All Pregnant Women Should Know This

The following information was obtained on the World Wide Web on the Medical and Public Health Law Site and The Law and the Physician Homepage:

Authority to Consent
Except for certain fertility treatments, the patient has sole authority to make the decisions about her care.  Paternalism in obstetric care is legally dangerous.  An obstetrician who tells a patient not to worry because everything will be fine is making a guarantee on the outcome of a pregnancy with almost no ability to influence that outcome.  Consent is a simple problem made complicated by misinformation.  A pregnant woman is the only person who may consent to her medical care.  This is always true for adults, and in most states, a pregnant minor has the right to consent to her medical care.  Husbands, lovers, prospective grandparents, prospective adoptive parents, or adoption agencies do not have a right to consent to, or interfere in, the medical care of the pregnant woman.  Any discussion of the woman’s medical care with such third parties is a violation of the patient’s rights unless she has given her explicit permission.

Participation of Others
While the pregnant woman has the right to exclude all third parties from consultation about her medical care, most women want to involve other persons in their decisions.  The birth plan should include the names of any persons the patient designates to receive information about her pregnancy.  The patient may also want to sign a durable power of attorney to delegate the right to consent to care to a third party if she becomes medically incompetent to consent to her own care.  If the patient wants her husband or other person in the delivery room, this should be stated in the birth plan.  The plan should discuss any restrictions on the presence of this third person (special training, a hospital orientation tour, etc.) and under what circumstances the person will be excluded.  It is recommended that the husband or other person mentioned in the plan also be requested to read and sign the relevant portions of the plan.

Purpose of a Birth Plan
The birth plan serves three purposes.  First, it structures the discussion between the physician and the patient.  This ensures that all important issues are addressed with each patient.  Second, it provides a framework for resolving inconsistencies between the patient’s expectations and the risks of her particular pregnancy.  Finally, it serves as documentation of the agreement between the physician and the patient.  This will obviate questions about the information given the patient and any promises by the physician as to the management of the delivery.  Legally most important, it will document the risks of pregnancy and the specific risks attendant on the delivery strategy chosen by the patient.  This will not relieve the physician of liability for negligence.  However, it will bolster the physician’s claim that certain injuries were foreseeable risks of pregnancy and not iatrogenic birth injuries.

~ by cmb0414 on July 21, 2010.

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