Two in five women in labour have procedures performed without their consent, survey finds
Two in five (42.4%) women giving birth have had procedures performed on them without their consent, a survey has found.
The online survey, which received 1,584 responses, was launched to mark Birth Trauma Awareness Week, which runs from 15-21 July 2024. Of those who said that they’d had a procedure performed without consent, the survey found that the most common procedure was vaginal examination, carried out on 209 women (17.9%).
Other procedures commonly performed without consent included episiotomy (16.6%), cervical sweep (12.5%) and rupture of the membranes (9.8%).
One woman said: “I was given a cervical sweep that I was not informed about beforehand and did not consent to. I was only told about it after I questioned why my contractions had increased. ‘Oh, I gave you a sweep’ the midwife said breezily – like I should be grateful. The only thing I felt was violated and completely left out of my own birth experience.”
Some women described incidents in which other people appeared without permission in the birthing room. One wrote: “A 10-person obstetric review team WANDERED into the room less than five minutes before my son was born, I was not told they would be entering the room. My feet were in stirrups so I was physically vulnerable and there was no respect for my dignity, one member of staff who walked in was stood playing on their phone. No one even addressed me to say hello. I would have understood if there was a medical emergency, in which case, by all means act first and ask questions later. But the casual nature and lack of respect for my dignity when there was no need was extremely dehumanising and has left me more traumatised than a previous experience of sexual assault did.”
Nearly 70% of respondents said that they had operating room procedures, such as caesarean, that required written consent. Of those, a full 53.3% said that they did not feel fully competent to give consent at that point, while 16.7% said they were unsure whether they felt competent or not.
A number described feeling too ill or exhausted to consent fully. One wrote: “I didn’t feel like I had the option to say no but also was barely conscious. I was naked, covered in sick and blood and had no idea what was happening, what my options were or what I needed. I had a piece of paper waved in my face and ‘We need your consent, please sign here’ as I was already on the move to theatre. I was drifting in and out of consciousness but somehow managed to sign.”
Commenting on the findings, Donna Ockenden, chair of the independent review into maternity Services at the Shrewsbury and Telford Hospitals NHS Trust, and of the ongoing review into maternity Services at Nottingham University Hospitals NHS Trust, said:
“It is extremely disappointing to hear from the recent Birth Trauma Association survey, that so many women described having intrusive procedures performed without consent. Women must be informed about the care they are receiving, every step of the way. Without open communication, women cannot make the right decisions for them, nor have full autonomy over their bodies.”
She added: “From more than 30 years’ of experience in and around maternity services, I can say without a doubt that it is not acceptable to perform any procedures without informed consent. It is not only good practice, but the responsibility of all healthcare professionals to inform women of their role and to gain informed consent before performing procedures such as cervical sweeps or a vaginal examination. Women and their families should be at the heart of everything we do, and should not end their maternity journey feeling vulnerable, traumatised, or distressed. What is clear from the recent Birth Trauma report and now this survey, is that far too many women are left feeling this way – which is unacceptable and must change.”
Anna Williamson, the Birth Trauma Association’s celebrity ambassador, said: “Birth is scary enough without women having to also fear something might be done to them without their consent during labour. This survey has highlighted just how much further we have to go to reduce the chance of a traumatic birth. I’m really proud to be Birth Trauma Association’s Ambassador”.
Commenting on the findings, Kim Thomas, CEO of the Birth Trauma Association, said: “Earlier this year, the parliamentary inquiry into birth trauma found that many women were having procedures performed on them without their consent during labour and birth. This new survey confirms those earlier findings. It is shocking that four in 10 women say that they weren’t asked for consent before being subjected to procedures such as vaginal examination, or rupture of the membranes. By law, health professionals are required to obtain informed consent before they carry out a procedure, and our survey shows that in many cases, this simply isn’t happening.
“It also shows that when written consent is needed for emergency procedures such as forceps or caesarean section, more than half of women do not feel in a fit state to give consent, demonstrating the need for conversations about the risks and benefits of instrumental birth or caesarean section to start in the antenatal period. We need a culture change in maternity so that it is never considered acceptable to perform procedures without a woman’s consent.”
Note for editors:
1. The survey was carried out online using Mailchimp between 17 and 30 June, 2024, and received 1,584 responses.
2. Birth Trauma Awareness Week, which is organised by the Birth Trauma Association, runs from 15-21 July 2024.
3. The Birth Trauma Association is a UK-based charity supporting parents with psychological distress as a result of traumatic birth: www.birthtraumaassociation.org
For further information, or to talk to case studies, please contact Kim Thomas on 07779 275032 or at kim@birthtraumaassociation.org
