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What should be discussed when considering an induction of labour? A UK-wide, multi-centre Delphi study to develop a
Eve Bunni1,2,3, Carol Kingdon2, Vicky Bradley1,2
1Department of Women's and Children's Health, Institute of Life Course and Medical Sciences, University of Liverpool, Faculty of Health and Life Sciences, Liverpool, UK.
Objective:
To develop a core information set for induction of labour. Rates of induction of labour for childbirth are rising in many high-income countries. In England, a third of women have their labours induced. National guidelines recommend women receive information to make informed decisions about induction.
Design:
Two-stage consensus study using modified Delphi.
Setting:
UK.
Participants:
Pregnant people, parents and professionals.
Outcomes:
Stage 1: A long list of information points was identified through a systematic review of reviews, reviewing patient leaflets, qualitative interviews and a stakeholder survey, with ongoing patient, public and professional involvement. Stage 2: Think-aloud 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 items taken forward to a consensus meeting.
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 four think-aloud 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; one item excluded, and three items were carried forward for consensus meeting discussion where 12 overarching information points were agreed on.
Conclusions:
This study has established a consensus-based core information set for induction of labour from a sample of the birthing population and staff providing their care. The resultant set has been populated with evidence in line with national guidelines. It can be used by women and clinicians as a standardised starting point from which to personalise discussions about birth.
Trial Registration Number:
COMET Initiative registration 2600: Developing a core information set for induction of labour.
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