Kokkosi Eriketi, Stavros Sofoklis, Moustakli Efthalia, Vedam Saraswathi, Potiris Anastasios, Mavrogianni Despoina, Antonakopoulos Nikolaos, Panagopoulos Periklis, Drakakis Peter, Gourounti Kleanthi, Iliadou Maria, Sarella Angeliki
Department of Midwifery, Faculty of Health and Caring Sciences, University of West Attica, 122 43 Athens, Greece.
Third Department of Obstetrics and Gynecology, University General Hospital "ATTIKON", Medical School, National and Kapodistrian University of Athens, 124 62 Athens, Greece.
Nurs Rep. 2025 Jul 29;15(8):273. doi: 10.3390/nursrep15080273.
Respectful maternity care involves privacy, dignity, and informed choice within the process of delivery as stipulated by the World Health Organization (WHO). Informed consent is a cornerstone of patient-centered care, representing not just a formal document, but an ongoing ethical and clinical process through which women are offered objective, understandable information to support autonomous, informed decision-making. This narrative review critically examines the literature on informed consent in maternity care, with particular attention to both obstetric-led and midwifery-led models of care. In addition to identifying institutional, cultural, and systemic obstacles to its successful implementation, the review examines the definition and application of informed consent in perinatal settings and evaluates its effects on women's autonomy and satisfaction with care. Important conclusions emphasize that improving women's experiences and minimizing needless interventions require active decision-making participation, a positive provider-patient relationship, and ongoing support from medical professionals. However, significant gaps persist between legal mandates and actual practice due to provider attitudes, systemic constraints, and sociocultural influences. Women's experiences of consent can be more effectively understood through the use of instruments such as the Mothers' Respect (MOR) Index and the Mothers' Autonomy in Decision Making (MADM) Scale. To promote genuinely informed and considerate maternity care, this review emphasizes the necessity of legislative reform and improved provider education in order to close the gap between policy and practice.
尊重产妇护理涵盖世界卫生组织(WHO)规定的分娩过程中的隐私、尊严和知情选择。知情同意是以人为本的医疗护理的基石,它不仅是一份正式文件,更是一个持续的伦理和临床过程,在此过程中,女性会获得客观、易懂的信息,以支持自主、知情的决策。本叙述性综述批判性地审视了有关产妇护理中知情同意的文献,特别关注产科主导和助产主导的护理模式。除了确定其成功实施的制度、文化和系统性障碍外,该综述还审视了围产期环境中知情同意的定义和应用,并评估了其对女性自主权和护理满意度的影响。重要结论强调,改善女性体验并尽量减少不必要的干预需要积极的决策参与、良好的医患关系以及医疗专业人员的持续支持。然而,由于提供者态度、系统限制和社会文化影响,法律规定与实际做法之间仍存在重大差距。通过使用诸如“母亲尊重”(MOR)指数和“母亲决策自主权”(MADM)量表等工具,可以更有效地理解女性的同意体验。为了促进真正知情且体贴的产妇护理,本综述强调立法改革和改善提供者教育的必要性,以弥合政策与实践之间的差距。