Yesterday, Dr. Morgentaler died at the age of 90. For those who are not Canadian - Dr. Morgentaler is the person who brought to the Supreme Court of Canada the case that struck down Canada's abortion law as being unconstitutional in 1988.
It was a landmark decision - one that made it clear that a woman alone has the right to autonomy over her own body and that the law as it was, was an infringement on a woman's constitutional rights. The law as it was before 1988 imposed considerable barriers to accessing abortion in Canada. An abortion had to be medically indicated and approved by a panel of physicians as being appropriate. A woman could not have an abortion "just because" she did not want to endure pregnancy and childbirth. As a result, illegal abortions and their consequences were far more common. It is also likely that more children were put up for adoption, more children may have been neglected or abused, more women were derailed from the pursuit of education or careers. To the degree that Dr. Morgentaler made certain that women could determine for themselves whether or not to take on the mantle of pregnancy and childbirth, and improved the lives of women and children - he is a man who is to be applauded.
Although abortion remains controversial in Canada - a woman's right to access one is clear and it is a decision that is hers alone. Her care provider is not obligated to perform an abortion, but is obligated to not interfere with her right to access one.
Shockingly, the situation surrounding patient choice cesarean in Canada is more akin to the situation facing women wanting to access abortion prior to 1988. Currently, access to patient choice cesarean is subject to the whims of care providers and facilities and it seems as though some doctors and hospitals interfere with a woman's right to choose cesarean with impunity. In any other context - such interference with a patient's autonomy would rightfully be met with outrage, but when it comes to patient choice cesarean it seems as though the interference is met by only judgement for the woman who wants a cesarean. It seems as though the idea that a woman has the right to decide what is done with her body is forgotten when the decision is about how her child is born, even though the consequences of that choice are borne by the woman and her child alone.
As a result, women are often denied informed consent and informed choice in childbirth. As a result, tokophobic women, unsure of their ability to access a patient choice cesarean, may choose to abort much wanted children. As a result, some women who are subjected needlessly to a delivery they did not choose may suffer from PTSD. As a result, some women might have difficulties bonding with their children. Some may choose to only have one child. As a result, full reproductive freedom in Canada remains elusive.
There's a lot that can be learned by Canada's approach to abortion and applied to the situation regarding patient choice cesareans in Canada. I hope that one day - a woman's right to choose a cesarean and to informed consent will be as respected and as tolerated as her right to choose an abortion.