The history and purpose of informed consent are explored and its legal components are detailed. Recommendations are given to meet the criteria for informed decision-making at home, including discussion of unusual circumstances. The nature of assistance at childbirth, especially at home, is explored in relation to legal obligations. The article includes some observations on cultural dissonance regarding informed consent. Finally, the authors recommend a focus on a therapeutic alliance with the client as the best outcome of effective informed consent and as the second best preventive measure against malpractice, the first being competent care.