"I don'twant to give birth": Clinical and ethico-legal dilemmas and the role of graded exposure therapy on an urgent basis in a post-term pregnantwoman with blood-injection-injury phobia

Abstract

Introduction: Blood-injection-injury (BII) phobia is a common anxiety disorder that is non-fatal in most cases. Nevertheless, BII phobia in pregnancy can pose intricate medico-legal management issues. Case Presentation: A 24 year-old post-term (40 weeks + 9 days) primigravida refused induction of labour because of BII phobia, thereby presenting a serious obstetrical dilemma due to the precarious balance between patient's autonomy and the pressing risk of intrauterine death. Caesarean section was successfully performed after sessions of urgent graded exposure therapy. Conclusions: This case highlights the importance of close multidisciplinary teamwork.