When you walk through the doors of a maternity unit in labour, you do not leave your right to make decisions about your body at the door.
Being pregnant does not remove your bodily autonomy. Being in labour does not automatically give your healthcare team permission to examine you or perform procedures on you. Interventions described as “routine”, “recommended” or “hospital policy” do not mean that you have to agree.
A significant Australian court case in 2026 brought this distinction sharply into focus. In Gawthrop v Bendigo Health (2026) the Supreme Court of Victoria considered the experience of Larissa Gawthrop during the birth of her first child.
During pregnancy, Gawthrop had prepared a detailed birth plan. She made clear that she declined vaginal examinations unless there was an urgent medical reason and that her informed verbal consent would be required.When she attended hospital in labour in November 2020, a vaginal examination was requested by her health care team, she declined. There was no urgent medical reason for the examination at that stage.
Over approximately two hours, while she was labouring, in pain and becoming increasingly distressed, she was placed in a situation where admission to the ward, access to pain relief and contacting her midwife were tied to her having a vaginal examination, eventually, she agreed to the procedure.
But the important question for the Court was whether that agreement represented free and voluntary consent, the Court concluded that it did not. The circumstances had placed Gawthrop under such pressure that she was not freely and voluntarily consenting when the examination was performed. Her claim of assault and battery was therefore accepted. Bendigo Health was also found negligent.
The Court assessed general damages at $275,000 AUD, with a further $5,288.55 AUD in agreed special damages. This case provides a powerful contemporary illustration of a principle that is highly relevant to maternity care everywhere; submission is not the same as freely given consent.
Consent still matters during labour.
For women giving birth in the UK, this is not simply about having a positive birth experience. Consent is a fundamental legal and ethical principle of healthcare.
Understanding your options before labour begins can also make a real difference. When you are well informed about birth, common interventions and the choices that may arise, you are better prepared to ask questions and participate in decisions about your care.
Birth cannot always be planned, but you can prepare to make informed decisions that are right for you.
What is informed consent?
Informed consent is much more than somebody asking, “Is that okay?” immediately before carrying out an examination or procedure. For consent to be valid, it needs to be voluntary and informed, and the person making the decision must have the capacity to do so.
In practical terms, you should be given enough information to understand:
what is being recommended and why.
what the examination, treatment or intervention involves.
the potential benefits and risks.
what alternatives are available.
whether doing nothing or waiting is an option.
what may happen if you decide not to proceed.
Most importantly, the decision needs to be yours.
The NHS describes valid consent as voluntary, informed and given by a person with capacity. It also makes clear that a decision should not be the result of pressure from medical staff, friends or family.
The General Medical Council (GMC) describes decision making and consent as an ongoing process based on meaningful dialogue. Information, time and support should be provided so informed decisions can be made about care.
Being informed before labour begins matters
One of the best ways to support informed decision making during labour is to begin preparation before labour starts. Birth can be intense, emotional and unpredictable. When you are experiencing labour, tiredness, pain or anxiety, it may be much harder to take in new information, understand unfamiliar terminology, weigh up different options and decide how you feel about them. That’s why good birth preparation isn't simply about learning breathing techniques, packing your hospital bag or understanding the stages of labour. It’s also about understanding your choices.
NICE (National Institute for Health and Care Excellence) recommends discussing preferences and choices for labour and birth as early as possible during pregnancy. NICE specifically recognises that making and recording choices in advance gives women more time to think about their options, while also emphasising that they remain free to change their minds, including during labour and birth.
Understanding why interventions might be recommended, their potential benefits and risks, and the possible alternatives means that you are not necessarily hearing about them for the first time while trying to navigate your labour.
Being prepared isn't about controlling birth. It is about being better equipped to participate in the decisions that arise.
When you understand the language being used and have already considered what matters to you, you may find it easier to ask questions, understand the answers and consider how a recommendation fits with your circumstances and preferences.
Ultimately, the purpose of good birth education should not be to tell you which choices to make. It should help you understand your options so that you can make decisions that feel right for you. For one person, an informed decision may be to decline an intervention. For another, presented with the same options, the right decision may be to accept it, both can represent informed choice. You may not be able to plan exactly how your labour will unfold, but you can prepare to be part of the decisions along the way.
Consent to one examination isn't consent to every examination
Consent is an ongoing process. If you consented to a prodedure earlier in labour, that does not automatically mean you have consented to another one later, the circumstances may have changed, you may have changed your mind. You might feel comfortable being examined by one healthcare professional but not another. You might decide that you don't want further interventions unless there is a particular clinical concern. Each proposed examination should involve appropriate communication and consent.
You can say “Stop!” at anytime.
Consent can also be withdrawn. If a procedure has started and you want it to stop, you can say so, you do not have to wait until it has finished simply because you initially agreed.
Does being in labour affect your ability to consent?
Labour can be physically and emotionally intense. You may be feeling exhausted, anxious, experiencing pain or trying to process a lot of information very quickly. Your healthcare team should take the circumstances into account when communicating with you. Being in labour does not automatically mean that you lack the capacity to make decisions. You are allowed to make a choice about your body.
What if my healthcare professional thinks my decision is unsafe?
This can be one of the most difficult situations during labour. A midwife or doctor may genuinely believe that an examination, monitoring method or intervention is important for your safety or your baby's safety. They need to explain those concerns clearly. They can tell you what they are worried about, they can explain the potential consequences, they can discuss alternatives. However, there is an important distinction between giving somebody the information they need to make a decision and pressuring somebody until they give the desired answer. Where an adult has capacity to make a voluntary and informed decision, the NHS states that the decision to consent to or refuse treatment must be respected.
What about the baby's safety?
This can understandably be an emotional subject. During pregnancy and labour, conversations about consent are sometimes framed around what is “best for baby”. Of course your baby's wellbeing matters, however, concern for your baby does not mean that your own bodily autonomy simply disappears.
NHS guidance on consent makes a particularly important point: if an adult has capacity to make a voluntary and informed decision to consent to or refuse treatment, that decision must be respected, even if refusing treatment could result in serious consequences, including death, for the woman or her unborn baby.
This does not prevent clinicians from explaining why they are concerned or strongly recommending a particular course of action. It means that informed decision-making remains important even when the conversation is difficult.
“It's hospital policy”
You may sometimes hear phrases such as: “It's hospital policy”, “This is what we normally do,” “Our policy is to examine every four hours.” Hospitals need policies and clinical guidelines, they are important tools for supporting consistent and safe care. However, a policy does not, by itself, provide consent for something to be done to your body.
The Gawthrop case is particularly thought provoking in this respect because hospital procedures and staff understanding of policy played a significant role in the circumstances surrounding the examination. Policies can guide healthcare professionals, they do not replace the need for valid consent.
Your body remains yours during birth
Being pregnant or being in labour does not automatically remove your ability to participate in decisions about your care. The 2026 Australian case of Gawthrop v Bendigo Health provides a powerful reminder of what can happen when the distinction between genuine consent and reluctant submission is lost. But informed consent shouldn't begin when you arrive at hospital in labour, it starts with education, conversations and preparation during pregnancy. Learn about birth, learn about your options, ask questions, talk about what matters to you.
You cannot know exactly how your birth will unfold, and you do not need to make every decision in advance. Being well informed and prepared simply means that, when choices arise, you are better equipped to understand them and make decisions that are right for you.
Respectful maternity care is not only about what care is provided, it’s also about how that care is provided. You are not simply the person birth is happening to, you are the person decisions should be made with.
References and further reading
Gawthrop v Bendigo Health [2026] VSC 157, Supreme Court of Victoria, 27 March 2026. The Court found that the vaginal examination at issue was performed without free and voluntary consent and accepted the plaintiff's assault and battery claim. Bendigo Health was also found negligent. General damages were assessed at $275,000 AUD, with agreed special damages of $5,288.55 AUD.
National Institute for Health and Care Excellence (NICE).Intrapartum care, NG235. See particularly recommendations 1.1.3, 1.4.10 and 1.8.9 concerning antenatal discussion of birth choices, women's involvement in decision-making, and informed consent for vaginal examinations.
General Medical Council (GMC).Decision making and consent. Guidance on shared decision-making, informed consent, individualised discussion of benefits, harms and reasonable alternatives, and capacity.
NHS.Consent to treatment. Guidance explaining the requirements for valid consent, including that it should be voluntary and informed and given by a person with capacity.
Montgomery v Lanarkshire Health Board [2015] UKSC 11. UK Supreme Court judgment concerning disclosure of material risks and reasonable alternative or variant treatments.
Online resources
NICE — Intrapartum care: recommendations
GMC — Decision making and consent
Montgomery v Lanarkshire Health Board [2015] UKSC 11 — BAILII judgment
Birthrights — UK commentary on Gawthrop v Bendigo Health
This article is intended to provide general education and information about informed consent and maternity care and does not constitute individual medical or legal advice. The legal position may depend upon individual circumstances and the relevant UK jurisdiction. Gawthrop v Bendigo Health is an Australian decision and is discussed as an illustration of issues surrounding consent; it is not binding authority in the United Kingdom. If you have questions about your individual maternity care, discuss them with an appropriately qualified healthcare professional. If you require advice about your legal rights or a particular experience of maternity care, consider obtaining independent legal advice.