PURPOSE:
The London Regional Maternity Team has co-created a Personalised Care and Choice Framework to support women, birthing people, and maternity staff when navigating care requests that fall outside clinical recommendations. This project aims to promote informed, respectful, and collaborative decision-making, ensuring high standards of care while recognising women’s rights to choice and control.

DISCUSSION:
Regional engagement highlighted challenges for both service users and maternity staff when discussing care options outside standard guidance. Women reported requests driven by anxiety about childbirth, previous negative experiences, or concerns about safety and staffing. Inconsistent access to home birth services, variation in policies, and lack of clear resources for informed decision-making were common themes. Seven multidisciplinary focus groups, including midwives, obstetricians, paramedics, doulas, and women, explored these issues in depth.

EVIDENCE WHERE RELEVANT:
Alongside stakeholder engagement, an extensive literature review of international research, policy, and practice was conducted to shape the project. The framework is underpinned by UK law, human rights principles, and an evidence-based approach, ensuring it is both robust and culturally sensitive to London’s diverse communities.

KEY MESSAGE:
Personalised care is not about disregarding clinical guidance but enabling meaningful, informed conversations that respect choice and promote safety. The new London Framework and Toolkit provides maternity staff with guiding principles, an informed decision-making tool, and practical resources to confidently facilitate personalised care. It also supports multidisciplinary collaboration, staff wellbeing, and knowledge sharing. Co-production has been central to this work, ensuring women's voices, expert knowledge, and frontline experiences shape solutions that work in practice. Poster session 2 (Group A)