Work

My Birthplace - An app to support shared decision making

Year: 2014

Type: article

Abstract: The Challenge: Women often receive subjective information about safety and facilities for place of birth from professionals, the internet, media, friends & family and our local birth-rate data demonstrated that a high number of low risk women were delivering in the Obstetric Unit. We believed they weren’t aware of the safety associated with the alternatives, despite the 2011 evidence (Hollowell et al, 2011)1. In addition, the majority of women do not register a preference for place of birth by 36 weeks gestation, therefore it is difficult to plan maternity services. The Response: We wanted to use national data from Birthplace research (Hollowell et al, 2011)1 to offer women objective and evidence based information that would help them identify their preferred place of birth. We considered ways of providing this information whilst supporting the principles of shared decision making between women and their midwives. Using contemporary technology and maternity service users an app was developed for women and midwives. The app was designed to be used on many platforms as it is web-based. It contains Birthplace1 and local data to encourage women to consider their thoughts and feelings about where they would prefer to have their baby. The app development was an iterative process and each stage was developed by maternity service users and midwives, incorporating their feedback to refine the end product. The prototype app was piloted with 236 women who would deliver in October or November 2013 their midwives. We introduced shared decision making training for these midwives (n=30). The women’s preferences for place of birth were recorded at 36 weeks gestation. We designed surveys and held focus groups for women and midwives to understand the usefulness of the app. International Journal of Integrated Care – Volume 14, 01 November – URN:NBN:NL:UI:10-1-116464– http://www.ijic.org/ International Digital Health and Care Congress, The King’s Fund, London, September 10-12 2014. Results: Surveys demonstrated that using an app was acceptable in communicating this information to women and midwives and they valued the evidence based data. 166 women in the pilot group, due to give birth between October and November 2013 were introduced to the app from 25 weeks and preferences were recorded at 36 weeks. We compared this to the preferences routinely collected at their 12 week appointment. Then 75 (45%) had decided about their preferred birthplace at 12 weeks and this increased to 143 (86%) at 36 weeks. This information was captured using digital pens and specifically designed digital forms within the handheld maternity notes. Quotes: “For me, I think that the thing that has worked really well is having an app designed by local women for local women and their families”(Sarah Barton, Maternity Services Liaison Committee).

Source: International Journal of Integrated Care

DOI: 10.5334/ijic.1789