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New program makes planning a birth after C-section simpler

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CHÉOS Scientist Dr. Sarah Munro and her team have created a new interactive online program to support people who have had a previous C-section make better-informed decisions about navigating their next pregnancy and birth.

Dr. Sarah Munro

There’s minimal support for people between pregnancies, says Dr. Munro, also an assistant professor in obstetrics and gynaecology in the UBC Faculty of Medicine. She developed the program, My Next Birth, with her team at UBC, to help bridge this gap in care.

A collaboration with with Perinatal Services BC, provincial health authorities, the Ministry of Health, as well as patient partners, the My Next Birth program is now being used throughout British Columbia.

We spoke to Dr. Munro about the project.

Why can planning a birth after a previous C-section be challenging for families?

People want to learn about the options for their next birth after a C-section sooner. We conducted a series of qualitative studies and surveys here in B.C. and found that families and care teams needed more support when exchanging information. Families wanted to know, what were the reasons for their first C-section? Was it from something unexpected that happened during labor? Is this something that might happen again in the future? What are the options for their next birth?

Over 75 per cent of people in B.C. who have had a C-section before are good candidates for a vaginal birth after caesarean (VBAC). The choice is up to them, but families often have to wait until the next pregnancy to start discussing options with their care team.

Families want information sooner, and our program aims to build dialogue and support families that desire social support and connection with their care teams.

Tell us a bit more about My Next Birth and how it fits into this?

My Next Birth is a personalized online interactive patient decision aid. Simply put, it’s an interactive website that helps people who have previously had a C-section review their options. It helps them think about their preferences and jot down their questions, and it provides tailored information that’s specific to their values and needs. It also factors in where they live geographically in B.C., so that they can consider what resources are available locally. After they go through the website, they get a personalized summary printout to guide conversations and questions with their health care team.

My Next Birth is a personalized online interactive patient decision aid.

How does the program improve patient care?

Shared decision-making is at the core of patient-centred care. It shifts the dialogue so that families’ questions and preferences are at the centre of conversations. To support this, My Next Birth has tools for health care teams including a decision support algorithm that walks the care provider through the patient’s journey and a list of conversation prompts to guide discussions after the C-section—in the early postpartum period, at their six-week postpartum checkup, and then into the next pregnancy.

Shared decision-making is a two-way street, and the My Next Birth program aims to support both sides of the conversation – the patient and the care team.

What impact do you hope this will have for patients?

Having this long-term dialogue can not only help families make informed decisions that match their values, it can enhance the relationship with their care team. In this time of social isolation and virtual care, families want more support and connection.

Our hope is the My Next Birth program can be a support for families to be active participants in their care.

Originally published on UBC Medicine’s website.

Watch Dr. Munro’s recent Work in Progress seminar on pregnancy and labour experiences during COVID-19 HERE.

Read more about her previous research on understanding the factors that influence how health care providers support choices for mode of birth after C-section.

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