Should we inform women about the recognised risks of childbirth?

Autor: Jean Wong, Hugh L. Giddings, Alan P. Meagher
Rok vydání: 2021
Předmět:
Zdroj: Australian and New Zealand Journal of Obstetrics and Gynaecology. 62:37-39
ISSN: 1479-828X
0004-8666
DOI: 10.1111/ajo.13411
Popis: BACKGROUND At present in Australia women are not routinely, systematically informed of the risks of childbirth. AIMS It is hoped this presentation of the perspective of some women who suffer unexpected obstetric complications will encourage change. MATERIALS AND METHODS The experience of women involved in obstetric medicolegal reports prepared by a colorectal surgeon over ten years is analysed. RESULTS Twenty women were identified. Sixteen had vaginal deliveries. All 16 suffered third or fourth-degree tears, six developed rectovaginal fistulae, six required stomas and 11 developed faecal incontinence. Of the four women who delivered by caesarean section, there were two post-operative caecal perforations, one unrecognised small bowel enterotomy, and one patient developed sepsis due to an infected haematoma. Seventeen of the 20 women were noted to suffer psychological sequalae. None of the women recollected being warned of the complication they suffered, and there was no record of such warnings in their medical records. CONCLUSION Informed written 'consent' for natural vaginal delivery is, understandably, a contentious topic. Although learning from medicolegal cases may go against the grain, as medical professionals it is very difficult to ethically justify the status quo, where women are not routinely simply informed of the risks of childbirth. This is not fair. Even if informing women does not decrease the incidence of complications, the women who subsequently suffer these complications may well handle them much better, recognising they could occur.
Databáze: OpenAIRE