Consent and the problem of epistemic injustice in obstetric care

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An episiotomy is 'an intrapartum procedure that involves an incision to enlarge the vaginal orifice,'1 and is primarily justified as a way to prevent higher degrees of perineal trauma or to facilitate a faster birth in cases of suspected fetal distress. Yet the effectiveness of episiotomies is controversial, and many professional bodies recommend against the routine use of episiotomies. In any case, unconsented episiotomies are alarmingly common, and some care providers in obstetric settings often fail to see consent as necessary in context. In their article, 'The ethics of consent during labour and birth: episiotomies,' van der Pijl et al reiterate that consent is necessary for episiotomies. They specify, further, that the antenatal period is crucial for exchanging information, establishing trust between the birthing subject and provider, and exploring the birthing subject's - rather than the care provider's - values and preferences regarding episiotomies. They recommend an individualised approach, which would enable birthing subjects to choose how and when they want to give consent.

Original languageEnglish
JournalJournal of Medical Ethics
Volume49
Issue number9
Number of pages2
ISSN0306-6800
DOIs
Publication statusPublished - 2023

Bibliographical note

Publisher Copyright:
© Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ.

    Research areas

  • Ethics, Obstetrics, Primary Health Care, Reproductive Medicine

ID: 371911747