TY - JOUR
T1 - Informing Decision-Making About Caesarean Birth: A Delphi Study to Develop a Core Information Set
AU - the Options Collaborative Group
AU - Kingdon, Carol
AU - Greenfield, Ben
AU - Aljubeh, Mahmoud
AU - Bunni, Eve
AU - Hunt, Alexandra
AU - Bradley, Vicky
AU - Cunningham, Caroline
AU - Holt, Siobhan
AU - Demetri, Andrew
AU - Burden, Christy
AU - Ficquet, Joanna
AU - Otero-Romero, Elena
AU - Smith, William Parry
AU - Black, Mairead
AU - Bradley, Fiona
AU - Elsmore, Amy
AU - Frizelle, Jenna
AU - Jones, Tabitha
AU - Merriel, Abi
AU - Lawlor, Deborah
AU - Smith, Gordon
AU - Norman, Jane
AU - Heron, Jon
AU - Kenny, Louise
AU - Lawton, Michael
AU - McGuinness, Sheelagh
AU - Davies, Anna
AU - Lavender, Tina
AU - Burden, Christy
AU - Ives, Jonathan
AU - Grant, Simon
AU - Abdel-Fattah, Sherif
AU - Bakhbakhi, Danya
AU - Bonnet, Laura
AU - Demetri, Andrew
AU - Dewhurst, Christopher
AU - Black, Mairead
AU - Finnikin, Sam
AU - Wilson, Amie
AU - Freeman, Alexandra
AU - Blair, Pete
AU - Birchenall, Katherine
AU - Johnson, Joanne
AU - Johnstone, Gary
AU - Kenyon, Carol
AU - Marshall, Amber
AU - Maden, Michelle
AU - Sharp, Andy
AU - Weeks, Andrew
N1 - Publisher Copyright:
© 2025 The Author(s). BJOG: An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd.
PY - 2025/7/8
Y1 - 2025/7/8
N2 - ObjectiveTo develop a caesarean birth core information set. Caesareans are the most common surgery performed in many countries. Women need information for informed decision-making and consent. Core information sets (CISs) provide baseline information, agreed upon by parents and clinicians, for discussion before a procedure.DesignTwo-phase consensus study using modified Delphi.SettingUnited Kingdom, 2024.SamplePeople planning a pregnancy/currently pregnant/new parents and maternity professionals.MethodsPhase 1: Long-list of information points identified from 273 systematic reviews, 50 patient leaflets, three pre-existing qualitative studies and a stakeholder survey (n = 230); Operationalised into a Delphi questionnaire comprising 11 information points with 108 items. Phase 2: Think-aloud interviews (n = 9) informed questionnaire restructure into information about planned caesarean birth, unplanned caesarean birth (within 72 h) and emergency caesarean birth (EMCB; ≤ 30 min), followed by two-round Delphi survey and consensus meetings.ResultsN = 360 participated in the Delphi survey Round 1. All items were carried forward, and three were added for Round 2 (n = 188/56.4% attrition rate). From Round 2, one item was removed, 73 included and 37 items no-consensus. Free-text responses identified an unmet need for a postnatal EMCB-CIS. Over four meetings (n = 36) consensus was reached for an antenatal-caesarean-birth-CIS (14 points), EMCB-CIS (5 points) and a postnatal EMCB-CIS (12 points).ConclusionsThis study has established three caesarean birth CISs to support informed decision-making discussions between women and clinicians: (1) an antenatal CIS for planned and unplanned caesareans when there is time for discussion in clinic; (2) a one-page CIS for emergency caesarean birth (within 30 min) when there is little time for discussion; (3) and a postnatal CIS for use after an unplanned caesarean birth before hospital discharge.
AB - ObjectiveTo develop a caesarean birth core information set. Caesareans are the most common surgery performed in many countries. Women need information for informed decision-making and consent. Core information sets (CISs) provide baseline information, agreed upon by parents and clinicians, for discussion before a procedure.DesignTwo-phase consensus study using modified Delphi.SettingUnited Kingdom, 2024.SamplePeople planning a pregnancy/currently pregnant/new parents and maternity professionals.MethodsPhase 1: Long-list of information points identified from 273 systematic reviews, 50 patient leaflets, three pre-existing qualitative studies and a stakeholder survey (n = 230); Operationalised into a Delphi questionnaire comprising 11 information points with 108 items. Phase 2: Think-aloud interviews (n = 9) informed questionnaire restructure into information about planned caesarean birth, unplanned caesarean birth (within 72 h) and emergency caesarean birth (EMCB; ≤ 30 min), followed by two-round Delphi survey and consensus meetings.ResultsN = 360 participated in the Delphi survey Round 1. All items were carried forward, and three were added for Round 2 (n = 188/56.4% attrition rate). From Round 2, one item was removed, 73 included and 37 items no-consensus. Free-text responses identified an unmet need for a postnatal EMCB-CIS. Over four meetings (n = 36) consensus was reached for an antenatal-caesarean-birth-CIS (14 points), EMCB-CIS (5 points) and a postnatal EMCB-CIS (12 points).ConclusionsThis study has established three caesarean birth CISs to support informed decision-making discussions between women and clinicians: (1) an antenatal CIS for planned and unplanned caesareans when there is time for discussion in clinic; (2) a one-page CIS for emergency caesarean birth (within 30 min) when there is little time for discussion; (3) and a postnatal CIS for use after an unplanned caesarean birth before hospital discharge.
KW - birth
KW - caesarean
KW - choice
KW - consent
KW - core information set
KW - Delphi
U2 - 10.1111/1471-0528.18269
DO - 10.1111/1471-0528.18269
M3 - Article
C2 - 40626370
AN - SCOPUS:105011142315
SN - 1470-0328
VL - 132
SP - 2024
EP - 2039
JO - BJOG: An International Journal of Obstetrics and Gynaecology
JF - BJOG: An International Journal of Obstetrics and Gynaecology
IS - 13
ER -