Consent and refusal of procedures during labour and birth: a survey among 11 418 women in the Netherlands

Background Informed consent for medical interventions is ethically and legally required; an important aspect of quality and safety in healthcare; and essential to person-centred care. During labour and birth, respecting consent requirements, including respecting refusal, can contribute to a higher sense of choice and control for labouring women. This study examines (1) to what extent and for which procedures during labour and birth women report that consent requirements were not met and/or inadequate information was provided, (2) how frequently women consider consent requirements not being met... Mehr ...

Verfasser: van der Pijl, Marit Sophia Gerardina
Klein Essink, Margot
van der Linden, Tineke
Verweij, Rachel
Kingma, Elselijn
Hollander, Martine H
de Jonge, Ank
Verhoeven, Corine J
Dokumenttyp: TEXT
Erscheinungsdatum: 2024
Verlag/Hrsg.: BMJ Publishing Group Ltd
Schlagwörter: Original research
Sprache: Englisch
Permalink: https://search.fid-benelux.de/Record/base-29176676
Datenquelle: BASE; Originalkatalog
Powered By: BASE
Link(s) : http://qualitysafety.bmj.com/cgi/content/short/33/8/511

Background Informed consent for medical interventions is ethically and legally required; an important aspect of quality and safety in healthcare; and essential to person-centred care. During labour and birth, respecting consent requirements, including respecting refusal, can contribute to a higher sense of choice and control for labouring women. This study examines (1) to what extent and for which procedures during labour and birth women report that consent requirements were not met and/or inadequate information was provided, (2) how frequently women consider consent requirements not being met upsetting and (3) which personal characteristics are associated with the latter. Methods A national cross-sectional survey was conducted in the Netherlands among women who gave birth up to 5 years previously. Respondents were recruited through social media with the help of influencers and organisations. The survey focused on 10 common procedures during labour and birth, investigating for each procedure if respondents were offered the procedure, if they consented or refused, if the information provision was sufficient and if they underwent unconsented procedures, whether they found this upsetting. Results 13 359 women started the survey and 11 418 met the inclusion and exclusion criteria. Consent not asked was most often reported by respondents who underwent postpartum oxytocin (47.5%) and episiotomy (41.7%). Refusal was most often over-ruled when performing augmentation of labour (2.2%) and episiotomy (1.9%). Information provision was reported inadequate more often when consent requirements were not met compared with when they were met. Multiparous women had decreased odds of reporting unmet consent requirements compared with primiparous (adjusted ORs 0.54–0.85). There was considerable variation across procedures in how frequently not meeting consent requirements was considered upsetting. Conclusions Consent for performing a procedure is frequently absent in Dutch maternity care. In some instances, procedures were ...