I deliver babies alone most nights, which means I've thought more about autonomy than most people ever will. A woman in labour who feels watched, judged, managed — she tenses, she doubts herself, the whole thing gets harder and slower and less hers. The moment I step back and let her body lead, things change. She knows what to do. She always did. My job is to be invisible enough that she remembers it. That's what autonomy actually is — not the absence of help, but the absence of interference disguised as help. We've built systems everywhere that do the opposite, that manage people into dependency and call it care. I think autonomy is the goal because the alternative is a life spent asking permission to do what you already know how to do.
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