Excerpt 1: Field note from Labour Ward. Consent for External Cephalic Version This is C’s second pregnancy. She found out through a telephone call from clinic midwife a couple of days earlier (Friday afternoon) but the call was brief and they ‘just said they could try to turn baby to make birth easier’. Since then she has been ‘stressed all weekend’ and ‘Googling madly’ and is very worried. | |
C | sitting on bed is quite apprehensive and says she doesn’t really know the score – Dr. pops in says someone will be back. Waiting for 20 min or so – people popping in – seems busy and C very tense, fidgety |
HCP | enters room with junior Dr. + medical student + midwife – asks C if she understands what they want to try to do – friendly but hurried – all 3 standing looking at C on bed |
C | ‘sort of’ ‘not had very much information’ – explains phone call – nothing else |
HCP | standing - explains purpose of ECV and how procedure done – pressure for 15 mins – might hurt |
C | listens intently - looks terrified – HCP appears not to notice |
HCP | have risks been explained? |
C | ‘no, looked at Google’ very confused |
HCP | doesn’t seem to realise how ill-prepared C is. Explains that there are very few risks – mainly that it won’t work no other risks mentioned (? Why not) (should there be discussion of Cesarean Section?) Asks C if she has any questions |
C | wants to know how likely it’ll work – not really answered. Very rushed |
HCP | asks C to sign consent form – form signed leaves says they’ll be back as soon as they can |
C to researcher | says she hopes she’s doing the right thing – I get the sense she feels a bit trapped by coming to the Labour Ward as though she can’t change her mind |
Impression | C needs more chance to discuss – this does not really constitute proper consent in any way – it’s been very fast (Labour ward is busy) and there’s been no discussion of pros and cons |
Excerpt 2: Field note from Labour Ward/Ante-natal clinic. Consent for Cesarean Section T is a primiparous womanwith an IVF pregnancy. She is being seen in ante-natal clinic but admitted to Labour ward for monitoring (due to raised glucose readings) and potentially a CS in a few days | |
HCP | explains CS procedure – details of practicalities of anaesthesia – T seems very relaxed Explains risks of CS very thoroughly & clearly – infection/antibiotics; deep vein thrombosis/TED Stockings; bleeding; bladder injury; damage to other structures/repair – very reassuring – checks T seems comfortable physically sitting. HCP goes slowly and asks T if any questions several times – is that clear? does that make sense? - seems to be trying to make sure T is really engaged without alarming her or making her feel pressured into asking questions |
T | looks attentive but not sure if she’s really taking it in – seems to be saying yes to everything! Lots of laughter very excited by birth – seems very relaxed about risks |