Mother's Autonomy in Decision Making (MADM)

The Mother's Autonomy in Decision Making (MADM) Scale is a 7-item self-report measure of an individual woman's experience of autonomy and participation in decision making during maternity care. Different aspects of autonomy and shared decision making captured by the scale include communication with provider regarding decision making, education about maternity care options, and the mother's freedom of choice among these options.


Geographies Tested: Canada

Populations Included: Female

Age Range: Adults


Please describe your experiences when making decisions and choosing options for care during this pregnancy. (Blanks auto-populated with provider type: i.e., family physicianobstetricianmidwife)

1. My _______ asked me how involved in decision making I wanted to be
2. My _______ told me that there are different options for my maternity care
3. My _______ explained the advantages and disadvantages of the maternity care options
4. My _______ helped me understand all the information
5. I was given enough time to thoroughly consider the different maternity care options
6. I was able to choose what I considered to be the best care options
7. My _______ respected that choice

Response Options:
(6-point Likert scale)
Completely disagree - 1
Strongly disagree - 2
Somewhat disagree - 3
Somewhat agree - 4
Strongly agree - 5
Completely agree - 6

Scoring Procedures

Scores are summed across the seven items (range of scores 7-42). Higher scores reflect that women experienced greater agency and autonomy when engaging in the shared decision making process with a maternity care provider.

Original 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), e0171804.

Psychometric Score

Ease of Use Score

Scoring breakdown

Formative Research

Qualitative Research

Existing Literature/Theoretical Framework

Field Expert Input

Cognitive Interviews / Pilot Testing








Criterion (gold-standard)



Ease of Use


Scoring Clarity


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