A 26-year-old woman, gravida 1 para 0, is admitted to the hospital in active labor at 38 weeks gestation. Twelve hours after admission, she had a spontaneous vaginal birth of a newborn boy weighing 3.8 kg (8.4 lb) and receiving Apgar ratings of 8 and 9, respectively, at 1 and 5 minutes. The patient received no normal prenatal care. She does not have any chronic medical issues or drug allergies. Following birth, the patient is advised that erythromycin ointment will be required to avoid an eye infection and potential blindness caused by untreated gonorrhea. The patient claims that her son does not require therapy because she has never been exposed to a sexually transmitted virus.

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Eductional Objective: This patient is refusing prescribed therapy for her infant since she has never had a sexually transmitted virus (STI). This might be due to a misunderstanding that STIs can be asymptomatic, as well as a misunderstanding that prophylactic therapy is indicated for all babies. The patient should be advised that preventive erythromycin is indicated for all babies to avoid Neisseria gonorrhoeae blindness.
All required information on treatment indications, as well as the risks and advantages of accepting and refusing treatment, should be supplied as part of the informed consent process, and the patient should be encouraged to ask questions. Whenever a patient declines or is hesitant to accept treatment, the initial step is for the physician to assess the patient's knowledge, provide clarification when needed (as in this case), listen to concerns, and understand the specific reasons for the refusal. The process of obtaining informed consent should be conducted in a nonjudgmental and noncoercive way.

A 26-Year-Old Woman, Gravida 1 Para 0, Is Admitted to the Hospital