title: 'Informed and uninformed decision making'--women's reasoning, experiences and perceptions with regard to advanced maternal age and delayed childbearing: a meta-synthesis.
abstract: OBJECTIVE
  To identify what factors affect women's decisions to delay childbearing, and to explore women's experiences and their perceptions of associated risks.
  
  
  METHODS
  Systematic procedures were used for search strategy, study selection, data extraction and analysis. Findings were synthesised using an approach developed from meta-ethnography.
  
  
  METHODS
  We included qualitative papers, not confined to geographical area (1980-2009). Databases included CINAHL, MEDLINE, EMBASE, PsycInfo, ASSIA, MIDIRS, British Nursing Index and the National Research Register. We selected qualitative empirical studies exploring the views and experiences of women of advanced maternal age who were childless or primigravidae with a singleton pregnancy or primiparous.
  
  
  METHODS
  Twelve papers fulfilled the selection criteria and were included for synthesis.
  
  
  RESULTS
  Women appear to face an issue of 'informed and uninformed decision making'; those who believe they are informed but may not be, those who are not informed and find out they are at risk once pregnant, and those who are well informed but choose to delay pregnancy anyway. Maternity services could provide information to enable informed choice regarding timing of childbearing.
  
  
  CONCLUSIONS
  Health professionals need to be mindful of the fact that women delay childbearing for various reasons. A strategy of pre-conception education may be beneficial in informing childbearing decisions. Obstetricians and midwives should be sensitive to the fact that women may not be aware of all the risks associated with delayed childbearing.
authors.affiliation: Central Manchester University Hospitals NHS Foundation Trust and The University of Manchester, United Kingdom. Alison.Cooke@manchester.ac.uk
authors.forename: Alison
authors.initials: A
authors.lastname: Cooke
authors.forename: Tracey A
authors.initials: TA
authors.lastname: Mills
authors.forename: Tina
authors.initials: T
authors.lastname: Lavender
mesh_terms: D003657:Decision Making; D005260:Female; D006801:Humans; D008423:Maternal Age; D011247:Pregnancy