There has been a lot of discussion in the pregnancy and birth world about the Irish case of Aja Teehan, who wanted to have a homebirth after cesarean (HBAC). Irish midwives are professionally prohibited from attending homebirths that are considered too risky, and vaginal birth after cesarean (VBAC) risks a woman out of homebirth.
The question posed was whether the woman had the RIGHT to homebirth. This leads to some interesting questions about rights and whose rights they are.
In pregnancy and birth, there are several interested parties who may or may not have “rights” in various health-related decisions. These people include the woman, the man who impregnated her, the person who will be raising the child with her, the fetus/infant, and the practitioners providing reproductive health care and medical services.
For instance, there are rights around getting pregnant. Here we might ask
- Does a woman have the right to get pregnant?
- Does she have the right not to get pregnant?
- Does a practitioner have the right to refuse assisted reproductive technologies to a woman who the practitioner does not want to serve (for instance because she is single or a lesbian, or because she already has several children)?
- Does a woman have a right to terminate a pregnancy?
- Does a fetus have a right to reside in a woman’s body until its gestation is completed?
- Does a man who has impregnated a woman have a right to demand that she continue the pregnancy? Or that she not continue the pregnancy?
- Does a woman have the right to continue a pregnancy that will result in a child who will suffer? What about a child who will present costs to society or the state?
- Does a woman have the right to medical treatment for her own health conditions while pregnant?
- Does a woman have the right to engage in behavior that could potentially harm a fetus she intends to birth?
During labor and birth
- Does a woman have the right to refuse to birth in the way her practitioner thinks best?
- Does a woman have the right to refuse birth interventions a practitioner believes to be optimal? Does she have the right to refuse interventions that are standard hospital policy?
- Does a practitioner have the right to refuse to attend a woman who will not follow the practitioner’s medical advice?
- Whose rights to life and health should predominate in the birth process: the woman’s or the infant’s?
The links in the questions above are not all-encompassing, but are examples of issues implicit in these questions. May we always remember that a woman is a human being whether there is a fetus in her uterus or not.