Can Women in Labor Give Informed Consent to Epidural Analgesia?

12 Pages Posted: 22 May 2019

See all articles by Kyoko Wada

Kyoko Wada

Western University

Louis Charland

Western University

Geoff Bellingham

affiliation not provided to SSRN

Date Written: May 2019

Abstract

There are reasons to believe that decision‐making capacity (mental competence) of women in labor may be compromised in relation to giving informed consent to epidural analgesia. Not only severe labor pain, but also stress, anxiety, and premedication of analgesics such as opioids, may influence women’s decisional capacity. Decision‐making capacity is a complex construct involving cognitive and emotional components which cannot be reduced to ‘understanding’ alone. A systematic literature search identified a total of 20 empirical studies focused on women’s decision‐making about epidural analgesia for labor pain. Our review of these studies suggests that empirical evidence to date is insufficient to determine whether women undergoing labor are capable of consenting to epidural analgesia. Given such uncertainties, sufficient information about pain management should be provided as part of prenatal education and the consent process must be carefully conducted to enhance women’s autonomy. To fill in the significant gap in clinical knowledge about laboring women’s decision‐making capacity, well‐designed prospective and retrospective studies may be required.

Keywords: decisionā€making capacity, epidural analgesia, feminism, informed consent, labor pain, mental competence

Suggested Citation

Wada, Kyoko and Charland, Louis and Bellingham, Geoff, Can Women in Labor Give Informed Consent to Epidural Analgesia? (May 2019). Bioethics, Vol. 33, Issue 4, pp. 475-486, 2019. Available at SSRN: https://ssrn.com/abstract=3392539 or http://dx.doi.org/10.1111/bioe.12517

Kyoko Wada

Western University ( email )

1151 Richmond St
London, Ontario N6A 3K7
Canada

Louis Charland (Contact Author)

Western University ( email )

1151 Richmond St
London, Ontario N6A 3K7
Canada

Geoff Bellingham

affiliation not provided to SSRN

No Address Available

Register to save articles to
your library

Register

Paper statistics

Downloads
2
Abstract Views
31
PlumX Metrics