Activisim Birth Trauma Cesarean Section Hospital Birth Informed Consent Jennifer Legal
by Jennifer
Does a Laboring Woman Have Any Rights?
I have been doing a lot of reading about the case of a woman who exercised her legal right to informed consent and refused a cesarean, and subsequently had her baby taken away because of it. This woman’s case hits very close to home for me. She labored in a way that was described as “combative,” “uncooperative,” “erratic,” “noncompliant,” “irrational” and “inappropriate.” I can imagine that the midwives who assisted in the delivery of my son would label the way I labored in much the same way. These terms are all very subjective, and I can imagine them being used for a patient that was vocal about refusing procedures they wanted her to comply with. The court records were vague on the next similarity, but it also seems that this woman was in an abusive environment. She even called the police from her hospital room. From everything I have read, it seems that they are using her accusations of abuse as proof that she was being irrational, and I have seen no description of what abuses occurred, as if the entire subject is too crazy a notion to spend any time on. I think if there was abuse, this is a pretty good explanation of her actions during labor. Another explanation is that she was previously treated for PTSD. A woman who has had PTSD in the past who enters a hostile environment, is in the vulnerable position that being in labor creates, is pressured and perhaps abused, will be triggered by all this and react - there is simply no way around that. When a person with PTSD is triggered, they go into panic mode which will insight the fight, flight or freeze mechanism. She obviously went to “fight”, since she could not flee or freeze at such a time. Instead of the people around her being understanding of her responses, a psych evaluation was done while she was in labor. Her past history of being treated for a mental illness was dug up, and a case was made that her and her husband (since he agreed with her), were not fit parents and the child was removed from their care.
There are several alarming factors in this case. It is legal for a woman in labor to refuse care. Every person has a legal right to informed consent and refusal. Informed consent means that the person will be given the risks, benefits and alternatives of a procedure. Informed consent includes the right to refuse care. But people always say, what if it is an emergency and the baby will die without treatment? The fetus is not legally a person, and therefore a pregnant woman has the legal right to make decisions for her own body, regardless of how those decisions affect the fetus. Furthermore, a parent of a living child has the right to choose or refuse medical treatments for their child. The only legal way that any person can be forced into medical care is if a court order is obtained that deems them incapable of making that decision. I am assuming that the psych evaluation during this woman’s labor was the first step in them trying to obtain a court order. This did not work however, because the first person to examine the woman deemed her mentally capable of refusing care. The second person to examine this woman was unable to complete his examination before her healthy baby was born.
I had no idea that it was legal to have a psych evaluation done while a woman is in labor. I am guessing that this is the only way to obtain a court order, but it seems that it should only be allowable for that purpose. It is unclear to me whether or not these evaluations had any bearing on the decision to remove her child. I find it very unsettling that a woman’s mental health can be evaluated for any purpose while in labor since women enter a different state of mind in order to accomplish the monumental task of giving birth. Is this natural alternate state of being understood by the evaluators? Do they realize that what they are seeing is not mental illness but just a woman in “labor land”? Are they able to decipher the natural affects of being in labor from true mental illness? It seems that any findings from a woman in labor would be in question, so the fact that this was even done with seemingly no understanding that they may not get accurate results is just extremely alarming.
Many people are quick to point out that the c-section refusal was not the final reason given for the removal of her child, but it was her mental illness and her and her husbands unwillingness to work with the system in having their child returned to them. As for her mental illness, she had been treated in the past for PTSD. She had completed her treatment. Many women have a history of being treated for a mental illness. If a woman has ever been to therapy, chances are there is a diagnosis of some kind in her records somewhere. Many women have been on medication at one time or another. Lots of women have been treated for postpartum mood disorders. Will these things now be held against us when we have children? Is it legal to remove a child from a home just because a woman has been treated for a mental illness in the past and they feel that she is therefore at greater risk of abusing or neglecting her child? The irony is that the very system who caused my PTSD can now remove any future children I have because of it? And this is all perfectly legal in this country? As for their unwillingness to work with the system, I can understand that. In those first weeks after being traumatized and devastated, and seeing things through this lens of overwhelming emotions, I am not too sure that they would be capable at that point of seeing the benefits of cooperating with the people who just did this to them.
So, does a laboring woman have any rights? Do the laws of informed consent and refusal apply to her? Why is it that a woman is stripped of all her legal and civil rights during the window of time that she is giving birth, yet she has personal and parental rights at any other time in her life? The laws of informed consent are on the books, but they can’t be upheld legally. If she is violated and damaged, she can not sue for compensation simply because no lawyers will take a case like that. I was just told last week by a lawyer that I had no legal right to refuse any unwanted physical contact or medical procedure during my labor since I had signed a blanket consent form upon arriving to the hospital. Apparently, according to him, a woman can scream “no” and “stop” all she wants to, but she has no legal rights do so, since once she signs that consent form she is allowing the hospital and it’s staff to do whatever they deem necessary from that point on. I disagreed with him, but he holds the beliefs and opinions of most of the lawyers and judges and health care providers in this country. In order for a woman to have any rights, it has to be able to be upheld legally in court. Otherwise, it is just a useless law written in a book somewhere and has no power or bearing on women’s lives. Therefore, I would say that no, women have no legal rights while in labor or giving birth. I think this is the singular problem with our maternity care system. If a woman has no legal rights to refusal in an emergency, then everything becomes an emergency, and she suddenly has no legal rights over anything that happens to her from vaginal exams, to IV’s, to fetal monitoring, to episiotomies and c-sections. In order to change the system, women must be granted their legal rights. Education can only go so far. We can all be highly educated victims, or we can change the system and insist that we have a right to informed consent and refusal in maternity care.
Your point is valid, but if they will let a laboring woman choose an epidural, why not refuse a cesarean? Perhaps because the choice of an epidural is the cultural norm for a hospital? ACOG has the informed refusal policy. Who is supposed to use it if not a laboring woman? I unfortunately don’t have answers, just more questions. But it’s good to start the dialogue.
Lydia,
I think there is a big difference between making a decision about the health and well being of the baby and yourself, and having an overall psych evaluation. As an example, lets say that a person is in a high stress situation and is being chased by someone (and no this is not quite comparable to being in labor, but it is the best I could come up with). That person is not quite themself, but they are capable of making life or death decisions. If there is a passenger in their car with them, they may be being told to make a left turn to save their lives, and the driver is capable of taking in this suggestion and evaluating the situation for himself to make sure it is indeed safe to make a left. If he chooses not to follow this suggestion, other people may disagree with his determination, but he might be able to see obstacles that they don’t. However, if there was a psychiatrist in the back seat asking the person about his overall mental health while all this was happening, and he was being judged by how he is acting in the moment and how he is answering questions posed to him that may have nothing to do with the current situation, then he may not come out looking sane. It would be very difficult to shift attention while such an intense experience is going on.
Laboring women in “labor land” are also capable of making a decision to “make a left turn” when called on to do so while in labor. They are focused on their babies and on the situation at hand, and if they are kept informed of what is happening, they are the best person to make those decisions. No one cares about the well being of her baby more then she does. In order to take her decision making power away from her, one would have to prove that she is incapable of making those decisions. However, laboring women, despite the fact that they are laboring, are called on to make many decisions while they are in labor. As Robin says above, she is offered things like pain medications, which have risks that the woman will need to weigh. Laboring women are generally “offered” one intervention after another as she labors. All come with risks, that she may or may not be informed of, but their are constant decisions that she is called on to make. The problem comes when she tries to refuse a procedure. Then she is suddenly seen as not able to make decisions for herself simply because she made a choice that the provider did not recommend. This is a double standard. If she is capable of making the decisions to accept care, then she is capable to make decisions to refuse care.
In this situation, the woman was right. Her baby was born healthy and she did not need the c-section. Her psych evaluation showed that she was capable of making informed choices, and she made an informed choice which was the correct one. She may have seemed to be acting irrationally, but despite being in labor and not herself, she was perfectly capable of making the right decision for her baby.
My husband, who is also an attorney, believes that a group similar to the NAACP should be set up with the specific intent of preserving, protecting, and defending a woman’s RIGHT to refuse procedures as well as to not be subjected to battery during the childbearing process. This would include a group of lawayers who have specifically agreed to do the legal work for this cause. By doing this, there would be funds and resources available aka an attorney, who could be contacted at 3am if a doctor were trying to obtain a court order to force a cesarean onto a woman, simply because he “doesn’t do VBAC” births. This would also make it possible for women to sue a doctor for battery in instances where the doctor has cut an episiotomy in spite of a woman giving her explicit informed refusal. Let’s get the fundraising going, and get this organization put together!! It is past time, and the need is increasing daily!!!
By the way, my husband is in disagreement with your attorney regarding the legal inability to refuse once a blanket consent has been signed. They are still required to obtain your INFORMED consent for the procedure, and if they fail to provide you with adequate information about the procedure along with your options, your right to refuse is NOT waived.
Delia,
I like your husband’s idea! This is what is totally needed I believe, and I see little hope of things actually changing in maternity care without it. There was an organization called Birth Lawyers (birthlawyers.org) that seemed to be setting themselves up to do this, but their site seems to have been taken down. There is also the National Advocates for Pregnant Women: http://www.advocatesforpregnantwomen.org/ They are working on similar issues, but are not specializing in this one area. I have recently connected with a few lawyers over this issue (unfortunately from other states than I live in, so they cannot represent me) and they assure me they are trying to educate other lawyers so they will take these cases. It seems that lawyers in general are not aware that PTSD can be an injury, and something that will be awarded compensation if proven to be caused by the actions of the provider at the birth.
And, the attorney who told me that about blanket consent was not “my” attorney, he was the hospital’s attorney. Since I could find no lawyers who would even talk to me, I took the advice of the hospital’s patient rep and filed a claim on my own (not a lawsuit claim, just a provision to get compensation for an injury). I was told that the claim would be decided by the county’s board of commissioners, however, as it turns out, the claim is decided by attorney’s of the hospital itself. It seems they only pay claims if they think someone can sue them for more, as a way to save money. So it turned out to be a huge waste of my time and energy. The attorney that told me that about blanket consent was the last person I talked to, who I had asked to please reconsider a rejection to my claim. He said he would look at it again, but I have not heard from him since I wrote this post, so I think that is a dead end as well. Since filing the claim and having it rejected, I talked to an investigator several times, a woman from the hospital, and this attorney, and they all insisted on the same thing; that I had no legal rights to refuse care once I signed the blanket consent. They went round and round with me, but in the end, they know that it would be nearly impossible for me to get a lawyer, so they know they don’t have to pay. It is very frustrating. And now I am well past most of the statute of limitations that I could use - with one possibility remaining, but no prospective attorneys, so I guess that is that.
Delia’s husband is right on target. thirteen years ago, when I was in labor with my first child, I refused to have an epidural, as I was coping well with the pain. The hospital threatened to call Child Protective Services and take my baby away. They were attempting to prep me for an unnecessary c-section. Under their threats I caved, and I will regret it for the rest of my life. I had many complications from the c-section. It was Hell. I have since spoken with other women who were threatened that CPS would be called if they refused epidurals at the same hospital. When my second child was born, at a different hospital less than two years later,they called a psych consult because I was tandem nursing. Go figure.
I’ve been organizing a symposium that talks about *just these issues*. Two panels are particularly relevant to this discussion: Legal Issues Concerning Birth as a Reproductive Right, and Birth Practices and Childbirth as a Reproductive Right. I’m hoping it will get things moving in the right direction for birthing women! Please take a look (and share the info!): http://www.birthsymposium.com. There is power in numbers, and in coalition-building!
I was just told last week by a lawyer that I had no legal right to refuse any unwanted physical contact or medical procedure during my labor since I had signed a blanket consent form upon arriving to the hospital. Apparently, according to him, a woman can scream ?no? and ?stop? all she wants to, but she has no legal rights do so, since once she signs that consent form she is allowing the hospital and it?s staff to do whatever they deem necessary from that point on.
Wow. So by that reasoning…if a woman says “yes” to sex, but then changes her mind somewhere in the midst of foreplay, it isn’t rape if the man forces himself on her?
The last time I birthed in the hospital I crossed out the part of the consent form about giving consent to anything, and wrote in that specific verbal consent was required prior to performing any procedure or administering any medication. Kind of startled my OB…but he did sign it.
Jessica,
Yes, I’ve seen your symposium plans! I work with the organization Solace for Mothers: Healing After Traumatic Chilbirth (www.solaceformothers.org) and my partner and I were hoping to attend, however, we did not end up having the funds. Will you be doing another one ever?
Knitted,
That is a great point about saying “yes” to sex and then changing your mind. About the consent form though, I don’t think it matters at all what you put on it. Recently I am wondering if I even signed a consent form. I don’t recall doing so, it was not in my medical records, and they never refer to a “consent form” they always just say “once you sign on with the midwife program” or “once you come to the hospital to give birth” [then you've consented to whatever we feel is needed]. I don’t think that an altered consent form would protect a woman legally, the only way it would help is if it has some small impact on a particular provider. But legally, no, no lawyer I have contacted has asked me about a consent form. They have all said that they can not take a case based on PTSD, that there is no precedent for that in my state (there is like one case from 1993, and not from my state). I also wonder if altering a consent form in some cases would anger the provider and staff, and the woman may be treated worse. I’m glad it worked out in your case though.
You cannt compare an episiotomy to a cesarean with refusal. There is absolutely no medical indication for an episiotomy and it would be rare that a physician would perform one just for the heck of it. The cesarean section on the other hand has multiple instances, cephalopelvic disproportion, fetal distress, etc where there is definite need or baby and mother might die. Are cesareans necessary, not always, but if you say never then you need to be comfortable with a higher maternal-fetal mortality rate.
If the patient has a right to refuse a procedure (which I agree with) then the physician also has the right to refuse a procedure. If you want a birth that is without risk of cesarean then you should not deliver with an OB and should opt for a home birth where you can do what you want. It’s like the Catholics saying they are going to quit because they will not let women be priests. You don’t have to be a Catholic to believe in Jesus. They have rules and they abide by the rules they have, you don’t have to abide by them if you don’t want to, but why do people insist on going somewhere they know their “way” is different when they can go somewhere they will be embraced. Who is being difficult here?
TheOtherSide, that is an interesting perspective. I see things a bit differently though.
“You cannt compare an episiotomy to a cesarean with refusal. There is absolutely no medical indication for an episiotomy and it would be rare that a physician would perform one just for the heck of it.”
I’m confused, it seems like you are contradicting yourself here. If there is never a medical indication for an episiotomy, yet physicians don’t perform them “just for the heck of it”, then why are so many done? Why are so many forced on women, or done without their consent or knowledge, or done against their explicit written or verbal refusal? After they are done, we are told there was a medical reason, that the baby needed to come out ASAP. If there is never a medical reason, why are we lied to? I actually do think that many providers would disagree with you and say there can be a medical reason, as it does speed up delivery by a small amount, and if a baby is really in distress, the provider may feel that this small amount would benefit the baby.
“The cesarean section on the other hand has multiple instances, cephalopelvic disproportion, fetal distress, etc where there is definite need or baby and mother might die. Are cesareans necessary, not always, but if you say never then you need to be comfortable with a higher maternal-fetal mortality rate.”
Whether cesareans are necessary or not, or how often, is actually irrelevant to this discussion. The point is that women need to be informed of the risks, benefits and alternatives to each procedure and be allowed to decide or refuse it, including cesareans. The WHO recommends a 15% cesarean rate and ours is over 30% and climbing. Anything beyond 15% is no longer healthy for mothers and babies and will start to affect the maternal-infant mortality rate. There is no doubt that at least 15% of cesareans are unnecessary, and women should definitely be informed of the increased risks of a cesarean to her and baby, and the alternatives to having one, and then be allowed to make the choice for herself free of coercion or manipulation or outright force.
“If the patient has a right to refuse a procedure (which I agree with) then the physician also has the right to refuse a procedure.”
No, actually, it is not the physicians job to refuse or accept procedures for a patient. It is also illegal. The physician’s job is to present the patient with their options, explain the risks, benefits and alternatives, and then allow the patient to decide which course of treatment or non-treatment they think is best for themselves.
“If you want a birth that is without risk of cesarean then you should not deliver with an OB and should opt for a home birth where you can do what you want.”
There is no such thing as a birth without the risk of cesarean. Every homebirth midwife has a certain percentage of transfers for c-section, which is generally around 4 to 5%. This percentage is lower then the WHO’s recommended 15% because, first, homebirth midwives only take on low risk women, and second, homebirthing women are not exposed to the iatrogenic risks of the hospital (e.g. epidural, narcotics, immobility, lack of food and water, induction, augmentation, etc.). Also, women don’t expect to have a birth without risks of intervention, and even homebirthing women know that a transfer to the hospital may be needed if the expertise of an OB is warranted. The point of my post was to say that women should have their legal rights to informed consent and refusal upheld, whether birthing at home or at the hospital. When an intervention is needed, the woman should be informed and allowed to make a choice without pressure. Also, most women are given the impression from their hospital based childbirth classes and from their providers prenatally that they will have choices and options and be allowed to refuse certain interventions or treatments. If physicians and hospitals do not intend to allow women their legal rights to informed consent, then they should inform the women of this prenatally so that women can choose a provider that will uphold their legal rights to informed consent. Most women though do not expect to be coerced, manipulated, or forced into things they did not want or need.
“It?s like the Catholics saying they are going to quit because they will not let women be priests. You don?t have to be a Catholic to believe in Jesus. They have rules and they abide by the rules they have, you don?t have to abide by them if you don?t want to, but why do people insist on going somewhere they know their ?way? is different when they can go somewhere they will be embraced. Who is being difficult here?”
Women have a legal right to informed consent, they have parental rights to make decisions for their child, and a fetus is legally not a person, so they have personal rights to make decisions for their own bodies before the baby is born. If the “rules” in a hospital infringe on the personal, parental, and civil rights of an individual, then those “rules” are in contempt of the law. Also, your illustration is not valid. Catholics are upfront about the fact that they do not allow women to be priests, thus people are free to make an informed choice about whether or not they want to belong to that religion. Hospitals and many providers are not upfront about the fact that they do not allow women to have personal autonomy, parental rights, or have the ability to make informed decisions for themselves about their own health care. In fact, many women are mislead to believe they will have these choices, and then when they arrive to give birth, they are not allowed to make them. Had the hospitals and providers been as upfront and honest as the Catholics, then perhaps many women would not be choosing this setting to give birth in.
Hi Jennifer,
Your reply is excellent. “TheOtherSide” is an OB in Tucson, Arizona that has been making the rounds leaving anonymous comments on various blogs. Sort of anonymous… the IP address is there and searchable.
TOS said: “Are cesareans necessary, not always, but if you say never then you need to be comfortable with a higher maternal-fetal mortality rate.”
TOS (Dr. S.T. in AZ)- Is anyone saying “never” here? I haven’t seen an argument to date for no cesareans. And you’re also saying that cesareans are not always necessary, so that’s an argument for fewer cesareans. I would have to agree with you.
This comment and the other I saw this morning have the same reactive tone, which comes across as “Oh yeah, well if you guys can do this, then we should be able to do this, too.” ACOG’s Committee Opinion 385 says you *do* have the right to refuse to perform a procedure, no?
TOS said: “If you want a birth that is without risk of cesarean then you should not deliver with an OB and should opt for a home birth where you can do what you want.”
So you agree that it would be a positive if all women who wanted a home birth actually had the option to plan a home birth with a licensed midwife? I think that’s great. I didn’t realize that you were a fan of women having a range of choices in birth location. Do you cooperate with local out-of-hospital midwives? The U.S. needs more home birth friendly doctors like you.
TOS asked: “Who is being difficult here?”
I guess in your mind it is the women who don’t want to play by your rules, which are comparable to those of the Catholic Church? Well, I suppose as long as you are actively advocating for a strong out-of-hospital network of options for women who, according to your allegory, don’t want to be Catholic, then your argument is partly reasonable. There will still be those of us who push for institutional change at the same time.
See you on Twitter.
Pardon my ignorance, but who will she sue if she refuses treatment and the baby is then injured and/or dies? Should she sue the people who stood back and ignored their hypocratic oath by letting her have her way?
(There are reasons why abortions aren’t usually allowed after x months - why suddenly let the kid die on the insistence of non-medically trained people? YES, it’s her kid, but doesn’t she want to save it?)
“But Doctor, what do I do?”
“Nothing - you’re not qualified” may be funny in the movie (Monty Python’s Meaning of Life), but it’s not entirely untrue, since most mothers aren’t medical trained at all.
YES, I realise that birth is often being over-medicalised, but since one of Australia’s foremost spokeswomen on natural births, midwives, etc, etc just spent _3 days_ in labor AND lost her baby, I should have thought that some balance of “natural” and “sensible idea to get help when it’s standing right there waiting” should be reached.
Kim Asher,
You raise a lot of points, and I will take them one at a time:
“Pardon my ignorance, but who will she sue if she refuses treatment and the baby is then injured and/or dies?”
First, this is a scenario that would rarely occur. Most situations in maternity care are not life or death, and most mothers, when given the risks, benefits and alternatives would choose a life saving procedure over death. If she chose to withhold a life saving treatment, the physician has the option of obtaining a legal court order. It is illegal for the physician to treat her against her will without a court order. If she is found to have the psychological capacity to choose or refuse treatment, her choice to withhold treatment may be upheld by the courts. This is her legal right because a fetus is not legally a person and therefore she has the right to refuse treatment to her own body, even if it means the fetus might die. Second, it is not required that she sue someone if her baby dies or is injured, and it would be very rare that she would do so if she had true informed consent and made her own choice not to treat.
“Should she sue the people who stood back and ignored their hypocratic oath by letting her have her way?”
Which part of the hypocratic oath are you referring to? After reading the entire oath, I do not see any section of it that a physician would be violating by offering a person treatment option and then allowing them to make a choice on how to proceed. If that were so, many physicians would be in violation of this oath, since in most areas of medicine informed consent and personal choice is standard practice. People do not always choose the course of treatment a physician recommends. That is their legal right.
“(There are reasons why abortions aren?t usually allowed after x months - why suddenly let the kid die on the insistence of non-medically trained people? YES, it?s her kid, but doesn?t she want to save it?)”
The act of seeking medical care for her birth would show us that she has a vested interest in “saving” her infant. That does not mean she must submit to any procedure recommended to her. It is rarely a life and death situation. Baby’s lives are not being saved by their mothers being forced vaginal exams, AROM, or continual fetal monitoring. In the case of this post, the recommended medical procedure, a c-section, was not necessary. That was proven when the baby was born alive and healthy vaginally. Studies show that interventions are being overused and causing harm to babies. Mothers being granted their legal rights to refuse these treatments would most often be benefiting their babies lives, not putting them in harms way.
?But Doctor, what do I do??
?Nothing - you?re not qualified? may be funny in the movie (Monty Python?s Meaning of Life), but it?s not entirely untrue, since most mothers aren?t medical trained at all.”
Most people who seek any type of medical care are not medically trained, however, they are still allowed to make decisions for themselves based on the physician’s explanation of the issues, and being presented with the risks, benefits and alternatives of treatment or non-treatment of an illness. All patients have these legal rights and make choices for their health care despite the fact that they do not hold medical degrees. Pregnancy and birth is rarely a medical event, it just happens to take place in a hospital in this country as a cultural practice. This means that most of the “treatments” or procedures a woman chooses or refuses are not life or death, they are done to augment, induce, or otherwise tamper with a normal process. She should certainly have the right to accept or reject something that doesn’t even have a medical or health benefit, and may be potentially dangerous for her or her baby.
“YES, I realise that birth is often being over-medicalised, but since one of Australia?s foremost spokeswomen on natural births, midwives, etc, etc just spent _3 days_ in labor AND lost her baby, I should have thought that some balance of ?natural? and ?sensible idea to get help when it?s standing right there waiting? should be reached.”
This is a completely different topic, and not one that I wrote about in this post, so I am unsure why you are bringing it up? I am not sure who you are referring to or what the circumstances of her birth was. However, I was not writing about natural birth in this article, I was writing about informed consent and refusal in maternity care. Those are two different topics. In this article, I am advocating that patients be allowed their legal rights to make their own choices, not that patients make the choice to birth naturally at all costs. I have no problem with women making informed choices for their maternity care that would include procedures or treatments that may not be considered “natural”. I do have a problem with physicians making these decisions for women and then coercing, manipulating, or forcing them to comply with what the physician feels is the best course of action without giving the mother a true choice. One does not have to be an advocate of natural birth to be an advocate of informed consent and refusal in maternity care.
Kim asked: “Pardon my ignorance, but who will she sue if she refuses treatment and the baby is then injured and/or dies?”
I used to think people were kidding when I saw this question in comment threads– that they were trying to make a joke. I came to realize that people were really wondering.
Why would she sue anyone? Is that a given that someone must be sued if there is a negative birth outcome? Why?
And if you’re referring to the case above, the baby was just fine. The cesarean recommendation was totally unnecessary. The hospital has a 50 percent cesarean rate.
As a labor & delivery nurse I have seen this kind of treatment of women by doctors and hospitals. The true problem in this society is women who are sue-crazy. Doctors want to bail out of a woman’s labor process the minute there is any sign that it’s not progressing, the baby is not tolerating the contractions or the baby is breech and it is completely driven by their fear of being sued in the end. I have seen women come in and want their “au natural” experience and then when something turns up wrong with the baby because she labored too long with a questionable fetal heart rate tracing, the woman is the first in line with her lawyer to sue. As women, we are our own worst enemies in this system!
Kimberly,
When doctors manipulate, coerce and force their patients to comply with any and all of their recommendations, they should not be surprised when the parents sue over a bad outcome. If there was any kind of birth injury in my own birth experience, I would have delighted in suing my providers for everything I could get. If doctors don’t want their patients suing them, perhaps they should work with them instead of ordering them around or physically forcing them to comply.
How tragic that a nurse who is supposed to encourage and support women in labor sees them all as aggressive and threatening.
I had a bad experiance with an OB who was overheard by L&D nurses to have said “Every pregnant woman is a lawsuit waiting to happen” apparently her husband is a laywer and has her terrified of lawsuits. If we had known that before hand we never would have gone to her. On another note, I get annoyed when people talk about how woman can’t make decisions in labor because they are in ‘labor land’. Yes, I realize that SOME women do go into a different state of mind, but that state of mind isn’t necessarily illogical or prohibitive to thinking. I was completely coherent during my entire unmedicated labor, my only issue with ‘labor land’ was I had almost no sense of time. (Usually I can tell you want time it is within ten minutes 24 hours a day regardless of how long its been since I’ve seen a clock or if I’m awake or just been woken, during labor I had no internal sense of time at all) Not all women have a problem following even complex conversations or information during labor. Ironically I just posted about a woman’s rights in labor/delivery on my blog, tigaseren.blogspot.com , but went at it from a very different perspective.
Your post raises in my mind this question– Is a woman in “labor land” even capable of making an appropriate decision about refusing a c-section if she can’t even answer basic questions for a psych evaluation? Medical care decisions are complex, as you know.