Introduction In Germany, the cesarean section rate is rising steadily and is currently at 30.9%. Most cesarean sections may not be medically necessary. This includes breech births, where often a preference-sensitive choice can be made between a cesarean section and a vaginal birth. Only a few international studies explore person-centered approaches to increase vaginal birth rates. Providing audio recordings of medical discussions has shown positive impacts on decision-making, knowledge, and emotional well-being. This simple intervention could enhance person-centeredness in birth planning for breech births and thereby increase vaginal birth rates.

This study aims to assess the acceptance, relevance, and feasibility of providing audio recordings of birth planning discussions in medical encounters for breech presentations. It seeks perspectives from pregnant individuals and physicians.

Methods In this multicenter mixed-methods study, we will record and analyze n=10 decision-making discussions in each of three obstetric clinics. We will evaluate decisional conflict before and after discussions as well as the implementation of shared decision-making in those encounters (via Observer OPTION5). After listening to their discussions’ audio recordings, pregnant individuals and physicians will give feedback on the intervention in semi-structured interviews. Those will be analyzed via qualitative content analysis.

Results The study will reveal insights into attitudes toward audio recordings in birth planning discussions for breech presentations and decision-making processes during those encounters.

Discussion This is the first study in Germany evaluating a person-centered intervention in birth planning for breech presentations. By adopting a mixed-methods approach it will offer insights into decision-making processes and may identify differences between institutions.

Conclusion Implementing audio recordings as a simple intervention could potentially enhance person- centeredness and increase vaginal birth rates.