We need to treat pregnant women as adults Women should be consented for an attempt at normal vaginal birth as for operative delivery, with risks and potential complications explained

摘要

Since the mid-90s, Australian law has required doctors to disclose material risks of proposed treatment. Medical practitioners have had two decades to adapt, and, by and large, patient autonomy is acknowledged and respected by obtaining 'informed consent'. While problems with obtaining consent do surface in medico-legal litigation, practitioners are generally aware of the need to do so and usually comply with requirements. However, not in obstetrics. Here, even if material risk of a serious adverse event in an attempt at vaginal birth in a given case is over 50% (as it would be in the case of a 35-year-old primigravida at 41 + 3) obtaining informed consent is the exception rather than the rule. This degree of paternalism is not just unethical and immoral. It is illegal - and it needs to change.