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Informed Consent in Perinatal Care: Challenges and Best Practices in Obstetric and Midwifery-Led Models
Eriketi Kokkosi1, Sofoklis Stavros2, Efthalia Moustakli3
1Department of Midwifery, Faculty of Health and Caring Sciences, University of West Attica, 122 43 Athens, Greece.
Abstract:
Background/Objectives: Respectful maternity care involves privacy, dignity, and informed choice within the process of delivery as stipulated by the World Health Organization (WHO). Informed consent is a cornerstone of patient-centered care, representing not just a formal document, but an ongoing ethical and clinical process through which women are offered objective, understandable information to support autonomous, informed decision-making. Methods: This narrative review critically examines the literature on informed consent in maternity care, with particular attention to both obstetric-led and midwifery-led models of care. In addition to identifying institutional, cultural, and systemic obstacles to its successful implementation, the review examines the definition and application of informed consent in perinatal settings and evaluates its effects on women's autonomy and satisfaction with care. Results: Important conclusions emphasize that improving women's experiences and minimizing needless interventions require active decision-making participation, a positive provider-patient relationship, and ongoing support from medical professionals. However, significant gaps persist between legal mandates and actual practice due to provider attitudes, systemic constraints, and sociocultural influences. Women's experiences of consent can be more effectively understood through the use of instruments such as the Mothers' Respect (MOR) Index and the Mothers' Autonomy in Decision Making (MADM) Scale. Conclusions: To promote genuinely informed and considerate maternity care, this review emphasizes the necessity of legislative reform and improved provider education in order to close the gap between policy and practice.
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