The judge noted from testimony that doctors in Singapore are not required to obtain formal consent for episiotomy or manual fundal pressure, which are routine procedures for natural birth.
A woman who sued her doctor over claims that she was not consulted for procedures during childbirth had her claims dismissed by the High Court.
In a written judgment published on April 3, Justice Choo Han Teck said Dr Khoo Chong Kiat should have exhibited a good bedside manner by explaining to the woman that he was about to perform an episiotomy – a surgical cut in the area between her anus and vagina – during childbirth.
“However, medical procedures often involve numerous steps and routine actions,” Justice Choo added.
“Requiring doctors to obtain explicit consent for each individual act within a medical procedure is impractical and would place an unreasonable burden on them.”
The woman had claimed in a medical negligence suit filed in 2023 that Dr Khoo did not seek her consent before carrying out cervical sweeps, manual fundal pressure and the episiotomy, and when repairing a tear she sustained during childbirth.
Doctors apply manual fundal pressure around the upper region of the uterus to assist with delivery.
The judge noted from testimony provided by Dr Han How Chuan, senior consultant obstetrician and gynaecologist and urogynaecologist at HC Han Clinic for Women, that doctors in Singapore are not required to obtain formal consent for episiotomy or manual fundal pressure, which are routine procedures for natural birth.
Justice Choo said that Dr Khoo’s failure to tell the 32-year-old woman before conducting both procedures is not a breach of the standard of care as a medical practitioner.
He also noted that the doctor had explained to the woman the purpose and process of the cervical sweep before proceeding with it. In a cervical sweep, a finger is used to induce labour.
In her suit, the woman said Dr Khoo had also failed to consult a colorectal surgeon before repairing the tear she sustained during childbirth. The woman said she excreted faecal matter from a 0.5cm tear she sustained during childbirth on May 3, 2020.
She said she continued to excrete faecal matter from her vagina for months after the delivery procedure performed by Dr Khoo, who practises at CK Khoo Clinic for Women & Laparoscopy.
The woman said the doctor’s alleged negligence by not providing appropriate treatment caused her to suffer from major depressive disorder and other financial losses.
Dr Khoo was represented by Senior Counsel Kuah Boon Theng, while the woman was represented by Mr Cumara Kamalacumar.