This paper addresses epistemic aspects of the phenomenon of obstetric violence—which has been described as a kind of gender violence—mainly from the perspective of recent theories on epistemic injustice. I argue that what is behind the dismissal of women’s voices in labor is mainly how the birthing subject, in general, is conceived. Thus, I develop a link between the phenomenon of testimonial injustice in labor and the marked irrationality that is seen as a core characteristic of birthing subjects: an irrationality (...) that appears to be always at odds with the kind of knowledge that is, wrongly, privileged within medicalized childbirth. I use Miranda Fricker’s analysis to argue that a central part of obstetric violence involves laboring women being “wrongfully undermined specifically in their capacity as knowers” : they are disbelieved in the labor room because of a double prejudice, one deriving simply from their condition as women, the second involving the kind of knowledge that many women find useful in the process of birthing. Women in labor thus suffer from both systematic and incidental kinds of testimonial injustice. (shrink)

What is a uterus to a woman and to society? This article calls for a holistic reevaluation of how we perceive and what we expect from women’s uteruses. We explore the powerful and deeply rooted cultural representations of women’s uteruses as mere receptacles and the impact of such representations on biological categories, medical practices, and current policies. Considering controversies surrounding hysterectomies, cesarean sections, and uterus transplants, we elucidate ambivalent narratives that either promote an essentialist approach where the uterus is emblematic (...) of womanhood, or imply that the uterus is a dispensable organ useless outside of reproduction. (shrink)

In this paper I assess the labour ward admission policies introduced by some National Health Service trusts during the COVID-19 pandemic, arguing that these intersected with other policies in a manner which may have coerced birthing people into consenting to vaginal examinations they might have otherwise refused. In order to fully understand the potential severity of these policies, I situate this critique in the historical and contemporary context of the problematic relationship between consent and vaginal examinations. Identifying the legal wrongs (...) associated with performing coerced vaginal examinations, I highlight that the law is inadequately equipped to provide appropriate redress. Further, I illustrate that the issue explored in this paper reflects broader problems which exist with regard to the focus of, and the investment in, the maternity services. (shrink)

This paper critically analyses ‘the paradox of autonomy and consent in maternity care’. It argues that maternity care has certain features that increase the need for explicit attention to, and respect for, both autonomy and rigorous informed consent processes. And, moreover, that the resulting need is considerably greater than in almost all other areas of medicine. These features are as follows: (1) maternity care involves particularly socially sensitive body parts that are regularly implicated in consent‐centred procedures, as well as in (...) unconsented interventions, in ordinary, non‐medical life; and (2) much of maternity care (especially intervening in childbirth) is medically unique, in that it harms one patient (the mother) not primarily for the promotion of her own health but for the benefit of another (the baby). The apt comparison, within medicine, is therefore with non‐therapeutic research and transplantation medicine—both of which have elevated consent requirements characterized by very rigorous consent processes. At the same time—and this delivers the titular paradox—the importance of autonomy and consent in maternity care is at particular risk of being denied or disregarded. Jointly, these considerations make a very strong case for change: attention to and respect for autonomy and consent should be (1) core values; (2) key points of practical attention in the years ahead; and (3) central quality indicators in maternity care. (shrink)