The right to privacy protects every person’s ability to make personal decisions about sexuality, reproduction, and the family without government interference. As the European Court of Human Rights has observed, “the right concerning the decision to become a parent includes the right of choosing the circumstances of becoming a parent,” and “the circumstances of giving birth incontestably form part of one’s private life.” The right to privacy demands that the legal system and the healthcare system support reproductive healthcare choices in a straight-forward way without imposing restrictions or limitations on the basis of other peoples’ moral judgments or preferences. The application of the right to privacy to cover the right to choose the circumstances of childbirth acknowledges that decision-making around childbirth is a reproductive justice issue. Recognition of the right to choose the circumstances of childbirth requires states to legitimize and support the full range of women’s birth choices, including the choice to give birth with a midwife at home or in a birth center, or with a doctor or midwife at a hospital. The state should not enforce medical monopoly and make women’s choices less safe by treating out-of-hospital birth choices as illegitimate and driving them underground. The right to choose the circumstances of childbirth has implications for women’s right to support for vaginal birth. This issue is pressing, as the cesarean rate rises and thousands of women are told that their local hospitals will not support or “allow” vaginal birth. Birthing women have an autonomy right to walk out of an abusive hospital imposing unnecessary surgery, but that leaves many women with only the choice for an unassisted home birth. Birthing women also have a reproductive right to choose physiological childbirth with meaningful healthcare support and emergency backup. Birthing women make decisions around childbirth in accordance with their personal needs. Women’s needs and decisions around modesty and privacy during labor and birth, pain relief, medical assistance, and surgery are different because women are different. Maternity care systems should be able to anticipate and support a diverse range of needs and choices around pregnancy and childbirth, and to support those needs with respect and non-judgment. Respectful maternity care optimizes health for mother, baby, and community.
