loading page

What should be discussed when considering a caesarean birth? : A Delphi Study to develop a Core Information Set for caesarean birth.
  • +16
  • Carol Kingdon,
  • Benjamin Greenfield,
  • Mahmoud Aljubeh,
  • Eve Bunni,
  • Alexandra Hunt,
  • Vicky Bradley,
  • Caroline Cunningham,
  • Siobhan Holt,
  • Andrew Demetri,
  • Christy Burden,
  • Jo Ficquet,
  • Elena Oteroromero,
  • William Parry-Smith,
  • Mairead Black,
  • Fiona Bradley,
  • Amy Elsmore,
  • Jenna Frizelle,
  • Tabitha Jones,
  • Abi Merriel
Carol Kingdon
University of Liverpool Department of Women's and Children's Health
Author Profile
Benjamin Greenfield
University of Liverpool Department of Women's and Children's Health
Author Profile
Mahmoud Aljubeh
Liverpool Women's Hospital
Author Profile
Eve Bunni
University of Liverpool Department of Women's and Children's Health
Author Profile
Alexandra Hunt
University of Liverpool Department of Health Data Science
Author Profile
Vicky Bradley
University of Liverpool Department of Women's and Children's Health
Author Profile
Caroline Cunningham
Liverpool Women's Hospital
Author Profile
Siobhan Holt
Liverpool Women's Hospital
Author Profile
Andrew Demetri
University of Bristol
Author Profile
Christy Burden
University of Bristol
Author Profile
Jo Ficquet
Royal United Hospitals Bath NHS Foundation Trust
Author Profile
Elena Oteroromero
Cambridge University Hospitals NHS Foundation Trust
Author Profile
William Parry-Smith
Keele University Faculty of Medicine & Health Sciences
Author Profile
Mairead Black
University of Aberdeen
Author Profile
Fiona Bradley
Liverpool University Hospitals NHS Foundation Trust
Author Profile
Amy Elsmore
Keele University Faculty of Medicine & Health Sciences
Author Profile
Jenna Frizelle
Liverpool Women's Hospital
Author Profile
Tabitha Jones
University of Liverpool Faculty of Health and Life Sciences
Author Profile
Abi Merriel
University of Liverpool Department of Women's and Children's Health

Corresponding Author:[email protected]

Author Profile

Abstract

Objective To 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. Design Two-phase consensus study using modified Delphi. Setting United Kingdom, 2024 Sample People planning a pregnancy/currently pregnant/new parents and maternity professionals Methods Phase 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 hours), and emergency caesarean birth (EMCB; ≤30 minutes), followed by two-round Delphi survey and consensus meetings. Results N=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). Conclusions This study has established three caesarean birth CISs to support informed decision-making discussions between women and clinicians: (1) CIS for planned and unplanned caesareans when there is time for discussion; (2) CIS for EMCB (within 30 minutes); (3) CIS post-EMCB pre-hospital discharge.