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Database - Alliance francophone pour l'accouchement respecté (AFAR)

Description of this bibliographical database (AFAR website)
Currently 3069 records
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Created on : 09 Feb 2019
Modified on : 09 Feb 2019

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Bibliographical entry (without author) :

Women desiring less care than recommended during childbirth: Three years of dedicated clinic. Birth Issues in Perinatal Care. Wiley Online Library.

Author(s) :

Matthijs van der Garde, Martine Hollander, Gert Olthuis, Frank Vandenbussche, Jeroen van Dillen

Year of publication :


URL(s) :…

Résumé (français)  :

Abstract (English)  :


Some women decline recommended care during pregnancy and birth. This can cause friction between client and provider.


A designated outpatient clinic was started for women who decline recommended care in pregnancy. All women who attended were analyzed retrospectively. The clinic used a systematic multidisciplinary approach. During the first visit, women told their stories and explained the reasoning behind their birth plan. The second visit was used to present the evidence underpinning recommendations and attempt to reach a compromise if care within recommendations was still not acceptable to the woman. During the third visit, a final birth plan was decided on.


From January 1, 2015, until December 31, 2017, 55 women were seen in the clinic, 29 of whom declined items of recommended care during birth and were included in the study. After discussions had been completed, 38% of birth plans were within recommendations, 38% were a compromise, in which both the woman and the care provider had made certain concessions, and 24% did not reach an agreement and delivered with another provider either at home or elsewhere. All maternal and perinatal outcomes were good.


Using a respectful and systematic multidisciplinary approach, in which women feel heard and are invited to explain their motivations for their birth plans, we are able to arrive at a plan either compatible with or much closer to recommendations than the woman’s initial intentions in most cases, thereby preventing negative choices.

Sumário (português)  :

Resumen (español)  :

Comments :

Argument (français) :

Certaines femmes refusent les soins recommandés pendant la grossesse et l’accouchement. Cela peut causer des frictions entre la patiente et le fournisseur de soins.

Argument (English):

Some women decline recommended care during pregnancy and birth. This can cause friction between client and provider.

Argumento (português):

Algumas mulheres recusam os cuidados recomendados durante a gravidez e o parto. Isso pode causar atrito entre o cliente e o provedor.

Argumento (español):

Keywords :

➡ attendance ; physiology ; guidelines ; informed consent

Author of this record :

Bernard Bel — 09 Feb 2019

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This database is managed by Alliance francophone pour l'accouchement respecté (AFAR,
affiliated with Collectif interassociatif autour de la naissance (CIANE,
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