Informed choice in maternity care: an evaluation of evidence based leaflets


Communicating effectively with and involving patients in decisions about their own health care is a major priority for the NHS. The objective of this report was to provide a large scale evaluation of a series of patient information leaflets used to promote informed choice during pregnancy and childbirth. The leaflets, originally produced by the Midwives Information and Resource Service (MIDIRS) together with the CRD, have been in use throughout the UK since 1996, and this study was commissioned to assess their effectiveness in promoting informed choice.


The research found that whilst nearly all of the women who received each leaflet reported that it was helpful or very helpful, there was no evidence that the leaflets were effective in increasing the proportion of women who reported having exercised informed choice. The report outlines several reasons why the leaflets did not promote informed decision making including: the lack of a coherent strategy for leaflet distribution or for the promotion of informed decision making; a number of working practices hindered the distribution of leaflets and rendered them invisible to most women; 'informed choice' was simply equated with having the leaflets; different, and often incompatible understandings of the concept of informed choice were articulated by midwives, childbearing women and obstetricians.

Conducted by: CRD and the School of Nursing and Midwifery, University of Sheffield


NHS Centre for Reviews and Dissemination. Informed choice in maternity care: an evaluation of evidence based leaflets. CRD Report 20. York: University of York. 2001

NHS Centre for Reviews and Dissemination. A pilot study of 'Informed Choice' leaflets on positions in labour and routine ultrasound. CRD Report 7. York: University of York. 1996


Commissioned by the Department of Health