Carol Kingdon

and 18 more

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.

Eve Bunni

and 19 more

Objective: This study aims to develop a core information set (CIS) for induction of labour. A CIS is an agreed set of information points for discussion prior to an intervention. Design: First a long list of information points was identified through a systematic review of reviews, reviewing patient leaflets, analysis of pre-existing qualitative interviews and an initial stakeholder survey. A long list of items was collated before combining and refining alongside an involvement group. Cognitive interviews were undertaken to refine the Delphi Survey before a two-round modified Delphi process where participants voted on the importance of the information items. Pre-specified criteria were used to select the items taken forward to a consensus meeting. Participants were recruited via UK hospital sites, online and social media platforms and included parents and professionals. Setting and population: Participants were recruited via UK hospital sites, online and social media platforms and included parents and professionals. Main outcome: A core information set for induction of labour. Results: 199 information points were identified through systematic review (110), patient information leaflets (162), qualitative interviews (58) and a survey (93). 46 unique information items entered the first Delphi round after 4 cognitive interviews, 2 items were added following round 2. 368 people (310 parents/ 58 professionals) participated in round 1 and 177 people (154 parents/23 professionals) in round 2. 44 items met inclusion criteria; 1 item excluded, and 3 items were carried forward for consensus meeting discussion where 12 overarching information points were agreed upon. Conclusion: This CIS can help to inform and support discussions about induction to enable parents to make informed decisions about birth.