Principle-based medical ethics focuses on the four concepts of autonomy, beneficence, nonmaleficence and justice. Informed consent requires several elements: capacity of the patient to make a decision, freedom or voluntariness of the patient in decision-making, disclosure of adequate information to the patient, understanding of that information by the patient, and consent by the patient to the procedure. Ensuring that these elements have been addressed and obtaining consent for procedures in laboring patients can be extremely challenging. Every labor carries the risk of maternal-fetal conflicts. Cultural and religious beliefs may complicate care of the laboring patient and require consideration in managing ethical conflicts. When a laboring woman refuses critical intervention, all efforts should be made to inform her of the risks and benefits of refusal of treatment, including the use of interpreter services if needed to a conduct careful and complete discussion.