I’ve seen a couple of things recently that has turned my mind to this topic, and I’m curious as to what my readers may think.
Let’s say that you’re a midwife who attends home births (for simplicity’s sake, pretend there are no legal or practical obstacles to this), and a woman asks you to attend the birth of her baby at home. No big deal, right? Except at some point you realize that she (or her baby) is high risk and she shouldn’t be giving birth at home — that it really is safest for her to give birth in the hospital. She refuses, and says that if you don’t attend her at home, she will give birth unassisted. What do you do?
If you attend her birth, are you tacitly approving of it, despite verbal protestations?
If you attend her birth, are you enabling her to give birth in a dangerous situation, because she just might change her mind and give birth in the hospital if she really had to “go it alone”?
If you attend her birth, and something happens, will she resist or outright refuse a timely and/or necessary transfer to the hospital?
If she refuses to go to the hospital, what exactly will you be doing as a midwife? — your job description is to keep her and her baby safe, and since she won’t go to the hospital and OB care now when it would be prudent, will she change her mind in labor? or only after her baby dies or is badly injured?
If you refuse to attend her birth and she does go unassisted, and something goes wrong, will you feel guilty that you weren’t there? or glad that you weren’t there, and the responsibility for the negative outcome isn’t on you?
Would you get the authorities involved, or child protective services?
Would you support her right to give birth wherever and however she wanted, even though the baby would possibly be hurt or killed?