Danna Nitzani, Jacqueline Nicholls, Katherine Maslowski, Robert Craig, Sohail Bampoe, Melissa Whitten, Anne Lanceley
Anaesthesia, 12 May 2025
Abstract
Introduction
Women undergoing induction of labour often utilise epidural analgesia. Obtaining consent for labour epidural presents a unique challenge for the obstetric anaesthetist, who must comply with the legal standards of consent. This study explores how women perceive the consent process for epidural analgesia during induction of labour.
Methods
This was a qualitative, single-centre, interview-based study. Fourteen women who received an epidural for labour analgesia were interviewed using a semi-structured interview guide. Data were analysed using thematic analysis.
Results
Four themes described women’s experience of the consent process. Understanding alternatives, risks and benefits; for example, time constraints hindering the effective communication of information around epidural analgesia, including alternative analgesic options. Timing of information; for example, the value of information was diminished by pain, fatigue and the imminence of the procedure. Timing of consent; for example, physiological and psychological demands of labour negatively impacted patients’ ability to engage with the consent process. Anaesthetists’ assessment of patient understanding; for example, confirmation of patient understanding by anaesthetists was lacking.
Discussion
Women’s experiences of the consent process for induction of labour suggest that in the context of the pain and exhaustion of labour, inadequate and untimely information provision and dialogue between women and their anaesthetists can undermine the implementation of lawful consent.
Center for Informed Consent Integrity 