BACKGROUND:
The theoretical and ethical framework for obstetric practices during childbirth. Yet studies, particularly those into obstetric violence, show that acts are performed on women's bodies without their consent. Beyond this simple observation, we need to understand why women's autonomy through informed consent is not a priority standard.

OBJECTIVES:
Understanding the barriers to informed consent in obstetrics to better explore the persistence of obstetric violence and negative birth experiences.

METHODS:
Using a phenomenological approach, we conducted 32 semi-structured interviews with obstetricians and midwives and performed 30 days of participant observation in maternity wards. Data were analyzed thematically using NVivo software.

RESULTS:
Four major barriers to informed consent were identified: (1) A complex caregiver-patient relationship shaped by power dynamics and time constraints; (2) Ethical distress among professionals due to institutional pressures and clinical workload; (3) A prevailing "safety-first" paradigm prioritizing fetal outcomes, often at the expense of shared decision-making ; (4) Informed Consent in childbirth as a Source of Tension

CONCLUSIONS:
Healthcare professionals described informed consent in obstetrics as an "idealized" concept, difficult to implement in practice due to time constraints, institutional norms, and medico-legal concerns. Many reported ethical distress when unable to engage in shared decision-making, highlighting the tension between professional duty, patient autonomy, and systemic constraints.

KEY MESSAGE:
The conditions for informed and free consent were not operational in ou study. Ensuring meaningful informed consent in childbirth requires structural changes, including improved communication training, ethical support for caregivers, and institutional reforms promoting a patient-centered approach. Addressing these challenges is crucial to improving maternal experiences and professional well-being in obstetric care. French - equity & breastfeeding (including three-minute presentation competition)