Power Sharing

Co-design in this study required genuine power-sharing rather than symbolic participation. Facilitators used safe spaces, expertise recognition, accessible language, transparency, and separate groups to reduce power divides. Birthing parents and companions were not placed in the same workshops as providers because facilitators judged the power imbalance to be too large. Separating stakeholder groups protected some participants but created tension with the goal of face-to-face accountability. Tokenistic inclusion of disadvantaged groups may prevent their perspectives from influencing higher-level decisions. Existing hierarchies among healthcare workers limited open dialogue, making the workshop environment important.