Decision-making during pregnancy: examining the challenges that women face today

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Pregnancy is a time where the woman is in a position where the medical care not only concerns her, but also the health of the future child. The focus of medical care during pregnancy is overwhelmingly centred around avoiding risk, and particularly risk towards the foetus. There is an increasing concern that this approach can cause the pregnant women's autonomy to be undermined, by restricting the choices she can make regarding her behaviour. My research will examine how the principle of respect for autonomy operates in the context of pregnancy, and whether women are being adequately supported in making their own decisions regarding their care. Advances in medicine mean that the foetus has become a more visible entity, and regarded as a patient (although not a legal person under English law), separate to the mother. Although sometimes referred to as the 'maternal-foetal conflict', this terminology is misleading, as the legal disputes in this area involve the woman and the healthcare provider, not the foetus. Rather than maternal-foetal, it is an 'obstetric conflict'. This theoretical approach better reflects that a woman may be voluntarily pregnant, not being in conflict with the foetus, but may nevertheless be in a position where her ability to make meaningful decisions regarding her care is influenced by healthcare providers.