Informed Consent for Pelvic Floor Physiotherapists
Informed Consent for Pelvic Floor Physiotherapists
For pelvic floor physiotherapists, internal pelvic floor assessments are a routine yet sensitive aspect of care. These assessments provide invaluable insights into muscle function, tone, and dysfunction but require a heightened focus on informed consent due to their highly intimate nature. We discuss some tips on how to approach informed consent effectively in your practice to build trust, ensure compliance and safety for patient and therapist and enhance patient outcomes.
What Is Informed Consent?
Informed consent is a collaborative process where patients are educated about their treatment options, risks, benefits, and alternatives. It is not simply obtaining a signature on a form—it’s about ensuring patients understand the proposed internal pelvic floor assessment and feel empowered to make informed decisions about their care.
As Health Professionals we have both a Legal and Ethical Responsibility to correctly obtain informed consent correctly. Australian law places a duty on healthcare professionals to disclose all material risks and obtain informed consent before performing invasive procedures. As well as meeting the legal requirement we also have ethical responsibility to our clients when sugesting assessments or treatments and alternatives. Obtaining informed consent in an etihcal manner fosters a positive therapeutic relationship, helping patients feel respected and supported.
For internal pelvic floor assessments, informed consent involves:
Explanation: Detailing the purpose, process (including risks and alternatives), and what the patient can expect during the assessment.
Reassurance: Emphasising the patient’s right to decline or stop the procedure at any time without judgment.
Documentation: Accurately recording the conversation and patient’s agreement in their medical record.
How to Obtain Informed Consent for Internal Assessments
Set up the environment:
Provide a comfortable, private environment for the discussion. Ideally both therapist and patients are still seated at the consultation desk (not undressed on a treatment table) when this discussion taks place.
Use clear, non-technical language to explain what an internal pelvic floor assessment actually involves, its benefits, risks, alternatives and how the assessment contributes to their treatment plan (i.e. why it is being recommended).
Explain the Procedure in Detail:
Describe exactly what the assessment entails (e.g., insertion of a gloved, lubricated finger to assess muscle tone, strength, and function). Patients may not fully interpret what you mean when you simply say ‘an internal’.
Clarify and communicate the clinical rationale for the procedure, such as identifying areas of pain or weakness.
Address potential discomfort or side effects and how it will be minimised. It’s also critical prior to performing any assessment to clear any relevant precautions or contraindications, allergies or past experiences that might impact someone’s ability to undergo an assessment safely.
Encourage Questions and Concerns:
Invite and allow time for the patient to ask questions and express any hesitations.
Use open-ended questions like, "How do you feel about proceeding with this assessment?" to gauge their understanding and comfort level.
Offer Alternatives:
Explain and offer alternative assessment options (e.g., external palpation, biofeedback tools) if the patient is unsure or declines.
Document Thoroughly:
Record the consent discussion, including the patient’s questions and their agreement or refusal to proceed.
Use Ongoing Consent:
Treat consent as an ongoing process. Check in with the patient during the assessment, ensuring they remain comfortable and willing to proceed. Remind them they can stop at any time and how they may indicate to you that they wish to stop (e.g. raise a hand).
Conclusion
Informed consent is a cornerstone of safe, ethical, and patient-centred care in pelvic floor physiotherapy. It is not only a legal obligation but a critical opportunity to build trust and foster a positive therapeutic relationship.
By prioritising clear communication, respecting patient autonomy, and approaching assessments with sensitivity, you can ensure your patients feel respected, empowered, and supported throughout their care journey.
If you ever sense that a patient is unsure or consenting because they feel they "should" have the assessment, we recommend you pause and reconsider whether this is the right intervention for that point in time. Patient comfort and confidence should always guide your clinical decisions. Taking the time to listen, clarify, and adapt demonstrates not only professionalism but genuine care for the individual’s wellbeing.
Would you like templates or additional resources to enhance your consent processes? Stay tuned for more resources for you and our clinic on this topic!