Looking ahead to future decisions
In maternity care, you may be discussing care and treatment options weeks, or months, before your patient gives birth.
These discussions and your patient’s preferences may be recorded in a birth plan. There may be opportunities to explore patient concerns and treatment options in advance. For example, if your patient is exploring options around having a caesarean birth or is likely to require an induction of labour. Alternatively, you may be discussing treatment options that could arise during labour.
Where possible, anticipating these circumstances and discussing them with your patient in advance could be helpful. This means that in situations where patients are making a decision at pace, they’ve had some time and opportunity to consider relevant information and express their preferences.
Discussing risks is challenging in a time-pressured situation, particularly when your patient might be in pain, confused or afraid, and the mention of potential serious harm for the first time could be distressing.
Keeping patients and their birthing partners informed during the dynamic labour process and signposting early where a change arises can allow earlier opportunities for raising concerns and answering questions.
Our professional standards
34. Discussing options in advance doesn’t remove the need to have a further dialogue immediately before providing treatment, and at regular intervals as treatment or care progresses. Even if there’s a care plan in place, or the patient’s made an advance decision, you should still talk to them about the options available in case the options have changed or the patient has changed their mind.
58. Reviewing a decision is particularly important:
- if you haven’t personally had a discussion with the patient because they were initially seen by a colleague
- if significant time has passed since the decision was made
- if the patient’s condition has changed
- if you have reason to believe the patient might have changed their mind
- if any aspect of the chosen treatment or care has changed
- if new information has become available about the potential benefits or risks of harm of any of the options that might make the patient choose differently.
