Women's Experience of the Consent Process for Planned Caesarean Section

Dear Dr. Papageorghiou,

At the very outset, we would like to appreciate Nithiyananthan et al. for their research entitled ‘Women's experience of the consent process to planned caesarean section and its surgical risk: A qualitative study’ where they explored how women appreciated the risks within the consent process for planned caesarean section in a teaching hospital in central London [1]. However, we would like to enquire about a few points.

Since the study participants were selected on the convenience sampling method [2], we would like to enquire whether and how the diversity of the population was maintained in the representative sample. In addition, we wondered whether the interrogation of participants was conducted by a single researcher; this is important for purposes of generalizability, and we wonder whether a healthcare professional's gender or ethnicity may play a role in shaping participant responses.

The sample population consisted of both nulliparous and parous patients. A question that arises in our minds is whether parity is associated with variations in the risk comprehension among the recruited participants. As limitations in the consent process were surfaced following this research, did any of the participants ever choose to withdraw from the study or the proposed surgery (Caesarean section) after learning about the risks explained in the process of obtaining consent?

Realising the importance of this study, do Nithiyananthan et al. believe that antenatal classes or workshops can address the gaps identified in the quality of risk discussion? This is definitely an eye‐opener, and future quality improvement studies can be conducted as part of multicentre projects so that this aspect of consent taking is addressed adequately. Healthcare professionals must ensure emotional concerns while maintaining proper documentation of their informed consents.

Ethics Statement

This is a Letter to the Editor in response to a previously published BJOG article, so ethics committee approval is not necessary.

Conflicts of Interest

The authors declare no conflicts of interest.

Lanjewar P., Sarkar A., and Lanjewar P., “Women's Experience of the Consent Process for Planned Caesarean Section,” BJOG: An International Journal of Obstetrics & Gynaecology 133, no. 9 (2026): 1809–1809, 10.1111/1471-0528.18123.