International study: maternity care and "defensive practice"
An international study of maternity care professionals found that many clinicians engage in "defensive practice"—making clinical decisions primarily to reduce legal or professional risk rather than because they are medically necessary. The study identified defensive practices such as ordering unnecessary interventions; adhering rigidly to protocols without considering individual circumstances; and avoiding higher-risk patients or procedures due to fear of complaints, litigation, or regulatory consequences. Researchers found that these behaviors can contribute to increased healthcare costs, unnecessary interventions, clinician stress and burnout, and reduced patient-centered care without improving safety outcomes. The authors argue that reducing defensive practice requires system-level changes, including stronger organizational support, a just culture that emphasizes learning over blame, and regulatory and accountability frameworks that encourage evidence-based decision-making while maintaining patient safety.