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Chapter 12 - Intrapartum Management

from Section 3 - Professionally Responsible Clinical Practice

Published online by Cambridge University Press:  01 November 2019

Laurence B. McCullough
Affiliation:
Donald and Barbara Zucker School of Medicine at Hofstra/Northwell
John H. Coverdale
Affiliation:
Baylor College of Medicine, Texas
Frank A. Chervenak
Affiliation:
Donald and Barbara Zucker School of Medicine at Hofstra/Northwell
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Summary

This chapter provides an ethical framework to guide decision making about intrapartum management.

Most women deliver their babies vaginally. Vaginal delivery is clearly safer for the pregnant patient because no invasive clinical management is involved, even when fetal monitoring takes place. This clinical reality makes assisting vaginal delivery the default in clinical judgment, placing the burden of proof on justifying cesarean delivery. As a consequence, in traditional obstetric thinking, cesarean delivery is either indicated – the burden of proof is met – or nonindicated – the burden of proof is not met. When cesarean delivery is indicated, it should be recommended. When cesarean delivery is not indicated, it should not be offered, much less recommended.

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Chapter
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Publisher: Cambridge University Press
Print publication year: 2019

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