To be a crew member, a passenger, or plainly left behind – a qualitative study of women’s experiences of decision-making regarding interventions in labour and birth

PROBLEM AND BACKGROUND: Interventions in labour and birth are common. All interventions in healthcare need patient consent, yet research demonstrates this is often not the case. Interventions in labour and birth without consent from the woman might negatively affect her birthing experience. AIM: To explore women's experiences of the decision-making regarding interventions during labour with spontaneous onset. METHODS: 19 qualitative interviews, following a semi-structured interview guide, were analysed with inductive reflexive Thematic Analysis, using a constructivist perspective. FINDINGS: To highlight women's experiences of inclusion in decision-making, three themes were developed; To be a crew member, Choosing to be a passenger, and To be left behind. The experiences varied depending on personal expectations, the intensity and stage of labour, and the healthcare professionals' inclusion strategies. DISCUSSION: By receiving evidence-based information, and meeting healthcare professionals who adopt an open and inclusive mind regarding the woman's preferred level of decision-making, from antenatal care throughout labour and birth, the feeling of inclusion in the birth-team, and the overall birth-experience, might be positively affected. CONCLUSION: Women's experiences and preferences regarding inclusion in decision-making vary depending on individual expectations, the timing of interventions and the healthcare professional's inclusion strategies. Perinatal discussions, and healthcare professionals' openness for wishes and active inclusion of women regarding decision-making, might help women be involved at a level that suits their personal needs and wishes.