lacking capacity in an obstetric emergency
Research type
Research Study
Full title
phase1. lacking capacity in an obstetric emergency. A retrospective investigation of maternal capacity. phase2: lacking capacity in an obstetric emergency. A radomized controlled trail investigating whether prior information of women about obstetric emergencies via a leaflet and verbal counseling improves later decision making capacity.
IRAS ID
183899
Contact name
NEELAM SINGH
Contact email
Sponsor organisation
Betsi Cadwaladr University Health Board
Duration of Study in the UK
1 years, 0 months, 0 days
Research summary
This research is in 2 phases.
Phase1: Lacking capacity in an obstetric emergency, a retrospective study of maternal capacity.
Phase2: Lacking capacity in an obstetric emergency, a randomized controlled trial investigating whether prior information about obstetric emergencies improves later decision making capacity.The Mental Capacity Act (MCA) 2005 was introduced to protect patients’ autonomy and to provide for those lacking capacity. It has significant implications for consent in obstetric emergencies.
Due to the nature of obstetric emergencies, informed consent is challenging. Fear of fetal well-being, severe labour pains, strong opiates and emotional (dis)stress all affect capacity. Formal assessment of capacity takes considerable time, which may compromise fetal outcome through undue delay.
We recently conducted an audit and found that the majority of women interviewed within 24 hrs of an obstetric emergency, had no recollection of the consent process or risks of complications. Many admitted to not reading the consent form at all.
In phase1, we assess a mother’s ability to give informed consent in an emergency by conducting interviews within 24 hrs of birth, using a capacity assessment tool designed by us that incorporates basic principles of the MCA, based upon maternal recall of events.
In phase2: we are testing whether written information, supported by verbal counselling, before an emergency has occurred improves women’s decision making ability when an emergency occurs subsequently.
Women admitted for induction of labour or early labour will be randomized to receive additional information (intervention) or not (control). Those women who end up in theatre for an instrumental or caesarean delivery will be interviewed within 24 hrs to assess their capacity at the time of emergency.
Usual practice is to take consent when an emergency arises.This study will be conducted at Glan Clwyd Hospital and will last approximately 12 months. BCUHB will be the sponsor.
REC name
Wales REC 4
REC reference
15/WA/0273
Date of REC Opinion
27 Nov 2015
REC opinion
Further Information Favourable Opinion