Table 2 Agreed priorities taken to joint workshop from health care professionals and Women

1. Quality of information for women

1. Agreement of Caesarean section decision:

 o Inconsistency of information

 o A clear agreement to be made between health care professionals and women about the decision for a Caesarean section

 o Lack of research based information

 o Decision for Caesarean section to be made earlier in pregnancy

 o Bias of health care professionals in what information is shared

 o Flexibility around the decision, an opportunity to change mind at any point

2. Timing and discussion and information giving

2. Repetition of Caesarean section request and referrals:

 o Inconsistency of timing of information

 o Repeated discussion of Caesarean section request with health care professionals

 o When discussion is begun in late pregnancy, the rush to make suitable preparation for delivery

 o Multiple referrals and subsequent repetition of request

 o Need for early discussion and so time to plan for appropriate referrals where necessary and for delivery

3. Referrals and role of consultant midwife

 o Inconsistent and complex process for

3. Information about Caesarean section:

 o Lack of information about what the

 o women requesting caesarean section without medical indication

 o Caesarean section surgery experience is like

 o Central role of consultant midwife in the pathway for women requesting CS

 o Lack of risk information comparing vaginal birth, emergency and elective Caesarean section

 o Consultant midwife conflicting role: persuading women to change their minds and try for a vaginal delivery vs the need to support women in their choice

4. Recording decision – repetition of request from women

 o Women requesting Caesarean section often need to repeat their reason for the request to each HCP who cares for them

 o There appears to be a lack of detailed recording of discussion between women and health care professionals when requesting Caesarean section