Informed consent process before caesarean section: A study of patient’s perspective regarding adequacy of consent process

Abstract

Informed consent is an ethical and legal requirement and is practiced before all the surgical procedures. Cesarean section is the commonest obstetrics surgery and there is increased rate of C-section due to better diagnosis and early referral. A legitimate consent should be taken from the patient or her guardian before caesarean section. So this study was aimed to assess the adequacy of informed consent process and the understanding of information obtained by the patient. A cross sectional study was done with patients aged more than 18 years and who underwent elective or emergency caesarean section. Based on inclusion and exclusion criteria, a total of ninety three patients were included. A pretested and pre validated questionnaire was adopted for the study. The data were analyzed and expressed as percentage of proportion. The average age of the participants was 26.11± 3.97 years. About 70.96% of the participants underwent emergency caesarean section and 29.07% underwent elective section. About 91.3% of participants knew the necessity of the cesarean section, 94.62% were informed about the risk of surgery and 95.6% were informed about the benefits of C-section. About 98.92% of participants didn’t know about the type of anesthesia to be used and almost all patients were not informed about their right to refuse the procedure. The patients were well informed about the procedure, the risks and benefits involved in C-section. Still some elements of consent process needs to be improved which can be done by proper awareness and training of the health care professionals.

Surgical Informed Consent in Clinical Practice: Patients’ Perspective Undergoing Cesarean Section at Three Teaching Hospitals in Addis Ababa, Ethiopia

“…It was found that the majorities of the patients (81.4% & 91% respectively) were not informed about the type of anesthesia and were not given the chance to choose their anesthetic preference. This finding is comparable with other studies ( 6 , 18 ).…”

“…In the study, only 40.1% agreed to the fact that they were told that they might need surgery in the future during their antenatal visit (P=0.001). This finding is comparable with India's study finding that found 37.5 % of participants were told about the possibility the cesarean section during antenatal visits ( 18 ).…”

“…A similar study was conducted in Hawassa, Ethiopia, and shows comparable findings ( 15 ). On the other hand, a study conducted in the Department of OB/GYN, SRM medical college hospital and research center India found that participants received information on: the benefit of the surgery (95.6%), risk of surgery (94.6%), and alternative treatment (23.7%)( 18 ). Differences among these studies may be due to varying SIC practices, service delivery arrangements, or resource capacities.…”

The Quality of Informed Consent in Caesarean Section at a Tertiary Hospital in Addis Ababa, Ethiopia

“…7,8 Researches on the quality of informed consent concerning obstetric interventions are scanty in developing countries. [9][10][11] This research aims to assess the quality of informed consent in women undergoing CS on both emergency and planned basis and to identify factors associated with quality consent.…”