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The Ulysses contract in obstetrics: a woman's choices before and during labour
  1. Paul Burcher
  1. Alden March Bioethics Institute, Albany Medical College, Albany, New York, USA
  1. Correspondence to Dr Paul Burcher, Alden March Bioethics Institute, Albany Medical College, 43 New Scotland Avenue, Albany, NY 12208 USA; BurcheP{at}


Women recognise that labour represents a mind-altering event that may affect their ability to make and communicate decisions and choices. For this reason, birth plans and other pre-labour directives can represent a form of Ulysses contract: an attempt to make binding choices before the sometimes overwhelming circumstances of labour. These choices need to be respected during labour, but despite the reduced decisional and communicative capacity of a labouring woman, her choices, when clear, should supersede decisions made before labour.

  • Clinical Ethics
  • Obstetrics and Gynaecology

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