Associations Between TeamBirth and Trust and Autonomy Among Patients Reporting Complicated Births

Abstract Purpose: To examine whether complications during childbirth moderates the relationship between exposure to a TeamBirth huddle during labor and patient trust and autonomy. Study Design and Methods: Secondary analysis of patient experience surveys from 31 birthing hospitals in Oklahoma implementing TeamBirth between March 2022 and June 2024. Sample included 6,528 patients ≥15 years, of whom 774 reported childbirth complications. Patients were asked about demographic and clinical characteristics, experience with TeamBirth huddles, and responses to the Health Care Relationship Trust Scale (HCRTS-R) and My Autonomy in Decision-Making (MADM) scale. We used multivariable regression with interaction terms, adjusting for key demographic and clinical factors, to explore the role of complications in the relationship between TeamBirth exposure and patient trust and autonomy levels. Results: Reported childbirth complications significantly strengthened the positive association between TeamBirth exposure and patient trust and autonomy (HCRTS-R: b = 2.86, p < .001; MADM: b = 3.77, p < .001). Clinical Implications: Experiencing a TeamBirth huddle during labor is positively associated with improved patient-reported trust and autonomy across groups, with the strongest effects observed among patients with childbirth complications. Nurses play a key role in implementing the TeamBirth model to enhance patient-centered care and mitigate the potential negative effects of complications on childbirth experiences.