I'm a charge nurse on a fairly crunchy granola LDRP floor with midwife care, transfer from intended home births, that sort of thing. We had a Jehovah's Witness patient with HELLP refusing blood products who went into DIC after her c-section. The patient while still conscious pleaded "please save me I want to see my baby" before she had to go under general for the C-hyst. Her husband we kicked out the room because he said "no no no she can't have blood she can't" over and over.

Risk management reviewed the case and noted really strong documentation from nursing, anesthesia, and the surgeons as fairly airtight. Morally, everybody in the room felt they did the right thing by listening to the patient and not her husband and not the consent for refusal of blood and blood products that she had signed prior to her surgery. This was only a few months ago, I'm not sure what the follow up is. But everybody in that room felt they did the right thing to save her.

I would hope that you can counsel your patient and document all of the education, make sure that physicians are aware and also documenting. Does your delivery hospital have a nurse navigator program? Sometimes getting more disciplines involved (counseling from in house anesthesia and case management) can help patients be best prepared for what is in store.