What should be done if an obstetrical patient refuses to sign a consent form during delivery?
If concerns about potential medical interventions are leading to the refusal to sign the form, more dialogue about the patient’s preferences vis-a-vis medical judgment during labor and delivery is indicated. This discussion should be documented. If the patient has issues of trust which cannot be resolved–and is in the early stages of pregnancy–referral to another practitioner may be indicated. Referral to another practitioner during the third trimester is not advised. This could give rise to allegations of abandonment. The obstetrical practitioner, labor and delivery nurses, administration, and the risk manager should develop a coordinated plan to manage the delivery of a patient with unresolved issues of trust. In the latter situation, the absence of an institutionally required signed consent form still needs to be addressed. Document in office and hospital medical records the dialogue about the pregnancy and plans for labor and delivery that have occurred during the prenatal period
