Morris, Rebecca. Improving trial of labor and vaginal birth after cesarean patient education to minimalize decisional conflict in qualified women. Retrieved from https://doi.org/doi:10.7282/t3-h1xr-h011
DescriptionPurpose of Project: The purpose of the is project was to determine if a patient education tool would minimalize decisional conflict for pregnant women who have experienced one previous cesarean section delivery and qualify for a trial of labor after cesarean (TOLAC) and a vaginal birth after cesarean
(VBAC).
Methodology: This project provided qualified participants with a simple, appealing and easy to read Educational Tool/Decision Aid regarding both possible modes of delivery created by the ACNM and Share with Women Organization. Then assessed level of decisional conflict and patient-perceived knowledge post-implementation using the Traditional Decisional Conflict Scale (TDCS) created by The Ottawa Hospital Research Institute. Participants were given the educational tool at one visit, and asked to complete the TDCS at the next.
Results: Sixteen qualified participants with a gestational age of 20 weeks or more were recruited into the study and received the educational tool/decision aid and completed the TDCS. Less than 1% of participants experienced significant levels of decisional conflict, and about 94% of participants felt very informed, following the implementation of the educational tool/decision aid. Four of the participants reported wanting to attempt TOLAC, while 10 elected for ERCS and 2 reported they were still unsure.
Implications for Practice: The use of this educational tool/decision aid can significantly help women minimalize decisional conflict and feel more informed with deciding between TOLAC and ERCS. This tool can easily be used by midwives, doctors, physician’s assistants and more to help educate qualified women. This can overall, help women become active participants in their healthcare decisions and advocate for themselves and other women. This can eventually lead to better outcomes for all mothers and babies.