What it is
Shared decision-making (SDM) means the care team explains the options, benefits, risks, and uncertainties, and you explain what matters to you. The final plan reflects both. It is the recommended standard for preference-sensitive choices in pregnancy and birth (induction timing, VBAC, pain management, monitoring, screening) where there isn't one 'right' answer.
Evidence review links
Each link opens the full review on the publisher's site in a new tab.
Possible benefits
- Plans align with what actually matters to you, so you're more likely to feel at peace with the outcomeReview sources ↓
- Reduces decisional regret, especially for preference-sensitive choicesReview sources ↓
- Surfaces uncertainty honestly — 'we don't know' is a valid answerReview sources ↓
Possible risks
- Takes more time than a one-way recommendation; ask early rather than in a crunchReview sources ↓
- Can feel harder when you'd prefer someone else to just decide — it's okay to say 'what would you recommend and why?'Review sources ↓
Alternatives
- Ask your provider for a decision aid (many exist for VBAC, induction, prenatal testing)Review sources ↓
- Bring a partner, doula, or trusted person to help hold your priorities in the roomReview sources ↓
- Ask for a follow-up visit or a written summary before deciding non-urgent questionsReview sources ↓
Current evidence
ACOG Committee Opinion 819 frames shared decision-making as the standard for obstetric care, describing it as a collaborative process where clinicians share evidence and patients share values. The AHRQ SHARE Approach and NIH decision-aid research show SDM reduces decisional conflict and improves alignment between choices and personal values, especially in preference-sensitive care. This topic is meant to help you name what SDM looks like in a real visit, so you can ask for it by name.
Where the evidence is clear · where people may choose differently
For most topics, guidelines from ACOG, WHO, and other major bodies broadly agree on the core safety points (when to act in an emergency, informed-consent standards, monitoring baselines). Where reasonable people — and even guidelines — differ tends to be around thresholds (when to start or stop something), preferences (comfort, environment, support), and values (how you weigh small risks against benefits). Use the questions below to explore those pieces with your care team.
Educational only. Your care team can help you weigh what applies to your specific situation.
Related evidence topics
- Informed Consent & RefusalYour right to information about, and to accept or decline, any proposed care.
- Informed RefusalYour right to decline any test, procedure, or medication — even one that's recommended — after understanding the trade-offs.
- Maternity Rights in CareLegal and ethical rights that apply in prenatal visits, labor, birth, and postpartum — including the right to refuse, to move, to have support, and to leave.
- Scripts for Advocating in AppointmentsReady-to-use phrases for slowing down a conversation, asking for evidence, declining without conflict, and getting a decision put in writing.
Questions to ask your care team
- ?Can we walk through this as a shared decision — what the evidence says, and what matters to me?
- ?Is there a decision aid for this choice I can review before we decide?
- ?What do we know, what don't we know, and how strong is the evidence?
- ?If two reasonable people looked at the same evidence, could they choose differently — and why?
- ?How much time do I have to think about this?
Universal questions (works for any decision)
A short BRAIN-style set you can bring to any conversation about interventions, monitoring, or care decisions.
- ?Why are you recommending this now — is it urgent, routine, or optional?
- ?What happens if we wait an hour (or longer) before deciding?
- ?What signs would tell us this is working — or that we need to change course?
- ?What are the alternatives, including doing nothing?
- ?What would you recommend if this were your family?
- ?What would change your recommendation?
Sources & provenance
Tap a source to open the original guideline or review in a new tab.
- ACOG Committee Opinion 819: Informed Consent and Shared Decision Making in Obstetrics and Gynecology — ACOG
- The SHARE Approach: A Model for Shared Decisionmaking — AHRQ
- Decision aids for people facing health treatment or screening decisions (Cochrane review) — Cochrane
Written in plain language from general guidance published by the listed organizations. No verbatim excerpts; editors should re-verify wording and citations against current source versions before publish.
Last reviewed: 2026-07-03
Further reading — canonical references
Read the source material directly. Each link opens the publisher's own current guidance in a new tab — cross-check what we summarize against what they say.
Tier 1 · Clinical guidelines
Tier 2 · Systematic reviews
Educational only. Guidelines evolve — the linked publisher pages will reflect newer guidance than any static snapshot.
Version history — v1.0.0
v1.0.0 · 2026-07-03 · LlaMamma editors
Added shared decision-making as a foundational topic with ACOG, AHRQ, and Cochrane references.
Sources: ACOG Committee Opinion 819; AHRQ SHARE Approach; Cochrane decision-aids review
New guidance from ACOG, WHO, Evidence Based Birth, or other listed sources is recorded here and can be updated remotely without a new app release.