What should be discussed when considering a vaginal birth? : A Delphi
Study to develop a Core Information Set for vaginal birth.
Abstract
Objective Spontaneous vaginal births are often the presumed
choice and represent 45% of UK births. However, information is
inconsistently given about benefits and risks. This impacts
decision-making and experience. A Core Information Set (CIS) is an
agreed set of information points discussed prior to a decision. We aimed
to develop a CIS for vaginal birth. Design Information points
were identified from a literature search, patient information leaflets,
interviews, and a survey. These informed a two-round Delphi survey,
where stakeholders voted on the importance of items for inclusion. Items
supported by >80% of participants were discussed by 28
parents and professionals at consensus meetings. The final CIS was
populated with an engagement group ensuring accessibility.
Setting The study took place in the UK, with participants
recruited online. Population Pregnant and postnatal women,
birth partners, healthcare professionals, medico-legal professionals and
people working for interested/relevant organisations. Main
outcome A CIS for vaginal birth. Results 77 information items
were identified. In round 1 (631 participants) of the Delphi Survey,
84.5% were from the patient group and 15.5% from the professional
group; in round 2 (228 participants), 74.3% were from the patient group
and 25.7% from the professional group. 28 items met the criteria for
consensus discussion. The final CIS includes 19 information points
addressing: labour process, pain relief, labour complications,
procedures or interventions during labour, experiences after birth,
outcomes for the baby and environment during labour.
Conclusions This CIS can be used to facilitate discussions and
support informed decision-making about vaginal birth.