Finding Autonomy in Birth

Jurnal Promkes

Background: Maternal mortality is a health problem that has not been resolved until now. Based on data from January-September 2020 from the Public Health Center of Panti District, most pregnant women with high risk are those who have a risk of preeclampsia. Pregnant women have an important role and personal autonomy in decision-making during the process of pregnancy. Objective: To analyze the autonomy of high-risk pregnant women to prevent complications during childbirth. Methods: Qualitative research with a case study approach. Determination of the main informants using a purposive technique consisted of five pregnant women at risk of preeclampsia who were under 20 years old and above 35 years old. Data collection using in-depth interview guide and documentation. Data analysis using inductive thematic analysis. Results: intentions, affordability of information, situations in preparing blood donors, and maternity funds can form the negative autonomy of high-risk pregnant women in de...

Scholarly blog of the International Journal of Feminist Approaches to Bioethics, 2014

In this brief scholarly blog entry (available using the link below), I consider an April 2014 article in The Atlantic on Brazilian use of C-section which reaches extremely high rates. Specifically, I consider the role of the pregnant woman's medical autonomy in this case and in the US, drawing on Lyerly et al.'s excellent 2012 Hastings Center Report article, "Risk and the Pregnant Body," to consider how women's autonomy is constrained by the way risk and other concerns are viewed by both providers and patients.

Medicine, health care, and philosophy, 2015

This article examines one of the relevant concepts in the current debate on home birth-autonomy in place of birth-and its uses in general language, ethics, and childbirth health care literature. International discussion on childbirth services. A concept analysis guided by the model of Walker and Avant. The authors suggest that autonomy in the context of choosing place of birth is defined by three main attributes: information, capacity and freedom; given the antecedent of not harming others, and the consequences of accountability for the outcome. Model, borderline and contrary cases of autonomy in place of birth are presented. A woman choosing place of birth is autonomous if she receives all relevant information on available choices, risks and benefits, is capable of understanding and processing the information and choosing place of birth in the absence of coercion, provided she intends no harm to others and is accountable for the outcome. The attributes of the definition can serve a...

American Journal of Bioethics, 2012

Feminism & psychology, 2007

This thesis examines correlations between the midwifery philosophy of care and feminist reconfigurations of autonomy and choice. Based on content analysis, two sets of divergent models are compared: the medical model of informed consent and mainstream frameworks of autonomy, and the midwifery model of informed choice and feminist relational approaches. This investigation begins by examining the classic Principle of Respect for Patient Autonomy and the process of informed consent as proposed by Beauchamp and Childress. A critical survey of this framework brings to light shortcomings of bioethical theories that maintain a narrow ideology of autonomy and a limited perception of human characteristics. In response to mainstream bioethicists' theories of autonomy, many feminists have offered a relational approach recognizing the individual as situated within a broader social matrix. Distinguishing the unique elements of a relational model, Susan Sherwin's framework contrasts that of Beauchamp and Childress. Relational methods emphasize the manner in which external forces may enhance or restrict one's sense of self-trust and their capacity for autonomous decision-making. Autonomy is thus a process, developed and augmented through the acquisition of a series of skills. The midwifery model of care and the process of informed choice demonstrate an applied form of relational autonomy. Midwives aim to extend a women's sense of selftrust and empower her through the decision-making process. Shifting beyond the consent paradigm of the medical model, autonomy is respected in a fuller sense.

Psychology of Women Quarterly, 2004

Techné: Research in Philosophy and Technology, 2012

The emergence of new forms of reproductive technology raise an increasingly complex array of social and ethical issues. Nevertheless, this paper focuses on commonplace reproductive technologies used during labor and birth such as ultrasound, fetal monitoring, episiotomy, epidurals, labor induction, amniotomy, and cesarean section. This paper maintains that social pressures increase women’s perceived need to such reproductive technologies and thus undermine women’s capacity to choose an elective cesarean or avoid an emergency cesarean. Routine, normalized use of technology interferes with the possibility of choosing use of technology where best suited through misdirecting laboring women to use technological resources whenever possible. This normalized use of technology decreases risk tolerance and increases dependence on technology for reassurance, which bears significant implications for self-trust and self-confidence. My account encourages women’s cultivation of autonomy as a capacity interconnected with our own attitudes and those of other persons; and as a function of cultivating trust and confidence in one’s body.

The Journal of clinical ethics, 2013

Maternity careproviders often have strong views concerning a woman's choice of where to give birth.These views may be based on the ethical principle of autonomy, or on the principle of beneficence. The authors propose that an approach utilizing shared decision making allows careproviders and women to move beyond disagreements regarding which evidence on risk should "counts' instead adopting a process of increased knowledge and support for women and their partner while they make choices regarding place of birth.

Contraception, 2019

2012

The emergence of new forms of reproductive technology raise an increasingly complex array of social and ethical issues. Nevertheless, this paper focuses on commonplace reproductive technologies used during labor and birth such as ultrasound, fetal monitoring, episiotomy, epidurals, labor induction, amniotomy, and cesarean section. This paper maintains that social pressures increase women's perceived need to such reproductive technologies and thus undermine women's capacity to choose an elective cesarean or avoid an emergency cesarean. Routine, normalized use of technology interferes with the possibility of choosing use of technology where best suited through misdirecting laboring women to use technological resources whenever possible. This normalized use of technology decreases risk tolerance and increases dependence on technology for reassurance, which bears significant implications for selftrust and self-confidence. My account encourages women's cultivation of autonomy as a capacity interconnected with our own attitudes and those of other persons; and as a function of cultivating trust and confidence in one's body.