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Risk-Benefit Analysis

Although it is the patient who must consent to medical intervention, it is the physician who must provide the information necessary to make the decisions. Risk-benefit analysis in obstetrics is complicated because there are two patients and many social factors involved. The starting point for risk analysis in pregnancy is the risks of pregnancy itself. A woman must be warned that women die in childbirth, that 6 percent of children have some congenital abnormality, that things may happen in her pregnancy that will adversely affect the baby, and that some babies are inadvertently injured during birth. The woman must be warned about geographic risks such as high altitude and the limitation of local birth and emergency facilities.

The purpose of this background information is to establish the baseline risks of pregnancy. Understanding these risks is necessary to understanding the risks and benefits of various medical interventions. This is especially important for women who have been exposed to misinformation about the birth process. Some women believe that modern medicine is a conspiracy to subjugate women. While obstetric care could be made much more responsive to the needs of pregnant women, dispensing with medical attendance is not a proper response to this problem.

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