Decision aid development for large for gestational age (LGA) births
What is the Problem?
Many pregnant women are told late in pregnancy that their baby is “large for gestational age” (LGA), often leading to difficult decisions about the timing and mode of birth. These decisions involve weighing the risks of shoulder dystocia, birth trauma, and stillbirth with vaginal birth against the risks of caesarean section and early induction, both of which carry their own complications. Women often report feeling overwhelmed, poorly informed, and excluded from the decision-making process. There is currently no standardised, evidence-based tool to support women and clinicians in making shared decisions in this scenario. As a result, care is variable, and anxiety and decisional conflict are common.
What Will We Do?
This project has developed a patient-centred decision aid to support women and healthcare professionals in making informed, value-based choices about the mode and timing of birth when a baby is suspected to be large.
We will pilot the refined decision aid in real-world clinical settings to assess its impact on decision quality, patient satisfaction, anxiety levels, and the nature of shared decision-making.
This project will support safer, more respectful maternity care by helping women make choices that align with their values and clinical needs.
We began by reviewing the existing evidence and clinical guidelines, and conduct interviews with women, clinicians, and birth partners to understand their experiences, concerns, and information needs.
Using these insights, we co-designed a prototype decision aid, which includes plain language explanations, balanced risk information, visual aids, and prompts to support conversations around values and preferences.
The Decision Aid
The patient-centred decision aid is now available, both online and as a PDF. It explains why having a ‘big baby’ matters; options you may want to consider for the birth; other things you may want to think about or discuss with your doctor or midwife; frequently asked questions (FAQs); and links to additional resources (such as patient information, guidelines and academic papers).