| Obstetric ethics: an essential dimension of planned home birth. | |
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MedLine Citation:
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PMID: 21508761 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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The American College of Obstetricians and Gynecologists (the College) Committee Opinion, "Planned Home Birth," invokes two core concepts of obstetric ethics, the right of a woman to make a medically informed decision about delivery and the informed consent process. We set out a framework for obstetric ethics that empowers the autonomy of pregnant women by focusing on when, in beneficence-based clinical judgment, clinical management should be offered, should be recommended, and should be recommended against in the informed consent process. Using this ethical framework, we show that the College statement does not provide adequate guidance to obstetricians in fulfilling their ethical obligations in the informed consent process with pregnant women who express an interest in, or preference for planned home birth. Obstetricians have an ethical obligation to disclose the increased risks of perinatal and neonatal mortality and morbidity from planned home birth in the context of American healthcare and should recommend against it. Obstetricians should recommend hospital-based delivery and respond to refusal of these recommendations with respectful persuasion. As a matter of beneficence-based professional integrity, obstetricians should not participate in planned home birth. At the same time, obstetricians have a beneficence-based obligation to continue to provide prenatal and emergency obstetric care. The obstetric profession should continuously strive to make hospital births more humane and support home-birth-like environments in the hospital as well as continuously improve safety for both pregnant and fetal patients. |
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Authors:
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Frank A Chervenak; Laurence B McCullough; Birgit Arabin |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Obstetrics and gynecology Volume: 117 ISSN: 1873-233X ISO Abbreviation: Obstet Gynecol Publication Date: 2011 May |
Date Detail:
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Created Date: 2011-04-21 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0401101 Medline TA: Obstet Gynecol Country: United States |
Other Details:
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Languages: eng Pagination: 1183-7 Citation Subset: AIM; IM |
Affiliation:
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From the Department of Obstetrics and Gynecology, Weill Medical College of Cornell University, New York, New York; the Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, Texas; and the Center for Mother and Child, Marburg University Hospital, Marburg, Germany. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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