Time from consent to cesarean delivery during labor

ObjectiveThe objective of the study was to describe the time from consent to incision (consent time) when informed consent (IC) for cesarean delivery (CD) is obtained during labor and identify risk factors for especially short consent times.Study DesignThe study was a retrospective chart review of 90 cases of CD during labor. Medians and interquartile ranges for times were reported. Multivariable linear and logistic regressions were used to adjust for confounders. A Kaplan-Meier survival analysis was performed to compare consent time among women undergoing CD for fetal heart rate (FHR) indications with other women.ResultsThe median consent time was 48 minutes (interquartile range, 25-72); 28.9% of patients delivered less than 30 minutes after consent. When adjusted for potential confounders, the odds of delivering less than 30 minutes after consent were 4.7 times higher (95% confidence interval, 1.4-15.2, P = .01) among women who underwent CD for FHR indications than for women who underwent CD for other indications.ConclusionThis study demonstrates that when IC for CD is obtained during labor, consent time is brief, particularly among women undergoing CD for FHR indications. Although time is not necessarily a proxy for quality, an especially short consent time is likely to reduce the quality of the conversation and limit a patient's opportunity to understand and recall information. Additional research regarding the optimal approach to IC for CD in labor is needed; however, this study suggests that the practice of obtaining IC at the time the decision for CD is reached is unlikely to provide optimal time for a complete IC discussion.