ArticleBMC medical ethics2021
Health workers' perspectives on informed consent for caesarean section in Southern Malawi.
Article in BMC medical ethics, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 13 citations in OpenAlex.
- Perspectives and practices of counselling, consent and debriefing for cesarean sections: a mixed-methods study in two Indian states.BMC pregnancy and childbirth · 2026Article
- Attitude and subjective norms as predictors of intention of married men and women to accept caesarean section delivery in Lagos, Nigeria.Reproductive health · 2026Article
- Article
- Women's experiences of communication with medical staff before and after emergency caesarean birth in Zambia: A qualitative study.PloS one · 2026Article
- Incidence, management and outcomes of prolonged second stage of labour in a rural setting in Malawi: a retrospective cohort study.BMC pregnancy and childbirth · 2025Article
- Beyond survival: The impact of birth complications on postpartum wellbeing for mothers, babies, and households in Kenya.PLOS global public health · 2025Article
- Surgical informed consent practices and influencing factors in sub-Saharan Africa: a scoping review of the literature.BMJ quality & safety · 2024Article
- Association between delayed cesarean section and severe maternal and adverse newborn outcomes in the Somaliland context: a cohort study in a national referral hospital.Global health action · 2023Article
- Article
- Quality of Informed Consent Practices around the Time of Childbirth: A Cross-Sectional Study in Italy.International journal of environmental research and public health · 2022Article
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveInformed consent is a prerequisite for caesarean section, the commonest surgical procedure in low- and middle-income settings, but not always acquired to an appropriate extent. Exploring perceptions of health care workers may aid in improving clinical practice around informed consent. We aim to explore health workers' beliefs and experiences related to principles and practice of informed consent.
methodsQualitative study conducted between January and June 2018 in a rural 150-bed mission hospital in Southern Malawi. Clinical observations, semi-structured interviews and a focus group discussion were used to collect data. Participants were 22 clincal officers, nurse-midwives and midwifery students involved in maternity care. Data were analysed to identify themes and construct an analytical framework.
resultsDefinition and purpose of informed consent revolved around providing information, respecting women's autonomy and achieving legal protection. Due to fear of blame and litigation, health workers preferred written consent. Written consent requires active participation by the consenting individual and was perceived to transfer liability to that person. A woman's refusal to provide written informed consent may pose a dilemma for the health worker between doing good and respecting autonomy. To prevent such refusal, health workers said to only partially disclose surgical risks in order to minimize women's anxiety. Commonly perceived barriers to obtain a fully informed consent were labour pains, language barriers, women's lack of education and their dependency on others to make decisions.
conclusionsHealth workers are familiar with the principles around informed consent and aware of its advantages, but fear of blame and litigation, partial disclosure of risks and barriers to communication hamper the process of obtaining informed consent. Findings can be used to develop interventions to improve the informed consent process.
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