PPIE
Stakeholder involvement was facilitated through multiple public meetings, held in person and on-line during the research design stage [Service users influenced the design of the trial in multiple ways. They influenced the decision to begin the care pathway prior to 36 weeks. They emphasised the importance of providing earlier information and time to make decisions about care that would take place at 36 weeks. They carefully reviewed the consent process. Service user representatives advocated that all women who were randomised should still retain the option to accept or decline ECV, VBB or CB. This resulted in a pragmatic trial design suited to evaluating overall effectiveness of a care pathway, rather than the efficacy of one specific intervention over another. This also influenced the inclusion of the non-randomised cohort of women who were specifically requesting OptiBreech care. Service users were very keen that any results would not be used to remove choice and control, including the choice of planning a caesarean birth for women who preferred that.Finally, PPIE input influenced the sub-category analyses. Our PPIE group prioritised knowing how outcomes for VBB compared with those for cephalic birth, and this was included as a planned sub-group analysis. Later, service users advocated for an equity analysis due to growing awareness of increased risk of adverse outcomes among women of minoritised ethnicity and skin colour in the UK [