Informed consent for epidural analgesia in labour: a survey of Irish practice

Abstract

Currently, we do not have a national standard regarding epidural consent in Ireland. The aim of this survey was to assess practice in obstetric units in Ireland with regard to obtaining informed consent prior to epidural insertion, and whether the risks discussed with women are being documented. A postal survey of anaesthetists in Irish obstetric units was performed in January 2012 to assess practice regarding obtaining informed consent prior to epidural insertion, and documentation of the risks discussed. The response rate was 16/18 (88%). There was major variation both in which risks are discussed with women in labour and what risks are quoted. The most frequently quoted risks were headache - 15/16 (93.8% of the respondents), partially/not working epidural - 15/16 (93.8%), drop in blood pressure -14/16 (87.5%) and temporary backache/local tenderness - 12/16 (75%). The more serious risks were not discussed as frequently: permanent nerve damage - 8/16 (50%), paralysis - 8/16 (50%), epidural abscess/haematoma - 6/16 (37.5%), meningitis - 3/16 (18.7%). The vast majority of respondents supported introduction of a national standardised information leaflet, detailing all the benefits and risks of epidural analgesia, to be shown to all women before consenting to epidural insertion.