Midwifery perspectives: The consent process in the context of patient safety and medico-legal issues

Abstract

Obtaining consent is a legal and ethical necessity prior to midwifery care provision. Furthermore, midwives must act in the best interests of women at all times and make sure that properly informed consent is obtained and documented prior to carrying out any action. Although the judgment made at the Supreme Court, in Montgomery v Lanarkshire Health Board, involved an obstetrician, the recommendations of this case will have far reaching implications for midwives within the consent process. Midwives will be required to consider informing women of any material risks involved in any recommended care and treatment, including how likely women are to attach significance to such risk. The risk discourse that pervades maternity care is well cited and midwives need to strive to achieve a safe, holistic, woman-centred approach to care whilst implementing the recommendations of Montgomery. Challenges exist for midwives in obtaining informed consent particularly resulting from sub-standard communication issues. This clearly impacts negatively upon patient safety issues. Ultimately, NICE advocate that pregnant women should be offered evidence based information and support to enable them to make informed decisions about their care and treatment. Montgomery provides the highest level of legal support for this position.