What should be discussed when considering a vaginal birth?: A Delphi Consensus Study

the Options Collaborative Group; Andrew Demetri; Anna  Davies; Danya Bakhbakhi; Alexandra Hunt; Sharea Ijaz; Gemma Beasor; Gemma L Clayton; Vicky Bradley; Eve Bunni; Carol Kingdon; Andrew Sharp; Christy Burden; Asma Khalil; Louise C. Kenny; Abi Merriel; et al

doi:10.1111/1471-0528.70071

What should be discussed when considering a vaginal birth? A Delphi Consensus Study

the Options Collaborative Group, Andrew Demetri, Anna Davies, Danya Bakhbakhi, Alexandra Hunt, Sharea Ijaz, Gemma Beasor, Gemma L Clayton, Vicky Bradley, Eve Bunni, Carol Kingdon, Andrew Sharp, Christy Burden, Asma Khalil, Louise C. Kenny, Abi Merriel^*, et al

^*Corresponding author for this work

Research output: Contribution to journal › Article (Academic Journal) › peer-review

Abstract

Objective:
Spontaneous vaginal births are often the presumed choice, representing 45% of UK births. However, information about benefits and risks is inconsistently given, impacting 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:
A Delphi study was used to create the CIS. Information points were identified from a literature search, patient leaflets, interviews, and a survey. These informed a two-round Delphi survey, where stakeholders rated item importance. Items rated critically important by ≥80% of parents or professionals, and of limited importance by <15%, progressed to consensus meetings, where 20 parents and professionals discussed retained items. 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, medicolegal professionals, and representatives from 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. 29 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 labour environment.

Conclusions:
This CIS can facilitate discussions and support informed decision-making about vaginal birth.

Original language	English
Pages (from-to)	520-531
Number of pages	12
Journal	BJOG: An International Journal of Obstetrics and Gynaecology
Volume	133
Issue number	3
Early online date	18 Nov 2025
DOIs	https://doi.org/10.1111/1471-0528.70071
Publication status	Published - 1 Feb 2026

Bibliographical note

Publisher Copyright:
© 2025 The Author(s). BJOG: An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd.

Keywords

consensus
core information set
Delphi technique
informed consent
stakeholders
vaginal birth
women
women's health

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Cite this

the Options Collaborative Group, Demetri, A., Davies, A., Bakhbakhi, D., Hunt, A., Ijaz, S., Beasor, G., Clayton, G. L., Bradley, V., Bunni, E., Kingdon, C., Sharp, A., Burden, C., Khalil, A., Kenny, L. C., Merriel, A., & al , E. (2026). What should be discussed when considering a vaginal birth? A Delphi Consensus Study. BJOG: An International Journal of Obstetrics and Gynaecology, 133(3), 520-531. https://doi.org/10.1111/1471-0528.70071

@article{95eb0f86e5784b3aa216d2867a623ec3,

title = "What should be discussed when considering a vaginal birth?: A Delphi Consensus Study",

abstract = "Objective: Spontaneous vaginal births are often the presumed choice, representing 45\% of UK births. However, information about benefits and risks is inconsistently given, impacting 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: A Delphi study was used to create the CIS. Information points were identified from a literature search, patient leaflets, interviews, and a survey. These informed a two-round Delphi survey, where stakeholders rated item importance. Items rated critically important by ≥80\% of parents or professionals, and of limited importance by <15\%, progressed to consensus meetings, where 20 parents and professionals discussed retained items. 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, medicolegal professionals, and representatives from 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. 29 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 labour environment. Conclusions: This CIS can facilitate discussions and support informed decision-making about vaginal birth.",

keywords = "consensus, core information set, Delphi technique, informed consent, stakeholders, vaginal birth, women, women's health",

author = "\{the Options Collaborative Group\} and Andrew Demetri and Anna Davies and Danya Bakhbakhi and Alexandra Hunt and Sharea Ijaz and Gemma Beasor and Clayton, \{Gemma L\} and Vicky Bradley and Eve Bunni and Carol Kingdon and Andrew Sharp and Christy Burden and Asma Khalil and Kenny, \{Louise C.\} and Abi Merriel and et al",

note = "Publisher Copyright: {\textcopyright} 2025 The Author(s). BJOG: An International Journal of Obstetrics and Gynaecology published by John Wiley \& Sons Ltd.",

year = "2026",

month = feb,

day = "1",

doi = "10.1111/1471-0528.70071",

language = "English",

volume = "133",

pages = "520--531",

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the Options Collaborative Group, Demetri, A , Davies, A , Bakhbakhi, D, Hunt, A, Ijaz, S, Beasor, G, Clayton, GL, Bradley, V, Bunni, E, Kingdon, C, Sharp, A, Burden, C, Khalil, A, Kenny, LC, Merriel, A & al , E 2026, 'What should be discussed when considering a vaginal birth? A Delphi Consensus Study', BJOG: An International Journal of Obstetrics and Gynaecology, vol. 133, no. 3, pp. 520-531. https://doi.org/10.1111/1471-0528.70071

TY - JOUR

T1 - What should be discussed when considering a vaginal birth?

T2 - A Delphi Consensus Study

AU - the Options Collaborative Group

AU - Demetri, Andrew

AU - Davies, Anna

AU - Bakhbakhi, Danya

AU - Hunt, Alexandra

AU - Ijaz, Sharea

AU - Beasor, Gemma

AU - Clayton, Gemma L

AU - Bradley, Vicky

AU - Bunni, Eve

AU - Kingdon, Carol

AU - Sharp, Andrew

AU - Burden, Christy

AU - Khalil, Asma

AU - Kenny, Louise C.

AU - Merriel, Abi

AU - al , et

PY - 2026/2/1

Y1 - 2026/2/1

N2 - Objective: Spontaneous vaginal births are often the presumed choice, representing 45% of UK births. However, information about benefits and risks is inconsistently given, impacting 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: A Delphi study was used to create the CIS. Information points were identified from a literature search, patient leaflets, interviews, and a survey. These informed a two-round Delphi survey, where stakeholders rated item importance. Items rated critically important by ≥80% of parents or professionals, and of limited importance by <15%, progressed to consensus meetings, where 20 parents and professionals discussed retained items. 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, medicolegal professionals, and representatives from 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. 29 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 labour environment. Conclusions: This CIS can facilitate discussions and support informed decision-making about vaginal birth.

AB - Objective: Spontaneous vaginal births are often the presumed choice, representing 45% of UK births. However, information about benefits and risks is inconsistently given, impacting 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: A Delphi study was used to create the CIS. Information points were identified from a literature search, patient leaflets, interviews, and a survey. These informed a two-round Delphi survey, where stakeholders rated item importance. Items rated critically important by ≥80% of parents or professionals, and of limited importance by <15%, progressed to consensus meetings, where 20 parents and professionals discussed retained items. 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, medicolegal professionals, and representatives from 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. 29 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 labour environment. Conclusions: This CIS can facilitate discussions and support informed decision-making about vaginal birth.

KW - consensus

KW - core information set

KW - Delphi technique

KW - informed consent

KW - stakeholders

KW - vaginal birth

KW - women

KW - women's health

U2 - 10.1111/1471-0528.70071

DO - 10.1111/1471-0528.70071

M3 - Article (Academic Journal)

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AN - SCOPUS:105023980088

SN - 1470-0328

VL - 133

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EP - 531

JO - BJOG: An International Journal of Obstetrics and Gynaecology

JF - BJOG: An International Journal of Obstetrics and Gynaecology

IS - 3

ER -