Interactional practices of decision making during childbirth in maternity units

ISRCTN ISRCTN16227678
DOI https://doi.org/10.1186/ISRCTN16227678
IRAS number 211358
Secondary identifying numbers 14/70/73, CPMS 32505, IRAS 211358
Submission date
16/01/2018
Registration date
13/02/2018
Last edited
17/03/2023
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Pregnancy and Childbirth
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English summary of protocol

Background and study aims
Government policy states that women in labour should be involved in decisions about their care and treatment. It is known what is said during labour matters for how women experience birth. However, policy recommendations to staff about how to communicate with women in labour are not based on evidence about what actually happens in birth. This is because most existing research is based on interviewing or surveying women some weeks after birth, so the details of what was said in labour are lost. Research is needed that provides details of actual talk about decisions during labour. The details of talk matter because as other studies of communication in medical settings have shown, even small changes in use of words can make a difference to what happens in healthcare e.g. one study in a GP setting showed that changing from ‘is there anything else?’ to ‘is there something else?’ increased the
number of reported symptoms told to the doctor. The aim of this study is to find out how decisions are reached and communication through the talk that happens between staff, women in labour and their birth partners when giving birth in maternity units. It also aims to provide staff and women with detailed information about the effects of talk during labour in order to inform and empower staff, women and birth partners.

Who can participate?
Women , their birth partners and health care practitioners.

What does the study involve?
Participants who consent to taking part in the study are video or audio recorded during labour and birth. This is to establish how decisions are made during labour and birth. Participants are also asked to complete an ante-natal and a post –natal questionnaire at 35 weeks and 6 weeks post birth respectively to assess the relationship between their expectations before birth, their birth experience and their satisfaction post-birth.

What are the possible benefits and risks of participating?
There are no direct risks or benefits to those taking part in the study.

Where is the study run from?
1. University of York (UK)
2. Calderdale Royal Hospital (UK)
3. Sheffield Royal Hallamshire Hospital (UK)

When is the study starting and how long is it expected to run for?
May 2017 to August 2020 (updated 07/04/2020, previously: March 2020)

Who is funding the study?
National Institute for Health Research (UK)

Who is the main contact?
1. Professor Ellen Annandale (Scientific)
ellen.annandale@york.ac.uk
2. Dr Lyn Brierley-Jones (Public)
lyn.brierley-jones@york.ac.uk

Study website

Contact information

Prof Ellen Annandale
Scientific

University of York
York
YO10 5DD
United Kingdom

ORCiD logoORCID ID 0000-0002-5305-039X
Phone +44 1904 324 561
Email ellen.annandale@york.ac.uk
Dr Lyn Brierley-Jones
Public

University of York
York
YO10 5DD
United Kingdom

Phone +44 1904 323 055
Email lyn.brierley-jones@york.ac.uk

Study information

Study designThree year observational multi centre study
Primary study designObservational
Secondary study designCohort study
Study setting(s)Hospital
Study typeOther
Participant information sheet ISRCTN16227678_PIS_01Aug17_V4.docx
Scientific titleVoices in Partnership/Video In Practice: Interactional practices of decision making during childbirth in maternity units
Study acronymVIP
Study objectivesThe aim of this study is find out how decisions are reached and communicated through the talk that happens between staff, women in labour and their birth partners when giving birth in maternity units.
Ethics approval(s)South Yorkshire Research Ethics Committee, 15/05/2017, ref: 17/YH/0102
Health condition(s) or problem(s) studiedMaternity Services
InterventionA pilot study precedes this study and used the Conversation Analytic method for analysing data from ‘One Born Every Minute documentary created by Channel 4. The first year of the study is also an internal pilot but this is a pilot of recruitment not of the full methodology. If four analysable recordings are obtained by the end of this internal pilot period, then the full study can proceed.

This study aims to video (or audio record if women prefer) the labours of 50 low-risk, full-term women and write down in full what was said and how it was said (e.g. laughing, sighing). Participants receive ante natal and post natal questionnaires to these women to ascertain what their expectations for birth were and whether these expectations were met during childbirth. Further, this study investigates how decisions are made during labour and how these impacted on outcomes.

Health care professionals are also interviews: 10 at each site. In total, 12 midwives and 8 obstetricians are interviewed, all of varying professional grades.
Intervention typeOther
Primary outcome measureDecision making is measured using the conversation analytic technique at the time of labour and birth.
Secondary outcome measuresSatisfaction is measured using both ante-natal and post-natal questionnaires at 35 weeks gestation and at 6 weeks post birth respectively.
Overall study start date01/05/2017
Completion date12/08/2020

Eligibility

Participant type(s)Mixed
Age groupAdult
SexBoth
Target number of participants50 women
Total final enrolment37
Key inclusion criteria1. Women: any woman (aged 16+) attending two study two sites with a low risk, singleton pregnancy and who expects to have a vaginal birth at full-term in a midwife-led maternity unit (Sheffield) or birth centre (Calderdale).
2. Birth Partners: The women’s birth partners.
3. Healthcare Practitioners (HCPs): all clinical staff involved in maternity care at study sites.
Key exclusion criteria1. High risk pregnancy
2. Under 16 years of age
Date of first enrolment16/10/2017
Date of final enrolment30/01/2019

Locations

Countries of recruitment

  • England
  • United Kingdom

Study participating centres

University of York
Heslington
York
YO10 5DD
United Kingdom
Calderdale Royal Hospital
Salterhebble
Halifax
HX3 0PW
United Kingdom
Sheffield Royal Hallamshire Hospital
Glossop Road
Sheffield
S10 2SF
United Kingdom

Sponsor information

University of York
University/education

Heslington Village
York
SW1A 2NS
England
United Kingdom

Phone +44 1904 325 154
Email michael.barber@york.ac.uk
Website www.york.ac.uk.
ROR logo "ROR" https://ror.org/04m01e293

Funders

Funder type

Government

National Institute for Health Research
Government organisation / National government
Alternative name(s)
National Institute for Health Research, NIHR Research, NIHRresearch, NIHR - National Institute for Health Research, NIHR (The National Institute for Health and Care Research), NIHR
Location
United Kingdom

Results and Publications

Intention to publish date28/02/2020
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryNot expected to be made available
Publication and dissemination planDissemination will be via two workshops in months 31-36 of the project and dissemination leaflets will be printed at this time. The RCM’s Progress Theatre Group will assist the project team in transferring the anonymised transcripts into artistic performance. By the end of month 36 a draft final report will have been submitted to NIHR and a first article submitted to a journal. These dissemination milestones will be achieved by 28/02/2020.
IPD sharing planWe are not expecting to make our raw data publicly available in order to preserve the anonymity of women, their birth partners and health care practitioners. Anonymised data will be held by the University of York.

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Participant information sheet version V4 01/08/2017 01/04/2019 No Yes
Protocol file version V5 01/01/2018 01/04/2019 No No
Results article 01/12/2022 17/03/2023 Yes No
HRA research summary 28/06/2023 No No

Additional files

ISRCTN16227678_PIS_01Aug17_V4.docx
Uploaded 01/04/2019
ISRCTN16227678_PROTOCOL_01Jan18_V5.docx
Uploaded 01/04/2019

Editorial Notes

17/03/2023: Publication reference, IRAS and total final enrolment added.
07/04/2020: The following changes were made to the trial record:
1. The overall end date was changed from 30/03/2020 to 12/08/2020.
2. The plain English summary was updated to reflect these changes.
01/04/2019: The participant information sheet and protocol (not peer reviewed) have been uploaded.