Shared decision-making (SDM)
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Shared decision-making (SDM) involves vital collaborative work between you and your medical care providers, to help you attain the best health outcomes possible with fully-informed consent.
At its core, shared decision making is an interpersonal, interdependent process in which the health care provider and the patient relate to and influence each other as they collaborate in making decisions about the patient’s health care. Shared decision making is patient specific, and it relies on the medical evidence, the provider’s clinical expertise, and the unique attributes of the patient and his or her family. (Légaré and Witteman, 2013)
Your relationship with your care provider is a partnership, and you play an important role in that partnership!
Shared decision making remains integral to both patient-centered care and evidence-based practice. “[I]n a profession with a long and strong tradition of hierarchy and paternalism, [care providers] may struggle with sharing power and responsibility with patients” (Foster and Forcino, 2020).
You have authority in decisions regarding your health care. You have a right to:
- Affirming care
- Involvement in decisions regarding your care
- The care provider’s shared knowledge
- Two-way communication in language and terms you can understand
- Deliberate regarding your options
- Informed consent
- Respect of your autonomy as a decision‐making agent
SDM is not a “perk” but rather a baseline for responsive, respectful care.
For those in the perinatal period, although shared decision-making can begin during pregnancy, it must continue during labor and birth (Begley, et. al., 2019).
We know that time management can be a factor in whether or not a medical practitioner abides by shared decision-making (Yahanda and Mozersky, 2020). Here are some ways you can maximize your time:
- Define the purpose of your visit.
- Practice asserting your needs: “My appointment is x minutes long. I still have x amount of time left.”
- Ask about decision aids, or bring your own. The BRAIN acronym is a great one!
Support excellence in perinatal care by standing up for your right to engage in shared decision-making.
Learn more about shared-decision making
- Why shared decision-making matters more than ever from Contemporary OB-GYN
- American College of Nurse Midwives position statement (PDF)
- The Rights of Childbearing Women (PDF), assembled by Childbirth Connection
- Shared Decision Making: Bring Birth Back Into The Hands Of Mothers Vol1, Book by Dr. Brad Bootstaylor
- Shared decision‐making in maternity care: Acknowledging and overcoming epistemic defeaters
- What’s the Role of Time in Shared Decision Making? from the AMA Journal of Ethics
- Shared Decision Making: Examining Key Elements And Barriers To Adoption Into Routine Clinical Practice
- Center for Shared Decision Making, Dartmouth-Hitchcock
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