Quality of Informed Consent Practices around the Time of Childbirth: A Cross-Sectional Study in Italy

Abstract

Background: Few studies have explored consent request practices during childbirth. Objective: We explored consent request practices during childbirth in a referral hospital and research centre in Italy, capturing both women and health workers’ perspectives. Methods: Data were collected using self-administrated questionnaires between December 2016 and September 2018. Nine key maternal and newborn procedures were analysed. Associations between consent requests and women characteristics were explored by multiple logistic regression. Results: Among 1244 women, the rate of consent requests varied widely, with caesarean section (CS) showing the highest rate (89.1%) and neonatal conjunctivitis prophylaxis presenting the lowest rate (11.4%). Information provided on “risks/benefits” and “reasons” for procedures by health staff was most often not comprehensive for procedures of interest (range 18.6–87.4%). The lack of informed consent is not specifically linked to any pattern of women characteristics. According to 105 health workers, adequate protocols and standard forms for consent requests were available in 67.6% and 78.1% of cases, respectively, while less than one third (31.4%) reported having received adequate training and supportive supervision on how to deliver informed consent. Conclusions: Study findings align with previous evidence showing that consent request practices during childbirth need to be largely improved. More research is needed to investigate effective strategies for improvement.

Quality of maternal and newborn care around the time of childbirth in Luxembourg during the COVID‐19 pandemic: Results of the IMAgiNE EURO study

“…31 HCP practices such as lack of communication and consent request, and not providing information or immediate attention for patients, may be the result of large gaps in effective provider supervision as well as in training on patients' rights and communication strategies. 32 This study highlighted several areas in which vast improvements are warranted, for the health and well‐being of women and infants. Further studies should explore health workers' perspectives as an integrative view of QMNC.…”

“…However, it strongly suggests that the Luxembourg law on patients' rights adopted in 2014 is still not fully implemented 31 . HCP practices such as lack of communication and consent request, and not providing information or immediate attention for patients, may be the result of large gaps in effective provider supervision as well as in training on patients' rights and communication strategies 32 . This study highlighted several areas in which vast improvements are warranted, for the health and well‐being of women and infants.…”

Consent and refusal of procedures during labour and birth: a survey among 11 418 women in the Netherlands

“…Most unconsented procedures were those where consent was not asked, most often reported for postpartum oxytocin (47.5%) and episiotomy (41.7%). In other countries, episiotomy is also identified as procedure for which consent is often not asked: in 39% of the cases in Italy and 34.5% in Australia 11 22. Over-ruled refusal occurred less frequent; most often reported for augmentation of labour (2.2%) and episiotomy (1.9%).…”

Consented maternal care and associated factors among mothers who gave birth at public health institutions in South Wollo Zone, Amhara region, Ethiopia 2022

“…Despite its importance, there is limited evidence showing the utilization of consent care in healthcare service delivery around the globe. 23 Spatially in Ethiopia, there is no single study done regarding the proposed problem. To assess consented care and associated factors during labor and delivery, this study is being conducted.…”