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Informed consent for operative vaginal delivery: how likely is it?
  1. K Goyder,
  2. B K Strachan,
  3. R Bahl
  1. St Michael's Hospital, Bristol, UK

Abstract

Background It is a basic requirement of ethical practice and a recommendation by the RCOG that informed consent is obtained prior to conducting an operative vaginal delivery (OVD). As women's ability to assimilate new information may be limited in active labour, it is useful that women have prior knowledge about the indications, risks and benefits of OVD.

Aim of the study To explore women's understanding of OVD towards the end of pregnancy.

Method Nulliparous women at 37 weeks or more from different social and cultural backgrounds were purposely sampled. Semi structured interviews were conducted focusing on their knowledge of OVD.

Results 23 women participated in the study. There appeared to be a poor understanding of OVD. Six women did not know about OVD. Among the remaining participants, there was an overall impression of ambiguity in the responses such as ‘as far as I can gather’ ‘I do have a general idea’ ‘I don’t really know much more than that' ‘I would be guessing’. There was a negative perception of OVD, for example, ‘ … its always bad stuff that you would associate with instruments’, ‘your baby can look quite battered’, ‘baby's head apparently was in bits for about a week’.

Conclusion In the study population, there was an overall poor understanding of OVD towards the end of pregnancy. This can have significant implications on the women's ability to give informed consent in labour, especially in urgent situations. Antenatal education should be restructured to improve women's knowledge of OVD.

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