A Person-Centered Approach to Pregnancy and Birth Decisions
Pregnancy and birth involve lots of decision making, and while there’s a lot of pressure to make the “right” choices, person-centered decision making recognizes that there is often more than one reasonable option. Person-centered decision making combines the best available evidence with your individual goals, values, preferences, and circumstances.
The Birth Place Lab breaks down four responsibilities and eight elements of decision making.
Here are some ways you can use a person-centered approach with birth decisions!
1. Identify the Decision-Makers
The first step is determining who should be involved in the decision.
For most pregnancy and birth decisions, the pregnant woman is the primary decision-maker. Partners, family members, doulas, and healthcare providers may also play important supportive roles. Clarifying who is involved and to what extent helps everyone understand and respect each others’ roles.
2. Name and Explain the Issue
Before a decision can be made, everyone needs a clear understanding of the situation.
What decision needs to be made? Why is it being discussed? Is there a medical concern, a routine option, or a change in circumstances?
Taking time to clearly define the issue prevents confusion and makes sure everyone is working from the same information.
3. Establish Preferences for Information
Not everyone wants information presented in the same way.
Some people prefer detailed research and statistics, while others prefer a broader overview. Some learn best through conversation, while others want written materials to review.
So when a woman is in labor, does she prefer information to be given bluntly as soon as possible, or would she rather have a gentler back and forth conversation? These are questions to determine ahead of time.
4. Present the Options and Discuss Pros and Cons
Once the issue is understood, all reasonable options should be presented.
For each option, discuss:
Potential benefits
Possible risks
Alternatives
Areas of uncertainty
What may happen if no action is taken
The goal is not to persuade someone toward a particular choice, but to help them understand all the available options.
5. Clarify and Check Understanding
Good communication goes both ways.
Providers should confirm that families understand the information presented, and families should feel comfortable asking questions or expressing concerns.
This step helps identify misunderstandings before a decision is made and ensures everyone is on the same page.
6. Personalize the Care Plan
A decision is not made in a vacuum.
Medical evidence is important, but so are a family's values, priorities, cultural beliefs, previous experiences, support systems, and individual circumstances.
The best care plans reflect both the evidence and the unique needs of the person receiving care.
7. Allow Time for Consideration and Reflection
Most decisions do not need to be made immediately.
When possible, families should be given time to think, ask additional questions, seek support, and reflect on what feels right for them.
Thoughtful decisions often require space, time, and privacy.
8. Make or Defer the Decision
After discussing the options and considering personal values, a decision can be made collaboratively.
In some cases, the best decision may be to move forward with a particular option. In others, it may be appropriate to wait, gather more information, or revisit the discussion later. The key is that everyone is on board with the plan and agrees on the next steps.
As new information becomes available, decisions may need to be revisited. Follow-up conversations ensure the care plan continues to reflect the family's goals and the current situation.
