Informed consent for obstetrics management: a urogynecologic perspective

Obstetric management has been modified for conditions with acute, short-term consequences (i.e. breech presentation). It is timely to address those conditions related to the vaginal birth process which may have a delayed but significant negative impact on the mother's quality of life (i.e. urinary and fecal incontinence) but which may be reduced by selectively avoiding the vaginal birth process. The known possible consequences, and other associated risks and benefits, should be discussed with the pregnant patient and her spouse, in order to allow their input into the obstetric decision-making process and to individualize management. Urogynecologists are in a unique, no-conflict-of-interest position to further the acceptance of the concept of obstetrical informed consent. Cesarean delivery should not be seen as a failure of obstetric management, but rather as a safe and acceptable option to the vaginal delivery process, chosen after completing an informed decision-making process.