ArticleBMJ quality & safety2024
Consent and refusal of procedures during labour and birth: a survey among 11 418 women in the Netherlands.
Article in BMJ quality & safety, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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12 citing papers in PubMed, 20 citations in OpenAlex.
- Health workers' perspectives on the quality of maternal and newborn health care around the time of childbirth: Results of the Improving MAternal Newborn carE in the EURO Region (IMAgiNE EURO) project in 12 countries of the World Health Organization European Region.Journal of global health · 2024Trial
- Midwives' lived experiences of obstetric violence: a hermeneutic phenomenological study.International journal of qualitative studies on health and well-being · 2026Article
- Experiences of disrespect and abuse during childbirth in the World Health Organization European region: A mixed-method study among 22 countries.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2026Article
- Ethics round table: choice and autonomy in obstetrics.Journal of medical ethics · 2025Article
- The Undercommons of Childbirth and Their Abolitionist Ethic of Care. A Study into Obstetric Violence Among Mothers, Midwives (in Training), and Doulas.Violence against women · 2025Article
- Autonomy support in prenatal consultation: A quantitative observation study in maternity care.European journal of midwifery · 2025Article
- Consent for interventions during childbirth: A national population-based study.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2025Article
- What Is Truly Informed Consent in Medical Practice and What Has the Perception of Risk Got to Do with It?Healthcare (Basel, Switzerland) · 2024Article
- Experienced disrespect & abuse during childbirth and associated birth characteristics: a cross-sectional survey in the Netherlands.BMC pregnancy and childbirth · 2024Article
- Article
- The ethics of consent during labour and birth: episiotomies.Journal of medical ethics · 2023Article
- L'expérience de l'accouchement en milieu surveillé dans la province d'Essaouira au Maroc: Quelle réalité?Sexual and reproductive health matters · 2023Article
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Authors and funding
8 authors at 5 institutions in 5 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundInformed 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.
methodsA 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.
results13 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.
conclusionsConsent for performing a procedure is frequently absent in Dutch maternity care. In some instances, procedures were performed in spite of the woman's refusal. More awareness is needed on meeting necessary consent requirements in order to achieve person-centred and high-quality care during labour and birth.
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