[Jehovah's witness patients in obstetrics : challenges and strategies]

The refusal of blood transfusions by Jehovah's Witness patients is a major challenge in obstetrics. Although transfusions are rare (1.4 % in obstetrics), the lack of blood transfusions during severe hemorrhage significantly increases the risk of maternal death. This article analyzes the shift in the ethical paradigm in Switzerland, marked by the transition from paternalism to respect for the self-determination of the competent patient. It details blood management strategies (PBM), ranging from antenatal hemoglobin optimization to early surgical hemostasis. Multidisciplinary planning and the formalization of an individualized care plan remain the cornerstones of care that respects both values and medical safety.