The Quality of Consent - What is the Evidence?

Robertson, Cameron G.; Verco, C. J.

doi:10.1111/ajo.12125

Cited by 4 publications

(5 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our findings confirm and expand previous evidence [ 14 , 15 , 16 , 17 , 18 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 ]. The lack of informed consent is one of the typologies of mistreatment during childbirth [ 49 , 50 ].…”

Section: Discussionsupporting

confidence: 93%

“…Many mothers experience birth only once in life, thus previous experience is limited. Effective communication can be challenged by many factors, including: the limited time available for discussion in emergency situations (e.g., emergency caesarean section, foetal and/or maternal complications), the possible influence of women’s pain, fatigue, and emotions and by the availability of standardised documents clarifying risks and benefits of procedures [ 18 , 37 , 38 , 39 ]. When interpreting our results, therefore, we believe that it is important to avoid blaming health professionals for “low rates” of consent requests.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

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

Valente

Mariani

Covi

et al. 2022

IJERPH

View full text Add to dashboard Cite

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.

show abstract

Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

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

Valente

Mariani

Covi

et al. 2022

IJERPH

View full text Add to dashboard Cite

show abstract

“…In addition, informing women may well not decrease the incidence of complications, although the women who subsequently suffer these complications would be expected to handle them much better, understanding they could occur. 13,15 Moreover, clearly the issue of written consent for natural vaginal delivery is an ongoing discussion nationally [7][8][9][10][11][12] and internationally. [16][17][18] Yet, the purely legal aspects may be somewhat beside the main point.…”

Section: Discussionmentioning

confidence: 99%

“…Regarding consent, there is ongoing disagreement between midwives and obstetricians, and between different obstetricians, on matters such as whether actual written consent is required for a 'natural' process. [7][8][9][10][11][12] One of the authors is a colorectal who also does occasional medicolegal reports, sometimes for colorectal complications of childbirth. Over the years it became clear there was a recurring theme in many of these women's experiences regarding the prenatal explanation of the risks of childbirth.…”

Section: Introductionmentioning

confidence: 99%

Should we inform women about the recognised risks of childbirth?

Giddings

Wong

Meagher

2021

Aust NZ J Obst Gynaeco

View full text Add to dashboard Cite

BackgroundAt present in Australia women are not routinely, systematically informed of the risks of childbirth.AimsIt is hoped this presentation of the perspective of some women who suffer unexpected obstetric complications will encourage change.Materials and MethodsThe experience of women involved in obstetric medicolegal reports prepared by a colorectal surgeon over ten years is analysed.ResultsTwenty women were identified. Sixteen had vaginal deliveries. All 16 suffered third or fourth‐degree tears, six developed rectovaginal fistulae, six required stomas and 11 developed faecal incontinence. Of the four women who delivered by caesarean section, there were two post‐operative caecal perforations, one unrecognised small bowel enterotomy, and one patient developed sepsis due to an infected haematoma. Seventeen of the 20 women were noted to suffer psychological sequalae. None of the women recollected being warned of the complication they suffered, and there was no record of such warnings in their medical records.ConclusionInformed written ‘consent’ for natural vaginal delivery is, understandably, a contentious topic. Although learning from medicolegal cases may go against the grain, as medical professionals it is very difficult to ethically justify the status quo, where women are not routinely simply informed of the risks of childbirth. This is not fair. Even if informing women does not decrease the incidence of complications, the women who subsequently suffer these complications may well handle them much better, recognising they could occur.

show abstract

“…In keeping with global trends, caesarean section rates in Australia and New Zealand have steadily increased from 19% in 1990 to 34% in 2016. Audits of consent for caesarean section have demonstrated deficiencies in the documentation of rare but significant risks such as hysterectomy, implications for the fetus such as respiratory morbidity and laceration or trauma, implications for future pregnancies, post‐operative pain and the associated difficulties with caring for a newborn baby …”

Section: Introductionmentioning

confidence: 99%

Multimedia in improving informed consent for caesarean section: A randomised controlled trial

Truong

Ellett

Hicks

et al. 2020

Aust NZ J Obst Gynaeco

View full text Add to dashboard Cite

Background: Multimedia modules have been used as an adjunct to improve patient knowledge and recall for various elective surgical procedures, but have been incompletely evaluated in patients undergoing caesarean section. Aims: To compare the use of a supplementary multimedia module with written information in improving the informed consent process prior to elective caesarean section. Materials and methods: This was a prospective randomised controlled trial (ACTRN12616000430437). Primary outcomes were knowledge and anxiety scores immediately following the intervention and on the day of surgery. Secondary outcomes were patient satisfaction, length of stay, time to cessation of analgesia, and patient assessment of the consent types. Results: Seventy-five patients completed the study. Both multimedia module and written information groups demonstrated a significant increase in knowledge scores with no difference between the groups. In the multimedia-assisted consent group, scores improved from baseline by +2.31 (P < 0.001) immediately after watching the multimedia module and by +2.41 (P < 0.001) on the day of surgery. In the written information group, scores improved by +1.76 (P < <0.001), and +2.31 (P < 0.001) respectively. There was no adverse impact on anxiety in either group. Patient-reported understanding (92.4% vs 78.5%, P = 0.001), and helpfulness (90.1% vs 73.3%, P = 0.001) was significantly higher in the multimedia module group than in the written information group. The multimedia module was assessed as 'slightly too long' and provided 'slightly too much information'. Conclusions: Multimedia modules are a valuable adjunct to traditional processes of obtaining informed consent for elective caesarean section and should be offered and made available to patients prior to surgery.

show abstract

The Quality of Consent - What is the Evidence?

Cited by 4 publications

References 5 publications

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

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

Should we inform women about the recognised risks of childbirth?

Multimedia in improving informed consent for caesarean section: A randomised controlled trial

Contact Info

Product

Resources

About