Women’s and midwives’ views on the optimum process for informed consent for research in a feasibility study involving an intrapartum intervention: a qualitative study

Abstract Background Recruitment to intrapartum research is complex. Women are expected to understand unfamiliar terminology and assess potential harm versus benefit to their baby and themselves, often when an urgent intervention is required. Time pressures of intrapartum interventions are a major ch...

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Main Authors: Mary Alvarez, Emily J. Hotton, Sam Harding, Jonathan Ives, Joanna F. Crofts, Julia Wade
Format: Article
Language:English
Published: BMC 2023-06-01
Series:Pilot and Feasibility Studies
Subjects:
Online Access:https://doi.org/10.1186/s40814-023-01330-1
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author Mary Alvarez
Emily J. Hotton
Sam Harding
Jonathan Ives
Joanna F. Crofts
Julia Wade
author_facet Mary Alvarez
Emily J. Hotton
Sam Harding
Jonathan Ives
Joanna F. Crofts
Julia Wade
author_sort Mary Alvarez
collection DOAJ
description Abstract Background Recruitment to intrapartum research is complex. Women are expected to understand unfamiliar terminology and assess potential harm versus benefit to their baby and themselves, often when an urgent intervention is required. Time pressures of intrapartum interventions are a major challenge for recruitment discussions taking place during labour, with research midwives expected to present, discuss and answer questions whilst maintaining equipoise. However, little is known about these interactions. An integrated qualitative study (IQS) was used to investigate information provision for women invited to participate in the Assist II feasibility study investigating the OdonAssist™—a novel device for use in assisted vaginal birth with an aim to generate a framework of good practice for information provision. Methods Transcripts of in-depth interviews with women participants (n = 25), with recruiting midwives (n = 6) and recruitment discussions between midwives and women (n = 21), accepting or declining participation, were coded and interpreted using thematic analysis and content analysis to investigate what was helpful to women and what could be improved. Results Recruiting women to intrapartum research is complicated by factors that impact on women’s understanding and decision-making. Three key themes were derived from the data: (i) a woman-centred recruitment process, (ii) optimising the recruitment discussion and (iii) making a decision for two. Conclusion Despite evidence from the literature that women would like information provision and the research discussion to take place in the antenatal period, intrapartum studies still vary in the recruitment processes they offer women. Particularly concerning is that some women are given information for the first time whilst in labour, when they are known to feel particularly vulnerable, and contextual factors may influence decision-making; therefore, we propose a framework for good practice for information provision for research involving interventions initiated in the intrapartum period as a woman centred, and acceptable model of recruitment, which addresses the concerns of women and midwives and facilitates fair inclusion into intrapartum trials. Trial registration ISRCTN. This qualitative research was undertaken as part of the ASSIST II Trial (trial registration number: ISRCTN38829082. Prospectively registered on 26/06/2019).
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spelling doaj.art-184f93ac4cb04e9ea3e8590e194c39d92023-06-18T11:06:51ZengBMCPilot and Feasibility Studies2055-57842023-06-019111410.1186/s40814-023-01330-1Women’s and midwives’ views on the optimum process for informed consent for research in a feasibility study involving an intrapartum intervention: a qualitative studyMary Alvarez0Emily J. Hotton1Sam Harding2Jonathan Ives3Joanna F. Crofts4Julia Wade5Department of Women’s and Children’s Health, Southmead Hospital, North Bristol NHS TrustDepartment of Women’s and Children’s Health, Southmead Hospital, North Bristol NHS TrustDepartment of Women’s and Children’s Health, Southmead Hospital, North Bristol NHS TrustBristol Medical School, Bristol UniversityDepartment of Women’s and Children’s Health, Southmead Hospital, North Bristol NHS TrustBristol Medical School, Bristol UniversityAbstract Background Recruitment to intrapartum research is complex. Women are expected to understand unfamiliar terminology and assess potential harm versus benefit to their baby and themselves, often when an urgent intervention is required. Time pressures of intrapartum interventions are a major challenge for recruitment discussions taking place during labour, with research midwives expected to present, discuss and answer questions whilst maintaining equipoise. However, little is known about these interactions. An integrated qualitative study (IQS) was used to investigate information provision for women invited to participate in the Assist II feasibility study investigating the OdonAssist™—a novel device for use in assisted vaginal birth with an aim to generate a framework of good practice for information provision. Methods Transcripts of in-depth interviews with women participants (n = 25), with recruiting midwives (n = 6) and recruitment discussions between midwives and women (n = 21), accepting or declining participation, were coded and interpreted using thematic analysis and content analysis to investigate what was helpful to women and what could be improved. Results Recruiting women to intrapartum research is complicated by factors that impact on women’s understanding and decision-making. Three key themes were derived from the data: (i) a woman-centred recruitment process, (ii) optimising the recruitment discussion and (iii) making a decision for two. Conclusion Despite evidence from the literature that women would like information provision and the research discussion to take place in the antenatal period, intrapartum studies still vary in the recruitment processes they offer women. Particularly concerning is that some women are given information for the first time whilst in labour, when they are known to feel particularly vulnerable, and contextual factors may influence decision-making; therefore, we propose a framework for good practice for information provision for research involving interventions initiated in the intrapartum period as a woman centred, and acceptable model of recruitment, which addresses the concerns of women and midwives and facilitates fair inclusion into intrapartum trials. Trial registration ISRCTN. This qualitative research was undertaken as part of the ASSIST II Trial (trial registration number: ISRCTN38829082. Prospectively registered on 26/06/2019).https://doi.org/10.1186/s40814-023-01330-1Informed consentIntrapartum interventionQualitative researchMaternityResearch ethics
spellingShingle Mary Alvarez
Emily J. Hotton
Sam Harding
Jonathan Ives
Joanna F. Crofts
Julia Wade
Women’s and midwives’ views on the optimum process for informed consent for research in a feasibility study involving an intrapartum intervention: a qualitative study
Pilot and Feasibility Studies
Informed consent
Intrapartum intervention
Qualitative research
Maternity
Research ethics
title Women’s and midwives’ views on the optimum process for informed consent for research in a feasibility study involving an intrapartum intervention: a qualitative study
title_full Women’s and midwives’ views on the optimum process for informed consent for research in a feasibility study involving an intrapartum intervention: a qualitative study
title_fullStr Women’s and midwives’ views on the optimum process for informed consent for research in a feasibility study involving an intrapartum intervention: a qualitative study
title_full_unstemmed Women’s and midwives’ views on the optimum process for informed consent for research in a feasibility study involving an intrapartum intervention: a qualitative study
title_short Women’s and midwives’ views on the optimum process for informed consent for research in a feasibility study involving an intrapartum intervention: a qualitative study
title_sort women s and midwives views on the optimum process for informed consent for research in a feasibility study involving an intrapartum intervention a qualitative study
topic Informed consent
Intrapartum intervention
Qualitative research
Maternity
Research ethics
url https://doi.org/10.1186/s40814-023-01330-1
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