Shared Decision-Making for Delivery Mode: An OPTION Scale Observer-Based Evaluation

Objective: Shared decision-making (SDM) may help to reduce the rate of Cesarean Delivery (CD). The aim of the study was to evaluate the extent to which pregnant women are involved in SDM about the mode of delivery, applying the Italian version of the OPTION12 scale to obstetric consultations. Methods: Fifty-eight outpatient consultations were rated; statistical associations between OPTION12 scores and sociodemographic data of both patient and physicians were determined. Results: The OPTION12 total scores showed a skewed distribution in the lower range of total scores. Total scores in a percentage basis ranged from 0 to 69, with a mean of 21.2 (±19.84) and a median of 13.5. Mean and median scores for all the 12 OPTION12 items never reached the minimum skill level. Conclusion: A low level of patient involvement in deciding between a CD and a Vaginal Delivery (VD) was demonstrated. Interventions aiming at educating obstetricians as well as the adoption of decision aids are requested. Practice implications: The OPTION12 scale may prove useful for testing the extent of pregnant women's involvement in deciding between CD and VD. The awareness of a low patient involvement seems mandatory to improve SDM and may lead to medico-legal protection.