Background: Pregnancy due to sexual abuse in schizophrenic patients always become a clinical problem in the obstetrics and gynaecology that can arise ethical dilemmas and medicolegal issues. Doctors must be able to balance between the obligation to protect patients from morbidity (nonmaleficence) and also respect the rights and decisions regarding patient reproduction (respect for autonomy). Ethical and medicolegal dilemmas can be resolved with consideration of clinical ethics namely indications of medical, preferential from the patient, life qualities and features of the contextual.
Case description: It is a case a 35-year-old patient diagnosed with Schizophrenia 4 years ago. Currently, the third pregnant patient due to sexual abuse (rape). In these conditions, there are two dilemmatic conditions, namely whether the patient continues the pregnancy with the risk that the baby will be born stranded or termination of pregnancy and carried out steady contraception?.
Conclusion: The decision was taken to terminate and Pomeroy tubectomy as a contraceptive choice for patients with various considerations such as age, adequate children and especially chronic mental illness. Patients with problems like this are at risk of having a poor quality of life. Decision making for solid contraception is supported by the representative of the social ministry of the Republic of Indonesia and the patient's family.