Quality of Informed Consent Practices around the Time of Childbirth: A Cross-Sectional Study in Italy.

BACKGROUND

Few studies have explored consent request practices during childbirth.

OBJECTIVE

We explored consent request practices during childbirth in a referral hospital and research centre in Italy, capturing both women and health workers' perspectives.

METHODS

Data were collected using self-administrated questionnaires between December 2016 and September 2018. Nine key maternal and newborn procedures were analysed. Associations between consent requests and women characteristics were explored by multiple logistic regression.

RESULTS

Among 1244 women, the rate of consent requests varied widely, with caesarean section (CS) showing the highest rate (89.1%) and neonatal conjunctivitis prophylaxis presenting the lowest rate (11.4%). Information provided on "risks/benefits" and "reasons" for procedures by health staff was most often not comprehensive for procedures of interest (range 18.6-87.4%). The lack of informed consent is not specifically linked to any pattern of women characteristics. According to 105 health workers, adequate protocols and standard forms for consent requests were available in 67.6% and 78.1% of cases, respectively, while less than one third (31.4%) reported having received adequate training and supportive supervision on how to deliver informed consent.

CONCLUSIONS

Study findings align with previous evidence showing that consent request practices during childbirth need to be largely improved. More research is needed to investigate effective strategies for improvement.