPublic Library of Science (PLoS)PLOS Global Public Health2767-33752022-01-01211e000126410.1371/journal.pgph.0001264Caesarean section or vaginal delivery for low-risk pregnancy? Helping women make an informed choice in low- and middle-income countries.Alexandre DumontMyriam de LoenzienHung Mac Quo NhuMarylène DugasCharles KaborePisake LumbiganonMaria Regina TorloniCelina GialdiniGuillermo CarroliClaudia HansonAna Pilar BetránQUALI-DEC consortiumWomen's fear and uncertainty about vaginal delivery and lack of empowerment in decision-making generate decision conflict and is one of the main determinants of high caesarean section rates in low- and middle-income countries (LMICs). This study aims to develop a decision analysis tool (DAT) to help pregnant women make an informed choice about the planned mode of delivery and to evaluate its acceptability in Vietnam, Thailand, Argentina, and Burkina Faso. The DAT targets low-risk pregnant women with a healthy, singleton foetus, without any medical or obstetric disorder, no previous caesarean scarring, and eligibility for labour trials. We conducted a systematic review to determine the short- and long-term maternal and offspring risks and benefits of planned caesarean section compared to planned vaginal delivery. We carried out individual interviews and focus group discussions with key informants to capture informational needs for decision-making, and to assess the acceptability of the DAT in participating hospitals. The DAT meets 20 of the 22 Patient Decision Aid Standards for decision support. It includes low- to moderate-certainty evidence-based information on the risks and benefits of both modes of birth, and helps pregnant women clarify their personal values. It has been well accepted by women and health care providers. Adaptations have been made in each country to fit the context and to facilitate its implementation in current practice, including the development of an App. DAT is a simple method to improve communication and facilitate shared decision-making for planned modes of birth. It is expected to build trust and foster more effective, satisfactory dialogue between pregnant women and providers. It can be easily adapted and updated as new evidence emerges. We encourage further studies in LMICs to assess the impact of DAT on quality decision-making for the appropriate use of caesarean section in these settings.https://doi.org/10.1371/journal.pgph.0001264 |
| spellingShingle | Alexandre Dumont Myriam de Loenzien Hung Mac Quo Nhu Marylène Dugas Charles Kabore Pisake Lumbiganon Maria Regina Torloni Celina Gialdini Guillermo Carroli Claudia Hanson Ana Pilar Betrán QUALI-DEC consortium Caesarean section or vaginal delivery for low-risk pregnancy? Helping women make an informed choice in low- and middle-income countries. PLOS Global Public Health |
| title | Caesarean section or vaginal delivery for low-risk pregnancy? Helping women make an informed choice in low- and middle-income countries. |
| title_full | Caesarean section or vaginal delivery for low-risk pregnancy? Helping women make an informed choice in low- and middle-income countries. |
| title_fullStr | Caesarean section or vaginal delivery for low-risk pregnancy? Helping women make an informed choice in low- and middle-income countries. |
| title_full_unstemmed | Caesarean section or vaginal delivery for low-risk pregnancy? Helping women make an informed choice in low- and middle-income countries. |
| title_short | Caesarean section or vaginal delivery for low-risk pregnancy? Helping women make an informed choice in low- and middle-income countries. |
| title_sort | caesarean section or vaginal delivery for low risk pregnancy helping women make an informed choice in low and middle income countries |
| url | https://doi.org/10.1371/journal.pgph.0001264 |
| work_keys_str_mv | AT alexandredumont caesareansectionorvaginaldeliveryforlowriskpregnancyhelpingwomenmakeaninformedchoiceinlowandmiddleincomecountries AT myriamdeloenzien caesareansectionorvaginaldeliveryforlowriskpregnancyhelpingwomenmakeaninformedchoiceinlowandmiddleincomecountries AT hungmacquonhu caesareansectionorvaginaldeliveryforlowriskpregnancyhelpingwomenmakeaninformedchoiceinlowandmiddleincomecountries AT marylenedugas caesareansectionorvaginaldeliveryforlowriskpregnancyhelpingwomenmakeaninformedchoiceinlowandmiddleincomecountries AT charleskabore caesareansectionorvaginaldeliveryforlowriskpregnancyhelpingwomenmakeaninformedchoiceinlowandmiddleincomecountries AT pisakelumbiganon caesareansectionorvaginaldeliveryforlowriskpregnancyhelpingwomenmakeaninformedchoiceinlowandmiddleincomecountries AT mariareginatorloni caesareansectionorvaginaldeliveryforlowriskpregnancyhelpingwomenmakeaninformedchoiceinlowandmiddleincomecountries AT celinagialdini caesareansectionorvaginaldeliveryforlowriskpregnancyhelpingwomenmakeaninformedchoiceinlowandmiddleincomecountries AT guillermocarroli caesareansectionorvaginaldeliveryforlowriskpregnancyhelpingwomenmakeaninformedchoiceinlowandmiddleincomecountries AT claudiahanson caesareansectionorvaginaldeliveryforlowriskpregnancyhelpingwomenmakeaninformedchoiceinlowandmiddleincomecountries AT anapilarbetran caesareansectionorvaginaldeliveryforlowriskpregnancyhelpingwomenmakeaninformedchoiceinlowandmiddleincomecountries AT qualidecconsortium caesareansectionorvaginaldeliveryforlowriskpregnancyhelpingwomenmakeaninformedchoiceinlowandmiddleincomecountries |