Informed choice? Evidence of the persuasive power of professionals.

Two themes feature prominently in current National Health Service (NHS) priorities: the importance of evidence-based health care and the value of informed choice for users of health services. There is evidence both within and outside health care showing that choices are in ̄uenced by the way options are presented. Nearly 20 000 women each year in the United Kingdom will have an uncomplicated breech pregnancy at term. The Royal College of Obstetricians and Gynaecologists (RCOG) has recommended that they should be offered `external cephalic version' (ECV). ECV is a safe and cost-effective procedure that signi®cantly increases a mother's chance of having a normal cephalic vaginal delivery, halving the caesarean section rate. Despite the recommendations of the Royal College (which have been echoed by the US College), there remains a reluctance amongst senior obstetricians to accept the procedure. Although ECV was rarely undertaken by the consultants in North Staffordshire before 1995, it was one of the top topics prioritized in a multidisciplinary democratic forum Achieving Sustainable Quality in Maternity (ASQUAM). Indeed, thereafter acceptable levels of offering ECV (over 90 per cent in all the consultants' antenatal clinics) and of successful ECV (about 50 per cent) were soon achieved. This study was undertaken to establish the proportion of women accepting the procedure after being offered ECV. Methods