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Perinatal Mental Health: The Lens of Relational Ethics 

Perinatal Mental Health: The Lens of Relational Ethics
Chapter:
Perinatal Mental Health: The Lens of Relational Ethics
Author(s):

Lori d’Agincourt-Canning

, and Deirdre Ryan

DOI:
10.1093/med/9780190851361.003.0011
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date: 30 May 2020

This chapter reviews ethical issues pertaining to the care of women with mental illness during pregnancy and the postpartum period. The incidence of perinatal depression and anxiety and psychotic disorders and their respective treatments are described. Ethics principles and perspectives that guide perinatal mental health care are discussed critically. Relational autonomy is shown to be a key principle to guide treatment decisions for these women. The value of relational autonomy in addressing ethical challenges is illustrated by three cases in reproductive mental health: psychotropic medication decisions during pregnancy; enforced treatment; and disclosure of medication use to fathers. A fourth case addresses social justice considerations of mother–baby units for women experiencing a perinatal mental health crisis. This analysis calls for a notion of self-determination that accounts for how autonomy occurs and is enacted within specific relational, social, cultural, and political contexts.

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