BACKGROUND:
Shared decision making (SDM) is accepted as a vital component of woman-centred care. Women with a traumatic birth experience often feel they had no choice or control in their maternity care and wish for a more empowered experience in a subsequent pregnancy.

OBJECTIVES:
To explore women’s views on the concept of SDM in a subsequent pregnancy following a traumatic birth experience.

METHODS:
Fourteen women were recruited to participate in a semi-structured interview exploring their views on SDM. Women were given a project designed maternity planning guide to support SDM in antenatal care. The guide included a definition of SDM and information for women to consider what was important to them to discuss for pregnancy, labour and birth, caesarean, postnatal care and going home with baby. This included a SDM template. Interview data were recorded, transcribed, and de-identified. Data were analysed using reflexive thematic analysis.

RESULTS:
Women who primarily received holistic pregnancy care from a known midwife and/or obstetrician experienced SDM thematically as ‘Trust and Control’. However, in the absence of relationship-based care, women found that SDM was not a component of their maternity care, thematically expressed as ‘powerlessness’. For some women, the maternity planning guide gave them ‘a voice’.

CONCLUSIONS:
Shared decision-making was found to be an acceptable term, with most women having an understanding that they are the ultimate decision-makers. Continuity of care in the antenatal period, with a holistic approach, promotes a reciprocal relationship of trust that empowers each woman to make decisions that are best for her and her baby.

KEY MESSAGE:
Relationship-based care in pregnancy, with the aid of a maternity planning guide, empowers women to be active decision-makers for their entire maternity care. Enabling environment 1