How healthcare provider communication about risk and decision making role affects decisions about birth after caesarean

Despite clinical and policy consensus that all eligible candidates for vaginal birth after a caesarean should be presented with that option, there is controversy and mixed opinion among maternity care providers about the best approach to birth after caesarean and clinical superiority of one option over another has not been established. Shared decision making requires complex risk information for each option to be provided in a format that best facilitates understanding and promotes engagement in decision-making. There is qualitative evidence that sub-optimal risk communication by healthcare providers prohibits women with a history of caesarean section from making informed decisions about subsequent births, but this has not been confirmed in empirical research. Several features of healthcare provider communication may undermine effective shared decision-making, including selective communication of partial risk and benefit information to reflect/create a persuasive bias, providing information about likelihood of outcomes in relative format, and discouraging patient involvement in decision making. We experimentally investigated how health care provider communication of risk information and women’s role in decision-making influenced women’s mode of birth decisions after a previous caesarean