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Choice in episiotomy – fact or fantasy: a qualitative study of women’s experiences of the consent process

BACKGROUND: Consent to episiotomy is subject to the same legal and professional requirements as consent to other interventions, yet is often neglected. This study explores how women experience and perceive the consent process. METHODS: Qualitative research in a large urban teaching hospital in Londo...

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Autores principales: Djanogly, Tanya, Nicholls, Jacqueline, Whitten, Melissa, Lanceley, Anne
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8862370/
https://www.ncbi.nlm.nih.gov/pubmed/35189846
http://dx.doi.org/10.1186/s12884-022-04475-8
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author Djanogly, Tanya
Nicholls, Jacqueline
Whitten, Melissa
Lanceley, Anne
author_facet Djanogly, Tanya
Nicholls, Jacqueline
Whitten, Melissa
Lanceley, Anne
author_sort Djanogly, Tanya
collection PubMed
description BACKGROUND: Consent to episiotomy is subject to the same legal and professional requirements as consent to other interventions, yet is often neglected. This study explores how women experience and perceive the consent process. METHODS: Qualitative research in a large urban teaching hospital in London. Fifteen women who had recently undergone episiotomy were interviewed using a semi-structured interview guide and data was analysed using thematic analysis. RESULTS: Three themes captured women’s experiences of the episiotomy consent process: 1) Missing information – “We knew what it was, so they didn’t give us details,” 2) Lived experience of contemporaneous, competing events – “There’s no time to think about it,” and 3) Compromised volitional consent – “You have no other option.” Minimal information on episiotomy was shared with participants, particularly concerning risks and alternatives. Practical realities such as time pressure, women’s physical exhaustion and their focus on the baby’s safe delivery, constrained consent discussions. Participants consequently inferred that there was no choice but episiotomy; whilst some women were still happy to agree, others perceived the choice to be illusory and disempowering, and subsequently experienced episiotomy as a distressing event. CONCLUSIONS: Consent to episiotomy is not consistently informed and voluntary and more often takes the form of compliance. Information must be provided to women in a more timely fashion in order to fulfil legal requirements, and to facilitate a sense of genuine choice.
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spelling pubmed-88623702022-02-23 Choice in episiotomy – fact or fantasy: a qualitative study of women’s experiences of the consent process Djanogly, Tanya Nicholls, Jacqueline Whitten, Melissa Lanceley, Anne BMC Pregnancy Childbirth Research BACKGROUND: Consent to episiotomy is subject to the same legal and professional requirements as consent to other interventions, yet is often neglected. This study explores how women experience and perceive the consent process. METHODS: Qualitative research in a large urban teaching hospital in London. Fifteen women who had recently undergone episiotomy were interviewed using a semi-structured interview guide and data was analysed using thematic analysis. RESULTS: Three themes captured women’s experiences of the episiotomy consent process: 1) Missing information – “We knew what it was, so they didn’t give us details,” 2) Lived experience of contemporaneous, competing events – “There’s no time to think about it,” and 3) Compromised volitional consent – “You have no other option.” Minimal information on episiotomy was shared with participants, particularly concerning risks and alternatives. Practical realities such as time pressure, women’s physical exhaustion and their focus on the baby’s safe delivery, constrained consent discussions. Participants consequently inferred that there was no choice but episiotomy; whilst some women were still happy to agree, others perceived the choice to be illusory and disempowering, and subsequently experienced episiotomy as a distressing event. CONCLUSIONS: Consent to episiotomy is not consistently informed and voluntary and more often takes the form of compliance. Information must be provided to women in a more timely fashion in order to fulfil legal requirements, and to facilitate a sense of genuine choice. BioMed Central 2022-02-21 /pmc/articles/PMC8862370/ /pubmed/35189846 http://dx.doi.org/10.1186/s12884-022-04475-8 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Djanogly, Tanya
Nicholls, Jacqueline
Whitten, Melissa
Lanceley, Anne
Choice in episiotomy – fact or fantasy: a qualitative study of women’s experiences of the consent process
title Choice in episiotomy – fact or fantasy: a qualitative study of women’s experiences of the consent process
title_full Choice in episiotomy – fact or fantasy: a qualitative study of women’s experiences of the consent process
title_fullStr Choice in episiotomy – fact or fantasy: a qualitative study of women’s experiences of the consent process
title_full_unstemmed Choice in episiotomy – fact or fantasy: a qualitative study of women’s experiences of the consent process
title_short Choice in episiotomy – fact or fantasy: a qualitative study of women’s experiences of the consent process
title_sort choice in episiotomy – fact or fantasy: a qualitative study of women’s experiences of the consent process
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8862370/
https://www.ncbi.nlm.nih.gov/pubmed/35189846
http://dx.doi.org/10.1186/s12884-022-04475-8
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