ArticleJournal of medical ethics2023
The ethics of consent during labour and birth: episiotomies.
Article in Journal of medical ethics, 2023. 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, 32 citations in OpenAlex.
- Medical Interventions and Women's Perceptions of Respectful Intrapartum Care: A National Survey-Based Cohort Study.BJOG : an international journal of obstetrics and gynaecology · 2025Article
- Patient perception of consent processes for epidural analgesia in induction of labour: a qualitative study.Anaesthesia · 2025Article
- The effect of midwifery-led continuum of care to improve maternal and newborn outcomes in the Sidama region, Ethiopia: A non-randomized control trial study.SAGE open medicine · 2025Article
- Is pregnancy a disease? A normative approach.Journal of medical ethics · 2024Article
- Antenatal Anovaginal Distance, a Potential Indicator of Perineal Damage during Pregnancy.Healthcare (Basel, Switzerland) · 2024Article
- Consent and refusal of procedures during labour and birth: a survey among 11 418 women in the Netherlands.BMJ quality & safety · 2024Article
- Shame, health literacy and consent.Clinical ethics · 2024Article
- Article
- Experienced disrespect & abuse during childbirth and associated birth characteristics: a cross-sectional survey in the Netherlands.BMC pregnancy and childbirth · 2024Article
- Academic education of midwives in Germany (part 2): Opportunities and challenges for the further development of the profession of midwifery. Position paper of the Midwifery Science Committee (AHW) in the DACH Association for Medical Education (GMA).GMS journal for medical education · 2024Article
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Authors and funding
5 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Unconsented episiotomies and other procedures during labour are commonly reported by women in several countries, and often highlighted in birth activism. Yet, forced caesarean sections aside, the ethics of consent during labour has received little attention. Focusing on episiotomies, this paper addresses whether and how consent in labour should be obtained. We briefly review the rationale for informed consent, distinguishing its intrinsic and instrumental relevance for respecting autonomy. We also emphasise two non-explicit ways of giving consent: implied and opt-out consent. We then discuss challenges and opportunities for obtaining consent in labour and birth, given its unique position in medicine.We argue that consent for procedures in labour is always necessary, but this consent does not always have to be fully informed or explicit. We recommend an individualised approach where the antenatal period is used to exchange information and explore values and preferences with respect to the relevant procedures. Explicit consent should always be sought at the point of intervening, unless women antenatally insist otherwise. We caution against implied consent. However, if a woman does not give a conclusive response during labour and the stakes are high, care providers can move to clearly communicated opt-out consent. Our discussion is focused on episiotomies, but also provides a useful starting point for addressing the ethics of consent for other procedures during labour, as well as general time-critical medical procedures.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.