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Women Refusing Standard Obstetric Care: Maternal Fetal Conflict or Doctorpatient Conflict?
Martine Hollander*, Jeroen van Dillen, Toine Lagro-Janssen, Evert van Leeuwen, Wilma Duijst and Frank VandenbusscheRadboud University Nijmegen Medical Centre, Nijmegen, Netherlands
- Corresponding Author:
- Martine Hollander
Radboud University Nijmegen Medical Centre
Nijmegen, Netherlands
Tel: 31612858004
E-mail: martine_hollander@hotmail.com
Received April 26, 2016; Accepted April 28, 2016; Published April 30, 2016
Citation: Hollander M, Dillen JV, Janssen TL, Leeuwen EV, Duijst W, et al. (2016) Women Refusing Standard Obstetric Care: Maternal Fetal Conflict or Doctor-patient Conflict? J Preg Child Health 3:251. doi:10.4172/2376-127X.1000251
Copyright: © 2016 Hollander M, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Abstract
Evidence based guidelines can help healthcare practitioners to provide better and more cost effective care for the average patient with a specific medical problem [1]. During the past 15 years, the Cochrane Collaboration, NICE, and many other national and international organizations have provided obstetric medicine with a wealth of new evidence based guidelines. However, more protocolized care also means less room for personalized medicine. Not all patients have the same perception of risk as medical staff [2] and some attach more importance to avoiding a certain intervention (for instance caesarean section) than to incurring a small increase in risk of perinatal morbidity or mortality. One of the consequences of the plethora of protocols in obstetric medicine could be a real or perceived increase in the number of patients who wish to go outside the standard of care. No quantitative surveys on this subject have been done to date, so exact numbers are not available. Much is still unclear among professionals about the rights of a pregnant woman, those of her fetus, and the legal position of a healthcare provider who is willing to assist a woman who wants to give birth outside the standard protocol. The debate is as yet unresolved whether the law can or indeed should intervene in situations where the woman’s decision seems to put the fetus’s life at risk. This is often described by obstetricians as a maternal-fetal conflict. In this paper we will provide some insight into the legal and ethical context surrounding women’s rights in childbirth and the issues mentioned above. We will also review some professional organizations’ statements on these issues. Legal measures against pregnant women in literature.
