Women’s experience of consent for intrapartum interventions: a systematic review and meta-summary

Obtaining intrapartum consent can be challenging due to its unpredictability and urgency. This review synthesises women’s experiences of intrapartum consent. Eight databases were searched (inception-23 October 2025) for qualitative, quantitative, and mixed-methods studies. Sandelowski meta-summary was performed. Thematic sentences were generated, and frequency effect sizes (FES) indicate the proportion of studies contributing to themes. Forty-seven studies (28,615 women) yielded twelve themes, most commonly: feeling unable to refuse procedures (FES=45%); preference for antenatal consent discussions (FES=36%); and impaired decision-making during labour (FES=23%). Other themes included valuing disclosure of serious risks; and preference for verbal over written consent. Women reported greater satisfaction providing consent to a familiar clinician, though some viewed consent as ‘ritualistic’. Women from ethnic minority backgrounds reported more non-consensual care and language-related barriers. We found earlier, personalised, respectful consent discussions are needed. Antenatal preparation, continuity, inclusive communication, and addressing structural inequalities can support more equitable intrapartum care. PROSPERO, CRD42020222591.