TY - JOUR

T1 - Consent and the problem of epistemic injustice in obstetric care

AU - Lee, J. Y.

N1 - Publisher Copyright: © Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ.

PY - 2023

Y1 - 2023

N2 - An episiotomy is 'an intrapartum procedure that involves an incision to enlarge the vaginal orifice,'1 and is primarily justified as a way to prevent higher degrees of perineal trauma or to facilitate a faster birth in cases of suspected fetal distress. Yet the effectiveness of episiotomies is controversial, and many professional bodies recommend against the routine use of episiotomies. In any case, unconsented episiotomies are alarmingly common, and some care providers in obstetric settings often fail to see consent as necessary in context. In their article, 'The ethics of consent during labour and birth: episiotomies,' van der Pijl et al reiterate that consent is necessary for episiotomies. They specify, further, that the antenatal period is crucial for exchanging information, establishing trust between the birthing subject and provider, and exploring the birthing subject's - rather than the care provider's - values and preferences regarding episiotomies. They recommend an individualised approach, which would enable birthing subjects to choose how and when they want to give consent.

AB - An episiotomy is 'an intrapartum procedure that involves an incision to enlarge the vaginal orifice,'1 and is primarily justified as a way to prevent higher degrees of perineal trauma or to facilitate a faster birth in cases of suspected fetal distress. Yet the effectiveness of episiotomies is controversial, and many professional bodies recommend against the routine use of episiotomies. In any case, unconsented episiotomies are alarmingly common, and some care providers in obstetric settings often fail to see consent as necessary in context. In their article, 'The ethics of consent during labour and birth: episiotomies,' van der Pijl et al reiterate that consent is necessary for episiotomies. They specify, further, that the antenatal period is crucial for exchanging information, establishing trust between the birthing subject and provider, and exploring the birthing subject's - rather than the care provider's - values and preferences regarding episiotomies. They recommend an individualised approach, which would enable birthing subjects to choose how and when they want to give consent.

KW - Ethics

KW - Obstetrics

KW - Primary Health Care

KW - Reproductive Medicine

U2 - 10.1136/jme-2023-109156

DO - 10.1136/jme-2023-109156

M3 - Review

C2 - 37344201

AN - SCOPUS:85164444464

VL - 49

JO - Journal of Medical Ethics

JF - Journal of Medical Ethics

SN - 0306-6800

IS - 9

ER -