Patient consent for obstetric analgesia and anesthesia involves several confounding issues in addition to the basic elements of consent. These include capacity during active labor, maternal-fetal conflict, and the care of pregnant minors. In this review, we focus on these unique consent issues. Despite pain and anxiety, women maintain the capacity to understand and recall information imparted during labor. Anesthesia providers generally disclose high-frequency and high-morbidity side effects and complications. The use of written materials and early antenatal education may improve retention of information and maternal satisfaction. Successful navigation of the consent process requires knowledge of the guidelines and laws that govern each provider's individual jurisdiction.