How much autonomy do women actually have when giving birth?

by Bashi Kumar-Hazard, Hannah Dahlen, Kate Brewer, The Conversation

edited by Swati Mestri, reviewed by Andrew Zinin

Swati Mestri

Scientific Editor

Meet our editorial team
Behind our editorial process

Andrew Zinin

Chief Editor

Meet our editorial team
Behind our editorial process Editors' notes

This article has been reviewed according to Science X's editorial process and policies. Editors have highlighted the following attributes while ensuring the content's credibility:

fact-checked

trusted source

written by researcher(s)

proofread

The GIST Add to Preferred Sources

You spend your pregnancy researching and planning for when your baby finally arrives, as well as considering what might happen if things don't go according to plan.

But as overstretched hospitals rush women through labor and discharge them early where possible, you might be left with less choice than you expected.

In recent years, parliamentary inquiries in New South Wales and Tasmania have investigated the mistreatment of women during childbirth, showing how ignoring their right to autonomy and informed consent contributes to physical and mental trauma.

Thousands of submissions and testimonies described a lack of autonomy, disrespect and coercion into unwanted birth interventions.

Women from minority groups (including First Nations, migrant, refugee, lesbian, nonbinary, single and disabled women) are even more vulnerable to discrimination, coercion and lack of autonomy.

So what rights do women actually have when giving birth?

Informed consent includes the right to refuse

Providers must obtain informed consent before performing treatment. Even in genuine emergencies, a conscious patient has the final say.

Informed consent makes permissible medical treatment that would otherwise constitute civil and criminal assault or battery.

Pregnant women have the right to refuse any proposed medical treatment or intervention without having to justify their reasons.

Australian courts have consistently declined to override a competent pregnant woman's refusal of treatment, even if it means putting herself or the fetus at risk.

As NSW Health notes, "Women have the right to give, withhold or withdraw consent at any time, for any reason, even when that decision has the potential to lead to harm to themselves or their unborn babies. Their decision must be respected."

The courts confirm coercing treatment is illegal

This year, the Victorian Supreme Court clarified the legal implications of coercing women into interventions they expressly refuse in childbirth.

In 2020, Larissa Gawthrop and her midwife had developed a birth plan that stated, "I decline all vaginal examinations unless there is an urgent medical reason to do so."

When Gawthrop arrived at her local hospital (Bendigo Health) in labor, however, staff would not admit her or call her midwife unless she agreed to a vaginal examination. After laboring for a few hours, she relented and was formally admitted.

Justice O'Meara held that the hospital's conduct constituted battery and negligence. Battery is an old legal word for unlawful physical contact. In Gawthrop's case, the contact was unlawful because her "consent" was not freely given.

Bendigo Health was ordered to pay general damages.

This judgment reflects growing social expectations that providers, like everyone else, have an obligation to respect women's bodily autonomy and informed choice.

What a provider should do if a woman refuses

A woman's refusal does not mean that a provider can just walk away.

Providers owe a duty of care not to cause injury to a child who is later born alive. But this is not a duty to prevent injury.

Negligent conduct during pregnancy or birth that foreseeably causes injury to a child can give rise to an action in negligence by that child.

The focus is on the provider's communication, not the woman's decision-making. A provider who performs their duty and documents their recommendations and the woman's decision cannot be held responsible for her choices.

Being present and continuing to support the woman mitigates any negligence claim based on inaction.

How a provider should obtain consent

Ideally, a midwife or doctor will engage in meaningful, honest and ongoing discussions about a woman's birth preferences from the very first prenatal appointment. This builds the foundation for a sound, trusting relationship.

The discussions should consider all birthing options, such as waiting for labor to start spontaneously, inductions and planned cesareans, and any other proposed interventions requiring physical contact, diagnostic tests or medications.

These discussions will form the basis for a birth plan that can be fine-tuned throughout the pregnancy.

Discussions about specific treatment options require a multidimensional approach: the "if," "what," "where," "how," "why," "who" and "whether" dimensions.

What this might look like in practice

Let's say an induction of labor has been recommended because a pregnancy has gone past the due date.

It's not ethical or legal to simply tell the woman that induction is required. Discussions must involve:

• what the treatment is
• why it is being recommended
• how, when and where it would happen
• whether there are alternatives
• whether it will affect the woman physically and mentally.

The risks and likelihood of an induction failing—and leading to a forceps or vacuum delivery or a cesarean—must be discussed, as well as the possibility of more pain, having continuous monitoring and a longer hospital stay.

Any risk for the baby when a woman goes past her due date must be explained in a way that is easily understood, such as a risk of stillbirth of one in 1,000 births or one in 500 births.

This is the information women need to give the consent required by law.

Following the discussion, the woman must be given time, without pressure, to ask questions, discuss her options with her support person and weigh them before communicating her decision.

She can agree, delay, decline or stop an induction at any time without having to explain herself. Her team must respect and record her decision, while keeping open the opportunity for further dialogue if she changes her mind.

Building relationships and trust has significant benefits for mothers and babies. Women cared for by a known midwife experience fewer interventions and greater satisfaction.

We need to humanize maternity care so women can have autonomy in their decision-making and emerge from their birth feeling respected and empowered.

Key medical concepts

Informed Consent

Clinical categories

Obstetrics & gynecologyPregnancyWomen's health Provided by The Conversation Who's behind this story?

Swati Mestri

Swati Mestri holds a bachelor's degree in Electronics Engineering and has worked as a content editor since 2019. She has experience editing research documents across technology, health care, and materials science, and has a particular interest in technology and space. Full profile →

Andrew Zinin

Master's in physics with research experience. Long-time science news enthusiast. Plays key role in Science X's editorial success. Full profile →

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Citation: How much autonomy do women actually have when giving birth? (2026, October 23) retrieved 23 October 2026 from https://medicalxpress.com/news/2026-10-autonomy-women-birth.html This document is subject to copyright. Apart from any fair dealing for the purpose of private study or research, no part may be reproduced without the written permission. The content is provided for information purposes only.