A comparison of informed consent for obstetric anaesthesia in the USA and the UK.

The practice of 75 UK and 75 US obstetric anaesthetists in obtaining informed consent for obstetric anaesthesia (for caesarean section) and obstetric analgesia (for labour) was compared using a postal questionnaire. The response rate was approximately 60% for each group. Of the US anaesthetists 47% obtained separate written consent for obstetric anaesthesia compared to 22% of the UK group (P=0.012). Corresponding percentages for epidural analgesia were 52% for the US, and 15% for the UK (P < 0.001). Significantly more of the listed risks and benefits relating to general anaesthesia were discussed by the US anaesthetists compared to the UK group, median (interquartile range), 6 (4-7) and 3 (1-4), P < 0.001. There was no significant difference in discussion before regional anaesthesia but the US group discussed more information before epidural analgesia for labouring mothers obtunded by pain or drugs. These results suggest that discussion and documentation of informed consent for obstetric anaesthesia and analgesia could be improved in both countries, especially the UK.