This essay aims to show that the nations of Central America must create access to safe and legal abortion as well as promote a political dialogue on the subject that is based on reason and science, rather than religion. Not only does prohibiting abortion constitute a violation of women's human rights, but, based on international human rights law as well as the minimum duties of civil ethics, failing in to provide such access or dialogue would mean failing to meet the standards of a legitimate democratic state.

In 2010, Taffy Brodesser-Akner published an article entitled, “How Childbirth Caused my PTSD,” on Salon.com. Much to my surprise, her claims that she was seriously traumatized by childbirth encountered strong resistance and disbelief. In trying to understand the source of this resistance, I discovered a type of violence, which I refer to as “metaphysical violence,” that is often overlooked, yet prevalent, in what many people in the United States understand as normal childbirth practices and protocols. In this essay, I will use María Lugones’s Pilgramages/Peregrinajes to offer a detailed account of what constitutes metaphysical violence, how it functions, and why it is so damaging to at least 9% of post-partum women who meet the criteria for PTSD and the 18% of post-partum women who show some sign of the disorder. Then, I will offer suggestions for how we can help women who may be victims of metaphysical violence during birth avoid some of the trauma it so often induces.

The birth plan has become an increasingly institutionalized tool of Western birth practices, used both in medicalized and midwifery settings. Limited empirical research has been done on the efficacy of birth plans in achieving a commonly-ascribed goal: empowering women in their birth experiences. Still, less work has been done on the ethical dimensions of birth plans. As such, this tool has become nearly ubiquitous in birthing practices, yet they warrant further reflection. In this paper, I articulate the ethical goals of writing birth plans. I frame the birth plan as a narrative project: one that women are encouraged to write out, after careful consideration, as a kind of story that articulates the values, experiences, and relationships that are most important to shaping their experience of a “good birth.” Given the importance of the birth experience for many women, birth plans are ethical projects that the attempt to reframe and improve the deeper political dimensions of birth and patient choice. Birth plans are meant to structure the experience, guide women’s understanding of the process, and foster important clinical relationships. In this way, they are similar to advance directives, which are written to shape successful end-of-life care. Yet, the success of birth plans as tool for this ethical work is questionable. This tool aiming at women’s empowerment and ethical self-reflection often sets women up for a kind of ethical injury, in the attempt to avoid unwanted physical harms of labor and delivery. Birth plans are not legally binding, despite how they are framed as pseudo-contracts. Instead of resisting the challenges of a medicalized birth and to be empowered agreements, birth plans often set women up to fail, often aiming at unreasonable expectations. In my argument, I ask to identify for whom the birth plan works, and in which ways the birth plan experience can be improved. Finally, I address how the failure to give birth plans uptake during emergencies often undermines the patient-physician relationship, working against the primary goal of empowerment.

As the field of assisted-reproductive technology progresses, bioethicists continue to debate whether and how the availability of this technology creates new moral duties for parents-to-be. It is rare for these debates to seriously engage with questions related to race and class. Camisha Russell asks us to move race from the margins to the center of our discussions of reproductive ethics. She argues that this shift can work as a kind of corrective that will lead to better theory. In this paper, I build on Russell’s work by considering two proposals related to prenatal genetic diagnosis [PGD] that received a lot of attention and debate—Julian Savulescu and Guy Kahane’s argument in favor of a “principle of procreative beneficence” and Janet Malak and Judith Daar’s argument in favor of a legal duty, in certain cases, to use PGD. My analysis of each of these arguments shows how a lack of diverse viewpoints leads to bad theory. I end the paper by showing how including a diversity of perspectives shifts our focus from rights to justice.