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Medical law relating to obstetric anaesthesia has unique issues. There are legal implications of caring for two patients simultaneously, mother and fetus, and issues may arise when the welfare of one is in conflict with that of the other. This chapter addresses the extent to which a woman can be forced to consider the needs of her fetus, case law relating to enforced caesarean sections, and the current legal position. Although the majority of expectant mothers have capacity, there are situations where this may not be the case. Law concerning the care of teenage obstetric patients, the difficult areas of capacity and consent in labour, and the role of birth plans are therefore explored. Fundamental topics in medical law such as battery, negligence, manslaughter, and confidentiality are addressed, in addition to law relating to the teaching and supervision of junior medical staff, and clinical research and its publication. The chapter also considers areas of developing importance such as the legal implication of clinical guidelines and the degree to which these may be viewed as a standard of care. Finally, the chapter offers, where possible, the obstetric anaesthetist some practical guidance on incorporating the current legal position in these key areas of medical law into everyday practice.

The risk to women’s health is increased during pregnancy, and maternal mortality is used as an indicator of general healthcare provision as well as a target for improving women’s health worldwide. Morbidity is more difficult to define than mortality but may also be used to monitor and improve women’s care during and after pregnancy. Despite international efforts to reduce maternal mortality, there remains a wide disparity between the rate of deaths in developed (maternal mortality ratio less than 10–20 per 100,000 live births) and developing (maternal mortality ratio as high as 1000 or more per 100,000 live births in some countries) areas of the world. Similarly, treatable conditions that cause considerable morbidity in developed countries but uncommonly result in maternal death (e.g. pre-eclampsia (pre-eclamptic toxaemia), haemorrhage, and sepsis) continue to be major causes of mortality in developing countries, where appropriate care is hampered by a lack of resources, skilled staff, education, and infrastructure. Surveillance systems that identify and analyse maternal deaths aim to monitor and improve maternal healthcare through education of staff and politicians; the longest-running and most comprehensive of these, the Confidential Enquiries into Maternal Deaths in the United Kingdom, was halted temporarily after the 2006–2008 report but is now active again. Surveillance of maternal morbidity is more difficult but systems also exist for this. The lessons learnt from such programmes are thought to be important drivers for improved maternal outcomes across the world.