Planning a birth after C-section made simpler
My Next Birth is a personalized online interactive patient decision aid now being used throughout BC to help people who have previously had a C-section make better-informed decisions about navigating their next pregnancy and birth. Over 75% of people in BC who have had a C-section are good candidates for a vaginal birth after cesarean, but families often have to wait until the next pregnancy to start discussing options with their care team. People want to learn about their options for their next birth sooner. Researchers conducted a series of qualitative studies and surveys in BC and found that families and care teams needed more support when exchanging information.[1-4] Families wanted to know what the reasons were for their first C-section. Was it from something unexpected that happened during labor? Is this something that might happen again in the future? What are the options for their next birth?
The program helps them think about their preferences and jot down their questions, and it provides tailored information specific to their values and needs. It also factors in where they live in BC so they can consider what resources are available locally. After they work through the website, they receive a personalized summary to guide conversations and questions with their health care team.
The program also provides tools for health care teams, including a decision support algorithm that walks the care provider through the patient’s journey and a list of conversation prompts to guide discussions after a C-section. The hope is that the program can be a support for families to be active participants in their care.
Dr Sarah Munro, an assistant professor in obstetrics and gynecology, developed the program with her team at UBC in partnership with Perinatal Services BC, provincial health authorities, the Ministry of Health, as well as patient partners. For more information, visit www.perinatalservicesbc.ca/health-professionals/professional-resources/birth-after-caesarean.
References
1. Munro S, Kornelsen J, Wilcox E, et al. Implementation of shared decision-making in healthcare policy and practice: A complex adaptive systems perspective. Evidence and Policy: A Journal of Research, Debate and Practice 2020;16:393-411.
2. Munro S, Wilcox E, Lambert LK, et al. A survey of health care practitioners’ attitudes toward shared decision-making for choice of next birth after cesarean. Birth Issues in Perinatal Care 2021;48:194-208.
3. Munro S, Janssen P, Corbett K, et al. Seeking control in the midst of uncertainty: Women’s experiences of choosing mode of birth after caesarean. Women and Birth 2017;30:129-136.
4. Munro S, Kornelsen J, Corbett K, et al. Do women have a choice? Care providers’ and decision makers’ perspectives on barriers to access of health services for birth after a previous cesarean. 2017;44:153-160.
