Please cite this paper as: Siassakos D, Clark J, Sibanda T, Attilakos G, Jefferys A, Cullen L, Bisson D, Draycott T. A simple tool to measure patient perceptions of operative birth. BJOG 2009;116:1755–1761. OBJECTIVE: To assess the feasibility and validity of a maternal satisfaction measurement tool, the SaFE study Patient Perception Score (PPS), after operative delivery. DESIGN: Cross-sectional survey. SETTING: A large maternity unit in England. SAMPLE: 150 women who had had an operative birth. METHODS: We recruited women within 24 hours of birth and quantified their satisfaction with two questionnaires: PPS, and the Mackey Childbirth Satisfaction Rating Scale (CSRS; modified). MAIN OUTCOME MEASURES: Participation rate to determine feasibility; Cronbachʼs alpha as measure of internal consistency; PPS satisfaction scores for groups of accoucheurs of different seniority to assess construct validity; correlation coefficient of PPS scores with total scores from the CSRS questionnaire to establish criterion validity. RESULTS: Participation rate approached 85%. We observed high scores for most births except a few outliers. Internal consistency of the PPS was high (Cronbachʼs alpha = 0.83). Total PPS scores correlated strongly with total CSRS scores (Spearmanʼs r = 0.64, P < 0.001). CONCLUSIONS: The PPS is a simple and valid tool for patient-centred assessments. High scores were observed for most births but there were a small minority of accoucheurs who consistently scored poorly and these data could be used during appraisal and training.