Maternity Care Informed Consent Practices and Perspectives: A Qualitative Study at a Tertiary Maternity Unit.

Area of Science:

• Obstetrics and Gynecology
• Medical Ethics
• Patient Rights

Background:

• Informed consent is crucial in maternity care, but its application in planned vaginal birth remains contentious.
• New standards for informed consent in maternity care necessitate an evaluation of current practices.
• The NSW Consent Manual highlights discrepancies in existing maternity consent procedures.

Purpose of the Study:

• To investigate informed consent and material risk disclosure in childbirth.
• To examine the practices and perspectives of midwives and obstetricians regarding informed consent.
• To assess compliance with the 2020 NSW Consent Manual standards.

Main Methods:

• A prospective qualitative study was conducted.
• Semi-structured interviews were used to gather data from 22 participants (18 obstetricians, 4 midwives).
• The study focused on current practices and perceived barriers to change in informed consent.

Main Results:

• 100% of participants reported practices non-compliant with the NSW Consent Manual.
• 83% of obstetricians found maternity care risk communication and informed consent practices inadequate.
• Material risks of vaginal birth, caesarean section, and instrumental birth are not routinely disclosed antenatally.

Conclusions:

• Current informed consent practices in maternity care do not meet the standards outlined in the NSW Consent Manual.
• Significant improvements are required in risk communication and informed consent procedures.
• Enhancements are essential to uphold women's legal right to bodily autonomy in childbirth.