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Consent on the labour ward: a qualitative study of the views and experiences of healthcare professionals

Kennedy, S; Lanceley, A; Whitten, M; Kelly, C; Nicholls, J; (2021) Consent on the labour ward: a qualitative study of the views and experiences of healthcare professionals. European Journal of Obstetrics & Gynecology and Reproductive Biology , 264 pp. 150-154. 10.1016/j.ejogrb.2021.07.003. Green open access

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Abstract

Objective: Consent on the labour ward is a complex and controversial topic which is poorly understood. Consenting labouring women is recognised as challenging and problematic, and thus, it is uncertain that pregnant women experience true informed consent during labour. This project aims to explore healthcare professionals’ views and experiences of consent practice on the labour ward. / Design: Qualitative research performed in a tertiary hospital labour ward in Central London with 5,500 patients annually. Eleven obstetricians and seven midwives participated. In-depth one-on-one semi-structured interviews were conducted, and the data were analysed by thematic analysis. / Results: Three themes were identified: 1) The value of women’s choice: healthcare professionals framed consent as an agreement process rather than an exercise of choice. Implicit paternalism was evident with some healthcare professionals imposing their own recommendations upon patients. 2) Communicating risk: many participants viewed full risk communication, including extremely rare risk disclosure as their duty to ensure the validity of obstetric consent despite the risk of overwhelming women. 3) Law and professional practice: many healthcare professionals lacked knowledge of the implications to practice of current law. / Conclusion: Healthcare professionals’ experiences of consent on the labour ward reflect uncertainties and ambiguities in consent practice such that it sometimes falls short of legal and professional requirements. Difficulties in discussing risk with women in an appropriate way at an appropriate time threatens the lawfulness of consent. If consent is to remain as the legal standard of autonomy, we recommend the provision of specialist training to assist professionals in providing timely consultation dialogues which endorse women’s right to choose.

Type: Article
Title: Consent on the labour ward: a qualitative study of the views and experiences of healthcare professionals
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.ejogrb.2021.07.003
Publisher version: https://doi.org/10.1016/j.ejogrb.2021.07.003
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher's terms and conditions.
Keywords: Consent, Choice, Labour ward, Autonomy, Montgomery, Healthcare professionals’ views
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL EGA Institute for Womens Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL EGA Institute for Womens Health > Womens Cancer
URI: https://discovery.ucl.ac.uk/id/eprint/10131292
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