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Delivering the Truth: Challenges and Opportunities for Error Disclosure in Obstetrics

Carranza, Leslie MD, MHS; Lyerly, Anne Drapkin MD, MA; Lipira, Lauren MSW; Prouty, Carolyn D. DVM; Loren, David MD; Gallagher, Thomas H. MD

doi: 10.1097/AOG.0000000000000130
Contents: Current Commentary

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.

As disclosing errors to patients becomes more common, obstetricians should consider the challenges in doing so and learn to disclose errors effectively.

Department 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.

Corresponding author: Thomas H. Gallagher, MD, Professor of Medicine, Bioethics & Humanities, University of Washington, Box 354981, 4311 11th Avenue NE, Suite 230, Seattle, WA 98105-6367; e-mail:

Supported by The Doctors Company Foundation.

The authors thank Thomas J. Benedetti, MD, MHA, for his important contributions to the concepts presented in this article.

Financial Disclosure The authors did not report any potential conflicts of interest.

© 2014 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.