In Australia, approximately one-third of birthing women experience birth trauma. Psychological birth trauma is often due to systemic issues like inadequate information provision and poor doctor-patient communication in obstetric care. To rectify this, doctors should strive to understand patient goals and values to improve communication and care by making enquiries antenatally and during labour and birth. This paper examines the obligations of obstetricians to make active enquiries about what is significant to patients. ‘Active enquiries’ in this research refers to reasonable efforts to understand patient values, goals, and concerns. Through medical literature review, legal doctrinal analysis, and assessment of professional standards and ethical principles, we establish that no legal obligation to proactively enquire about what is significant to patients exists in the law of negligence. There is a professional obligation for doctors to make these enquiries, however this may not be done reliably in practice. In the absence of a legal obligation, patients who are harmed because their doctor did not enquire about what was significant to them cannot access compensation for their birth trauma. While legal reform could address this issue, it is unlikely to occur quickly. We propose a solution to this problem by embedding formal ‘goals of care’ discussions in the antenatal care schedule and on admission to hospital for birth where possible. This would improve doctor-patient communication and better support doctors in fulfilling their professional obligations. Our aim is to reduce the prevalence of birth trauma by improving doctor-patient communication through respect for autonomy.