A pregnant woman nearing delivery, with an uncomplicated pregnancy and no immediate indication for caesarean section (CS), can either deliver vaginally or by CS. Historically CS has been viewed as more dangerous than vaginal delivery. However, CSs are far safer today and the complications of unmonitored labour are increasing, especially in the public sector.Delivery should be discussed during the antenatal period. The decision to have a CS is usually followed by signing an authorisation form -incorrectly referred to as the consent form. Women who decide to deliver vaginally are not asked to sign a similar form, possibly because consent is procedure specific and a vaginal delivery is not seen as a procedure. However, natural birth, a normal physiological process, and modern medical vaginal childbirth are not synonymous and each intervention in the latter requires consent, albeit often tacit.The merits of antenatal care and monitored childbirth are obvious. However, it is not clear to most people that when a woman seeks medical attention and is admitted into an antenatal programme for her pregnancy and subsequent childbirth (including a 'normal' vaginal delivery), there is a transition to medicalised care. Hence the ethical and legal tenets must apply to management in this context. Therefore, does the modern medical vaginal birth process itself require an authorisation form? This is because the process includes medical interventions and unique risks, and there is a clear alternative. When well informed the woman has probably passed the threshold for consent from an ethical point of view, but is there an additional legal threshold that must be crossed, given the increasing tendency to litigation?While presenting current scientific opinions on the risks and benefits associated with vaginal and abdominal delivery, we do not argue for either mode of delivery. We recognise women's right to choice in respect of mode of delivery. We argue that even when a normal vaginal delivery is anticipated, the practitioner is obliged to discuss the alternative of CS with the woman. We argue that the context and environment of the delivery ward are important components of the communication. These are informed by the doctrine of informed consent, which we examine from the legal perspective. We aim to stimulate discussion and debate on the current and future status of vaginal deliveries. Vaginal delivery or caesarean sectionthe factsDespite being more costly and associated with maternal and neonatal complications, morbidity and mortality more often than vaginal delivery, 1-4 CS is an increasingly common procedure in the public and private sectors in South Africa. 5 South Africa's CS rate is much higher than the ideal rate of 10 -15% in low-risk obstetric populations recommended by the World Health Organization in 1985. 6 According to the Health Systems Trust the public sector rate was about 17% in 2005, and rates of about 30% were reported by regional and tertiary public hospitals in Durban. 5High CS rates have been reported in the pri...

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The harmful effects of alcohol use during pregnancy have been well documented. Fetal alcohol spectrum disorder (FASD) is the collective term encompassing the various clinical diagnoses that can occur in a child who was exposed to alcohol prenatally. The affected child suffers a range of lifelong primary and secondary disabilities. There is no cure for FASD, but it is preventable if women do not drink during pregnancy. Should women be banned from, and/or punished for drinking during pregnancy for the sake of preventing fetal harm? This article considers the appropriateness of criminalising drinking during pregnancy as a means of preventing fetal harm and consequently FASD in children, and concludes that criminal approaches are unjustified, potentially discriminatory and likely to be ineffective.S Afr J BL 2016:9(1):26-30.

In view of the high prevalence of HIV and AIDS in South Africa, particularly among adolescents, the Departments of Health and Education have proposed a school-based HIV counselling and testing (HCT) campaign to reduce HIV infections and sexual risk behaviour. Through the use of semi-structured interviews, our qualitative study explored perceptions of parents regarding the ethico-legal and social implications of the proposed campaign. Despite some concerns, parents were generally in favour of the HCT campaign. However, they were not aware of their parental limitations in terms of the Children's Act. Their views suggest that the HCT campaign has the potential to make a positive contribution to the fight against HIV and AIDS, but needs to be well planned. To ensure the campaign's success, there is a need to enhance awareness of the programme. All stakeholders, including parents, need to engage in the programme as equal partners.