Use of evidence based leaflets to promote informed choice in maternity care: randomised controlled trial in everyday practice

ObjectiveTo assess the effect of leaflets on promoting informed choice in women using maternity services.DesignCluster trial, with maternity units randomised to use leaflets (intervention units) or offer usual care (control units). Data collected through postal questionnaires.Setting13 maternity units in Wales.ParticipantsFour separate samples of women using maternity services. Antenatal samples: women reaching 28 weeks'' gestation before (n=1386) and after (n=1778) the intervention. Postnatal samples: women at eight weeks after delivery before (n=1741) and after (n=1547) the intervention.InterventionProvision of 10 pairs of Informed Choice leaflets for service users and midwives and a training session for staff in their use.ResultsThere was no change in the proportion of women who reported that they exercised informed choice in the intervention units compared with the control units for either antenatal or postnatal women. There was a small increase in satisfaction with information in the antenatal samples in the intervention units compared with the control units (odds ratio 1.40, 95% confidence interval 1.05 to 1.88). Only three quarters of women in the intervention units reported being given at least one of the leaflets, indicating problems with the implementation of the intervention.ConclusionIn everyday practice, evidence based leaflets were not effective in promoting informed choice in women using maternity services.

What is already known on this topic

Decision aids can help patients to participate in their careTen evidence based leaflets (Informed Choice) are used by maternity services in the United Kingdom to promote informed choice in women using these services

What this paper adds

The leaflets did not help to promote informed choice in maternity careDecision aids may not be effective in the real world