Informed consent to breech birth in New Zealand

Powell, R. L., Walker, S. & Barrett, A. (2015). Informed consent to breech birth in New Zealand. New Zealand Medical Journal, 128(1418), pp. 85-92.

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Abstract

Summary: When managing a breech pregnancy (with baby’s head at the top of the uterus), New Zealand maternity care providers have legal duties to provide full and unbiased information about risks and benefits of all options, including a planned vaginal breech birth. Information should be presented in a balanced and accessible way and not limited to the maternity care provider’s personal preferences. Women have legal rights to make an informed choice, to give or refuse consent, to a second opinion and to co-operation among providers. Clinical policies should include appropriate and non-coercive care for women who choose to birth their breech-presenting baby vaginally and consideration should be given to any institutional reforms or educational priorities needed to achieve this.

Abstract: The authors note significant room for improvement in facilitating informed consent in the management of breech presentation. New Zealand maternity care providers, including midwives, general practitioners and specialist obstetricians, have legal duties to provide full and unbiased information about risks and benefits of all relevant treatment options. In the case of breech presentation, such options include the interventions of external cephalic version or planned caesarean section, as well as the option to decline intervention and proceed with a planned vaginal breech birth. Information should be presented in a balanced and accessible way and not limited to the provider’s personal preferences. Women have legal rights to make an informed choice, to give or refuse consent, to a second opinion and to co-operation among providers. The right of competent persons to refuse medical treatment, including the right to refuse caesarean section, is well established. Clinical policies therefore should include appropriate and non-coercive care for women who choose to birth their breech-presenting baby vaginally, compliance with such policies should be the norm, and consideration should be given to any institutional reforms or educational priorities needed to achieve this.

Item Type: Article
Subjects: R Medicine > RG Gynecology and obstetrics
R Medicine > RJ Pediatrics > RJ101 Child Health. Child health services
Divisions: School of Health Sciences > Department of Child Health & Children's Nursing
URI: http://openaccess.city.ac.uk/id/eprint/12320

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