Psychology of Childbirth - Introduction to Key Concepts

Special Topics in Biological and Cognitive Psychology

• Focus on the Psychology of Childbirth.

Assignments

• Assignments 7 & 8 are due April 15.

  • Joint assignment: combines the last two assignments.

  • Task: Write and submit 2 exam questions.

Learning Objectives

• Understand various topics related to childbirth and human rights:

  • Use of Electronic Fetal Monitoring (EFM) recordings during brain injury litigation.

  • Counterfactual reasoning and hindsight bias in childbirth scenarios.

  • The myth of cerebral palsy (CP) causation.

  • History of pregnant people's human rights in Canada and the US.

  • The unconstitutionality of therapeutic abortion committees in Canada and overall legalization of abortions.

  • Legal status of the fetus in Canada.

  • Consent rights in medical contexts.

  • Motivations behind unassisted childbirth (freebirth).

Fetal Heart Monitor Interpretation

• Types of Fetal Heart Rate Patterns:

  • Acceleration:

  • Abrupt increase in heart rate from baseline.

  • Commonly observed during labor (83% of labors).

  • Indicators of fetal well-being.

  • Variable Deceleration:

  • Abrupt decrease in heart rate from baseline, variability with contractions.

  • May signify fetal distress if repetitive or severe.

  • Late Deceleration:

  • Gradual decrease after contraction ends, indicative of potential complications.

EFM Records in Brain Injury Litigation

• Expert witnesses use EFM recordings to pinpoint irreversible neurological injury to babies.

• Records serve as a primary tool for blame in legal scenarios, supporting counterfactual claims of avoidance regarding poor outcomes.

Myths about Cerebral Palsy (CP) Causation

• CP is rarely caused by acute severe hypoxia (only about 2%).

• Most CP causes are believed to occur prior to labor (e.g., genetic factors, preterm birth).

• High litigation costs in maternity care exemplify the blame culture.

• There is no correlation between cesarean delivery rates and CP prevalence.

• CP incidence is consistent across developed and developing regions.

Human Rights of Pregnant People in the US

• Roe v. Wade (1973): Recognized constitutional rights to abortion prior to viability (7-2 decision).

• Dobbs v. Jackson (2022): Overturned Roe v. Wade, eliminating federal constitutional protections for abortion (6-3 ruling).

Human Rights of Pregnant People in Canada

• Historical Context (1800s): Abortion practices outlawed, period of strict criminalization.

• Legislative Changes (1900s):

  • 1969: Allowed for abortions under specific conditions via therapeutic committees.

  • R. v. Morgentaler (1988): Supreme Court ruled that abortion laws restricted access and were unconstitutional, leading to full legalization.

Fetal Legal Status in Canada

• Supreme Court Rulings:

  • Tremblay v. Daigle (1989): Affirmed that fetuses do not have legal personhood until birth.

  • R. v. Sullivan (1991): Clarified that legal charges related to murder cannot apply to a termination of pregnancy.

Consent Rights in Canada

• Every capable adult has the right to consent to or refuse medical care for any reason (moral, religious, etc.).

• Health Care Consent Act (British Columbia):

  • General rule: Consent is required for healthcare provision, except in life-threatening emergencies.

  • Health care providers may act without consent only to preserve life or alleviate severe pain.