KNOWLEDGE OF AND PREFERENCE FOR THE DOMINO DELIVERY OPTION

Objective: to examine women's knowledge of and preference for the DOMI NO (Domiciliary In and Out) delivery option in order to explain why up take is lower than might be expected. Design: descriptive study using a self completion postal questionnaire. Setting: Mid Staffordshire Hea lth Authority (now part of South Staffordshire Health Authority). Subj ects: a systematic random sample of 1568 women aged 16-44 drawn from t he Staffordshire Family Health Services Authority register of patients registered with a general practitioner. All women were included, rega rdless of childbirth experience. Main outcome measures: preference and knowledge levels for this delivery option. Main findings: the respons e rate was 74%. Thirty-nine per cent had heard of the DOMINO option pr ior to receiving the questionnaire. Sixteen per cent expressed a prefe rence for this option (95% CI 11.1-21.9). Some women who expressed a p reference were excluded owing to high risk factors, giving an adjusted preference of 11% (95% CI 5.2-16.4). Preference was not related to ei ther age, pregnancy experience or previous knowledge. Conclusions: mor e women expressed a preference for the option than would be expected f rom examination of national and local uptake figures. Lack of knowledg e appears to be an important factor in explaining the low uptake. Purc hasers, therefore, need to set contracts reflecting more realistic pre ferences and ensure that women have information on all options availab le to them, so that at the beginning of pregnancy women are enabled to make a shared decision on the choice of delivery. Both purchasers and providers need to monitor uptake and levels of knowledge.