Symbolically, for 9 months a group of committed researchers cooperated closely to write a grant proposal for a research project into ethical controversies in the mother-midwife relation during childbirth. This CARE-study (Controversies surrounding Autonomy and Responsibility: a care-Ethical study into the mother-midwife relation) is now granted, which means that a young and gifted researcher, philosopher and midwife Rodante van der Waal, is funded to perform her four year PhD study. Next to an empirical research into the advancements of respectful maternity care, the project involves a philosophical study into the ontology and history of pregnancy, childbirth and midwifery care. The project will be performed at the University of Humanistic Studies (Utrecht, The Netherlands) under the supervision of prof dr Carlo Leget. I am proud to be involved in this as co-supervisor.
With great interest I have read this study by Elizabeth Newnham and Mavis Kirkham who develop a care ethical outlook on midwifery as adequate alternative to bioethical and medical emphasis on respect for autonomy. The authors argue convincingly that the concept of autonomy is as such inadequate in ethical questions in midwifery care. Not only is a relational instead of an individualistic view required, as the pregnant woman is two-in-one, also autonomy does not represent the actual obstetric practice that already focuses on the unborn and is not free from paternalism. Hence attention and arguments for autonomy in everyday midwifery practice seem to be primarily rhetorical. An adequate alternative, the authors claim, is care ethics as it uncovers power relations (instead of covering them up) and focuses on concrete relational practices rather than abstract principles. A view that importantly underpins our research.