Informed consent and birth preparedness/complication readiness: A qualitative study at two tertiary maternity units

Informed consent and birth preparedness/complication readiness: A qualitative study at two tertiary maternity units
Original Article
Sally Ely, Susanne Langer, Hans Peter Dietz
The Australian and New Zealand Journal of Obstetrics and Gynaecology, 29 August 2021
Abstract
Background
Informed consent in obstetrics should involve full disclosure of risks, benefits and alternative interventions. However, we have found no evidence of a formal informed consent process before an attempt at vaginal delivery in published policy or practice. The idea of informed consent in vaginal birth has attracted controversy and has been the subject of some debate.
Aim
To explore the perspectives and experiences of informed consent and birth preparedness/complication readiness for birthing women in a high resource setting.
Materials and methods
Qualitative study using semi-structured interviews to examine experiences and perspectives of women following birth.
Results
Forty telephone interviews were concluded. Eight statement categories were identified: (i) no issues of consent, (ii) absent/inadequate informed consent, (iii) adequate birth preparedness/complication readiness, (iv) inadequate birth preparedness/complication readiness, (v) desire to forfeit decision making to a trusted and accountable health professional, (vi) belief that informed consent is not realistic in birth under some circumstances, (vii) negative feelings related to birth and (viii) poor postnatal follow-up.
Conclusions
When complications arose during birth, 20% of participants felt that informed consent was absent/inadequate, 25% of participants suggested policy change in favour of a formal informed consent process and 55% of participants suggested policy change in favour of increased birth preparedness/complication readiness. Our study suggests that informed consent for vaginal birth and formal birth preparedness/complication readiness should form part of routine antenatal care. Women’s preferences for decision-making and informed consent should be established before birth.

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