Court Ordered Cesarean Sections?

midwifemommyofmany · #1 (**permalink**) 02-20-2006, 12:20 PM

This isn't the entire article, but it gets to the point of the matter. Should courts be allowed to force women to have cesarean sections to save the baby's life?

Baby Talk
May, 2005
By Lisa Collier Cool

Amber Marlowe anticipated an easy delivery when she went into labor on January 14, 2004. But after a routine ultrasound, doctors at Wilkes-Barre General Hospital, in Pennsylvania, decided that the baby--at what looked like 13 pounds--was too big to deliver vaginally and told her that she needed to have a cesarean. The mom-to-be, however, wasn't convinced: After all, she'd given birth to her six previous kids the natural way, including other large babies. And monitoring showed that the fetus was in no apparent distress.

After she said no to surgery, doctors spent hours trying to change her mind. When that didn't work, the hospital went to court, seeking an order to become her unborn baby's legal guardian. A judge ruled that the doctors could perform a "medically necessary" c-section against the mom's will, if she returned to that hospital. Meanwhile, she and her husband checked out against the doctors' advice and went to another hospital, where she later gave birth vaginally to a healthy 11-pound girl. "When I found out about the court order, I couldn't believe the hospital would do something like that. It was scary and very shocking," says Marlowe. "All this just because I didn't want a c-section."

She and her husband, John, turned to the National Advocates for Pregnant Women (NAPW), in New York City, for help in contesting the judge's ruling--the first of its kind in Pennsylvania. The couple is also considering legal action against the hospital. "It's not about us," says John Marlowe. "What's going to happen to the next lady who goes there? We want everyone to know what's going on. What they did was wrong, and our goal is to put a stop to it so that other women don't end up with c-sections they don't need."
Coercive Medicine
Increasingly in the United States, pregnant women are encountering legal or more subtle pressures to have c-sections. Currently, more than a million expectant women have the operation annually, as America's rate of surgical deliveries has hit an all-time high. In 2003, cesareans accounted for nearly 28 percent of births in this country, compared with just 5 percent in 1970. Many factors contributed to this rise--increasing numbers of repeat c-sections, doctors' fears of malpractice lawsuits, and women waiting longer to have kids (which is related to higher rates of complications), to name a few. But while the procedure is usually quite safe and can be potentially lifesaving for mother and baby, it also poses a number of potential risks, including severe bleeding, infection, injury to the fetus, blood clots, and even the mother's death in extremely rare cases.

Yet hospitals in at least a dozen states have obtained court orders to compel unwilling women to undergo this major abdominal surgery. And while Marlowe was able to escape the scalpel, other patients were operated on-- despite their verbal or even physical resistance. In a tragic 1984 case, staff at a Chicago hospital forcibly tied a pregnant Nigerian woman who had declined a c-section to her hospital bed with leather wrist and ankle restraints. The woman objected to the surgery because she planned to return to Nigeria where the operation wasn't readily available, and she rightfully worried about health risks, including a ruptured uterus, if she became pregnant again and had another child vaginally back home. As she screamed for help and frantically tried to free herself, doctors, with a judge's permission, wheeled her off to the O.R. to perform the procedure.

Defying doctors' advice can even lead to criminal prosecution, as Melissa Rowland discovered last year. While pregnant with twins, the 28-year-old Utah mom initially declined a recommended c-section, even though doctors warned that without it her babies might die due to low levels of amniotic fluid and other problems. Several days later, on January 13, 2004, she changed her mind and had the operation. Her daughter, Hannah, survived after treatment with oxygen and antibiotics, but a twin boy was stillborn. Contending that the initial refusal caused his death, prosecutors charged Rowland with first-degree murder. After spending three months in jail, she accepted a deal in which the murder charge was dismissed in return for her guilty plea to two counts of child endangerment (unrelated to her c-section refusal). She's now free, and serving 18 months of probation.

"This case is a tragedy compounded by a shocking abuse of legal authority," contends Lynn Paltrow, executive director of NAPW and a lawyer specializing in reproductive issues. "It shouldn't be a crime for pregnant women to disagree with doctors and make their own medical decisions. Nor should they be punished for a bad outcome when there's always some risk to giving birth, regardless of whether it's vaginal or by c-section."

Emaline · #2 (**permalink**) 02-20-2006, 12:33 PM

I think it is

I'm completely against it. There was a case in NJ where a woman was forced to have a c/s and she and the baby died. Needless to say her family won a huge amount of money in a lawsuit against them.

My friend had a c/s on the 5th and they were afraid they left an instrument behind, so she had to go in for x-rays. Nice!

Doctors are looking at women these days and wanting to go by averages. You have to dilate so much in this amount of time. You have to gain this much. The baby must weigh this much. Your hips must be this big. It is all

Women need to be left alone and allowed to labor as they like.

I have nothing against c/s. They can be an amazing life saving technique. They just should not be routine.

I hate what women have to go through these days to get the birth that they want.

midwifemommyofmany · #3 (**permalink**) 02-20-2006, 12:47 PM

I have nothing against c/s. They can be an amazing life saving technique. They just should not be routine.

I totally agree with you. But I guess what I am referring to is when it is deemed to be a life saving procedure for the baby and the mom totally refuses.

Here is an interesting note about this. Sometimes it isn't the doctors that get the court order...its the hospital. My dh had this situation 2 years ago with a woman he was trying to get to let him c/section her (she had been in an automobile accident and her placenta was abrupting). Anyhow the hospital risk manager pages him and says they have a court order for this lady to get a c/section. He told the risk manager they would have to find another physician to do it bc he would not. He had not even contacted anyone about the situation.

Emaline · #4 (**permalink**) 02-20-2006, 12:51 PM

Yes but I've heard a lot of excuses before, like the woman in the story with the 11lb baby. That is not an emergency. That is not to save her life or the baby. That is why I'm mostly against it. I think it will be abused.

sugarmesweet · #5 (**permalink**) 02-20-2006, 01:06 PM

I don't think a woman should be forced to have a c-section any more than a Jehovah's Witness should be forced to have a blood transfusion.

That being said, I do think any woman who would refuse to try and save her baby's life probably doesn't deserve to be a parent anyway.

Nikel1979 · #6 (**permalink**) 02-20-2006, 01:16 PM

Originally Posted by sugarmesweet

That being said, I do think any woman who would refuse to try and save her baby's life probably doesn't deserve to be a parent anyway.

But at least in the case of the OP, neither the mother nor the baby were in danger. The only way to know that the baby would not have fit would have been a trial of labor. Since the mother had previously vaginally birthed 6 babies, including some larger birth weight ones, there really was no reason to leap to the c-section. Not to mention that u/s are notoriously wrong at "guesstimating" birth weight. The Dr said she'd have a 13 lb baby, and she had an 11 lb baby. That's a pretty big difference. My "8.5 lb" baby was only 6 lb 13 oz when she was born at 42 weeks.

Sotries like that just reaffirm my decision to use a midwife at a birth center rather than an OB in a hospital.

sugarmesweet · #7 (**permalink**) 02-20-2006, 01:19 PM

But at least in the case of the OP, neither the mother nor the baby were in danger.

Sorry I should have been more clear...I meant my statement in general to the topic, not so much about this particular woman.

Nikel1979 · #8 (**permalink**) 02-20-2006, 01:30 PM

Then who gets to decide if it's medically necessary? Obviously in the OP, the OB did think it was medically necessary, even though it wasn't. Granted, I'm not a fan of OBs (or the medical profession at all), but I've seen way too many times women being coerced with scare tactics and not all the facts. (Before any attacks me for that, I do realize there are good OBs out there, but there are plenty of them that don't practice evedence based medicine too.)

midwifemommyofmany · #9 (**permalink**) 02-20-2006, 01:51 PM

Ok but just for arguments sake what if the baby literally is in danger of dying and the mom refuses...I mean all arguments aside about big babies, etc... And then the baby does die (or is disabled) bc the mom refused the c/section.

Emaline · #10 (**permalink**) 02-20-2006, 02:02 PM

I don't know. I've never heard of a woman that was in full control of her facilities that refused a c/s to save her babies lives. Most women that I know that are against c/s are against them because they believe that a vaginal birth is safer for the mother and the baby. If it truly is a life saving situation, then I can't imagine a woman refusing one. Or atleast I do not understand it.

Unfortunately my gut instinct is no, I still do not believe the court has the right to force a woman to undergo one. It is her body and ultimately it should be her choice. I do not think we should have the right to force unwanted surgies upon people. We start here, where does it end?

midwifemommyofmany · #11 (**permalink**) 02-20-2006, 02:14 PM

I mean ultimately I feel like it is the mom's choice, her body and nobody should touch her without her consent. The whole picture in the article with the Nigerian lady and her being strapped down just haunts me....and the fact that a court could actually order that and people follow through with it for me personally just scares the crap out of me.

Nikel1979 · #12 (**permalink**) 02-20-2006, 02:18 PM

Originally Posted by Emaline

I don't know. I've never heard of a woman that was in full control of her facilities that refused a c/s to save her babies lives. Most women that I know that are against c/s are against them because they believe that a vaginal birth is safer for the mother and the baby. If it truly is a life saving situation, then I can't imagine a woman refusing one. Or atleast I do not understand it.

Unfortunately my gut instinct is no, I still do not believe the court has the right to force a woman to undergo one. It is her body and ultimately it should be her choice. I do not think we should have the right to force unwanted surgies upon people. We start here, where does it end?

I don't doubt that there are some women out there that would flat out refuse a c-section. I do doubt they make up any significant percentage of women though.

eden/averymum · #13 (**permalink**) 02-20-2006, 06:42 PM

I agree with what I have heard here.

If the baby is actually at risk and the mother refuses, then the courts need to become in volved as well as child services.

BobbiJo139 · #14 (**permalink**) 02-21-2006, 12:50 PM

Even if the child is in danger I don't think a court should be able to force a women to have a c-section. If the child doesn't survive it is tragedy but a court should not be allowed to ever force someone to have a medical procedure.

Mumfie · #15 (**permalink**) 02-21-2006, 01:03 PM

Originally Posted by BobbiJo139

Even if the child is in danger I don't think a court should be able to force a women to have a c-section. If the child doesn't survive it is tragedy but a court should not be allowed to ever force someone to have a medical procedure.

I couldn`t disagree more. Every childs life is way too important for a stupid *** cow to refuse lifesaving procedures and there shouldn`t even be necessary for the court to intervene in cases where the baby will die without a c-section. The dr`s should interven, without fear of repercussions.

As for the OP; as long as mother and baby are fine, dr´s should not be able to make decisions just because they think somthing MAY happen. The dr`s should only be able to intervene where all the facts say that a life is in danger.

Kadydid · #16 (**permalink**) 02-21-2006, 01:51 PM

I love how creative people get with the word @ss around here.

I think this is a really stick question. As much as I think the women should have a choice in what happens to her body, at some point there is a viable human being that doesn't need mom to survive anymore. For me that life is very valuable. I would hope that no women would choose not to save her baby.
UGH

BobbiJo139 · #17 (**permalink**) 02-21-2006, 02:04 PM

Should a women whose religious beliefs prevent her from consenting to a c-section be forced to under go one? It is my understanding that certain religions prevent you from recieving a blood transfusion which would increase the danger to the mother. Certain societies refuse modern medical care and should not be forced to recieve it.

Mumfie · #18 (**permalink**) 02-21-2006, 11:43 PM

Originally Posted by BobbiJo139

Should a women whose religious beliefs prevent her from consenting to a c-section be forced to under go one?

Withouth a doubt, imo. She`s not alone anymore, if she has a full term baby in her womb. The baby sure can`t speak up for itself so someone have to if the mother is willing to let the baby die just because she has some frucked up opinion about what she can and can not do. You don`t let your child whom you have carried for 9 months die, because "god" told you so, hos stupid is that!

Caryn1003 · #19 (**permalink**) 02-22-2006, 05:59 AM

Originally Posted by Kadydid

I think this is a really stick question. As much as I think the women should have a choice in what happens to her body, at some point there is a viable human being that doesn't need mom to survive anymore. For me that life is very valuable. I would hope that no women would choose not to save her baby.
UGH

I agree.
I also agree that I have no problems with C-sections used for emergency situations, I just don't they should be routine either.

Soon2Bmomof2inMN · #20 (**permalink**) 02-22-2006, 07:16 AM

The problem with this is if you start labeling that child as a person before it is born, that can have ramifications that go beyond forced c/sections.

As much as I would like for these court ordered c-sections to only be used in the most extreme cases, I also think it would be abused and would HATE to be on the cutting end of that knife.