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What should be discussed when considering a vaginal birth? : A Delphi Study to develop a Core Information Set for vaginal birth.
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  • Andrew Demetri,
  • Anna Davies,
  • Danya Bakhbakhi,
  • Alexandra Hunt,
  • Sharea Ijaz,
  • Sheelagh McGuinness,
  • Gemma Beasor,
  • Gemma Clayton,
  • Vicky Bradley,
  • Eve Bunni,
  • Carol Kingdon,
  • A. Sharp,
  • Christy Burden,
  • Asma Khalil,
  • Louise Kenny,
  • Abi Merriel
Andrew Demetri
Royal College of Obstetricians and Gynaecologists
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Anna Davies
University of Bristol
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Danya Bakhbakhi
University of Bristol
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Alexandra Hunt
University of Liverpool Department of Health Data Science
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Sharea Ijaz
University of Bristol
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Sheelagh McGuinness
University of Bristol
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Gemma Beasor
no affiliation
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Gemma Clayton
University of Bristol
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Vicky Bradley
University of Liverpool
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Eve Bunni
University of Liverpool
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Carol Kingdon
University of Liverpool
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A. Sharp
University of Liverpool
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Christy Burden
University of Bristol
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Asma Khalil
Royal College of Obstetricians and Gynaecologists
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Louise Kenny
University of Liverpool Faculty of Health and Life Sciences
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Abi Merriel
University of Liverpool Department of Women's and Children's Health

Corresponding Author:abi.merriel@liverpool.ac.uk

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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.