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Finding Autonomy in Birth

December 20, 2016

Over the last several years, as cesarean deliveries have grown increasingly common, there has been a great deal of public and professional interest in the phenomenon of women ‘choosing’ to deliver by cesarean section in the absence of any specific medical indication. The issue has sparked intense conversation, as it raises questions about the nature … Continued

Pregnant Women and Medical Research

December 20, 2016

Each year, millions of pregnant women are confronted with serious medical illnesses. Yet the evidence base for treating them is distressingly poor. Due in part to ethical concerns about conducting research with pregnant women, researchers and institutional review boards continue to regard pregnancy as a nearautomatic cause of exclusion, even in studies carrying no additional … Continued

Risks, Values, and Decision Making Surrounding Pregnancy

December 20, 2016

Assessing, communicating, and managing risk are among the most challenging tasks in the practice of medicine and are particularly difficult in the context of pregnancy. We analyze common scenarios in medical decision making around pregnancy, from reproductive health policy and clinical care to research protections. We describe three tendencies in these scenarios: 1) to consider … Continued

Factors That Affect Infertility Patients’ Decisions About Disposition of Frozen Embryos

December 20, 2016

OBJECTIVE: To describe factors that affect infertility patients’ decision making regarding their cryopreserved embryos. DESIGN: Forty-six semistructured in-depth interviews of individuals and couples participating in IVF programs. SETTING: Two major southeastern academic medical centers. PATIENT(S): Fifty-three individuals, including 31 women, 8 men, and 7 couples. MAIN OUTCOME MEASURE(S): Qualitative analysis of interview transcripts. INTERVENTION (S): … Continued

Paternalism

December 20, 2016

Lisa Morgan arrives in the office of Dr. Karen Anderson, her obstetrician/gynecologist. Dr. Anderson, who is going over her schedule for the day, hopes that Lisa is not pregnant again. Less than 2 years ago, Dr. Anderson had performed a therapeutic abortion for Lisa, who is now 20 years old and unmarried. The doctor’s concerns … Continued

Shame, Gender, Birth

December 20, 2016

In recent years, critics of modern obstetrics have cited technology as responsible for women’s discontent regarding childbirth. In this essay, I investigate and pry apart the connection between the quality of childbirth experience and technology. After identifying three factors considered constitutive of a ‘good birth,’ I demonstrate how technology can either facilitate or hinder each, … Continued