(1156) Discrepancies in perceived autonomy, trust and information between women and healthcare providers in childbirth decision-making

To assess the alignment between women’s preferences and healthcare providers’ perceptions regarding autonomy, trust and information preferences during decision-making in childbirth 

Study Design:

A cross-sectional, questionnaire-based study was conducted between March and November 2024. Participants included postpartum or laboring women (n=143) and healthcare professionals (n=167; physicians, midwives, nurses). Two parallel questionnaires  of 18 questions were administered assessing trust, level of autonomy in decision-making preferences, information sources, and communication needs. Responses were rated on 1–10 scales and compared using t-tests and chi-square analyses.

Results:

Women reported greater trust in their regular OB-GYN (8.3±2.2) and hospital physicians (8.7±1.7) than providers perceived (7.5±1.5, p< 0.001). Although 47.2% of women preferred shared decision-making, which staff accurately estimated (46.9%), significant gaps were found in other domains. Staff overestimated the influence of family/friends (7.4±1.9 vs. 6.2±2.7; p< 0.001) and religious authority (6.6±2.3 vs. 4.0±3.1; p< 0.001). Women valued information from physicians (9.1±1.4) and scientific literature (6.5±2.8) more than staff assumed (8.0±1.5 and 4.7±2.5, respectively; p< 0.001), while staff overestimated reliance on social media (7.3±1.9 vs. 3.7±2.8; p< 0.001). Real-time explanations during labor and informing birth companions were highly prioritized by women (9.2±1.5 and 9.2±1.8), again underestimated by providers (8.3±1.5 and 8.1±1.8, p< 0.001).

Conclusion:

Significant gaps exist between women’s preferences and healthcare providers' assumptions regarding autonomy, trust and information in childbirth decision-making. Addressing these perception gaps may improve communication, patient-centered care, and patients' satisfaction in obstetric settings.