Risks, Values, and Decision Making Surrounding Pregnancy

Assessing, communicating, and managing risk are among the most challenging tasks in the practice of medicine and are particularly difficult in the context of pregnancy. We analyze common scenarios in medical decision making around pregnancy, from reproductive health policy and clinical care to resea...

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Veröffentlicht in:Obstetrics and gynecology (New York. 1953) 2007-04, Vol.109 (4), p.979-984
Hauptverfasser: Lyerly, Anne Drapkin, Mitchell, Lisa M., Armstrong, Elizabeth M., Harris, Lisa H., Kukla, Rebecca, Kuppermann, Miriam, Little, Margaret Olivia
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container_end_page 984
container_issue 4
container_start_page 979
container_title Obstetrics and gynecology (New York. 1953)
container_volume 109
creator Lyerly, Anne Drapkin
Mitchell, Lisa M.
Armstrong, Elizabeth M.
Harris, Lisa H.
Kukla, Rebecca
Kuppermann, Miriam
Little, Margaret Olivia
description Assessing, communicating, and managing risk are among the most challenging tasks in the practice of medicine and are particularly difficult in the context of pregnancy. We analyze common scenarios in medical decision making around pregnancy, from reproductive health policy and clinical care to research protections. We describe three tendencies in these scenarios1) to consider the probabilities of undesirable outcomes alone, in isolation from women's values and social contexts, as determinative of individual clinical decisions and health policy; 2) to regard any risk to the fetus, including incremental risks that would in other contexts be regarded as acceptable, as trumping considerations that may be substantially more important to the wellbeing of the pregnant woman; and 3) to focus on the risks associated with undertaking medical interventions during pregnancy to the exclusion of demonstrable risks to both woman and fetus of failing to intervene. These tendencies in the perception, communication, and management of risk can lead to care that is neither evidence-based nor patient-centered, often to the detriment of both women and infants.
doi_str_mv 10.1097/01.AOG.0000258285.43499.4b
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source MEDLINE; Journals@Ovid Ovid Autoload
subjects Biological and medical sciences
Decision Making
Evidence-Based Medicine
Female
Gynecology. Andrology. Obstetrics
Health Policy
Humans
Medical sciences
Physician-Patient Relations
Pregnancy
Pregnancy Complications - prevention & control
Pregnancy Complications - therapy
Prenatal Diagnosis
Risk Assessment
Vaginal Birth after Cesarean
title Risks, Values, and Decision Making Surrounding Pregnancy
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