Women's Voices in Maternity Care: The Triad of Shared Decision Making, Informed Consent, and Evidence-Based Practices

J Perinat Neonatal Nurs. Jul-Sep 2016;30(3):218-23. doi: 10.1097/JPN.0000000000000182.


The United States is the only industrialized nation that has experienced dramatic increases in the use of maternity interventions resulting in poor birth outcomes. It is speculated that the increased rates of maternal mortality and other outcomes are attributed to the current maternity model of care focused on the overuse of interventions, such as induction of labor, in otherwise healthy pregnant women. The overuse of induction of labor to artificially speed up the birth process has been linked to an increase in preterm and cesarean births. The cost of these interventions and poor outcomes has been substantial. The purpose of this article is to present concepts that demonstrate the challenges and value of informed, shared decision making, informed consent, and women's use of evidence within the context of maternity care. To highlight these important concepts, this article presents original findings from a secondary analysis of data on induction of labor. Findings from this analysis further highlight the importance of including women as part of informed, shared decision making in models of maternity care.

MeSH terms

  • Decision Making*
  • Evidence-Based Practice / methods*
  • Female
  • Humans
  • Informed Consent*
  • Labor, Induced* / mortality
  • Labor, Induced* / psychology
  • Maternal Health / standards
  • Maternal Health / statistics & numerical data
  • Maternal Health Services / organization & administration*
  • Maternal Mortality
  • Maternal Welfare
  • Medical Overuse* / prevention & control
  • Medical Overuse* / statistics & numerical data
  • Patient Participation / methods
  • Patient Participation / psychology
  • Pregnancy
  • Pregnancy Outcome / epidemiology
  • Pregnant Women / psychology*
  • Quality Improvement
  • United States / epidemiology