“It gave me a voice”: Pre-pilot qualitative evaluation of a co-designed maternity planning guide

BACKGROUND: Lack of control and choice are major contributors to women experiencing birth as traumatic. Care planning, when developed collaboratively as part of shared decision-making, may help women feel more informed and in control of their care. AIM: To evaluate the acceptability and perceived utility of a co-designed maternity planning guide to support woman-centred care. A secondary aim was to explore women's understanding of shared decision-making, given its centrality to the guide's intent. METHODS: This pre-pilot study forms part of a multi-method research program. Women with previous negative or traumatic birth experiences and/or fear of birth were identified using a screening tool developed earlier in the research program and invited to use the guide. A subset participated in semi-structured interviews exploring the guide's utility, format and content, and their understanding of shared decision-making. Data were analysed using qualitative content analysis. FINDINGS: Fourteen women were interviewed. Women valued the guide for facilitating communication, presenting information as options or choices, and making their preferences visible and easier to raise in clinical conversations. For one participant, the guide "gave women a voice," prompting conversations that enhanced self-advocacy, choice, and control. Nine women discussed the term 'shared decision-making' and generally endorsed it as a respectful approach, recognising women's preferences alongside clinical expertise. CONCLUSION: The maternity planning guide was acceptable and perceived as useful in supporting woman-centred care and shared decision-making. Integrating such tools into routine antenatal care may enhance communication, foster respectful practice, and address factors associated with repeat traumatic experiences.