ArticleBMJ open2025
Barriers to informed consent in obstetric care during childbirth from practitioner's perspective: a qualitative study.
Article in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Clinicians' Experiences and Recommendations for Implementing Trauma-Informed Care in Perinatal Settings.Research in nursing & health · 2026Article
- Reliability and Validity of the MADM Scale in Measuring Maternal Autonomy During Hospital Births in Greece.Healthcare (Basel, Switzerland) · 2026Article
- Factors Associated with the Perception of Obstetric Violence and Its Emotional Impact on Healthcare Training: A Cross-Sectional Study.Nursing reports (Pavia, Italy) · 2025Article
- Obstetric violence and its association with postnatal depression: A longitudinal community-based study in rural Jharkhand, India.Women's health (London, England)Article
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo explore healthcare professionals' perspectives and practices regarding informed consent during childbirth, particularly in the context of increased public awareness and discourse surrounding obstetric violence (OV) in France.
designA qualitative study based on semistructured interviews and non-participant observations.
settingFour maternity units in France, representing a diversity of institutional contexts.
participantsA purposive sample of 32 participants, including midwives and obstetricians, was recruited across the four sites.
methodsData were collected through 32 semistructured interviews and in situ observations in labour and delivery rooms. A thematic analysis was conducted using a phenomenological approach, supported by NVivo software.
resultsFour main themes emerged: (1) relational malaise in the caregiver-patient relationship, reinforced by public discourse on OV, further hindered shared decision-making and open communication. (2) Challenges between caring values and systemic constraints (eg, lack of time, staffing shortages and protocol-driven care) limited professionals' ability to engage in meaningful informed consent discussions. (3) Safety paradigm in obstetrics: fetal well-being emerged as a central and non-negotiable argument to justify medical interventions during childbirth. (4) Informed consent as a source of tension, where professionals struggled to balance legal and ethical obligations with clinical urgency, often leading to coercive or merely formal consent processes.
conclusionsInformed consent during childbirth remains a critical and unresolved ethical challenge. This study highlights systemic, relational and emotional barriers that hinder shared decision-making and compromise the core ethical principles of autonomy, beneficence and justice. Addressing these issues requires structural changes, improved working conditions to support individualised care, better training in ethics and communication and greater recognition of the moral distress experienced by healthcare professionals. REGISTRATION NUMBER: Registration number 22-219 from CEEI-IRB INSERM (Research Institutional Review Board INSERM, France) (IRB 00003888, IORG 0003254, FWA 00005831).
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