SMFM Special Statement: Cognitive bias and medical error in obstetrics- Challenges and opportunities

The processes of diagnosis and management involve clinical decision-making. However, decision making is often affected by cognitive biases that can lead to medical errors. This statement presents a framework of clinical thinking and decision-making and shows how these processes can be bias-prone. We review examples of cognitive bias in obstetrics and introduce debiasing tools and strategies. When an adverse event or near miss is reviewed, the concept of a cognitive autopsy—a root cause analysis of medical decision-making and the potential influence of cognitive biases—is promoted as part of the review process. Finally, areas for future research on cognitive bias in obstetrics are suggested.

Key words: decision-making, diagnostic error, disparities, implicit bias, inequity, medical error, racism