Midwifery, Informed Choice, and Reproductive Autonomy: A Relational Approach

This article examines the parallels between the Canadian midwifery model of care and feminist reconfigurations of autonomy and choice. A critical survey of the medical model of informed consent and traditional notions of autonomy brings to light shortcomings of bioethical theories and decision-making practices that maintain a narrow ideology of autonomy and a limited perception of human characteristics. In contrast, relational models emphasize the social situatedness of the individual, and the relationship between self-trust and autonomous decision making. Shifting beyond the consent paradigm of the medical model, the midwifery model of care and the process of informed choice demonstrate an applied form of relational autonomy. It is my contention that Canadian midwifery’s avowed emphasis on empowerment and informed choice offers an exemplary standard of practice that maximizes women’s reproductive autonomy, thus demonstrating the merits of integrating relational approaches within bioethical theory and the health care context at large.