Dr Marija Kirjanenko
1Plunkett Centre For Ethics, ACU, Darlinghurst, Australia, 2Eastern Health, Box Hill, Australia, 3Victorian Virtual Emergency Department, Epping, Australia
Biography:
Dr Marija Kirjanenko is an emergency physician at Eastern Health and the Victorian Virtual Emergency Department in Melbourne. She graduated from Oxford University with a master's degree in practical ethics and is a Lecturer in Philosophical Bioethics at the Plunkett Centre for Ethics, Australian Catholic University.
Marija has taught professional and ethical practice for several years at the University of Melbourne Faculty of Medicine, Dentistry and Health Sciences and helps clinicians navigate acute ethical issues. Marija focuses on translating theoretical ethical concepts into practical applications in daily clinical practice.
Abstract:
Obstetric violence has gained increased attention in the medical community and beyond as a growing body of research highlights the detrimental impact it can have on the physical and psychological well-being of birthing individuals. There are increasing reports of obstetric violence and mistreatment during childbirth care. One in ten women has experienced obstetric violence, highlighting the urgent need to address this issue.
While there are different strategies in place to reduce obstetric violence, birth plans might be a promising approach, as they could allow respectful discussion between birthing individuals and healthcare professionals about preferences, values, and desired level of involvement, potentially reducing the risk of harm and promoting a more positive birth experience.
At present, birth plans are often overlooked as simply a list of preferences for labour and delivery. They are often ignored, resulting in women feeling disempowered and marginalized in the process. Drawing from the value directives in advance care planning and advance statements that are used in mental health in which individuals outline their preferences, values, and beliefs about future care, I propose that birth plans could be conceptualized as value directives that clearly articulate the birthing individual's core values, beliefs, and preferences for their care during the perinatal period. This could shift the dynamic from a list of preferences to be met or disregarded to a document that outlines the individual's values and autonomy in their care, potentially reducing the risk of obstetric violence and promoting a more positive birth.