“Informed” Consent: An Audit of Informed Consent of Cesarean Section Evaluating Patient Education and Awareness

Abstract

Introduction Better diagnosis and early referral due to increased health care coverage have increased the cesarean deliveries at tertiary-care hospitals of India. Improvements in the health care system raise many concerns and need of cross-checking system in place to counter the problems pertaining to patient education and participation of patient. While most of the cesarean sections are done in good faith for the patient, it does not escape the purview of consumer awareness and protection. Materials and methods This cross-sectional study was undertaken at a tertiary level government institution to understand the level of awareness of 220 patients regarding the various aspects of cesarean delivery which are essential for women to know before giving an informed consent. Results 71 % of the women had knowledge about the indication and need to do cesarean delivery. Of these, only one-third (25 % of total women) were properly explained about procedure and complications. Other demographic and social characteristics were also evaluated. Discussion While the health care schemes have had their improved results, the onus lies upon the caregivers to improve and maintain the quality of health care in these tertiary-care government hospitals in proportion to the increase in patient load. The results of this study highlight the need for proper counseling of patients regarding complications of cesarean section. The fact that only 25 % of 123total cases were explained proper procedure and complication as opposed to 71 % of patients having proper knowledge about the indication of cesarean section points out the lack of information in seemingly ''informed'' consent. The way forward To bring about awareness about the risks and complications of cesarean section, there is a need that patients be counseled during the antenatal visits, specifically when patients visit near term for antenatal check up.

How organizational learning is associated with patient rights: a qualitative content analysis

“…When nurses expressed their experiences, it was found that they ignored patient rights to receive information about the disease and their treatment, and accordingly, they were unable to select an appropriate treatment, so that this issue could cause irreparable complications for the patient. This issue has also been stated in the study by Kirane et al ( 46 ). According to their study, it was reported that only a quarter of the patients had received appropriate description about the procedures and their complications.…”

Pre-post implementation survey of a multicomponent intervention to improve informed consent for caesarean section in Southern Malawi

“…Several reports have recognised weaknesses in the process of acquiring surgical informed consent for obstetric procedures, such as providing no explanation of the indication for surgery, procedure-related risks or the postoperative trajectory 7–16. Women may feel pressured into undergoing surgery when little information is provided or information is not understood 9 14.…”

The Quality of Obtaining Surgical Informed Consent for Cesarean Section in Public Hospitals of Iran

“…Therefore, in most cases, the patient signs the form as a witness or do not sign it at all. A study in India reported that the IC forms are mostly signed by the relatives, not by the patients, and their relatives are informed before the surgery [9].…”

“…In case of CS, surgical IC is considered as an ethical and legal requirement. It provides information about the potential benefits and risks of CS, alternative therapy, and anesthesia options [9,10]. A recent metaanalysis reported that women with CS are at higher risk of maternal death and postpartum infection [2].…”