The Case for Recording Birth: Cameras, Trust, and the Ethics of Remembering What Happened
The Responsibility Clause - Video in the delivery room is not just about lawsuits. Used wisely, it can protect mothers, babies, and clinicians.
When something goes wrong in labor, the story splinters.
The parents remember panic. The team remembers rapid action. The chart shows clean lines and short time intervals. Weeks later in a conference room, everyone is arguing about minutes they cannot quite recall.
What if there were a secure video record of those critical moments, reviewed only with consent, used to understand rather than punish?
That is the ethical question behind routine video recording of births, an idea that now has a small but growing evidence base.
What the current evidence actually shows
Commentaries in Obstetrics & Gynecology have already argued that video recording during childbirth could foster transparency and trust, if policies are clear about purpose, consent, and storage. Bratches and Barr describe how hospitals already record surgeries and trauma resuscitations for quality improvement, and they explicitly link childbirth recording to police body-worn cameras as a way to document events and deter unprofessional behavior. Shanahan’s response emphasizes that the primary function of a recording matters: memento, medical record, or legal evidence, because each function implies different privacy and governance needs.
Outside obstetrics, several reviews show that patients value recordings of clinical encounters. Barr and colleagues found in a US survey that many patients already audio- or video-record visits for their own use, and that most clinicians had encountered this practice. Systematic reviews by Rieger and by Dommershuijsen report that consultation recordings improve recall, understanding, and satisfaction in oncology and older adult care, with only rare reports of distress.
Closer to birth, there are two strands of evidence. One focuses on the experience of women. McKay and Barrows showed that mothers who watched videotapes of their second stage of labor generally found it emotionally meaningful and helpful for processing the experience, not harmful. The second focuses on team performance. A prospective study from Zurich used video analysis of vaginal births and found frequent, concrete omissions in technique and teamwork that were not obvious in real time, concluding that video review is a “useful tool for teaching and learning” and likely improved quality through a Hawthorne effect.
In neonatology, Foglia and others have shown that video recording delivery room resuscitation provides an objective and reliable way to assess adherence to guidelines, while later work by Hill et al. shows that digital video review can drive structured quality improvement programs. A recent review by Herrick notes that most video work in neonatology focuses on task performance and timeline accuracy, not blame. Newer studies even use infrared thermal video to detect exact time of birth and cord clamping while masking faces, suggesting a technical route to protect privacy.
Clinicians are understandably ambivalent. An older survey of obstetricians and family physicians found that many saw videotaping obstetric procedures as valuable, but had concerns about medico-legal risk and consent. At the same time, qualitative work on patients covertly recording visits shows that patients often see recording as empowerment, while clinicians often experience it as a threat.
In short: recording in obstetrics and neonatology is already happening, often informally, and existing data point to clear benefits for learning, recall, and trust, with manageable risks when policies are explicit.
Lessons from police bodycams
The analogy to police bodycams is not just rhetorical. Bratches and Barr explicitly cite US Department of Justice guidance that body-worn cameras promote transparency, document evidence, and deter unprofessional behavior. A large analysis from the University of Chicago group found that police departments using bodycams had fewer complaints and less use of force, and that cameras sometimes exonerated officers in the face of false allegations.
The ethical parallel is this: both policing and obstetrics involve high-stakes, time-critical decisions where power imbalances are real and trust is fragile. Recording does not guarantee good behavior, but it raises the floor. People act differently when they know they will later see themselves on video. When combined with a culture of learning, that difference tends to favor safety.
Ethical pros: why recording birth deserves serious consideration
The literature supports several ethical advantages:
Truth and learning. Multiple studies show that video reveals important missed steps and communication gaps that were not documented in the chart or remembered later. For a shoulder dystocia, a delayed cesarean, or a complicated resuscitation, that objective record can guide honest morbidity reviews and better training.
Patient understanding and processing. Mothers who later watch their birth often describe it as a powerful way to make sense of what happened, especially when events were rapid or frightening.
Reinforcing trust. Consultation recording literature suggests that being recorded can increase clinician attentiveness and sense of accountability without degrading communication quality. Given that higher trust in clinicians is associated with better health outcomes, this matters.
Protection on both sides. While there are malpractice cases where video exposed substandard care, legal experts surveyed in orthopedics and other fields have noted that recordings can also demonstrate appropriate care and reduce speculative claims.
Ethical risks: what should be addressed up front
The same studies highlight serious concerns. Staff worry about privacy, being “on stage,” and punitive use of footage. Women may feel pressured to consent in a context of structural power imbalance, or fear that an intimate moment will end up on a server they do not control. Commentary pieces warn that family-filmed videos can be posted on social media, exposing staff without their consent.
Ethically, three safeguards are crucial:
Clear, revocable consent. Consent to be recorded must be specific, separate from general hospital consent, and revocable at any time. Both the pregnant woman and the team should know when the camera is on and why.
Strict governance and limited use. Hospitals need written policies that define who can view recordings, how long they are stored, and under what conditions they may be released outside the institution. Quality-improvement work and debriefings should be firewalled from routine disciplinary processes whenever possible.
Culture of learning, not surveillance. Experience from trauma and resuscitation video programs suggests that video succeeds when it is embedded in a non-punitive safety culture, with feedback focused on systems and teamwork rather than individual blame.
A practical and ethical recommendation
Given the evidence and growing policy interest, the ethically defensible path is not to ban recording, and not yet to mandate it, but to pilot voluntary, policy-driven video recording of selected deliveries within a transparent institutional framework.
Key elements should include:
Opt-in recording only. The discussion should occur before labor whenever possible, with the explicit option for either the patient or the team to decline or stop recording at any time, without affecting care.
Mutual consent from all participants. Every staff member present in the delivery room—obstetricians, nurses, anesthesiologists, midwives, and pediatric staff—must give written agreement before the system is activated. Recording without collective consent risks eroding professional trust.
Institutional and legal review. The hospital’s risk-management, legal, and ethics committees must jointly approve the policy before implementation. This ensures compliance with privacy law, HIPAA, and local regulations governing audio-visual data in healthcare.
Purpose limitation. Recordings should be used solely for patient-authorized review, internal quality improvement, education, or safety debriefings. Any other purpose—including public relations, media, or marketing—is ethically impermissible.
Prohibition on external use. Uploading, transmitting, or sharing any footage on social media or external platforms must be explicitly prohibited in policy and in consent forms. Violations should carry professional or institutional consequences, regardless of intent.
Secure storage and access control. Footage must be encrypted, stored on a secure hospital server, and accessible only to designated review committees. Each access must be logged and auditable.
Defined retention and deletion. Unless flagged for quality review, recordings should be automatically deleted after a set period (for example, 30–90 days). Both patients and staff should be informed of the exact retention schedule.
Structured review process. When an adverse event occurs, a multidisciplinary review team—including obstetric, nursing, legal, and ethics representatives—should review the recording in a confidential, non-punitive environment. Findings should focus on system learning, not individual blame.
Patient participation. Families should be invited to review the recording with a clinician, if they wish, as part of post-event counseling or debriefing.
Regular evaluation. Each program should be evaluated annually for its impact on maternal satisfaction, staff morale, medicolegal claims, and measurable quality-of-care indicators.
When these safeguards are in place, recording birth can become a genuine instrument of accountability and trust—not surveillance. It acknowledges that truth and empathy are not opposites, and that documentation, when governed wisely, protects everyone.
Bratches RWR, Barr PJ. Video Recording Policies During Childbirth: an opportunity to foster transparency and trust. Obstet Gynecol. 2023;141(2):419-421.
Olson L, Bui XA, Mpamize A, et al. Neonatal resuscitation monitoring: a low-cost video recording setup for quality improvement in the delivery room at the resuscitation table. Front Pediatr. 2022;10:952489.
Impact of the Neonatal Resuscitation Video Review program for neonatal resuscitation: Pediatric Research (Nature group) 2024; published online.
Video Recording Delivery Room Resuscitation. NeoReviews. 2017;18(11):e647-e657.
Legal implications of birth videos: A study reviewing videotaping obstetric procedures. J Legal Med. 1998;19(2):237–246. (Found on PubMed)
Hospital policy example: “Audio/Video Recording Policy” at Swedish Medical Center — permits audio/video recording of the birthing experience under defined rules.