The role of risk in contentious birth choices
Jindalae Skerman1, Not Applicable 1Not Applicable
Abstract
The concept of “risk” is often utilised in discussions around birth choices – particularly contentious choices such as homebirth. Pregnant women and people are routinely encouraged to avoid many forms of risk in pregnancy and birth. Those who are deemed to be at high-risk may be advised to avoid homebirth. But what is risk? And, perhaps more importantly, what role should it play in ethical discourse when pregnant people choose high-risk homebirth? Risk is not objective or value-free even if it derives from quantitative assessments, statistics and clinical studies. Clinical risk is interpreted and communicated subjectively. The choice of what risk to convey and the language used will reflect the values and priorities of the person giving the information. If this is not done sensitively, then it can lead to miscommunication and anxiety. Pregnant people may therefore lose the opportunity to properly reflect on information about risk in order to make an informed, authentic decision about birth. By this, I mean that they have been provided with the relevant information and can make an authentic decision that reflects on their own values. Ultimately, I argue that risk is both universal and unavoidable in pregnancy and birth. Rather than discuss risk in isolation, the goal should be to ensure that pregnant people have the opportunity to engage in an appropriate communication process around risk with their pregnancy care provider. Pregnant people are then in a position to reflect on the information and make an informed, authentic decision about their birth.
Biography
Dr Jindalae Skerman graduated from Sydney University in May 2023 with a PhD in bioethics, after submitting a thesis in 2022 about high-risk homebirth and contentious decisions in maternity care. She works outside of academia as an insurance lawyer based in Perth, but she still holds a passion for bioethical problems.