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  • Print publication year: 2005
  • Online publication date: August 2009

13 - The management of pregnancy and labour

Summary

Introduction

Medicine's increased capacities make intervention at all stages of pregnancy and labour both more common and more successful. The capacity to see the developing fetus in the womb and the skills of healthcare professionals around the moment of birth, when coupled with the sophistication of their knowledge about fetal development, genetics and safe delivery, also enhance the professionals' perceived responsibility to the child-to-be as well as to the mother.

Generally speaking this is likely to be both uncontroversial and welcome. Most pregnant women (and their partners) are likely to view the progress in prenatal screening and managed childbirth as being a definite bonus, increasing their reproductive liberties and maximising the safety of pregnancy and childbirth. Undoubtedly, in the vast majority of cases this will be the experience of women and their partners. However, this is not to say that the modern management of pregnancy is entirely uncontroversial, and – perhaps unfortunately – it is necessary to consider such controversy in this chapter. These controversies are often intimately linked to the primary focus of this chapter; namely issues surrounding consent and negligence.

Consent

It is widely accepted that – except in limited circumstances – consent is a prerequisite of both an ethical and a legal intervention. In an emergency situation where consent cannot be sought because of the patient's lack of consciousness, treatment may proceed without the patient's consent.

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