Autonomy in place of birth: a concept analysis

Area of Science:

• Maternal Health
• Bioethics
• Healthcare Decision-Making

Background:

• The debate surrounding home birth involves complex ethical considerations, particularly concerning patient autonomy.
• Understanding autonomy in the context of birthplace selection is crucial for informed decision-making in childbirth.
• Existing literature lacks a clear conceptualization of autonomy specifically related to the place of birth.

Purpose of the Study:

• To analyze the concept of autonomy in place of birth within general language, ethics, and healthcare literature.
• To define the attributes, antecedents, and consequences of autonomy in birthplace selection.
• To provide a framework for evaluating autonomy in decisions about where to give birth.

Main Methods:

• A concept analysis guided by the Walker and Avant model was employed.
• Literature review across general language, ethics, and childbirth healthcare domains.
• Identification and analysis of model, borderline, and contrary cases of autonomy in place of birth.

Main Results:

• Autonomy in place of birth is defined by three core attributes: access to information, capacity to understand, and freedom from coercion.
• The antecedent condition for this autonomy is the principle of not harming others.
• Accountability for the outcome is identified as a key consequence of autonomous birthplace decisions.

Conclusions:

• The defined attributes of autonomy in place of birth offer a practical tool for pregnant women, midwives, and healthcare professionals.
• This conceptualization aids in contemplating moral status and facilitating discussions regarding birthplace choices.
• Empowering informed and autonomous decisions supports ethical and patient-centered maternity care.