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 h) and emergency caesarean birth (EMCB; ≤ 30 min), 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) 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.
Trial registration: COMET Initiative | Development of a core information set for caesarean birth (comet-initiative.org).
Keywords: Delphi; birth; caesarean; choice; consent; core information set.
© 2025 The Author(s). BJOG: An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd.