Speakers - 2026

Title: Treatment compliance in high-risk pregnancies

Abstract

Though often life-threatening for mother and fetus, the outcome of high-risk pregnancies depends greatly on treatment compliance from the pregnant women. This fails upon certain conditions which have been clearly identified by specific research: extreme denial of the risk, cultural distance with the medical staff, lack of communication skills from the staff, household and/or work restrictions, patients’ healthcare beliefs, domestic violence, social marginalization, etc. Communication and attitudes from health care personnel have been shown to be adamant in reaching compliance, both in terms of the amount and quality of information provided as to the management of the balance in the pregnant woman’s mind between the subjective need to deny risks, on the one hand, and the adaptive requirement to be aware of the health situation in herself and the fetus, on the other. Medical staff professional and emotional involvement have also been issues to be researched, ranging from labor stress emerging from managing difficult cases (especially when facing poor perinatal results), to the fear of litigation from parents, thus inducing defensive Medicine which, in turn, leads to poor quality of care. Understudied categories related to high-risk pregnancies (such as psychosocial risk, or the psychological and mother-infant bonding effects of “near miss” cases) are also discussed. Subjective consequences on prospective-parents of prenatal diagnosis assessments -especially in the face of adverse results- are also approached. This presentation analyses these difficulties and provides suggestions for clinical management in the different scenarios. Interdisciplinary co-consultations, home medical visiting, preparation for both childbirth (including training in early neonatal care) are presented as aspects to be improved in regular health care provision.

What will the audience take away from presentation?

-better understanding of the subjective experience of a high risk pregnancy in their obstetric patients

-a critical revision of management of communication issues with pregnant women and their partners

-contact with clinical practices developed in other clinical contexts to be incorporated to everyday medical work (such as interdisciplinary co-consultation in regular pregnancy controls)

-awareness of certain under-studied issues and the consequent lack of adequate clinical management of subjective needs involved (such as the “near miss” situations)