It has been a long time time since I have written on this blog.Being an obstetrician now for almost 20 years ,I feel time has come for us doctors in private practice to empower our patients with more knowledge so that they can participate in managment and do not feel a particular managment plan has been imposed on them .Ofcourse I am only talking from the point of view of pregnancy and labour managment which in recent years is getting more and more medicalised. I am only talking about those mothers and their families who typically visit Private hospitals in metropolitan cities.These mothers are educated,professionally qualified and usually read up a lot about pregnancy and child birth on their own before visiting the doctor.To these mothers I want to give evidence based medical information.I want to make them understand that most medical situations are not black or white ,there are a lot of grey zones.Let me give you an example ,there is this lady who has epilepsy and is pregnant and wants to know whether she can continue to take antiepileptic drugs which are known to be teratogenic (harmful to the fetus).My advice would be that she would have to continue the drugs (under medical supervision) as the risk of not taking it can outweigh the risk of taking it.If she has a epileptic fit then she and her baby could be in grave trouble but the risk of the drugs could be kept low depending on the dose and type of drug. Therefore everything rests on this risk benefit ratio and it is like a weighing balance that all us doctors are mentally using everytime we prescribe you an antibiotic,we decide for induction, we decide to give you antihypertensive drug,decide for cesarian section so on and so forth. I think we need to give you universal evidence based information regarding the risk benefit analysis for situations that are available and then make you participate in your care.