ANN BEVERLY A.

REDUTA
BSN II-B
ETHICO-LEGAL ISSUES IN THE CARE OF MOTHER ON REPRODUCTIVE
TECHNIQUES
In Obstetric Practice

 There are obvious beneficence-based and autonomy based obligation to the pregnant
patient. While the health professional’s perspective on the pregnant woman’s interest
provides the basis of beneficence based obligations, her own perspective on those
interests provides the basis for autonomy-based obligations.
In Gynaecologic Practice

 Beneficence-based and autonomy-based clinical judgements in gynaecologic practice are

usually in harmony, like management of ruptured ectopic pregnancy. Sometimes they
may come into conflicts. In such situation, one should not override the other. Their
differences must be negotiated in clinical judgement and practice to determine which
management strategies protect and promote the patient’s interest.
In Contraception of the Teenage Girls

 Sometimes teenaged girls request for oral contraception. They are already in an active
sexual relationship. They do not want that their parents should know about them taking
contraceptives.

Ethical recommendations include:

1. We should assess whether the patient understand advice.

2. We should encourage the parent involvement.
3. We should take into account whether the patient is likely to sexual intercourse without
contraceptive treatment.
4. We should assess whether the physical, mental health would likely to suffer, if
contraceptive advice is not given.

In Antepartum Care

 Recently, pre-conceptional care is stressed more than only antenatal care, specially when
viewed in the context of its effect on pregnancy. History taking right from the age of the
patient with relevant complaints and relevant past and family history is very important.
Only history can be a clue for further diagnosis and management of many cases.
Avoidance of any relevant factors cause maternal and fetal hazards.

In Intrapartum Care
  Proper intrapartum management during labor is essential for a healthy child. In majority
of the mothers there is spontaneous onset of labor. Randomised controlled trial of EFM
and auscultation of fetal heart rate found that an increased incidence of caesarean
delivery and decreased neonatal seizures in the EFM group but no effect on cerebral
palsy or perinatal death. Newer methods like pulse oximeter or fetal electrocardiogram
analysis can prevent birth asphyxia and thereby minimize litigations.

In Instrumental delivery-forceps

 High forceps must be avoided; only low forceps can be indicated in special circumstances
to expedite the labor process. Ventouse must be avoided in premature baby and fetal
distress. Concerned personnel may be sued due to untoward effects like facial palsy or
visceral injury of mother and baby.

OBSERVATIONS

Poor quality of care at health facilities is a barrier to pregnant women and their families
accessing skilled care. Increasing access of pregnant women to skilled care during childbirth is a
key strategy for reducing maternal and early neonatal mortality and morbidity. To save women’s
live and improve maternal and new born health, women must see her doctor in hospital.
Following those health care provider’s advices and precautions will help the mother to have a
successful childbirth. And as a health care professionals, quality of care must including privacy,
health education and good communication be apply to have a better outcomes and to prevent any
complications during birth deliver.

ANALYSIS TO THE SITUATION

In maternity care, the completion of maternal observations refers to the measurement of

women’s temperature, heart rate, respiratory rate and blood pressure, during the antenatal,
intrapartum and postnatal period of maternity care. The failure to complete observations and
escalate action results in delays in intervention and increases the risk of maternal morbidity and
has been contributory factor in a number of avoidable deaths.

SUGGESTION AND REFLECTION

The most important thing women to learn while in labour is how to focus. I suggest that
prenatal yoga must be do during pregnancy, it is very helpful for the mother’s body to
strengthens, increases flexibility and gives you stamina but what is possibly even more helpful is
that it helps the mother’s mind to relax and focus. Proper food and exercises can help the mother
to have a successful birth delivery and can prevent the possible complications. At best, negative
thoughts make the labour stressful; at worst, they will actually intensify pain so changing
lifestyle during pregnancy can help the mother to be prepared and can help the baby to pass
through easily.