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Assisting women in autonomous decision making about vaginal birth after C section (VBAC): Designing motivational Apps in OptiBIRTH cluster randomised trial (ISRCTN10612254

Conference contribution
Authors Marlene Sinclair
Janine Stockdale
Cecily Begley
Mike Clarke
Declan Devane
Mechthild Gross
Sandra Morano
Ingela Lundgren
Koen Putman
Beverly Beech
Katri Vehvilainen-Julkunen
Marianne Nieuwenhuijze
Hugh Wiseman
Valerie Smith
Deirdre Daly
Gerard Savage
John Newell
Susanne Grylka-Baeschlin
Patricia Healey
Jane Nicoletti
Joan Lalor
Margaret Carroll
Evelien Van Limbeek
Christina Nilsson
Published in 31th ICM Triennial Congress 18-22 June 2017
Publication year 2017
Published at Institute of Health and Care Sciences
Language en
Subject categories Nursing, Reproductive health, Other Medical Sciences


Background: Optibirth is a funded FP7 research programme using a cluster randomised trial in Ireland, Germany and Italy, with 15 clusters of 94 women per cluster. The aim of OptiBIRTH is to evaluate the effectiveness of a complex intervention aimed at increased VBAC rates through enhanced women-centred care1 .The intervention consisted of motivationally enhanced, evidence-based, educational information for women and clinicians for use in face to face and online modes. Purpose/Objective: This paper reports the design process associated with creating three interrelated mobile apps, as part of a complex intervention, to enable women with a previous caesarean section to decide autonomously between a repeat caesarean section and a vaginal birth. The emphasis has been on using technology creatively and effectively maximizing optimality bearing in mind the needs of the new “Z” generation. Method: Focus groups were undertaken across six European countries to illicit women’s need for information about caesarean section and VBAC. Motivational theory underpinned the development of subsequent e-learning materials to enhance woman-led-decision-making. Ethical approval was obtained from Trinity College University, Dublin. Following analysis of focus group data, consultation with experts and exploration of technological solutions, three electronic applications were designed. Following three iterations, the Apps were reviewed for content, motivational design and functionality by Irish, German and Italian midwifery experts and translated into German and Italian. Key Findings: The following interrelated Apps were designed to provide women and health professionals with rapid access to women’s perceptions of their previous birth experience and their current decision-making-in-progress: “My birth story” uses a wordle to communicate past birth experience “My birth thoughts” enables women to communicate their current decision making “My Birth plan” generates a personalised birth plan Discussion: Discussion will focus on challenges facing midwives including, embedding the Apps into a motivationally-designed portal, staff support and training, timeline, cultural differences and translation issues

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