Clinical Review

Implementing shared decision making in labor and delivery: TeamBirth is a model for person-centered birthing care

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Patient response to TeamBirth is positive

Patients and providers alike have endorsed TeamBirth. In initial pilot testing across 4 sites, 99% of all patients surveyed “definitely” or “somewhat” had the role they wanted in making decisions about their labor.9

In partnership with the Oklahoma Perinatal Quality Improvement Collaborative (OPQIC), the impact of TeamBirth was assessed in a statewide patient cohort (n = 3,121) using the validated Mothers Autonomy in Decision Making (MADM) scale created by the Birth Place Lab at the University of British Columbia. The percentage of patients who scored in the highest MADM quartile was 31.3% higher for patients who indicated participation in a huddle during labor compared with those who did not participate in a huddle. This trend held across all racial and ethnic groups: For example, 93% of non-Hispanic Black/African American patients who had a TeamBirth huddle reported high autonomy, a nearly 20 percentage point increase from those without a huddle (FIGURE 2). Similarly, a higher percentage of agreement was observed across all 7 items in the MADM scale for patients who reported a TeamBirth huddle (FIGURE 3). TeamBirth’s effect has been observed across surveys and multiple validated metrics.

Data collection related to TeamBirth continues to be ongoing, with reported values retrieved on July 14, 2023. Rigorous review of patient-reported outcomes is forthcoming, and assessing impact on clinical outcomes, such as NTSV (nulliparous, term, singleton vertex) cesarean delivery rates and severe maternal morbidity, is on the horizon.

Qualitative survey responses reinforce how patients value TeamBirth and appreciate huddles and whiteboards.

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