Trial reportJournal of obstetric, gynecologic, and neonatal nursing : JOGNN
A randomized comparative trial of two decision tools for pregnant women with prior cesareans.
Trial report in Journal of obstetric, gynecologic, and neonatal nursing : JOGNN. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 6 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
15 citing papers in PubMed, 6 syntheses or guidelines pooled it.
- Decision aids for people facing health treatment or screening decisions.The Cochrane database of systematic reviews · 2024Pooled it
- The effectiveness of decision aids for pregnancy related decision-making in women with pre-pregnancy morbidity; systematic review and meta-analysis.BMC pregnancy and childbirth · 2022Pooled it
- Public target interventions to reduce the inappropriate use of medicines or medical procedures: a systematic review.Implementation science : IS · 2020Pooled it
- Adjunct clinical interventions that influence vaginal birth after cesarean rates: systematic review.BMC pregnancy and childbirth · 2018Pooled it
- Non-clinical interventions for reducing unnecessary caesarean section.The Cochrane database of systematic reviews · 2018Pooled it
- Decision aids for people facing health treatment or screening decisions.The Cochrane database of systematic reviews · 2017Pooled it
- Effect of shared decision making on mode of delivery and decisional conflict and regret in pregnant women with previous cesarean section: a randomized clinical trial.BMC pregnancy and childbirth · 2021Trial
- Trial
- Clinical decision support systems for maternity care: a systematic review and meta-analysis.EClinicalMedicine · 2024Article
- Exploring the acceptability of a decision aid for rural women with a history of prior cesarean birth regarding subsequent mode of birth in Coatepeque, Guatemala.Frontiers in global women's health · 2024Article
- Patient decision aid for trial of labor after cesarean (TOLAC) versus planned repeat cesarean delivery: a quasi-experimental pre-post study.BMC pregnancy and childbirth · 2021Article
- Implementation and evaluation of nonclinical interventions for appropriate use of cesarean section in low- and middle-income countries: protocol for a multisite hybrid effectiveness-implementation type III trial.Implementation science : IS · 2020Article
- Changes in perceived knowledge about childbirth among pregnant women participating in the Senses of Birth intervention in Brazil: a cross-sectional study.BMC pregnancy and childbirth · 2020Article
- Women's Preferences Regarding the Processes and Outcomes of Trial of Labor After Cesarean and Elective Repeat Cesarean Delivery.Journal of women's health (2002) · 2019Article
- A Review of Decision Aids for Patients Considering More Than One Type of Invasive Treatment.The Journal of surgical research · 2019Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
Abstract
objectiveEvaluate tools to help pregnant women with prior cesareans make informed decisions about having trials of labor.
designRandomized comparative trial.
settingA research assistant with a laptop met the women in quiet locations at clinics and at health fairs.
participantsPregnant women (N = 131) who had one prior cesarean and were eligible for vaginal birth after cesarean (VBAC) participated one time between 2005 and 2007.
methodsWomen were randomized to receive either an evidence-based, interactive decision aid or two evidence-based educational brochures about cesarean delivery and VBAC. Effect on the decision-making process was assessed before and after the interventions.
resultsCompared to baseline, women in both groups felt more informed (F = 23.8, p < .001), were more clear about their birth priorities (F = 9.7, p = .002), felt more supported (F = 9.8, p = .002, and overall reported less conflict (F = 18.1, p < 0.001) after receiving either intervention. Women in their third trimesters reported greater clarity around birth priorities after using the interactive decision aid than women given brochures (F = 9.8, p = .003).
conclusionAlthough both decision tools significantly reduced conflict around the birth decision compared to baseline, more work is needed to understand which format, the interactive decision aid or paper brochures, are more effective early and late in pregnancy.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.