Want to feel confident about every choice during your pregnancy?
Birth Informed care is the standard of care for modern maternity. It is providing women with evidence based information about all of their choices… then getting OUT OF THEIR WAY.
Here’s the problem:
Typically, pregnant women do not receive this type of care automatically. They receive hurried appointments and ambiguous guidance. They have things decided FOR them rather than WITH them.
Learn how research informed maternity care works, why shared decision-making is important, and how to ensure you receive it.
Let’s jump in!
Inside this guide:
- What Is Pregnancy Informed Care?
- Why Research-Guided Care Matters Right Now
- The Shared Decision-Making Process Explained
- Key Pregnancy Decisions Where Informed Choice Counts
- How To Advocate For Better Care
What Is Pregnancy Informed Care?
Pregnancy informed care involves counseling where all options are presented with up-to-date research, leaving the pregnant person to make the decision.
It seems easy. But that’s a dramatic change from the past 50 years.
The old paradigm: Clinicians decide what is “best” and patient consents. Pregnancy care using informed care by research changes that. Clinicians inform the patient of the evidence, risks/benefits and alternatives… The patient decides.
This framework is supported by large organisations such as NICE and the Royal College of Midwives. It’s also the principle that trusted independent midwives like Chrissie Yu build their practice around — allowing parents to make informed choices by giving them time, information and respect.
The result?
- Better birth experiences
- Lower rates of regret
- Stronger trust between parent and clinician
Why Research-Guided Care Matters Right Now
The data on UK maternity care is hard to ignore.
The new MBRRACE-UK report has revealed that in 2021 to 2023 the UK saw maternal mortality rates soar to 12.82 deaths per 100,000 births. That’s a rise of 21% when compared to 2009 to 2011. In the wrong direction.
And it gets worse…
According to a parliamentary briefing this week, 47% of maternity services inspected by the CQC received a rating of ‘requires improvement’ for safety and 18% were rated inadequate for safety. None were rated outstanding for safety.
It means that the system may not always have your back. You have to know what questions to ask yourself.
Evidence-based care is important because you have the research right there. You don’t have to take one midwife’s opinion or some hospital’s policy. You can look at the research yourself.
This is especially critical where decisions are portrayed as routine with no downside or trade-offs – induction, continuous monitoring, episiotomy and elective caesarean birth.
The Shared Decision-Making Process Explained
Shared decision-making (SDM) is the engine behind pregnancy informed care.
Here’s how it works:
The clinician provides the medical evidence. The pregnant patient brings their values and situation. They collaborate to create a plan that suits both.
The doctor is not bossing you around. You’re not blowing off doctor’s orders either. It’s a genuine dialogue.
The positive news is that this is beginning to change. In the 2025 CQC Maternity Survey, 77% of people reported they were ‘always’ involved in decisions about their care, which is up from 75% in 2024. Improvement… but still 1 in 4 women are not routinely involved.
A proper shared decision-making conversation should cover:
- What the recommended option is
- What the alternatives are (including doing nothing)
- The benefits and risks of each
- How likely each outcome actually is
- What matters most to you personally
When clinicians omit any of these steps the decision isn’t shared. It’s merely declared.
Key Pregnancy Decisions Where Informed Choice Counts
Of course not all pregnancies are created equal. These are just where informed choice can have the most impact.
Induction Of Labour
Induction is probably one of the most frequent interventions utilized in maternity care today. It is also probably one of the most overused interventions.
An informed care conversation should include discussion of the actual risks of waiting AND the actual risks of induction and your individual circumstances. Alarmingly, in the CQC 2025 survey, 14% of women who had their labour induced reported that they were not given information about all the options available to them including alternatives to induction.
That’s a major gap in informed consent.
Place Of Birth
You can choose hospital birth, midwife led unit or birth at home. There is varying levels of evidence to support each depending on if it’s your first baby and if it is a low risk pregnancy.
The correct answer will vary from person to person. However, you can only make an informed choice if all three are given to you.
Pain Relief
From breathing techniques to epidurals, you get to choose how you manage pain. An informed care provider should explain to you what each option entails, its effectiveness, and potential knock-on effects for labour and your baby.
Monitoring And Interventions
Induction, continuous fetal monitoring, vaginal exams, episiotomy, assisted delivery… All these things can be consented to or refused. Truly informed care is knowing that BEFORE you go into labour, when you are able to process the information.
How To Advocate For Better Care
Even with the best maternity care, you still need to show up ready. Here’s why.
Ask The BRAIN Questions
When any intervention is suggested, work through these:
- Benefits — what could go right?
- Risks — what could go wrong?
- Alternatives — what else could we try?
- Intuition — what does your gut say?
- Nothing — what if we do nothing for now?
This little framework turns a one-sided announcement into a real shared decision.
Write A Flexible Birth Preferences Document
A birth plan is not a contract…it’s a communication tool. Use it to communicate your wishes regarding pain relief, fetal monitoring, management of the third stage and the first few hours after birth with whoever is on shift.
Bring A Strong Advocate
Whether it’s your partner, doula, or family member… Having someone present who knows what you want and is NOT experiencing pain makes a HUGE difference in maintaining informed decision making.
Consider Continuity Of Care
The largest factor that makes parents feel listened to during maternity care is having the same midwife (or small team) throughout their journey. As this isn’t provided on the NHS pathway for most parents, they turn to private midwifery to bridge that gap.
Bringing It All Together
Trauma-informed maternity care shouldn’t be a luxury. Pregnancy informed care is how maternity care is SUPPOSED to function. The clinician explains the research, the pregnant person explains their values and a true decision is made together.
The stats right now look like there’s still some work to do. However, once pregnant people know what shared decision-making should look like, they can demand it when it’s not present.
To quickly recap:
- Pregnancy informed care = evidence + your values + your decision
- UK maternity safety data makes informed choice more important than ever
- Shared decision-making should cover every option, including doing nothing
- Induction, place of birth and pain relief are the biggest decision points
- BRAIN, birth plans and continuity of care keep you in the driver’s seat
Every appointment is a chance to ask better questions. Use it.
