The Ulysses contract in obstetrics: a woman's choices before and during labour.
Women recognise that labour represents a mind-altering event that may affect their ability to make and communicate decisions and choices. For this reason, birth plans and other pre-labour directives can represent a form of Ulysses contract: an attempt to make binding choices before the sometimes overwhelming circumstances of labour. These choices need to be respected during labour, but despite the reduced decisional and communicative capacity of a labouring woman, her choices, when clear, should supersede decisions made before labour.
Alden March Bioethics Institute, Albany Medical College, Albany, NY 12208, USA. BurcheP@mail.amc.edu
Paul
P
Burcher
D016223:Advance Directives; D016362:Analgesia, Obstetrical / Q000941:ethics*; D000767:Anesthesia, Epidural / Q000941:ethics; D026686:Beneficence; D002755:Choice Behavior; D032982:Contracts; D003657:Decision Making; D005260:Female; D006801:Humans; D007258:Informed Consent / Q000941:ethics / Q000523:psychology; D048949:Labor Pain / Q000188:drug therapy* / Q000523:psychology; D007743:Labor, Obstetric / Q000523:psychology; D016743:Mental Competency; D019365:Metaphor; D036801:Parturition / Q000523:psychology; D026684:Personal Autonomy; D011247:Pregnancy; D016064:Vaginal Birth after Cesarean / Q000941:ethics*