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

<ns3:p> 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 1 <ns3:sup>st</ns3:sup> January 2011 up to 15 <ns3:sup>th</ns3:sup> 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: <ns3:italic>Important information needs</ns3:italic> , <ns3:italic>Decision support needs</ns3:italic> and <ns3:italic>Timing of decision support</ns3:italic> . 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. </ns3:p>