Women's Decision-Making Process of Childbirth Methods
Abstract
Background: At normal situation, vaginal delivery is recommended to pregnant females who are at low risk of complications. Recently, there is a widespread discussion about the right of the women in choosing their childbirth methods, specifically cesarean section. Aim: We designated to critically discuss the ethical argument on female’s choice of childbirth method as well as the influential factors involved in their decision-making process. Methods: A comprehensive discussion relying on systematic literature reviews was conducted to address the ethics, policies, safety, and suggestions for the choice of childbirth approach. Findings: Most women would like to have the freedom in selecting the delivery method, whereas the decision-making process is complicated and multifactorial and needs to coordinate with safety issues, opinions from family members, and recommendations from doctors. Discussion: No evidences could define the safest fetal delivery method. However, in consideration of both the equality and ethical principle, obstetricians should respect the women’s autonomy while obligate to refuse their requests to lower the risk of both the mother and infant. The establishment of trust, exchange of information, fully consideration of all factors, and legal protection can ensure doctors helping the mothers to make the best decision for childbirth approach. Conclusion: The decision-making process for determining the childbirth method depends on the balance among females’ autonomy, family’s suggestions, obstetrician’s obligation, and legal protection of the doctor.
Keywords
Full Text:
PDFReferences
Goldberg H. Informed decision making in maternity care. The Journal of Perinatal Education 2009; 18(1): 32–40.
Gu C, Zhu X, Ding Y, et al. A qualitative study of nulliparous women’s decision making on mode of delivery under China’s two-child policy. Midwifery 2018; 62: 6–13.
McFarlin BL. Elective cesarean birth: Issues and ethics of an informed decision. Journal of Midwifery & Women’s Health 2004; 49(5): 421–429.
Klein MC. Cesarean section on maternal request: A societal and professional failure and symptom of a much larger problem. Birth 2012; 39(4): 305–310.
Loke AY, Davies L, Mak YW. Is it the decision of women to choose a cesarean section as the mode of birth? A review of literature on the views of stakeholders. BMC Pregnancy and Childbirth 2019; 19(1): 286.
Minkoff H. The ethics of cesarean section by choice. Seminars in Perinatology 2006; 30(5): 309–312.
Kaimal AJ, Kuppermann M. Decision making for primary cesarean delivery: The role of patient and provider preferences. Seminars in Perinatology 2012; 36(5): 384–389.
NIH State-of-the-Science Conference statement on cesarean delivery on maternal request [Internet]. 2006. Available from: http://www. nih. gov.
Mill JS. On Liberty. London: John W. Parker & Son; 1859.
Beauchamp TL, Childress JF. Principles of biomedical ethics. USA: Oxford University Press; 2001.
Fry ST, Johnstone MJ, Fletcher M. Ethics in nursing practice: A guide to ethical decision making. The Canadian Nurse 2003; 99(4): 20.
Burrow S. On the cutting edge: Ethical responsiveness to cesarean rates. American Journal of Bioethics 2012; 12(7): 44–52.
Nilstun T, Habiba M, Lingman G, et al. Cesarean delivery on maternal request: Can the ethical problem be solved by the principlist approach? BMC Medical Ethics 2008; 9(1): 11.
Williams HO. The ethical debate of maternal choice and autonomy in cesarean delivery. Clinics in Perinatology 2008; 35(2): 455–462.
Kingdon C, et al. Choice and birth method: Mixed-method study of caesarean delivery for maternal request. Journal of Obstetrics & Gynaecology 2009; 116(7): 886–895.
Okonkwo NS, et al. Maternal demand for cesarean section: Perception and willingness to request by Nigerian antenatal clients. International Journal of Women’s Health 2012; 4: 141.
Doherty C, Doherty W. Patients’ preferences for involvement in clinical decision-making within secondary care and the factors that influence their preferences. Journal of Nursing Management 2005; 13(2): 119–127.
ABIM Foundation. American Board of Internal Medicine, et al. Medical professionalism in the new millennium: A physician charter. Annals of Internal Medicine 2002; 136(3): 243–246.
Seedhouse D. Ethics: The heart of health care. 3rd ed. USA: John Wiley & Sons; 2008.
Szerletics A. Paternalism. The essex autonomy project green paper technical report. Colchester: Essex University, Department of Philosophy, 2011.
Paterson-Brown S. Should doctors perform an elective caesarean section on request? Yes, as long as the woman is fully informed. Bmj 1998; 317(7156): 462–465.
Wax JR. Maternal request cesarean versus planned spontaneous vaginal delivery: Maternal morbidity and short term outcomes. Seminars in Perinatology 2006.
Dietz HP. Pelvic floor trauma following vaginal delivery. Current Opinion in Obstetrics & Gynecology 2006; 18(5): 528–537.
Benedetti TJ, Baldwin LM, Skillman SM, et al. Professional liability issues and practice patterns of obstetric providers in Washington State. Obstetrics & Gynecology 2006; 107(6): 1238–1246.
Silver RM, Landon MB, Rouse DJ. Maternal morbidity associated with multiple repeat cesarean deliveries. Obstetrics & Gynecology 2006; 107(6): 1226–1232.
Phillips M. Maternal rights v. fetal rights: Court-ordered caesareans. Mo. L. Rev. 1991; 56: 411.
Annas GJ. At law: She’s going to die: The case of Angela C. Hastings Center Report 2012; 18(1): 23–25.
Chu S, Chen Q, Chen Y, et al. Cesarean section without medical indication and risk of childhood asthma, and attenuation by breastfeeding. PLoS One 2017; 12(9).
Hobbs AJ, et al. The impact of caesarean section on breastfeeding initiation, duration and difficulties in the first four months postpartum. BMC Pregnancy and Childbirth 2016; 16(1): 90.
Keloglan S, Yilmaz A, Gumus K. Factors affecting mothers’ breastfeeding. International Journal of Caring Sciences 2018; 11(1): 225–230.
Visco AG, Viswanathan M, Lohr KN, et al. Cesarean delivery on maternal request: Maternal and neonatal outcomes. Obstetrics & Gynecology 2006; 108(6): 1517–1529.
Committee on Bioethics. Fetal therapy—Ethical considerations. Women’s Health Issues 1990; 103(5): 1061–1063.
ACOG Committee Opinion Number. Maternal decision making, ethics, and the law. Committee Opinion No. 321 2005.
Allen VM, O’Connell CM, Baskett TF. Cumulative economic implications of initial method of delivery. Obstetrics & Gynecology 2006; 108(3): 549–555.
Druzin ML, El-Sayed YY. Cesarean delivery on maternal request: Wise use of finite resources? A view from the trenches. Seminars in Perinatology 2006.
He Z, Cheng Z, Wu T, et al. The costs and their determinant of cesarean section and vaginal delivery: An exploratory study in Chongqing Municipality, China. Journal of Biomedicine and Biotechnology 2016.
Gillon R. Ethics needs principles—Four can encompass the rest—and respect for autonomy should be “first among equals”. Journal of Medical Ethics 2003; 29(5): 307–312.
DOI: http://dx.doi.org/10.18686/jn.v9i3.173
Refbacks
- There are currently no refbacks.
Copyright (c) 2020 Leixi Li, Wenlin Wan
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
