Pregnant persons and birth partners' experiences of shared decision-making during pregnancy and childbirth: An umbrella review.

Abstract

This umbrella review aimed to summarize evidence on pregnant persons and/or their birth partners' experiences and expectations of SDM during pregnancy and childbirth. We searched eight databases from 2011 to 2023. Quantitative, qualitative and mixed methods systematic reviews were included in this review. We have identified 26 reviews that report on 622 primary studies involving over 213,000 pregnant persons and 22,000 birth partners, examining a broad range of decision-making scenarios in maternity care. The three-talk model was used to categorise the themes which include communication, weighing options, and making a decision. Multiple reviews have reported that pregnant persons and birth partners have mixed experiences in several decision-making scenarios, with insufficient information and inadequate consideration or answers to their questions being common issues. Pregnant persons and birth partners prefer clear explanations, simple communication, and involvement in decision-making. Exclusion from the decision-making during pregnancy and childbirth may lead to negative experiences, whilst involvement improves satisfaction, reduces distress and fosters empowerment. The review highlights the importance of promoting SDM in maternity care, as it is fundamental to promoting maternal, newborn, and family well-being. Health systems should redesign antenatal classes and train healthcare providers to enhance communication skills and encourage informed decision-making by pregnant persons and birth partners.