Jacques et al.: Episiotomy Without Consent (IJGO, 2025)
60-75% of episiotomy recipients never asked for consent
60.2% of women receiving episiotomy in France: the clinician did not ask consent. In the US (ICEA data), 75% of women with episiotomies reported having no choice.
Episiotomy is a surgical cut to the perineum during the second stage of labor. It is one of the more common procedures performed without explicit consent. The Jacques team studied this directly in France and found that 60.2 percent of women who received an episiotomy reported that the clinician did not ask for consent before making the cut.
US data from ICEA, the International Childbirth Education Association, puts the equivalent number at 75 percent. Episiotomy has been associated with longer healing time, higher rates of severe tearing, increased postpartum pain, and sexual dysfunction lasting months to years. ACOG and WHO both recommend against routine use, advising the procedure only for specific indications.
60.2%
France, no consent asked
75%
US, no choice given
Not routine
WHO and ACOG position
Why it matters
An incision through the perineum is a surgery. When it is performed on most patients without consent, the rule that surgery requires consent is being treated as optional in the birth setting.
This is one finding from the research library behind How to Birth a Mother. Everything here traces back to a study, a dataset, or a systematic review.