Decision tool could have 'substantial impact' on caesarean rates

A computerised decision analysis programme which helps women decide on the type of birth that is most appropriate for them could cut the number of caesarean sections performed in England and Wales by 4,000 a year, according to a study.

The study, published today (1 June 2007) on bmj.com, recruited nearly 750 pregnant women who were split in to three randomised groups. The first had the usual care from obstetric and midwifery staff, the second group had access to computer-based information on normal delivery and caesarean sections, and the third was provided with a more complex computer-based decision analysis programme.

The researchers found that the group with decision analysis programme had a higher proportion of vaginal deliveries compared with the other two groups.

They authors of the study conclude: 'Although the content was carefully designed to not favour one mode of delivery over another, even a small absolute change in decisions could have a substantial impact in national rates of caesarean section'.

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