Does mum have the final say? New study reveals confusion in maternity care

(Medical Xpress)—A study from The University of Queensland has highlighted the tension doctors and midwives experience when supporting women's right to decide what happens to them and their babies.

The research, from UQ's Queensland Centre for Mothers & Babies (QCMB), found midwives and obstetricians supported the notion that a woman should have the final say about her care, but when a woman's decisions may put the foetus at risk, they were willing to override the woman's wishes.

QCMB director, and lead author of the study, Professor Sue Kruske said the research highlighted that the ideal of a woman's rights might not always reflect what happens in practice.

"Like all health care consumers, pregnant women have the right to make autonomous decisions about their medical care and this is enshrined in law," Professor Kruske said.

However, this right creates some confusion. particularly in situations when a woman's decision is perceived to lead to increased risk of harm to the foetus, even when there is lack of good evidence that this will occur.

"This is played out in a range of ways including health professionals not allowing women to birth in water or decline continuous electronic monitoring in labour. Women have even been told that if they want these things, they can have their babies elsewhere," said Professor Kruske.

Professor Kruske said there also appeared to be confusion between doctors and midwives about their legal responsibilities.

"Doctors believe themselves to be ultimately legally accountable for outcomes experienced in pregnancy and birth, despite the legal position that all health care professionals are responsible only for adverse outcomes caused by their own negligent actions," she said.

"This study is timely, showing that midwives and doctors may not be as aware as they should be of women's rights to make autonomous and fully informed decisions about their care.

"The findings of this study support the need for guidelines on decision-making in pregnancy and birth for maternity care professionals, and for recognition of interprofessional differences in beliefs around the rights of the woman, her foetus and health professionals in order to facilitate collaborative practice."

The study, titled Maternity care providers' perceptions of women's autonomy and the law, has been published in the journal BMC Pregnancy and Childbirth.