Obstet Gynecol. 2014 Mar;123(3):656-9. doi: 10.1097/AOG.0000000000000130.

Delivering the truth: challenges and opportunities for error disclosure in obstetrics.

Carranza L1, Lyerly AD, Lipira L, Prouty CD, Loren D, Gallagher TH.

Author information

• 1Department of Obstetrics and Gynecology, University of California, Los Angeles, Los Angeles, California; Social Medicine, Center for Bioethics, Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; and the Departments of General Internal Medicine, Neonatology, and Medicine, Bioethics & Humanities, University of Washington, Seattle, Washington.

Abstract

Disclosing harmful medical errors to patients is a prominent component of the patient safety movement. Patients expect it and safety agencies and experts advocate its implementation. Obstetrics presents unique challenges to carrying out disclosure recommendations: childbirth is a life-changing, emotionally charged, and dynamic family event characterized by high expectations and unpredictability, and perinatal care is provided by complex ad hoc teams in a litigious area of medicine. Despite these challenges, transparent communication with parents about unexpected adverse birth outcomes remains critical. We call on clinicians and professional societies to pursue a deeper understanding of the unique challenges of disclosure in obstetrics and prepare themselves to conduct these difficult conversations well.