Risks of misguided judgement related to systematic uncertainty in medical decision-making |
Risks related to diagnosis in pregnant women |
Risk that pregnancy complications give similar symptoms as the epidemic (e.g., Ebola virus disease) |
Risks related to prevention and treatment of infected pregnant women |
Risk of lacking standards or guidance on when an investigational drug can and/or should be used in pregnant women |
Risks of misjudgements related to systematic uncertainty in policy decision-making and guideline development |
Risks related to the appropriate design or lack of individual hospital preparedness plans |
Risk that one cannot anticipate women's treatment choices in epidemics, which complicates the development of effective preparedness plans |
Risk related to lack of evidence on technical aspects |
Risk that there is limited evidence on the effects of a given epidemic on pregnant women and their fetuses |
Risk related to lack of guidance/answers on normative questions |
Risks related to unclarity to what extent policies for the prevention of mother-to-child transmission may influence or interfere with women's reproductive choices |
Issues of harm affecting pregnant women |
Issues of increased harms (mortality, morbidity) caused by insufficient access to health services in epidemics |
Risk that prevention of mother-to-child transmission is focused only on the well-being of the infant, noton the mother |
Risks of increased harms (mortality, morbidity) caused by inadequate provision of health services in epidemics |
Risk that during an epidemic, protective equipment makes it more difficult to deliver obstetric services safely |
Risk of harming infected mothers through stigmatization and criminalization |
Risk that mandatory testing and programmes for the prevention of mother-to-child transmission do not ensure confidentiality, causing stigma and discrimination |
General risks of harm caused by pregnancy in epidemics |
Risk that pregnancy can aggravate a pre-existing infection with an epidemic |
Risks of harming women of reproductive age |
Risks of increased harms caused by (organization of) screening in epidemics |
Risk that due to privacy breaches after screening, a woman of reproductive age experiences domestic violence |
Risk of stigmatization and persecution |
Risk that public discourse singles out women as sources of transmission, when in fact men are drivers in transmission, too |
Increased risk of infection for women of reproductive age |
Risk that because healthcare professionals are traditionally woman, transmission risks for healthcare professionals affect women disproportionately |
Risks of men violence as a reaction to preventive measures |
Risk that intra-marital sexual violence increases because the woman is perceived to fear contracting an epidemic from her partner |
Issues of harming the child |
Issues of infecting the child with the epidemic disease |
Risk that the epidemic contributes to infections, congenital disorders, disabilities, miscarriages, etc |
General issues arising as a consequence of the epidemic |
Risk that a child will be born to infected parents who will pass away or be unable to raise the child |
Issues of harming healthcare professionals |
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Conflict between health care workers’protective rights and the public health need for their services in emergencies |
Issues of harming the public/public health |
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Risk that infected pregnant women act as a catalyst, transmitting the epidemic to other parts of the population |
Issues regarding pregnant women’s autonomous decisions being compromised |
Risks of medical factors compromising autonomy or autonomous decisions |
Risk that infection renders the pregnant women unable (at least temporarily) to make decisions |
Issues of direct interference by others |
Risk that a pregnant woman’s choices about diagnosis and/or treatment are not respected |
Issues of indirect interference |
Conflict between a woman's wish to use contraceptives vs. religious values which do not allow them |
Risks that inadequate counselling about reproductive choices and maternal care precludes informed autonomous decision-making |
Risk that pregnant women do not receive enough counselling on the safety of a vaccine to make a proper risk assessment |
Risks related to the effectiveness of sexually transmitted disease epidemic control strategies |
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Risk that a control strategy for an epidemic includes an unrealistic degree of abstaining |
Risks related to the effectiveness of mother-to-child transmission programmes |
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Risk that prevention of mother-to-child transmission programmes are not accompanied by adequate counselling |