Why Informed Consent Should Guide Reproductive and Maternal Healthcare
- May 21, 2025
- 5 min read
Anne Wallen is a respected figure in women’s health with over 30 years of experience and is a leading voice on global change in maternity care, particularly for those at greatest risk.
In reproductive and maternal healthcare, where the stakes are personal and the outcomes deeply life-altering, informed consent is not just a legal formality, it is a moral imperative. Yet too often, patients, especially women, are placed in situations where consent is assumed, rushed, or implied, rather than thoroughly earned through honest, respectful communication. This practice is not only unethical, it undermines bodily autonomy, damages trust, and leads to poorer outcomes. In the United States, where maternal mortality rates continue to climb, we see an ugly, misogynistic undertone to maternal healthcare. A shift is needed, away from provider-dominated decision-making and toward a model where patients are respected as knowledgeable, equal partners in their care.
The false comfort of implied consent
Implied consent, which is often used by providers after a patient signs a waiver when admitted to the hospital, operates on assumptions: that the patient wants what the provider thinks is best, that she understands the implications of a test, medication, or procedure, and that silence equals agreement. But in reproductive and maternal healthcare, these assumptions are often wrong and dangerous. Decisions like choosing a birth plan, undergoing a cesarean section, terminating a pregnancy, or starting hormonal treatment carry layers of physical, emotional, and ethical weight. There is no room for assumption in such moments.
Informed consent, by contrast, requires dialogue. It requires clinicians to explain not just the procedure or treatment, but the risks, alternatives, and the option to say no. It is a process, not a box to check on a “to-do” list for caregivers. It affirms a patient’s right to understand and choose based on her own values, not the provider’s preferences.
Autonomy requires conversation, not authority
Respecting bodily autonomy doesn’t mean stepping aside, it means stepping up to communicate clearly, compassionately, and collaboratively. The most effective healthcare decisions are made not through command but through conversation. When a provider speaks with a patient as a peer, someone with unique insights into her own body and life, care becomes safer, more personalized, and more ethical. This always equates to better outcomes.
This team-based approach demands humility. It asks clinicians to temporarily set aside the training that once taught them to take control and instead listen with curiosity and respect. Patients are not problems to be solved or protocols to be applied; they are people with agency, insight, and the right to choose what happens to their bodies and their babies.
The dangerous legacy of the god complex
Unfortunately, in many medical settings, a culture still persists in which authority is mistaken for expertise, and ego is misused as a substitute for sound judgment. This so-called “God complex”, an attitude in which the provider assumes they always know best, creates a power imbalance that silences patients, fuels fear-based decision-making, encourages manipulation and coercion to gain compliance, and ultimately leads to harmful outcomes.
When providers operate from ego or fear, fear of liability, fear of losing control, fear of not being seen as the expert, they may push interventions that aren’t necessary, override patient preferences, or fail to listen when a woman says, “Something doesn’t feel right.” These decisions, born of arrogance, ignorance, or anxiety, not only erode trust but also result in higher rates of trauma, missed diagnoses, and even maternal and infant mortality.
Too often, women emerge from healthcare experiences feeling violated, dismissed, or invisible. These are not just emotional wounds, they’re structural failures that have long-term consequences for families and society as a whole. And they’re preventable.
Listening as a clinical skill
Listening is not a soft skill; it is a clinical one. A patient who is heard is more likely to provide relevant information, report early signs of complications, and participate fully in her own care. When a provider takes the time to ask, “What do you think is going on?” or “What feels right to you?” they unlock critical insights that can change the course of treatment. They also send a powerful message: you matter. Your experience matters. Your voice counts.
This is especially important in maternal healthcare, where the physical and emotional demands of pregnancy, childbirth, and postpartum recovery are profound, and where medical decisions can intersect with trauma, fear, and cultural or spiritual values. When clinicians take the time to involve patients fully in their care, they help protect not just physical health but dignity, identity, and mental well-being.
Reclaiming trust through shared decision-making
Trust is not given, it is earned. And in a healthcare system that has too often marginalized women’s voices, especially those of women of color, trust must be rebuilt deliberately. One of the most powerful ways to do this is through shared decision-making: a model where the provider brings expertise and options, and the patient brings context and preferences. Together, they choose a path forward.
This is not a threat to medical authority; it is a deeper expression of it. Quick and easy compliance should never be the ultimate goal. True leadership in healthcare doesn’t demand obedience; it cultivates understanding. It’s not about being the loudest voice in the room, it’s about making space for every voice that matters.
Conclusion: A call for humility, curiosity, and respect
Reproductive and maternal healthcare must be guided by partnership, not paternalism. Informed consent is not a bureaucratic requirement; it is the ethical heartbeat of medicine. Dismissing a patient’s insights, silencing their preferences, or assuming consent without genuine conversation undermines care and causes harm.
It’s time to retire the God complex. In its place, let us build a culture of humility, curiosity, and respect, one in which patients are full members of their care team and informed consent is the baseline, not the exception. Only then can we offer care that is not just clinically sound, but humanly right.
Anne Wallen, Director and Founder of MaternityWise Intl
Anne Wallen is a respected figure in women’s health with over 30 years of experience and is a leading voice on global change in maternity care, particularly for those at greatest risk. She continues to educate and empower birth professionals in more than 20 countries, contribute to a variety of curriculums, and shape the future of maternal health through her impactful role as a speaker and mentor. Anne is the Director and co-founder of MaternityWise International, and her legacy lies in inspiring generational changes around and elevating women's healthcare worldwide.
