title: "Informed" Consent: An Audit of Informed Consent of Cesarean Section Evaluating Patient Education and Awareness.
abstract: BACKGROUND
  Better diagnosis and early referral due to increased health care coverage have increased the cesarean deliveries at tertiary-care hospitals of India. Improvements in the health care system raise many concerns and need of cross-checking system in place to counter the problems pertaining to patient education and participation of patient. While most of the cesarean sections are done in good faith for the patient, it does not escape the purview of consumer awareness and protection.
  
  
  METHODS
  This cross-sectional study was undertaken at a tertiary level government institution to understand the level of awareness of 220 patients regarding the various aspects of cesarean delivery which are essential for women to know before giving an informed consent.
  
  
  RESULTS
  71 % of the women had knowledge about the indication and need to do cesarean delivery. Of these, only one-third (25 % of total women) were properly explained about procedure and complications. Other demographic and social characteristics were also evaluated.
  
  
  CONCLUSIONS
  While the health care schemes have had their improved results, the onus lies upon the caregivers to improve and maintain the quality of health care in these tertiary-care government hospitals in proportion to the increase in patient load. The results of this study highlight the need for proper counseling of patients regarding complications of cesarean section. The fact that only 25 % of total cases were explained proper procedure and complication as opposed to 71 % of patients having proper knowledge about the indication of cesarean section points out the lack of information in seemingly "informed" consent.
  To bring about awareness about the risks and complications of cesarean section, there is a need that patients be counseled during the antenatal visits, specifically when patients visit near term for antenatal check up.
authors.affiliation: Department of Obstetrics and Gynaecology, Government Medical College, Miraj, India ; 301, Kunal Apts, Near Raj Park, Rajaji Path, Dombivli East, Dist Thane, Mumbai, 421201 Maharashtra India.
authors.forename: Akhilesh G
authors.initials: AG
authors.lastname: Kirane
authors.affiliation: Department of Obstetrics and Gynaecology, Government Medical College, Miraj, India.
authors.forename: Nandkishor B
authors.initials: NB
authors.lastname: Gaikwad
authors.affiliation: Department of Obstetrics and Gynaecology, Government Medical College, Miraj, India.
authors.forename: Prashant E
authors.initials: PE
authors.lastname: Bhingare
authors.affiliation: Department of Obstetrics and Gynaecology, Government Medical College, Miraj, India.
authors.forename: Vidya D
authors.initials: VD
authors.lastname: Mule
keywords: Cesarean section; Informed consent; Patient education