Birth Trauma Awareness Week: the importance of ‘informed consent’ in maternity care
To mark Birth Trauma Awareness Week (15 - 21 July), associate Amy Anderson explores the theme of 'informed consent' and why it is critically important in the context of maternity care.
This week is Birth Trauma Awareness Week and this year's theme is 'informed consent'.
Research evidence shows that, sadly, 4-5% of women who give birth develop post-traumatic stress disorder. Staggeringly, this amounts to around 30,000 women in the UK every year, though the real number is likely to be higher considering not all those affected will have spoken out.
The concept of 'informed consent' is paramount in the hospital setting; a fundamental principle in legal and ethical terms.
In a nutshell, patients have the right to be informed and involved in decision-making about their medical care. And clinicians must be satisfied they have their patient's consent (or other valid authority) before providing treatment.
When is consent 'informed'?
Legally, consent must be voluntarily given and the person giving consent must be capable of doing so (i.e. understand the information they are being given and able to weigh it up to make an informed decision).
For consent to be considered 'informed', patients must be given all the relevant information about what the treatment involves, including the potential risks and benefits; and they must also be told whether there are reasonable alternatives.
This is deeply important in the context of maternity care.
Labour care is often delivered in environments of intense stress and pressure, which can sometimes derail the process for obtaining patients’ informed consent. Furthermore, it is often argued that formal consent may not be required in the traditional sense when emergency situations may arise and where the life of the mother and/or the baby is in jeopardy.
All-Party Parliamentary Group on Birth Trauma Listen to Mums: Ending the Postcode Lottery on Perinatal Care (2024)'
The recently published 'All-Party Parliamentary Group on Birth Trauma Listen to Mums: Ending the Postcode Lottery on Perinatal Care (2024)' discusses some of the issues commonly experienced by women with the consent process. You can read our prior article detailing our full summary of the Report and its findings.
Sadly, the Report reveals many women providing evidence were not informed of being at higher-than-usual risk of harm for particular complications, such as tearing, and this took away their ability to make appropriate, informed decisions about their care.
Others, it seems, were not adequately consented for procedures, such as vaginal examinations or cervical sweeps. Concerns were also raised regarding the consent process for interventions, such as use of forceps; and caesarean sections. Whilst an emergency situation obviously poses a dilemma for all involved, effectively undermining an individual’s autonomy and ability to make an informed decision can have a significant impact on them regardless of whether there is also a physical injury.
A common thread running through consent issues is communication. Consent should be a meaningful dialogue between the doctor and their patient. When it comes to maternity care, this dialogue should start early on and continue at all stages of the pregnancy.”
Amy Anderson is an associate in the personal injury and medical negligence team. She regularly deals with claims against hospital trusts, private clinicians, GPs, and other healthcare providers.
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