Women's Rights in the Health Care System: Caesarean Delivery on Maternal Request

This article explores a systems-theoretical question on the resonance capacity of medicine and law that has enabled a recent obstetric change. Insights from autopoietic theory guide my analysis of these subsystems' preconditions or self-referencing processes supporting obstetrics to take up pregnant women's requests for caesarean sections for social reasons. Previously, obstetricians performed caesarean sections on medical grounds only. That change became possible: it resonated with obstetrics, despite limitations imposed on obstetrics and law by these subsystems' unique codes and programs, and in light of law's self-determining individual. This article argues that although the change represents a victory for women's human rights in challenging paternalistic medical decision-making, paradoxically it extended medical control over childbirth by further displacing midwifery. However, obstetricians, midwives and pregnant women have been less empowered by the change. The article interprets how structural limitations or preconditions affect the capacity of communications to resonate and contribute to society's evolution.