The Effect of Shared Decision Making on Anxiety and Satisfaction of Decision about Mode of Delivery in Pregnant Women with A History of Previous Cesarean Section: A Randomized Clinical Trial

Background & aim: Anxiety in pregnant women can have negative perinatal consequences. The aim of this study was to determine the effect of shared decision making on anxiety and satisfaction of decision about mode of delivery in pregnant women with a history of previous cesarean section.Methods: In this clinical trial, ۷۸ pregnant women with previous cesarean section referred to the community health centers in Torbat-e Jam, Iran were selected and randomly assigned to the intervention and control groups. The Spielberger Anxiety Inventory was completed by the pregnant women at ۲۴-۳۰ weeks of pregnancy. In the experimental group, in addition to routine care, a counseling session based on three-stage shared decision making was held by a midwife and a supplementary counseling session by a gynecologist. The Anxiety Inventory was completed at ۳۵-۳۷ weeks of gestation and the Decision Satisfaction Questionnaire was completed ۸ weeks after delivery for mothers in both groups in the community health centers and questions were asked about mode of delivery. Data were analyzed using Mann-Whitney, Chi-square, student t-test and paired t-test.Results: After the intervention, the total anxiety score of pregnant women in the intervention group was lower than the control group and the difference between the two groups was significant (۷۰.۳۵±۱۱.۹۰ vs. ۷۵.۵۱±۶.۶۴; P=۰.۰۲). The score of decision satisfaction two months after delivery was higher in the intervention group than the control group and there was a statistically significant difference between the two groups (۲۱.۸۷±۳.۱۸ vs. ۱۹.۹۴±۳.۱۳; P=۰.۰۰۸).Conclusions: Shared decision making as a practical and effective approach can reduce the anxiety score and increase the score of decision satisfaction in pregnant women with a history of previous cesarean section.

Keywords:

Shared decision making , Vaginal Birth after Cesarean , Anxiety , Decision satisfaction