Rights and Realities in U.S. Maternity Care

Abstract

The global shift toward rights-based, patient-centered healthcare is giving rise to a paradigmatic reconsideration of human and reproductive rights in maternal healthcare. In recent years, international human rights bodies, the World Health Organization, and national NGOs have devoted increased attention to the implication of national and international human rights laws for the treatment of women during childbirth. This article presents a rights-based analysis of the structure and standards of maternal healthcare in the U.S. and internationally, and details changes necessary to ensure respect for the full range of human rights at stake in pregnancy and childbirth. It focuses on the significance of the right to autonomy and informed consent and refusal for shared decision-making and the reduction of cesarean section rates, as well as the implication of the right to privacy for supported reproductive choice around vaginal birth after cesarean and access to midwifery care. A shift to individualized, patient-centered care will require the professional collaboration of doctors and midwives as equal partners in the care of pregnant women and recognition of the woman herself as the central agent and authority regarding her healthcare.