Shared Decision‐Making on Late‐Term Gestation Management (
LATE
‐Study): A Cross‐Sectional Survey Among Maternity Care Providers
Anna E. Seijmonsbergen‐Schermers, Kika Grosheide, Fatima Hammiche, Hannah de Klerk, Judit K. J. Keulen, Caroline J. Bax, Lilian L. Peters, Corine J. Verhoeven ABSTRACT
Objective
Since 2021, a Dutch guideline recommends offering induction of labor (IOL) from 41 + 0 weeks, alongside the option of expectant management (EM), through shared decision‐making (SDM). We examined care providers' opinions and use of the guidelines' SDM tools, self‐reported adherence to SDM content recommendations, perspectives on SDM conversations, and its association with birth beliefs.
Methods
For this cross‐sectional survey, including 575 maternity care providers, an online questionnaire was developed. Most questions used a 5‐point Likert scale. Birth beliefs (medical vs. natural) were assessed using the Birth Beliefs Scale. Uni‐ and multivariable regression analyses were used to assess the association between a medical and natural view and SDM content and perspectives.
Results
Among participants aware of the tools, usage rates were 63% for Tool 1 (steps of SDM), 72% for Tool 2 (choice card IOL/EM), and 51% for Tool 3 (choice card alternatives). Helpfulness scores exceeded the neutral midpoint (3.7, 3.8, and 3.7). The majority of participants reported addressing most of the items of SDM that were recommended in the guideline, though lower rates were seen for addressing outcome percentages (37%), parity differences (33%), and EM beyond 42 weeks (37%). Birth beliefs influenced SDM content, emphasis on advantages of options, and perspectives; those with stronger natural views paid more attention to women's preferences and alternatives.
Conclusion
Care providers are generally positive about the tools in the late‐term management guideline, though not all use them. Key elements for SDM are often omitted, and birth beliefs influence how SDM is conducted.