634 Discordance between prenatal inclination and delivery decision among women with a history of cesarean delivery

To determine factors associated with discordance between prenatal inclination regarding delivery approach and decision at the time of admission among women a history CD. This was secondary analysis data from PROCEED trial, multi-centered randomized controlled trial studying impact patient centered app on rates TOLAC. Women participated in phone interview 34-37 weeks which they stated their completed measures quality. 1357 1470 participants had complete telephone data. At weeks, 692 (51%) were inclined to undergo TOLAC, 595 (44%) ERCD, 70 (5%) undecided. 187 (13.8%) underwent different than inclination. Among who 142 (20.5%) an ERCD admission. Conversely, reported have 45 (7.6%) undecided interview, 26 (37%) TOLAC 44 (63%) ERCD. Compared whose concordant more likely be publicly insured, speak Spanish, income <$100k, less college education, married/living partner. They also decisional uncertainty conflict, support effective decision-making (Table 1). A substantial minority prior CD change intended last pregnancy. While these changes may reflect incorporation new clinical information (i.e., labor status), lower quality measured association demographic indicates opportunities for continued discussion optimize patient-centered care, particularly vulnerable populations.