Table 2 Practices in relation to decision-making and indications for planned birth - % of respondents who agreed or strongly agreed with the statement
|  | % of all respondents | Hospital A, level 6 n = 78 | Hospital B, level 6 n = 36 | Hospital C, level 5 n = 37 | Hospital D, level 4 n = 18 | Hospital E, level 4 n = 36 | Hospital F, level 4 n = 20 | Hospital G, level 3 n = 20 | p-value | Midwives n = 191 | Medical staff n = 54 | p-value |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
Women’s involvement in decision-making | ||||||||||||
 Women are informed about the benefits and risks of interventions such as IOL and CS | 73 | 90 | 69 | 73 | 84 | 22 | 95 | 75 | < 0.001* | 68 | 93 | .007* |
 Women are supported to make decisions about their own care in relation to IOL | 59 | 79 | 45 | 59 | 67 | 25 | 60 | 70 | < 0.001* | 51 | 89 | < 0.001* |
 Women are supported to make decisions about their own care in relation to CS | 56a | 64 | 38 | 78 | 62 | 22 | 70 | 60 | < 0.001* | 49 | 81 | < 0.001* |
 Consideration is given to the wishes and preferences of the woman in decisions about her care in relation to IOL and CS | 67 | 84 | 49 | 77 | 73 | 36 | 80 | 70 | < 0.001* | 61 | 91 | < 0.001* |
Indications for planned birth | ||||||||||||
 In terms of the management of prolonged pregnancy, women from some ethnic groups, such as South Asian women, are induced at earlier gestations | 34 | 15 | 23 | 97 | 28 | 14 | 90 | 10 | < 0.001* | 31 | 45 | .110 |
 Women with uncomplicated DCDA twin pregnancies, where the presenting twin is cephalic, are supported to have a vaginal birth | 75 | 87 | 80 | 89 | 95 | 66 | 50 | 35 | < 0.001* | 71 | 89 | .011* |
 Women with uncomplicated MCDA twin pregnancies, where the presenting twin is cephalic, are supported to have a vaginal birth | 55a | 67 | 61 | 64 | 78 | 43 | 25 | 30 | < 0.001* | 50 | 73 | .003* |
 Women who are afraid of childbirth are counselled and provided with information about the pros and cons of CS | 68 | 78 | 67 | 65 | 78 | 55 | 65 | 60 | .218 | 64 | 84 | .004* |
 Women who request a CS (without a medical reason) are counselled and supported to have a vaginal birth | 73 | 75 | 72 | 79 | 67 | 69 | 90 | 55 | .471 | 71 | 82 | .182 |
 Women who had a previous CS are supported to have a vaginal birth | 82 | 88 | 78 | 97 | 100 | 72 | 65 | 90 | < 0.001* | 89 | 93 | .073 |
 Women with an uncomplicated breech (frank or complete breech, normal fetal size and welfare) are supported to have a vaginal birth, either in our unit or by referral to a unit which offers vaginal breech birth | 50 | 90 | 25 | 51 | 28 | 14 | 35 | 35 | < 0.001* | 45 | 65 | .019* |
 Women who had a previous uterine rupture are routinely recommended a CS | 82 | 88 | 72 | 92 | 89 | 64 | 75 | 85 | .103 | 78 | 96 | .001* |
 Women with abnormal fetal lie (e.g. transverse lie), where ECV is declined, unsuccessful or not appropriate, are routinely recommended a CS | 92 | 95 | 86 | 95 | 89 | 94 | 90 | 95 | .477 | 91 | 98 | .274 |
 Women with abnormal fetal lie (e.g. breech or transverse) are routinely offered a CS in preference to ECV | 24 | 15 | 28 | 19 | 33 | 42 | 25 | 50 | < 0.001* | 28 | 22 | < 0.001* |
 Women with prior classical or inverted T uterine incision are recommended a repeat CS | 90 | 95 | 86 | 100 | 77 | 86 | 80 | 80 | .386 | 87 | 98 | .033* |
 Women with previous perineal trauma (e.g. 3rd or 4th degree tear/obstetric anal sphincter injury) are offered a CS | 75 | 61 | 86 | 76 | 61 | 86 | 85 | 90 | .037* | 75 | 78 | .913 |
 Women with previous severe pelvic floor damage (e.g. prolapse) are offered a CS | 67a | 62 | 72 | 76 | 50 | 80 | 75 | 75 | .071 | 69 | 56 | .097 |
 Women with a previous fetal death in utero are routinely offered a CS | 12a | 13 | 8 | 8 | 23 | 8 | 20 | 5 | .579 | 12 | 9 | .089 |
 Women with previous shoulder dystocia are routinely offered a CS | 20a | 5 | 34 | 27 | 11 | 25 | 25 | 40 | .039* | 19 | 27 | .311 |
 Women who are colonised with Group B Strep are offered a CS | 1 | 1 | 3 | 0 | 0 | 0 | 0 | 0 | .486 | 1 | 0 | .070 |
 In our unit, women with uncomplicated pregnancies are offered IOL before 41 + 0 weeks | 14 | 5 | 31 | 8 | 11 | 25 | 5 | 25 | .002* | 18 | 2 | .003* |
 In our unit, planned CS for singleton pregnancy where there is no maternal or fetal indication for early birth, are offered before 39 + 0 weeks | 18 | 6 | 34 | 10 | 11 | 37 | 5 | 26 | .011* | 11 | 6 | .281 |