Exploring Black women's experiences of consent to vaginal examination during labour

Consent is the foundation of all lawful, autonomy-supporting clinical practice. Yet, limited evidence indicates that women's experiences of consent in obstetric settings are often unsatisfactory, with women's voices being disregarded. Black women are particularly vulnerable to poor obstetric experiences and inequitable outcomes. Vaginal examination (VE) is commonly used to assess progress in labour so was selected as a focus for our exploratory investigation of Black women's experiences of the consent process during labour. There has been little formal exploration of women's consent experiences in this context, and none specifically in Black women.

Qualitative study using semi-structured face-to-face interviews of 15 Black women. Data were analysed using thematic analysis.

Three overlapping themes were identified: unrecognised genuine choice - women were not aware that they could choose whether to have a VE; deficient information - most women were not provided with adequate information to support them in making an informed choice; distress and surprise - many women were troubled and shocked by their experience of VE. Overall, Black women did not perceive VEs as a choice, nor were they provided with adequate information to support valid consent.

Black women's experience of the VE consent process does not always align with current legal and professional requirements. Black women's support for choice-making was neglected and consent for VEs was not always voluntary or informed, highlighting the urgent need for healthcare professionals to address consent practices in this area.