Understanding and recollection of the risks associated with cesarean delivery during the consent process

To investigate women's recall of information provided during the consent process for cesarean delivery, specifically the associated risks, 24 hours after the procedure.

A prospective questionnaire-based study was conducted at the Barnet and Chase Farm Hospitals NHS Trust between May 2009 and August 2010. Women who had undergone a cesarean delivery (planned or emergency) completed a self-administered questionnaire 24 hours after delivery. Women who did not recall the risks associated with the procedure (group 1) were compared with those who did recall this information (group 2).

A total of 554 women participated in the study. Group 1 (n=140) were 4 times more likely to have undergone an emergency cesarean than group 2 (n=414) (OR 4; 95% CI, 2.5-6.2). Group 2 were more to likely to have higher than secondary level education, 7 times more likely to have understood the explanation of the procedure (OR 6.9; 95% CI, 3.3-14.2), and 9 times more likely to recall that the risks had been explained (OR 9.4; 95% CI, 5.2-17.1). More women in group 1 reported that they would have liked to receive an information leaflet about cesarean delivery at the first prenatal visit.

One in 4 women did not recall any risks associated with cesarean delivery shortly after the procedure and this group of women were less likely to understand or recall the details of the consent discussion.