{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T03:30:41Z","timestamp":1791603041699,"version":"4.3.4"},"reference-count":54,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,1,25]],"date-time":"2024-01-25T00:00:00Z","timestamp":1706140800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100015539","name":"Australian Government","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100015539","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Birth"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Pregnant women involved in decisions about their care report better health outcomes for themselves and their children. Shared decision\u2010making (SDM) is a priority for health services; however, there is limited research on factors that help and hinder SDM in hospital\u2010based maternity settings. The purpose of this study was to explore barriers and facilitators to SDM in a large tertiary maternity care service from the perspectives of multiple stakeholders.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Qualitative semi\u2010structured interviews were undertaken with 39 participants including women, clinicians, health service administrators and decision\u2010makers, and government policymakers. The interview guide and thematic analysis were based on the Theoretical Domains Framework to identify barriers and facilitators to SDM.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Women expect to be included in decisions about their care. Health service administrators and decision\u2010makers, government policymakers, and most clinicians want to include them in decisions. Key barriers to SDM included lack of care continuity, knowledge, and clinician skills, as well as professional role and decision\u2010making factors. Key facilitators pertained to policy and guideline changes, increased knowledge, professional role factors, and social influences.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study revealed common barriers and facilitators to SDM and highlighted the need to consider perspectives outside the patient\u2013clinician dyad. It adds to the limited literature on barriers and facilitators to SDM in hospital care settings. Organizational\u2010 and system\u2010wide changes to service delivery are necessary to facilitate SDM. These changes may be enabled by education and training, changes to policies and guidelines to include and support SDM, and adequately timed information provision to enable SDM conversations.<\/jats:p><\/jats:sec>","DOI":"10.1111\/birt.12812","type":"journal-article","created":{"date-parts":[[2024,1,25]],"date-time":"2024-01-25T12:27:15Z","timestamp":1706185635000},"page":"581-594","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["\u201cWe will be the ones bearing the consequences\u201d: A\u00a0qualitative study of barriers and facilitators to shared decision\u2010making in hospital\u2010based maternity care"],"prefix":"10.1111","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4900-4163","authenticated-orcid":false,"given":"Alex","family":"Waddell","sequence":"first","affiliation":[{"name":"Safer Care Victoria Victorian Department of Health  Melbourne Victoria Australia"},{"name":"Monash Sustainable 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