When talking about supporting informed decision-making in maternity, the consent form is a topic that comes up time and again. We are aware that, as part of a broader trend towards defensive practice, some trusts have been increasing their use of consent forms, in the (mistaken) belief that they offer a cloak of legal protection.
On July 10 2026, a prevention of future deaths report was published on the Court and Tribunals Judiciary website, along with responses from NHS England, the Department of Health and Social Care, and NICE, relating to the tragic death of baby Poppy Lomas following a VBAC (vaginal birth after caesarean) homebirth.
In the prevention of future deaths report, the coroner described the absence of consideration by trusts to “the patient signing a consent form that clearly sets out the risks” as an official “matter of concern”.
We were very pleased to see NICE referenced legal difficulties with the coroner’s “signed consent form” suggestion in their response to the coroner, and that both NICE and NHS England reiterated the importance of legal and professional standards relating to informed decision making.
We urge healthcare professionals not to fall into the “signed consent form” trap. Here are our legal “must knows” about consent forms:
- The legal standard for assessing whether or not informed consent was obtained looks at process, not output. In other words, it looks at whether the service user was offered a high quality, supportive conversation with their HCP, which outlined all material risks and benefits of all reasonable options, personalised to the individual’s own circumstances, and in language they can understand. It does not require a signed form, and having one offers no legal ‘magic’ that cannot be achieved by simply having the requisite conversation with the service user, and then documenting that conversation properly in the service user’s records. (To read more about what this conversation should look like, see our factsheet on consenting to treatment.)
- Where consent forms are used, this can actually undermine informed decision making, because:
- a. It may shift the focus away from having the types of supportive decision-making conversations described above, to instead prioritising getting a signature on a piece of paper.
- b. In time pressed scenarios, this can be even more problematic, as insisting on signing a pre-prepared, generalised form (and the related kerfuffle of logging into temperamental online systems or finding a working pen!) may entirely replace the personalised decision-making conversation. This approach is highly unlikely to satisfy the legal standard set out in Montgomery.
- c. It may introduce coercion into the decision-making process, which which would legally invalidate any consent subsequently given by the woman/birthing person, exposing the healthcare professional and trust to legal consequences.
Let’s consider a scenario where an otherwise ‘healthy, low risk’ woman who is predicted to have a large baby expresses an interest in homebirth. She is told that if she were to choose homebirth, this would be against all medical advice and she would need to sign a form purporting to discharge the hospital of all responsibility.
Terrified, she immediately ceases to ask about homebirth, and instead accepts the clinically recommended induction of labour on labour ward, without any conversation about the risks and benefits of induction, homebirth, or any reasonable alternative place or mode of birth.
Let’s then say that one of the (known, but undisclosed) risks of induction were to occur and she or her baby were to suffer harm as a result. In this type of situation, the trust’s inconsistent and coercive use of consent forms in some situations but not others may have actually created legal liability for the trust, rather than protected it.
Read our ‘End Coercion in Maternity Care in the UK’ Report