Informing Decision-Making About Caesarean Birth: A Delphi Study to Develop a Core Information Set.


Kingdon, Carol ORCID: 0000-0002-5958-9257, Greenfield, Ben, Aljubeh, Mahmoud, Bunni, Eve ORCID: 0009-0009-4991-3728, Hunt, Alexandra ORCID: 0000-0001-5510-0285, Bradley, Vicky, Cunningham, Caroline ORCID: 0009-0007-4340-5576, Holt, Siobhan, Demetri, Andrew ORCID: 0000-0002-2820-5919, Burden, Christy et al (show 10 more authors) (2025) Informing Decision-Making About Caesarean Birth: A Delphi Study to Develop a Core Information Set. BJOG : an international journal of obstetrics and gynaecology, 132 (13). pp. 2024-2039. ISSN 1470-0328, 1471-0528

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Abstract

<h4>Objective</h4>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.<h4>Design</h4>Two-phase consensus study using modified Delphi.<h4>Setting</h4>United Kingdom, 2024.<h4>Sample</h4>People planning a pregnancy/currently pregnant/new parents and maternity professionals.<h4>Methods</h4>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 h) and emergency caesarean birth (EMCB; ≤ 30 min), followed by two-round Delphi survey and consensus meetings.<h4>Results</h4>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).<h4>Conclusions</h4>This 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.<h4>Trial registration</h4>COMET Initiative | Development of a core information set for caesarean birth (comet-initiative.org).

Item Type: Article
Uncontrolled Keywords: Options Collaborative Group, Humans, Cesarean Section, Consensus, Decision Making, Pregnancy, Informed Consent, Delphi Technique, Adult, Female, Patient Education as Topic, Surveys and Questionnaires, United Kingdom
Divisions: Faculty of Health & Life Sciences
Faculty of Health & Life Sciences > Inst. Life Courses & Medical Sciences
Faculty of Health & Life Sciences > Inst. Population Health
Depositing User: Symplectic Admin
Date Deposited: 10 Jul 2025 10:08
Last Modified: 14 Nov 2025 02:31
DOI: 10.1111/1471-0528.18269
Open Access URL: https://obgyn.onlinelibrary.wiley.com/doi/10.1111/...
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URI: https://livrepository.liverpool.ac.uk/id/eprint/3193662
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