Achieving Shared Decision-Making In Women’s Health

The frustrating labor and delivery experience shared by physician and ethicist Carla Keirns in her Narrative Matters essay, “Watching The Clock: A Mother’s Hope For A Natural Birth In A Cesarean Culture,” published in the January issue of Health Affairs, was unfortunate. That is not debatable. That her outcome was favorable—a healthy baby ultimately delivered in the way that Keirns had hoped—does not excuse the less-than-ideal coordination, and communication, of care that she received.
Fortunately, Keirns had the tools at her disposal—such as medical training and solid relationships throughout the provider community—to help ensure that she was able to have the birth that she had planned. But few women have those tools. It is time for us to work harder to ensure that the voice of the mother is factored into the birth experience — both before labor and during delivery.
In obstetrics, there is a definite role for shared decision-making between physician and patient that respects and maintains patient autonomy. After all, there is no one-size-fits-all approach to labor and delivery. Women present with different medical needs and various preferences, and it is essential that obstetrician-gynecologists, as well as midwives and hospital nursing staff, respect a woman’s decisions while providing her with the right care at the right time. We believe that we can do a better job of doing both.
Of course, despite patient-centered planning, medical em...

Source: Health Affairs Blog - January 28, 2015 Category: Health Management Authors: John Jennings Tags: All Categories Health Care Delivery Narrative Matters Patient Safety Personal Experience Physicians Policy Quality Source Type: blogs