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Medical Care Law

Chapter 14 - Obstetrics

Highlights

Obstetrics is legally risky because of potential conflicts between the mother and baby.

Genetic counseling is legally complex.

Birth injury litigation can be greatly reduced with structured obstetrics records.

A birth plan can reduce legal conflicts.

Drug use and alcoholism put obstetric patients and health care practitioners in conflict.

Introduction

Genetic Counseling

Medical Risks

Screening for Neural Tube Defects as a Model

MSAFP and Down Syndrome

The Genetic History

Information about Specific Diseases

Patient Characteristics

Risks of the Diagnostic Procedures

Reliability of Testing

Time Limitations

Social Considerations

Am I the Baby's Father?

Can I Have a Healthy Baby with Someone Else?

Should We Get Married?

Should We Get Divorced?

What Should I Tell My Family?

Recordkeeping for Genetic Counseling

Fertility Treatment

Patient Privacy

Fitness

Medical Fitness

Psychiatric Problems

Prospects for Successful Treatment

Dealing with Multiple Gestation

Artificial Insemination

Consent

Choosing a Donor

The Husband as Donor

Related Donors

Unrelated Donors

Genetic Disease

Infection Control

Unmarried Couples

A Structured Approach To Obstetric Care

Zero-Defects Management

Legal and Ethical Benefits of Structured Care

Thinking Like a Plaintiff's Attorney

The Birth Plan

Purpose of a Birth Plan

Contraindications

Authority To Consent

Participation of Others

Risk-Benefit Analysis

The Patient's Interests

Risks to the Baby

Emergencies

Availability of Facilities and Personnel

Custom versus Fashion

Evaluating The Mother's Medical Condition

Maternal Disease

Legally Mandated Testing

Medical Interventions

Past-Term Pregnancies

Cesarean Sections

Home Deliveries

The Politics of Home Deliveries

Participating in Home Deliveries

Working With Midwives

Classes of Midwives

Referrals and Consultations

Behavioral Risks In Pregnancy

The American Medical Association Policy Statement22

Implications of the AMA Policy

Consent in High-Risk Pregnancies

The Self-Destructive Pregnant Woman

Obstetrics Risk Management

Preconception versus Postconception Remedies

Patients' Views about Abortion

Creating Unreasonable Expectations

The Birth-Injured Infant

References

Suggested Readings

Fertility Treatment

Genetic Counseling

General Obstetrics

 

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