Shared decision-making is a collaborative process that acknowledges patients' authority in their health care decisions (Barry and Edgman-Letivan, 2012). Shared decision-making offers the opportunity for patients to receive complete and accurate information, to clarify values, and to receive decisional support (Romano, 2013). Through the course of care, the midwife communicates evidence-based information, engages the patient in an exploration of their respective values, knowledge, and experience, and elicits a preference based on the results of that exploration.
Maternity care in the United States is becoming increasingly complex and procedure-intensive, and patients often have inadequate knowledge to make informed decisions (Gee and Corry, 2012). Advantages for using a shared decision-making process are higher client satisfaction, more positive relations among the care team, and higher levels of trust.
Midwives are uniquely poised to lead the maternity care community in implementing a more meaningful shared decision-making process. As patient-centered care is the heart and foundation of midwifery care, midwives have the skill to work in therapeutic partnership with women to navigate the uncertain evidence in maternity care. Through shared exploration of values and goals, midwives and patients develop a plan of care that balances the ethical obligations of beneficence and non-maleficence with respect for autonomy.
For more key points, information and background on shared decision-making please see the ACNM Position Statement on Shared Decision-Making in Midwifery Care. Click here.
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