Consent practices in midwifery: A survey of UK midwives

Abstract

Objective: To explore midwives’ knowledge and understanding of the law and practice of consent in the post-Montgomery world. Design: Cross-sectional online survey. Descriptive statistical analysis of midwives’ survey responses. Settings: Social media: Instagram, Facebook and Twitter. Survey distribution was via the UCL Opinio survey platform. Participants: A total of 402 midwives, surveyed over a four month period between 2nd March and 2nd July 2021. Measurements: Knowledge of legal consent, ‘sureness’ of meeting current legal requirements and competence to gain consent. Findings: 91% of participants acknowledged correctly that consent must be voluntary. 91% reported that women must be informed of all the risks associated with their care, although 26% reported that women should be informed of some of the risks associated with their care. Most participants were ‘sure’ that their discussions of consent meet current legal requirements (91%). 21% rated their competence to gain consent as ‘excellent’, 71% rated themselves as ‘very good’, whilst 1% rated their competence as ‘poor’. Deficiencies in fundamental knowledge of consent were noted in some participants rating themselves highest in ‘sureness’ of meeting legal requirements and competence to consent. Key conclusions: Fundamental gaps in midwives’ knowledge of legal consent were identified. Participants demonstrated uncertainty regarding the extent of risk disclosure and discussion of alternative care options. Participants generally rated themselves highly in their consenting practices, despite lacking in basic knowledge of legal consent, revealing a discrepancy between midwives’ self-perceptions and their actual knowledge. Implications for practice: The overconfidence displayed by some participants is concerning for clinical midwifery practice. Professional education and guidance for midwives on legal consent in keeping with Montgomery is urgently required to ensure that midwives are legally compliant in their consenting practices.