What are the information and decision-support needs of women planning mode of birth in routine antenatal care in high-income countries? A qualitative evidence synthesis

C Robertson; M Cruickshank; M Brazzelli; A Ekong; M Ade; P McDonagh Hull; P Manson; D Bick; D Devane; D Williams; G Taylor; L Braithwaite; M Kilonzo; T Fairley; S Bhattacharya; L Locock; M Rzewuska Diaz; M Black

doi:10.3310/nihropenres.14178.1

What are the information and decision-support needs of women planning mode of birth in routine antenatal care in high-income countries? A qualitative evidence synthesis

C Robertson
, M Cruickshank
, M Brazzelli
, A Ekong
, M Ade
, P McDonagh Hull
, P Manson
, D Bick
, D Devane
, D Williams
, G Taylor
, L Braithwaite
, M Kilonzo
, T Fairley
, S Bhattacharya
, L Locock
, M Rzewuska Diaz
, M Black

Research output: Contribution to journal › Article › peer-review

Abstract

Background
NICE guidance recommends that pregnant women should be engaged in evidence-based discussions about planned mode of birth (MOB) options. Decision aids can assist these discussions; however, no such resource exists for routine antenatal care. This qualitative evidence synthesis aimed to identify the information and decision-support needs of women planning MOB in high-income countries.

Methods
We searched seven electronic bibliographic databases for articles published in English from 1st January 2011 up to 15th November 2022. Studies were included if they provided qualitative data from current/previously pregnant women, without specific complications, about their information and decision support needs when planning MOB in a high-income country. Identified sub-themes were grouped and mapped onto three pre-established global themes: Important information needs, Decision support needs and Timing of decision support. Quality assessment was conducted using the CASP checklist for qualitative studies.

Results
Thirty-three studies of 2764 participants were included. Most studies were of adequate quality. Women want clear, balanced information comparing the risks/benefits of planned vaginal or caesarean birth. They were frustrated that they often received inadequate and/or unbalanced information. Information about other women’s experiences was often valued more than impersonal information.

Conclusions
A decision aid is needed to support personalised and balanced MOB discussions as part of routine antenatal care in the NHS.

Original language	English
Journal	NIHR Open Research
Volume	6
Issue number	4
DOIs	https://doi.org/10.3310/nihropenres.14178.1
Publication status	Accepted/In press - 8 Jan 2026

Bibliographical note

Vikki Entwistle and the charity NCT are acknowledged for their involvement in developing the study proposal and in the interpretation of study findings. We thank Kelly Gray, Aberdeen Centre for Women’s Health Research, University of Aberdeen, for her administrative support.

Data Availability Statement

Data are available from the following Open Science Framework data repository; Plan-A: What are the information and decision-support needs of women planning mode of birth in routine antenatal care in high-income countries? A qualitative evidence synthesis; DOI 10.17605/OSF.IO/S29KJ, available at https://osf.io/s29kj/63.

Funding

This project is funded by the National Institute for Health and Care Research (NIHR), Health and Social Care Delivery Research (HSDR) Programme (Grant Reference Number NIHR150979)]. The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Funders	Funder number
National Institute for Health and Care Research	NIHR150979

Keywords

Qualitative
systematic review
mode of birth
decision-aid

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.3310/nihropenres.14178.1Licence: CC BY

Plan-A: What are the information and decision-support needs of women planning mode of birth in routine antenatal care in high-income countries? A qualitative evidence synthesis
Robertson, C. (Creator), Black, M. (Creator), Brazzelli, M. (Creator) & Cruickshank, M. (Creator), University of Aberdeen, 17 Dec 2025
DOI: 10.17605/OSF.IO/S29KJ
Dataset

Cite this

Robertson, C., Cruickshank, M., Brazzelli, M., Ekong, A., Ade, M., McDonagh Hull, P., Manson, P., Bick, D., Devane, D., Williams, D., Taylor, G., Braithwaite, L., Kilonzo, M., Fairley, T., Bhattacharya, S., Locock, L., Rzewuska Diaz, M., & Black, M. (Accepted/In press). What are the information and decision-support needs of women planning mode of birth in routine antenatal care in high-income countries? A qualitative evidence synthesis. NIHR Open Research, 6(4). https://doi.org/10.3310/nihropenres.14178.1

Robertson, C , Cruickshank, M , Brazzelli, M, Ekong, A, Ade, M, McDonagh Hull, P, Manson, P, Bick, D, Devane, D, Williams, D, Taylor, G, Braithwaite, L, Kilonzo, M, Fairley, T, Bhattacharya, S , Locock, L , Rzewuska Diaz, M & Black, M 2026, 'What are the information and decision-support needs of women planning mode of birth in routine antenatal care in high-income countries? A qualitative evidence synthesis', NIHR Open Research, vol. 6, no. 4. https://doi.org/10.3310/nihropenres.14178.1

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abstract = "Background NICE guidance recommends that pregnant women should be engaged in evidence-based discussions about planned mode of birth (MOB) options. Decision aids can assist these discussions; however, no such resource exists for routine antenatal care. This qualitative evidence synthesis aimed to identify the information and decision-support needs of women planning MOB in high-income countries. Methods We searched seven electronic bibliographic databases for articles published in English from 1st January 2011 up to 15th November 2022. Studies were included if they provided qualitative data from current/previously pregnant women, without specific complications, about their information and decision support needs when planning MOB in a high-income country. Identified sub-themes were grouped and mapped onto three pre-established global themes: Important information needs, Decision support needs and Timing of decision support. Quality assessment was conducted using the CASP checklist for qualitative studies. Results Thirty-three studies of 2764 participants were included. Most studies were of adequate quality. Women want clear, balanced information comparing the risks/benefits of planned vaginal or caesarean birth. They were frustrated that they often received inadequate and/or unbalanced information. Information about other women{\textquoteright}s experiences was often valued more than impersonal information. Conclusions A decision aid is needed to support personalised and balanced MOB discussions as part of routine antenatal care in the NHS.",

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AU - Ekong, A

AU - Ade, M

AU - McDonagh Hull, P

AU - Manson, P

AU - Bick, D

AU - Devane, D

AU - Williams, D

AU - Taylor, G

AU - Braithwaite, L

AU - Kilonzo, M

AU - Fairley, T

AU - Bhattacharya, S

AU - Locock, L

AU - Rzewuska Diaz, M

AU - Black, M

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Y1 - 2026/1/8

N2 - Background NICE guidance recommends that pregnant women should be engaged in evidence-based discussions about planned mode of birth (MOB) options. Decision aids can assist these discussions; however, no such resource exists for routine antenatal care. This qualitative evidence synthesis aimed to identify the information and decision-support needs of women planning MOB in high-income countries. Methods We searched seven electronic bibliographic databases for articles published in English from 1st January 2011 up to 15th November 2022. Studies were included if they provided qualitative data from current/previously pregnant women, without specific complications, about their information and decision support needs when planning MOB in a high-income country. Identified sub-themes were grouped and mapped onto three pre-established global themes: Important information needs, Decision support needs and Timing of decision support. Quality assessment was conducted using the CASP checklist for qualitative studies. Results Thirty-three studies of 2764 participants were included. Most studies were of adequate quality. Women want clear, balanced information comparing the risks/benefits of planned vaginal or caesarean birth. They were frustrated that they often received inadequate and/or unbalanced information. Information about other women’s experiences was often valued more than impersonal information. Conclusions A decision aid is needed to support personalised and balanced MOB discussions as part of routine antenatal care in the NHS.

AB - Background NICE guidance recommends that pregnant women should be engaged in evidence-based discussions about planned mode of birth (MOB) options. Decision aids can assist these discussions; however, no such resource exists for routine antenatal care. This qualitative evidence synthesis aimed to identify the information and decision-support needs of women planning MOB in high-income countries. Methods We searched seven electronic bibliographic databases for articles published in English from 1st January 2011 up to 15th November 2022. Studies were included if they provided qualitative data from current/previously pregnant women, without specific complications, about their information and decision support needs when planning MOB in a high-income country. Identified sub-themes were grouped and mapped onto three pre-established global themes: Important information needs, Decision support needs and Timing of decision support. Quality assessment was conducted using the CASP checklist for qualitative studies. Results Thirty-three studies of 2764 participants were included. Most studies were of adequate quality. Women want clear, balanced information comparing the risks/benefits of planned vaginal or caesarean birth. They were frustrated that they often received inadequate and/or unbalanced information. Information about other women’s experiences was often valued more than impersonal information. Conclusions A decision aid is needed to support personalised and balanced MOB discussions as part of routine antenatal care in the NHS.

KW - Qualitative

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KW - decision-aid

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ER -

What are the information and decision-support needs of women planning mode of birth in routine antenatal care in high-income countries? A qualitative evidence synthesis

Abstract

Bibliographical note

Data Availability Statement

Funding

Keywords

UN SDGs

Access to Document

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Datasets

Plan-A: What are the information and decision-support needs of women planning mode of birth in routine antenatal care in high-income countries? A qualitative evidence synthesis

Cite this