Medicalisation of childbirth in maternity health policies: Ethical evaluation of the use of medicalisation in the Dutch and British maternity policies

Abstract

This thesis explores the ethical justifiability of medicalisation of childbirth in maternity health policies. This is done by setting a case study on the Dutch and British approaches to childbirth. The former takes the avoidance of medicalisation in low-risk births as a priority, while in the latter the priority goes to enhancing and respecting women's choice. I address the question of which of these approaches leads to more justifiable policy decisions from an ethical point of view. In order to answer this question, I structure a specific ethical framework and I apply it to the policies analysed. At the end of my ethical evaluation I find that the Dutch system is more justifiable from a utilitarian point of view, as it successfully maintains the balance between avoiding risks for high-risk pregnancies and limiting the burdens of medicalisation for low-risk ones. On the other hand the British official policy takes a non-utilitarian approach to maternity care, where the consideration of choice in childbirth is a central concern. In conclusion I suggest that this thesis can contribute to the discourse on maternity reform by clarifying the ethical assumptions of policy decisions.