Refusal of recommended maternity care: Time to make a pact with women?

Jenkinson, B; Kruske, S; Kildea, S

Refusal of recommended maternity care: Time to make a pact with women?

Jenkinson, B Kruske, S

Kildea, S

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Publication Type:: Journal Article
Citation:: Women and Birth, 2018, 31 (6), pp. 433 - 441
Issue Date:: 2018-12-01

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Field	Value	Language
dc.contributor.author	Jenkinson, B	en_US
dc.contributor.author	Kruske, S https://orcid.org/0000-0002-2317-3954	en_US
dc.contributor.author	Kildea, S	en_US
dc.date.available	2018-03-20	en_US
dc.date.issued	2018-12-01	en_US
dc.identifier.citation	Women and Birth, 2018, 31 (6), pp. 433 - 441	en_US
dc.identifier.issn	1871-5192	en_US
dc.identifier.uri	http://hdl.handle.net/10453/129749
dc.description.abstract	© 2018 Background: The right to refuse medical treatment can be contentious in maternity care. Professional guidance for midwives and obstetricians emphasises informed consent and respect for patient autonomy, but there is little guidance available to clinicians about the appropriate clinical responses when women decline recommended care. Objectives: We propose a comprehensive, woman-centred, systems-level framework for documentation and communication with the goal of supporting women, clinicians and health services in situations of maternal refusal. We term this the Personalised Alternative Care and Treatment framework. Discussion: The Personalised Alternative Care and Treatment framework addresses Australian policy, practice, education and professional issues to underpin woman-centred care in the context of maternal refusal. It embeds Respectful Maternity Care in system-level maternity care policy; highlights the woman's role as decision maker about her maternity care; documents information exchanged with women; creates a ‘living’ plan that respects the woman's birth intentions and can be reviewed as circumstances change; enables communication between clinicians; permits flexible initiation pathways; provides for professional education for clinicians, and incorporates a mediation role to act as a failsafe. Conclusion: The Personalised Alternative Care and Treatment framework has the potential to meet the needs of women, clinicians and health services when pregnant women decline recommended maternity care.	en_US
dc.relation.ispartof	Women and Birth	en_US
dc.relation.isbasedon	10.1016/j.wombi.2018.03.006	en_US
dc.subject.classification	Obstetrics & Reproductive Medicine	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Communication	en_US
dc.subject.mesh	Treatment Refusal	en_US
dc.subject.mesh	Decision Making	en_US
dc.subject.mesh	Personal Autonomy	en_US
dc.subject.mesh	Obstetrics	en_US
dc.subject.mesh	Pregnancy	en_US
dc.subject.mesh	Parturition	en_US
dc.subject.mesh	Informed Consent	en_US
dc.subject.mesh	Nurse Midwives	en_US
dc.subject.mesh	Physicians	en_US
dc.subject.mesh	Pregnant Women	en_US
dc.subject.mesh	Maternal Health Services	en_US
dc.subject.mesh	Professional Autonomy	en_US
dc.subject.mesh	Australia	en_US
dc.subject.mesh	Female	en_US
dc.subject.mesh	Practice Guidelines as Topic	en_US
dc.title	Refusal of recommended maternity care: Time to make a pact with women?	en_US
dc.type	Journal Article
utslib.citation.volume	6	en_US
utslib.citation.volume	31	en_US
utslib.for	1114 Paediatrics and Reproductive Medicine	en_US
utslib.for	11 Medical and Health Sciences	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
utslib.copyright.status	closed_access
pubs.issue	6	en_US
pubs.publication-status	Published	en_US
pubs.volume	31	en_US

Abstract:

© 2018 Background: The right to refuse medical treatment can be contentious in maternity care. Professional guidance for midwives and obstetricians emphasises informed consent and respect for patient autonomy, but there is little guidance available to clinicians about the appropriate clinical responses when women decline recommended care. Objectives: We propose a comprehensive, woman-centred, systems-level framework for documentation and communication with the goal of supporting women, clinicians and health services in situations of maternal refusal. We term this the Personalised Alternative Care and Treatment framework. Discussion: The Personalised Alternative Care and Treatment framework addresses Australian policy, practice, education and professional issues to underpin woman-centred care in the context of maternal refusal. It embeds Respectful Maternity Care in system-level maternity care policy; highlights the woman's role as decision maker about her maternity care; documents information exchanged with women; creates a ‘living’ plan that respects the woman's birth intentions and can be reviewed as circumstances change; enables communication between clinicians; permits flexible initiation pathways; provides for professional education for clinicians, and incorporates a mediation role to act as a failsafe. Conclusion: The Personalised Alternative Care and Treatment framework has the potential to meet the needs of women, clinicians and health services when pregnant women decline recommended maternity care.

Please use this identifier to cite or link to this item:

http://hdl.handle.net/10453/129749