Abstract:

Objective To explore the effects of the multiple shared decision?making mode using a decision aid manual in conjunction with online labor and delivery decision support on the delivery mode for pregnant women with a scarred uterus. Methods A total of 94 women with scarred uterus who received prenatal care at a tertiary hospital from September 2019 to October 2022 were enrolled and assigned to experimental and control groups using the random number table method. The control group received standard prenatal education， and the experimental group received multiple shared decision?making interventions in addition to standard prenatal education. The degree of conflict in decision?making for delivery， preference for delivery mode， postpartum decision regret， and the final delivery mode between the two groups were compared， respectively. Results Following the multiple shared decision intervention， decision conflict scores in the experimental group were significantly reduced （P < 0.001）. In the survey on delivery mode preferences， there was a reduction in the number of individuals in the experimental group expressing "uncertainty"， and an increase in those choosing vaginal delivery. Ultimately， in the experimental group， 30 women （68.2%） underwent cesarean sections， and 14 （31.8%） had vaginal deliveries. The level of post?decision regret in the experimental group was lower than that in the control group （P < 0.001）. Conclusions Multiple shared decision?making for women pregnant with a scarred uterus could reduce the level of decision?making conflict， increase the willingness for vaginal delivery， and assist them in making rational and scientifically informed decisions regarding childbirth.

Key words: scarred uterus, shared decision making, decision aid tool, elective repeat cesarean section, trial of labor after cesarean section