Digital Childbirth Education as a Strategy to Improve Shared Decision Making and Reduce Cesarean Births [ID 988]

INTRODUCTION: Cesarean births are associated with worse outcomes and higher costs compared to vaginal births. In-person patient education has been shown to reduce cesarean risk but education through digital health is understudied. This analysis evaluated how childbirth education through a digital health platform is associated with shared decision making and mode of birth. METHODS: This retrospective cohort study used data from 6,758 users of Maven, a digital health platform for women’s and family health. Logistic regression models, stratified by parity, estimated the associations between watching the childbirth education class and two outcomes: 1) user report that Maven helped them participate more with providers in making decisions about their labor and delivery, and 2) mode of birth. RESULTS: In adjusted models, watching the childbirth education class was significantly associated with 1) users reporting Maven helped them participate more with providers in making decisions about their labor and delivery (nulliparous: adjusted odds ratio [aOR] [95% CI], 1.23 [1.19, 1.26]; parous, no prior cesarean: aOR [95% CI], 1.24 [1.18, 1.31]; parous, prior cesarean: aOR [95% CI], 1.39 [1.19, 1.62]); and 2) a decreased likelihood of cesarean birth among both nulliparous members and those with a prior cesarean (nulliparous: aOR [95% CI], 0.97 [0.94, 0.99]; parous, prior cesarean: aOR [95% CI], 0.83 [0.72, 0.95]). CONCLUSIONS/IMPLICATIONS: Digital health has the potential to complement standard in-person prenatal care through increased accessibility of childbirth education resources. These resources can enhance shared decision making between patients and providers and reduce the likelihood of cesarean birth.