Background The national caesarean section (CS) rate is 25%. Valid consent must be obtained for CS, after providing information on benefits, risks and burdens.

Objective To audit the process of consent and recall of risks of CS. Sunderland Royal Hospital (SRH) guidelines require that seven risks are discussed and documented on consent forms compared to sixteen risks in Royal College of Obstetrics and Gynaecology (RCOG) advice.

Method In this registered, prospective audit, 100% compliance with standards was expected. A proforma was used to record data from 40 consecutive consent forms, then data were expanded by interview of the same 40 women.

Results Three women had a category 1 ‘crash’ CS: written consent was obtained for two, while one had no documented consent. There were thirty-seven less urgent CS in the audit: written consent was obtained for thirty-six and verbal consent was obtained for one. 60% of this group recalled all seven SRH risks with prompting whereas only 2.5% recalled all RCOG risks. Of all obese women, 44% were aware that obesity increased risk. SRH does not provide printed information about CS antenatally but 55% of women would appreciate this and 70% claim they would read it.

Conclusions Training is required to improve staff awareness about the importance of completing individualised consent forms for CS. All women should be provided with written information about CS antenatally. Prospective re-audit should be conducted one year after the changes.