Decision support for breech presentation: what do women want? British Maternal & Fetal Medicine Society (BMFMS) 17th Annual Conference 2015

Introduction: Breech presentation affects 3–4% of singleton term pregnancies and requires women to make decisions about external cephalic version and mode of delivery. Previous research has shown that shared decision making in this context is challenging. This study sought to address this by developing decision support for breech presentation. Methods: Women with experience of breech presentation (n = 43) were recruited from antenatal clinics and day units in three hospitals in the north east of England. Purposive sampling by parity and decisions made ensured a range of different perspectives were sought. Data were collected during observed consultations; semi-structured interviews and design workshops. A user-centred design process was used in design workshops. Data were audio-recorded, transcribed verbatim and analysed using the constant comparison method. Results: Respondents suggested that an internet resource which was freely available, and could therefore be accessed whenever in their pregnancy they chose, would be of value. Such a resource should complement information provided by health professionals and include factual information about risks and benefits; practical and visual information about the interventions; and trustworthy experiential information. These findings were used to develop decision support consisting of an animated film and website. Conclusion: Decision making about breech presentation is distributed across a number of clinical and lay interactions. In response to women’s suggestions, we have developed an animated resource which combines biomedical and epidemiological information with experiential knowledge obtained from women’s accounts to support the decision-making process.