Shared decision-making in a medicalized birth environment: mixed-methods exploratory study, Cyprus

Abstract Background Maternity care practices are not always supportive of participation in decision-making; a fundamental pillar of the WHO Respectful Maternity Care framework. With the highest caesarean section (C/S) rate in the EU (>60%), high episiotomy rates (70.9%) etc, the medicalised birth...

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Published in:European journal of public health 2023-10, Vol.33 (Supplement_2)
Main Authors: Middleton, N, Koliandri, I, Hadjigeorgiou, E, Christodoulides, V, Nicolaou, C, Kouta, C, Karanikola, M, Orphanides, I, Kolokotroni, O
Format: Article
Language:English
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Summary:Abstract Background Maternity care practices are not always supportive of participation in decision-making; a fundamental pillar of the WHO Respectful Maternity Care framework. With the highest caesarean section (C/S) rate in the EU (>60%), high episiotomy rates (70.9%) etc, the medicalised birth environment in Cyprus raises questions about Informed Choice. Methods Following focus groups (N = 12) with pregnant women and new mums (N = 62), an online survey was shared via the Baby Buddy Cyprus webapp. Women responded to the Maternal Autonomy in Decision-Making (MADM) scale along a battery of scales, including perceived efficacy in patient-provider interaction (PEPPI) and Kim Alliance Scale (KAS). Results Based on MADM classification, 54.3% of 387 participants (64% primiparas, 42% C/S, 80% private sector) were classified as having high autonomy, while one in five were classified as low or very low. There were lower scores among primiparous women (p = 0.02) and higher among those receiving care in the private sector (p 
ISSN:1101-1262
1464-360X
DOI:10.1093/eurpub/ckad160.1529