Maternal autonomy: ethics and the law

Concept Analysis of Maternal Autonomy in the Context of Breastfeeding

“…Although the concept is gaining popularity in nursing and other disciplines due to its implications in practice, research, and theory development, a review of the literature suggests several controversies with respect to concept definition. Sullivan and Douglas () consider maternal autonomy an ethical and moral right of a woman that must be fulfilled and respected. In the context of maternal health, Ross et al.’s () population‐based cohort study describes women's autonomy as the degree to which a woman demonstrates dependence on her partner and seeks her husband's approval to undertake any decisions in her daily life circumstances, including attending a healthcare facility, spending money, and buying or selling anything.…”

“…Availability of support enables lactating mothers to achieve their breastfeeding‐related goals (Cox & Turnbull, ; Labbok, ). Support may be offered by healthcare professionals, peer counsellors, family members, neighbors, friends, employers, and colleagues and can facilitate maternal autonomy regarding breastfeeding (Boyd, ; Cox & Turnbull, ; Fineman, ; Friedman, ; Raj & Plichta, ; Reece, ; Sullivan & Douglas, ; Wolf, ).…”

“…Ethically and medically, a mother can demonstrate autonomy only if she is competent to make decisions (Sullivan & Douglas, ). Competence as an antecedent of maternal autonomy in the context of breastfeeding refers to physical, intellectual, social, emotional, and moral competence of the mother.…”

Maternal-Fetal Intervention and Fetal Care Centers

“…And, although a parental decision may, in certain circumstances, be overridden for a child after birth, even the strongest evidence for fetal benefit would not be sufficient ethically to ever override a pregnant woman's decision to forgo fetal treatment. 4,5 A pregnant woman will often assume quite significant risks for her fetus, and some women might find it difficult to forgo these interventions because of pressures from within themselves, from their families, from their communities, or even from their care providers. 6 A pregnant woman's decision may be affected by factors such as her family's or society's expectations regarding her responsibility as a prospective mother, maternal feelings of guilt and her desire to try and make things "right," or even the psychosocial "therapeutic misconception," that is, the presumption that an intervention with no proven efficacy will actually work merely because it is offered by a center, is under a study protocol, or has been covered by the news media.…”

Lessons learned from obstetric anesthesia

“…Physicians ordinarily should not impose a treatment that the patient declines. 10 Some of you -as well as the authors of an editorial 11 published in the International Journal of Obstetric Anesthesia -might criticize my decision in this case. But before you throw stones at me, ask yourselves this question: Have you obtained true informed consent every time you have provided anesthesia for a stat cesarean delivery?…”