INSTRUCTIONS Mothers Autonomy in Decision Making (MADM) scale

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2 INSTRUCTIONS Mothers Autonomy in Decision Making (MADM) scale The Mothers Autonomy in Decision Making scale (MADM) was developed by women to describe their experiences of maternity care. The MADM scale is a reliable and valid tool that rates the level of agency and autonomy that a person experiences when participating in decisionmaking conversations with a maternity provider (Vedam et al., 2017). The tool, scoring system, and instructions for use are presented in this document. The scale is also available for download in Spanish (see below). For more information on the development of the MADM scale read the 2017 publication here. This scale is free for use in academic settings, clinical offices, or health care institutions. For academic studies and health institutions, there is no charge, but a User Agreement is required for each study, and each use. Please click here to complete the download request form. However, for any study carried out by a commercial group or if the study is wholly or partially supported by a commercial organization a fee may be payable. This fee scale is dependent on a variety of factors. For information please contact the Birth Place Lab directly: lynsey.hamilton@ubc.ca Any funds generated through the copyright arrangement are used exclusively to support the ongoing work of the Birth Place Lab. We have also developed a Mothers on Respect index (MOR) that can be used alongside this scale. Click here for MOR. Contact us for further information for use: lynsey.hamilton@ubc.ca MADM CITATION: Vedam, S., Stoll, K., Martin, K., Rubashkin, N., Partridge, S., Thordarson, D., & Jolicoeur, G. (2017). The Mother s Autonomy in Decision Making (MADM) scale: Patient-led development and psychometric testing of a new instrument to evaluate experience of maternity care. Plos One,12(2). doi: /journal.pone

3 MOTHERS AUTONOMY IN DECISION MAKING: THE MADM SCALE Please tell us about your discussions with your doctor or midwife about your options for care (for example: prenatal testing, starting your labour, medications, where to give birth, newborn care, whether to have a cesarean, etc.) My answers describe my conversations or experiences with a: Family doctor Obstetrician/OB-GYN doctor Midwife Not applicable, did not have a doctor or midwife Please describe your experiences with decision making during your pregnancy, labour and/or birth. (select one option for each) My doctor or midwife asked me how involved in decision making I wanted to be. My doctor or midwife told me that there are different options for my maternity care. My doctor or midwife explained the advantages/ disadvantages of the maternity care options. My doctor or midwife helped me understand all the information. I was given enough time to thoroughly consider the different care options. I was able to choose what I considered to be the best care options. My doctor or midwife respected my choices. Completely Disagree Strongly Disagree Somewhat Disagree Somewhat Agree Strongly Agree Completely Agree SUM OF ALL CIRCLED ITEMS = TOTAL SCORE:

4 The range of scores is 7-42, with higher score indicating more opportunities to take an active role and lead decisions. KEY Level of Autonomy (by quartiles) Total Score Indication of Respect 7-15 Very Low Patient Autonomy Low Patient Autonomy Moderate Patient Autonomy High Patient Autonomy

5 LA AUTONOMÍA DE LAS MADRES EN LA TOMA DE DECISIONES: LA ESCALA DE MADM (ESPAÑOL) Por favor, utilice las siguientes preguntas para contarnos acerca de las discusiones o conversaciones con su doctor(a) o partera sobre sus opciones de cuidado (Por ejemplo: exámenes prenatales, comienzo del trabajo de parto, medicamentos, cesárea, lugar para dar a luz, cuidado del bebé, etc.) Mis respuestas en esta sección describen mis conversaciones o experiencias con un(a)... (Elija una opción) Doctor(a) de familia Doctor(a) Obstetra/ Ginecólogo/a Partera No se aplica, no tuve un(a) doctor(a) o partera Por favor describa sus experiencias en la toma de decisiones durante su embarazo (Puntúe cada una de las situaciones enunciadas) Totalmente en desacuerdo Muy en desacuerdo Relativamente en desacuerdo Relativamente de acuerdo Muy de acuerdo Totalmente de acuerdo preguntó qué tan involucrada quería estar yo en la toma de decisiones dijo que hay diferentes opciones para mi cuidado materno explicó las ventajas y desventajas de las opciones de cuidado materno ayudó a entender toda la información Me dieron suficiente tiempo para considerar las distintas opciones de cuidado detenidamente Tuve la posibilidad de elegir las que yo consideré eran las mejores opciones Mi doctor(a) o partera respetó mis decisiones SUMA DE TODOS LAS PUNTUACIONES = PUNTUACIÓN TOTAL:

6 El rango de puntuación oscila entre 7 y 42; la puntuación más alta indica más oportunidades de tomar un papel activo en la toma de decisiones. Nivel de Autonomía (por cuartiles): Puntuación Nivel de Respeto total 7-15 Autonomía de la paciente Muy baja Autonomía de la Paciente Baja Autonomía de la paciente Moderada Autonomía de la paciente Alta