How Do Partners Make Pregnancy-Related Decisions? Understanding the Decision-Making Process of Couples: A Scoping Review

Figures & data

Figure 1. PRISMA flow diagram for a scoping review (Page et al., 2021).

Table 1. Characteristics of the included full-text articles.

Authors	Country	Study design	Study population	Study aims	Type of decision	Themes
(Barr & Skirton, 2013)	England	Focus groups	Pregnant women (n = 16) and their partners (n = 6)	To explore the experiences of prospective parents regarding the offer of antenatal screening for fetal abnormality	Antenatal screening for fetal abnormality	Decision-making authority
(Carroll et al., 2012)	United Kingdom	Semistructured interviews	Pregnant women and their partners (n = 13 couples, total n = 26 and only pregnant woman n = 3)	To explore how couples regard screening information and how they make decisions about undergoing prenatal screening for Down syndrome	Prenatal screening (Down syndrome)	Decision-making authority, communication between partners
(Dong et al., 2021)	China	Quantitative factor analysis and interviews	Women (n = 169)	To explore women’s viewpoint on informed decision-making regarding antenatal screening	Antenatal screening results	Decision-making authority
(Farrell et al., 2019)	United States	In-depth interviews	Partners (males) of pregnant women (n = 23)	To examine partners’ perspectives about cfDNA screening and preferences	Decisions about cfDNA	Partner involvement
(Gottfredsdóttir et al., 2009)	Iceland	Semistructured interviews	Couples (n = 10, 10 prospective mothers and 10 fathers)	To explore the influences on prospective parents’ decision-making in relation to nuchal translucency screening in early pregnancy and gain insight in the views of prospective mothers and fathers toward the benefits/implications of screening	Nuchal translucency screening	Decision-making authority, communication between partners
(Jaques et al., 2004)	Australia	Questionnaires	Pregnant women (n = 737)	To examine who women perceived as an influence during their decision about prenatal testing, with whom they would have liked to talk more. and what source of information they preferred	Prenatal testing for birth defects	Decision-making authority
(Laberge et al., 2019)	Canada	Questionnaires	Pregnant women (n = 882) and partners (n = 395)	To assess the preferences for information about NIPT of pregnant women and their partners	NIPT for Down syndrome	Decision-making authority
(Millo et al., 2021)	Israel	Semistructured interviews	Women (n = 27) or their partners (n = 15)	To explore expectant parents’ understanding of uncertain chromosomal microarray results, considerations for and against receiving such findings	Chromosomal-microarray-analysis	Decision-making authority
(Seidler et al., 2019)	Austria	Semistructured interviews	Women (n = 14) and their male partners (n = 11)	To explore the experiences for prenatal screening	Prenatal screening	Communication between partners, informational need/knowledge
(Wätterbjörk et al., 2012)	Sweden	Semistructured interviews	Pregnant women and partners (n = 10 women, 6 partners, 10 couples)	Describe the perception of pregnant women and their partners on the information given on prenatal screening	Prenatal screening	Decision-making authority, communication between partners
(Wätterbjork et al., 2015)	Sweden	Semistructured interviews	Couples (n = 15, total n = 30)	To explore the couples’ process of decision-making about prenatal screening	Prenatal screening	Phases and patterns of decision-making
(Werner-Lin et al., 2016)	United States	Semistructured interviews	Couples (n = 12, total n = 24)	To explore how women and men understand experiences of receiving abnormal or uncertain results from prenatal microarray testing	Prenatal microarray testing	Decision-making authority, partner involvement
(Williams et al., 2011)	England	Longitudinal qualitative pilot study	Expectant fathers (n = 8)	To explore and analyze men’s involvement in antenatal genetic screening and testing	Antenatal genetic screening and testing	Informational need/knowledge, partner involvement
(Åhman et al., 2012)	Sweden	Semistructured interviews	Expectant fathers (n = 17)	To explore men’s expectations of routine ultrasound and experiences when soft markers were discovered	Ultrasound screening identifying soft markers and amniocentesis	Decision-making authority, partner involvement
(Locock & Alexander, 2006)	United Kingdom	In-depth interviews	Women (n = 33), couples (n = 6, total n = 12) and male partners (n = 2)	Identifying several potentially conflicting male roles in screening, diagnosis, and subsequent decision-making	Fetal screening and diagnosis	Partner involvement
(Browner & Preloran, 1999)	United States	Interviews and observations	Couples (interviews n = 129, observations n = 65)	To explore the role male partners play in amniocentesis decisions of women	Amniocentesis	Decision-making authority, informational need/knowledge, partner involvement
(Carlsson & Mattsson, 2018)	Sweden	Interviews	Expectant fathers (n = 12)	To explore the experiences during the time of decision-making and diagnosis of males with a pregnant partner presented with congenital heart defect in the fetus	Prenatal diagnosis (congenital heart defect)	Decision-making authority, partner involvement
(Côté-Arsenault & Denney-Koelsch, 2016)	United States	Interviews	Mothers (n = 16) and partners (n = 13 fathers and 1 female partner)	To explore the experiences and developmental needs of parents who continue their pregnancy despite the lethal diagnosis	Parents who continued pregnancy with a lethal fetal diagnosis	Decision-making authority, partner involvement
(France et al., 2012)	United Kingdom	Secondary analysis of qualitative narrative interview data	Women (n = 24) and male partners (n = 4)	To explore the role that knowledge of disabilities/conditions can play in decisions to continue of errand a pregnancy with a fetal abnormality	Decision-making about fetal abnormality	Decision-making authority
(Humphreys et al., 2008)	Canada	Questionnaires	Women (n = 95)	To explore the reasons for the attendance/nonattendance of partners at advanced maternal age counseling and how aspects of the couple relationship might relate to the adjustment of women following PND counseling/testing	Prenatal diagnosis	Decision-making authority
(Kukulu et al., 2006)	Turkey	Questionnaires	Women undergoing amniocentesis (n = 85) and their male partners (n = 85)	Evaluate women’s and their spouses reasons for undergoing amniocentesis, their concerns regarding the procedure, and their psychological reactions during the testing period	Amniocentesis	Partner involvement
(Nazaré et al., 2011)	Portugal	Questionnaires	Couples (n = 112, total n = 224)	Understand how each member of a couple perceive the decision-making process regarding amniocentesis	Amniocentesis	Decision-making authority
(Phipps & Skirton, 2017)	United States	Semistructured interviews	Couples (n = 4, total n = 8)	To explore attitudes toward prenatal testing in couples where one partner had tested positive for the Muenke mutation	Prenatal testing in adults who have Muenke syndrome	Decision-making authority
(Rempel et al., 2004)	North America	Interviews	Mothers (n = 19) and fathers (n = 15)	Explore the issues parents face when managing their experience antenatal diagnosis of congenital heart disease	Antenatal diagnosis	Decision-making authority
(Sjögren, 1992)	Sweden	Semistructured interviews	Male partners (n = 20)	Elucidating the experiences of men in connection with PND	Prenatal diagnosis	Decision-making authority, informational need/knowledge,
(Sjögren & Uddenberg, 1988)	Sweden	Questionnaire and interview study	Women (questionnaire n = 211, interview n = 53)	Examine how male partners participate in the decision-making process	Prenatal diagnosis	Decision-making authority
(Brauer et al., 2019)	The Netherlands	In-depth interviews	Women who had experienced an unintended pregnancy (n = 109)	Describe the decision-making processes for women who have been faced with an unintended or unwanted pregnancy	Unintended/unwanted pregnancy	Partner involvement
(Calvès, 2002)	Cameroon	Survey data and interviews	Men and women (survey data n = 384, interviews n = 180)	To explore the social dynamics of premarital childbearing activities	Induced abortion and decision-making	Decision-making authority
(Chibango & Maharaj, 2018)	Zimbabwe	Focus groups	Men (n = 31) and women (n = 35)	To assess the role of men and women in decision-making about abortion	Abortion in a setting with a high prevalence of HIV	Decision-making authority
(Costescu & Lamont, 2013)	Canada	Questionnaire-based study	Couples, defined as a pregnant woman (n = 30) and the man with whom the pregnancy was most likely conceived (n = 29)	To explore how women and their partners navigate the pregnancy decision-making process	Seeking induced abortion	Decision-making authority, communication between partners
(Hirz et al., 2017)	The Philippines	In-depth interviews and focus groups	Men (interviews n = 15, focus groups n = 43)	To understand the beliefs about unintended pregnancy and abortion and perceptions about the male roles related to pregnancy decision-making	Induced abortion	Decision-making authority
(Johansson et al., 1998)	Vietnam	Interviews	Male partners (n = 20)	Analyzes the involvement of men in abortion	Induced abortion	Decision-making authority
(Kecir et al., 2021)	France	Semistructured interviews	Fathers (n = 8), day after termination of pregnancy (TOP)	Describe how fathers perceive the TOP, their feelings about caregivers, and their coping strategies	TOP for fetal anomaly	Partner involvement
(Rehnström Loi et al., 2018)	Kenya	In-depth interviews	Women (n = 9)	To explore the decision-making process of induced abortion among women with unwanted pregnancies	Induced abortion	Decision-making authority
(Schwandt et al., 2013)	Ghana	Focus group discussions and in-depth interviews	Women (focus group, n = 30, interview n = 20) and male partners focus group, n = 13, interview n = 19)	To explore the decisions women and men make when they are faced with an unwanted pregnancy	Unwanted pregnancy	Decision-making authority
(Aarnio et al., 2018)	Malawi	In-depth interviews	Couples (n = 12, total n = 24)	To provide information about the role of the nonpregnant partner in decision-making and health care seeking in case of pregnancy complications	Seeking health care for pregnancy complications	Decision-making authority, informational need/knowledge
(Denney-Koelsch & Cote-Arsenault, 2021)	United States	Interviews	Parents (mothers, n = 16, fathers n = 13 and 1 female partner)	To understand factors that parents consider and the process by which they make decisions about the care of their baby	Decision about prenatal and neonatal care in case of a life-limiting fetal condition	Phases and patterns of decision-making
(Ganle et al., 2015)	Ghana	Focus group and interviews	Expecting and lactating mothers (n = 185)	To explore how intrafamilial decision-making affects the ability of women to access and use maternal health services	Access and use of maternal health services	Decision-making authority
(Hildingsson, 2014)	Sweden	Longitudinal cohort study, questionnaires	Pregnant women (n = 1,074) and their partners (n = 1,068)	Compare couples’ personal and general attitudes toward birth and study the relationship between attitudes, birth preferences, and fear of birth in relation to mode of birth	Mode of birth	Decision-making authority
(Hollander et al., 2020)	The Netherlands	In depth-interviews	Male partners (n = 21)	Examine partners’ involvement in the decision-making process concerning a home birth in a high-risk pregnancy or unassisted childbirth	Home birth	Decision-making authority, communication between partners, informational need/knowledge, partner involvements
(Lindgren & Erlandsson, 2011)	Sweden	In-depth interviews	Fathers (n = 8)	Gain understanding of fathers’ experiences of a planned home birth	Home birth	Decision-making authority
(Martínez-Mollá et al., 2015)	Spain	Life stories, narrations and in-depth interviews	Couples (n = 11, total n = 22)	To explore the father’s role on decision-making regarding home birth from the perspective of both partners	Home birth	Decision-making authority, communication between partners, partner involvement
(Thompson et al., 2019)	England	Semistructured telephone interviews	Twelve parents (n = 9 female, n = 3 male partners)	To explore factors that influence parents’ decision-making for mode of breech birth at term gestation	Mode of breech birth at term of gestation	Decision-making authority

cfDNA: circulating free DNA; NIPT: noninvasive prenatal screening; PND: prenatal diagnosis; TOP: termination of pregnancy.

Table

("pregnant women"[MeSH Terms] OR "pregnancy in adolescence"[MeSH Terms] OR "prenatal diagnosis"[MeSH Terms] OR "ultrasonography, prenatal"[MeSH Terms] OR "pregnan*"[Title/Abstract] OR "prenatal"[Title/Abstract] OR "fetus"[MeSH Terms] OR "fetus"[Title/Abstract] OR "antenatal"[Title/Abstract]) AND (("decision making"[MeSH Terms] OR "choice behavior"[MeSH Terms] OR "decision*"[Title/Abstract] OR "choice*"[Title/Abstract] OR "choos*"[Title/Abstract] OR "chose*"[Title/Abstract]) AND ("sexual partners"[MeSH Terms] OR "spouses"[MeSH Terms] OR "illegitimacy"[MeSH Terms] OR "partner*"[Title/Abstract] OR "spous*"[Title/Abstract] OR "illegitimacy"[Title/Abstract] OR "husband*"[Title/Abstract] OR "married person"[Title/Abstract] OR "wife"[Title/Abstract] OR "wives"[Title/Abstract] OR "joint"[Title/Abstract] OR "shared"[Title/Abstract]))

Table

((DE "Pregnancy" OR DE "Adolescent Pregnancy" OR DE "Prenatal Diagnosis" OR DE "Fetus") OR TI (pregnan* OR prenatal OR fetus OR antenatal) OR AB (pregnan* OR prenatal OR fetus OR antenatal)) AND (((DE "Decision Making" OR DE "Choice Behavior") OR TI (decision* OR "choice* OR "choos* OR "chose*) OR AB (decision* OR "choice* OR "choos* OR "chose*)) AND ((DE "Family" OR DE "Sexual Partners") OR TI (partner* OR spous* OR illegitimacy OR husband* OR "married person" OR wife OR wives OR joint OR shared) OR AB (partner* OR spous* OR illegitimacy OR husband* OR "married person" OR wife OR wives OR joint OR shared)))

Table

(((MH "Pregnancy+") OR (MH "Pregnancy in Adolescence+") OR (MH "Expectant Mothers") OR (MH "Prenatal Diagnosis+") OR (MH "Fetus+")) OR TI (pregnan* OR prenatal OR fetus OR antenatal) OR AB (pregnan* OR prenatal OR fetus OR antenatal)) AND (((MH "Decision Making+") OR TI (decision* OR "choice* OR "choos* OR "chose*) OR AB (decision* OR "choice* OR "choos* OR "chose*)) AND (((MH "Family+") OR (MH "Sexual Partners") OR (MH "Spouses")) OR TI (partner* OR spous* OR illegitimacy OR husband* OR "married person" OR wife OR wives OR joint OR shared) OR AB (partner* OR spous* OR illegitimacy OR husband* OR "married person" OR wife OR wives OR joint OR shared)))

Table

(TS=(pregnan* OR prenatal OR fetus* OR antenatal)) AND (TS=(decision making OR choice behavior OR decision* OR choice* OR choos* OR chose*) AND TS= (spous* OR illegitimacy OR partner* OR husband* OR “married person” OR wife OR wives OR joint OR shared))

Table

1	exp pregnant woman/ OR exp pregnancy/ OR exp prenatal diagnosis/ OR exp fetus echography/ OR exp fetus/
2	(pregnan* OR prenatal OR fetus OR antenatal).ti,ab.
3	#1 OR #2
4	exp decision making/
5	(decision* OR choice* OR choos* OR chose*). ti,ab.
6	#4 OR #5
7	exp spouse/ OR exp illegitimacy
8	(partner* OR spous* OR illegitimacy OR husband* OR married person OR wife OR wives OR joint OR shared). ti,ab. not exp joint/
9	#7 OR #8
10	#3 AND # 6 AND #9

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