The Myth of Women’s Choices in U.S. Maternity Care

Nancy K. Lowe, Editor

Article first published online: 9 OCT 2015

The Editorial in the JOGNN discusses the two side of the maternity care debate.  While the article is focussed on the US health system, it provides a balanced discussion.

Two perspectives are discussed:

One is the perspective of childbirth that is holistic and centered on the woman and her infant and concentrates on the responsibilities of the health care staff members to them.

The alternative perspective is the medical concepts of risk where the focus is on health care in relation to maternal health status as defined by medical risk.

The article provides insight into what constitutes “choice” for childbearing women and their families

At its core, this debate is not about the superiority of midwives over doctors or hospitals over homes. It is about treatment intensity and when enough is enough.

Nancy Lowe’s conclusion is that the idea of choice in maternity care is a myth for many, if not most, U.S. women. Until and unless health care systems and insurers are required to provide a full range of options for place of birth and a full range of providers, the majority of U.S. women have no choice. This is not choice; it is an acute care, risk focused approach that has not been shown to provide any benefit to low-risk women and their infants.