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Consent during labour and birth as observed by midwifery students: A mixed methods study
Nigel Lee1, Lauren Kearney2, Emma Shipton3
1Level 3 Chamberlain, Building, School of Nursing Midwifery and Social Work, University of Queensland, St Lucia, Queensland, Australia.
Women and Birth : Journal of the Australian College of Midwives
|February 21, 2023
Summary
Informed consent during childbirth is often inconsistently applied, with risks and alternatives frequently omitted. This impacts women's choices, highlighting a need for standardized consent training in midwifery education.
Area of Science:
- Maternal Health
- Medical Ethics
- Midwifery Practice
Background:
- Respectful maternity care emphasizes consent, yet discrepancies exist between midwives' and women's understanding of its application during labor and birth.
- Midwifery students offer a unique perspective to observe consent processes in real-time.
Purpose of the Study:
- To investigate how final-year midwifery students observe midwives obtaining consent from women during labor and birth.
Main Methods:
- An online survey collected data from 225 final-year midwifery students across Australia.
- Questions focused on informed consent principles (indications, outcomes, risks, alternatives, voluntariness) for intrapartum care.
- Thematic analysis was used for qualitative data from recorded responses.
Main Results:
- Student observations indicated significant variability in the consent process based on clinical procedures.
- Discussions regarding the risks and alternatives associated with interventions during labor were often absent.
- The study found that 195 students completed the survey, with 20 providing audio data.
Conclusions:
- Findings suggest inconsistent application of informed consent principles during labor and birth.
- Presenting interventions as routine care may limit women's autonomy and choice.
- Improved guidelines and training on minimum consent standards, including risks and alternatives, are recommended for health and educational institutions.
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