Background Shared decision making (SDM) involves individuals who are receiving care and healthcare professionals (HCPs) exchanging information and considering options together to reach a decision which reflects the individual’s needs and preferences. Effective communication that facilitates information exchange between a woman and her caregiver is central to achieving SDM in maternity care. The National Maternity Strategy in Ireland recognises that women must be provided with information in a way they can understand in order to make informed decisions about their maternity care. This research used data from the National Maternity Experience Survey 2020 to determine the association between model of maternity care and whether respondents received answers to their healthcare questions to in a way they could understand.

Methods A mixed methods secondary analysis of qualitative and quantitative data was conducted. The survey asked respondents about their experiences of antenatal care, care during labour and birth, and care after birth; including whether their questions were answered in a way they could understand at each of these stages of care. Three different models of care (public care, private/semi-private care, midwifery-led care) were entered into hierarchical multiple regression analyses to determine their association with responses. Open-ended survey responses related to communication and information sharing were analysed using thematic analysis, in order to identify themes that may explain the variation of experience across models of care.

Results Respondents who received private/semi private care (β=.15, p<.001) or midwifery-led care (β=.10, p<.001) were significantly more likely to report that their questions were answered in a way they could understand during pregnancy. Respondents who received private/semi private care (β=.06, p=.003) were significantly more likely to report that their questions were answered in a way they could understand during labour and birth. Model of maternity care was not a significant predictor for whether respondents felt that their questions were answered in a way they could understand after birth. Qualitative findings identified the important contribution of trust through familiarity with HCPs and having time for discussion of information.

Conclusion Type of maternity care received is associated with perceptions of whether questions were answered in an understandable way during antenatal care and care during labour and birth. This is important as provision of information enables SDM in the maternity setting. These findings are informative given the ongoing rollout of the National Maternity Strategy in Ireland and the upcoming implementation of the second National Maternity Experience Survey.