Publication:

Medico-legal safeguards in obstetrics and gynaecology: a narrative review of legislative frameworks and preventive strategies

Obstetrics and gynaecology (OB-GYN) is recognized as one of the most litigious medical fields worldwide. The nature of care often involves two lives simultaneously, with high emotional and ethical implications, which makes it vulnerable to legal scrutiny. Legal actions usually arise from allegations of medical negligence, improper consent, or failure to meet standard protocols during antepartum, intrapartum, or postpartum care. However, understanding the application of relevant legal frameworks can help mitigate the risk of litigation. Any guidelines or acts stated by the government, if diligently followed, significantly reduce the risk of litigation by promoting transparency, ethical standards, patient safety, proper documentation and accountability. This narrative review was conducted through a systematic search of PubMed, Medline, and Google Scholar, supplemented by Government of India legislative documents and guidelines from professional bodies including FOGSI, WHO, and ICMR. Nine key legislative frameworks were identified as relevant to OB-GYN practice in India-the medical termination of pregnancy (MTP) act (1971, amended 2021), pre-conception and pre-natal diagnostic techniques (PCPNDT) act (1994, amended 2003), assisted reproductive technology (ART) Act (2021), surrogacy (Regulation) act (2021), protection of children from sexual offences (POCSO) act (2012), Family planning indemnity scheme (FPIS) (2005), clinical establishments act (2010), Indian medical council ethics regulations (2002), and the consumer protection act (CPA) (1986, amended 2019). Common medicolegal pitfalls included deficiencies in informed consent, inadequate documentation, errors in foetal and neonatal management, surgical oversights, and delayed emergency referrals. Comprehensive understanding of applicable laws, combined with clinical documentation, valid informed consent, and systematic risk management, substantially mitigates medicolegal vulnerability in OB-GYN practice.