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Ethical Implications of Obstetric Care in Hungary: Results from the Mother-Centred Pregnancy Care Survey

By Váczi Imre
Ethical Implications of Obstetric Care in Hungary: Results from the Mother-Centred 
Pregnancy Care Survey 
Imre SZEBIK Contact / Kontakt / Kapcsolat, Éva SUSÁNSZKY, Zsuzsa SZÁNTÓ, Anna SUSÁNSZKY & Nicholas Rubashkin
EJMH Vol 13 Issue 1 (2018) 51–69; https://doi.org/10.5708/EJMH.13.2018.1.5
Received: 22 February 2018; accepted: 1 March 2018; online date: 13 June 2018
Section: Research Papers
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Abstract

Background: Informed consent plays an important role in clinical decision making. It is a basis of self determination in health care. In ideal situations health care professionals inform their patients about all relevant aspects of care and alternative care options, map the value system of the patients, and adjust the information process accordingly. Objectives: Our objective was to see the frequency of selected interventions (birth induction, caesarean section, episiotomy, forced supinal position during birth, and the consent process associated to these interventions. Methods: 1,257 women (with childbearing capacity) between the age of 18 and 45 with children under the age of 5 were surveyed online. Results: Caesarian section was done without permission in 10.2% of women. Labour was inducted in 22.2% of all deliveries and it was done without permission in 25.4% . Episiotomy was done in 39.9% of women having vaginal delivery in the Sample 2 group and in 72.2% of women having vaginal delivery in the Sample 1 (representative) group. Women undergoing episiotomy were not asked for consent in 62.0% in the Sample 1 group and in 57.1% in the Sample 2 group. Freedom to choose labour position for women having vaginal birth was restricted in 65.7% in the Sample 1 group and in 46% in the Sample 2 group. Discussion and Conclusions: We have found that the right of women to informed consent and best available treatment is frequently and seriously violated in obstetric practice in Hungary in the given period. These findings should serve as an important basis for improving the quality of maternity care.

Keywords

respectful maternity care, midwifery model, informed consent, unconsented care, caesarean section, episiotomy, labour induction

Corresponding author

Dr. Imre SZEBIK
Semmelweis Egyetem
Általános Orvostudományi Kar
Magatartástudományi Intézet
Nagyvárad tér 4., 20. em.
H-1089 Budapest
Hungary/Ungarn
szebik.imre@med.semmelweis-univ.hu

 

Co-authors

Dr. SUSÁNSZKY Éva: Semmelweis Egyetem, Általános Orvostudományi Kar Magatartástudományi Intézet; Hungary
Dr. SZÁNTÓ Zsuzsa: Semmelweis Egyetem, Általános Orvostudományi Kar Magatartástudományi Intézet; Hungary
Anna SUSÁNSZKY: Semmelweis Egyetem, Általános Orvostudományi Kar Magatartástudományi Intézet; Hungary

Dr. Nicholas RUBASHKIN: Department of Obstetrics, Gynecology, and Reproductive Sciences & Institute of Global Health Sciences, University of California at San Francisco; USA