Pregnant women comply with, rather than choose, mode of birth

Competing demands and time pressures on health professionals ensure that pregnant women comply with, rather than choose, how they want to give birth. Stapleton and colleagues (p 639) observed 886 antenatal consultations and interviewed 383 pregnant women in Wales and found that health professionals often did not discuss the contents of the widely used leaflet Informed Choice. Women's trust in health professionals meant that they complied with professionally defined choices and rarely asked questions or made alternative requests. Fear of litigation, power hierarchies and technology limited the choices available. A randomised cluster trial by O'Cathain and colleagues (p 643) also found that Informed Choice was not effective in promoting informed choice of women using maternity services. There was no difference in the proportion of women in the intervention and control group who reported they exercised informed choice. However, women in the intervention group were more satisfied with the information they received, even though only three quarters of them reported actually being given a leaflet (the intervention).

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