The death of the 29-year-old, after a birth at a private maternity ward in Constanța, brings to the fore the debate on choosing the type of birth. Who should decide between natural birth and caesarean section? And what happens when complications occur and the doctor needs the patient’s agreement to intervene? When it comes to counter-carometer decisions, the doctor should do what he knows is best to save the patient, says Dr. Ciprian Pop Began. “Better a patient in life who can sue you than a patient who can no longer do at all.”
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Natural birth is always the first option, according to the World Health Organization and only 15% of births should be done by caesarean section. But when there are contraindications, things change completely.
Doctors say that the final decision must always belong to specialists.
“It is established, in principle, somewhere towards the end of the task, so you can accumulate all the data you have, but the decision can be changed according to the situation. There are indications by categories: in maternal interest, in fetal interest or indications in mixed interest, both maternal and fetal. (…) The pregnant woman and the family have the right to express their opinion. It’s just that it is your right, as a doctor, to decide the type of birth“, explains Dr. Ciprian Pop-Began, primary obstetrics-gynecology.
According to the doctor, there are several conditions that indicate a caesarean section instead of natural birth.
“Definitely exists. Usually related to coagulation changes, there are indications related to the positioning of the fetus, there are indications related to the hypertension induced by pregnancy or highlighted by pregnancy. Also, related to the anatomical structure of the mother and pregnancy: a placenta or a fibroid previa – that is, a placenta that is attached to the uterine, not on the uterine. caesarean this shows.
“Better a patient in life who can sue you than a patient who can no longer do”
And in terms of managing complications that can occur after birth – whether we are talking about natural or caesarean section – the decision must be primarily of the doctor, says Dr. Ciprian Pop -Began.
“To the extent that you have to make a decision related to minutes to save the woman’s life, even if from a legal point of view you need consent, as a doctor you can make the medical decision, and then explicitly to both the family and the woman why you made that decision. (…) Better a patient in life who can sue you than a patient who can no longer do at all. “
The doctor states that sometimes the consent may delay the time needed to save life.
“It would be good to be pink, you have time to explain, then make the decision and give you the agreement. Most of the time it can. But there are also critical situations in which, if you wait to understand the woman what is happening and give you an agreement, it can happen to be difficult to go further with therapeutic behavior. “
Ciprian Pop-Began, primary obstetrics and gynecology
Midwives Association in Romania: There are patients who do not take into account recommendations, but it is a reaction of fear
The Romanian Morns Association admits that there are pregnant women who do not take into account the medical recommendations, but it comes with a different perspective.
“It can happen, yes, to have pregnant women who do not take into account the recommendations of midwives or doctors. We believe that it is a reaction of fear and lack of confidence started from the non -compliant practices in maternity and we seek urgent measures to update the practices and teams of birth assistance, which must also include licensed midwives, according to the European Directive 2005/36/CR and the Order of the Minister of Health no. 3,368 of June 7, 2024, in force. We mention that the Order of MS has a transition period from the moment of publication and until the moment when the maternities must have licensed midwives in the structure of birth rooms, but there are no measures taken as by June 2026, the term in this order, to have these midwives already formed and they can cover the real needs and the needs of the maternities and the maternity needs “says Gyopárka Oprea, the vice -president of the Romanian Maosa Association.
The organization believes that women are the ones who have to choose, but informed.
“Our first recommendation is for women to be able to choose safely and fully informed and fully informed, any type of birth, in the absence of complications indicating during the caesarean pregnancy. We believe in the complete decision -making autonomy of women and in the importance of prenatal education, evidence -based information and safe and friendly conditions, in maternities that put patients in the center of care. (…) We are also missing the exercise of the team response to obstetric emergencies, in some of the maternities, practically the lack of an exact protocol to be respected by the medical staff when such emergencies appear. Because the problem does not arise if they appear, but when “says Gyopárka Oprea.
Gyopárka Oprea, vice -president of the Morișe Association of Romania
What happened at the private maternity ward in Constanța
At the beginning of the month, a 29 -year -old who was born in a private maternity ward died a few hours after birth, following a severe bleeding. The representatives of the medical unit claim that the doctors recommended a hysterectomy (no uterus removal), but the patient and the husband refused the intervention in writing, although they were explained that there is a risk of death. The young woman became pregnant with in vitro fertilization, suffering from thrombophilia and several maternities had refused her natural birth, so, although she was from Giurgiu, she decided to give birth to the private hospital in Constanța.
The surgeon Marius Ushiunsu puts the death of the young woman from Constanta on account of the “ticcots” and argues that the couple’s refusal to accept Caesarean section and hysterectomy is only the result of programmatic indoctrination in the last 6 years in the sovereign area.
