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

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 st January 2011 up to 15 th 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: Important information needs , Decision support needs and Timing of decision support . 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.