Professional Control or Women’s Choice in Childbirth? Is Either Possible?

Abstract

Over the last 50 years, the relationship between doctors and patients has changed dramatically. The paternalistic approach, seeing the patient as a passive recipient of the care prescribed by the doctor, who ‘knew best’, has changed as the autonomy of patients has come to be seen as an important factor in their care. They are acknowledged as having a right to be kept fully informed about the options for care and to take part in shared decision-making (General Medical Council, 1995). How this can be achieved in women’s reproductive health is a matter for debate, as midwifery has become more dominated by obstetricians since, at the time of writing, home birth has become uncommon. The majority of obstetricians and gynaecologists are men and so have only theoretical, second-hand, not experiential, knowledge of women’s health problems. Their focus on mortality and technology, rather than the psychological and emotional aspects of childbirth, may be seen to reflect a more masculine approach to life.