Approaches to supporting autonomy in medicine need to be able to support complex and sensitive decision-making, incorporating reflection on the patient's values and goals. This should involve deliberation in partnership between physician and patient, allowing the patient to take responsibility for her decision. Nowhere is this truer than in decisions around pregnancy and Caesarean section where maternal autonomy can seem to directly conflict with foetal interests. Medical and societal expectations and norms such as the expectations of a ‘mother’, constraints of (...) making decisions in an emergency, and the role of technology in viewing the foetus as a separate patient and surgery as a guarantor of results can all act to limit a woman's autonomy. In considering decisions about Caesarean section, maternal interests in bodily integrity can be dismissed as being less important than the foetus's own interests and the mother's duties to it, despite the inherent risks and impacts of such a major surgical procedure... (shrink)

This article explores the tensions between autonomy and expectations of mother-caregivers, in the context of normative trends in post-separation parenting law. Going back to first principles of feminism, the article asks what scope for autonomy there is for modern mothers in the face of socio-legal norms that prioritise shared parenting. The very relationship between mother-caregivers and children illustrates the important connection between relationships and autonomy: the caregiving that mothers provide enables children to become autonomous persons yet, at the same time, (...) this caregiving relationship constrains maternal autonomy. In the current context that encourages shared parenting, the potential for maternal autonomy may be even more compromised—a deep irony in a supposedly post-feminist era. A responsible mother is now expected to nurture a child’s relationship with the father, unless he is proven to be harmful. The ability of women to be at all autonomous from the fathers of their children in the face of this normative expectation is dubious, even when the adults live separately. Moreover, the dominance of the heterosexual and patriarchal family—always a challenge for women’s autonomy—is reproduced in this imposition of equal parenting in the name of children’s rights. This article uses a contextual approach to relational autonomy to point to an approach that might challenge the normative climate of shared parenting. (shrink)