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Warning: Not Having A C-Section Is Child Abuse

Posted by BeckySharper in You Have Got To Be Fucking Kidding Me, Anger, Motherhood, Rants, Reproductive rights, Uteri Police, Women's Health on Jul 29, 2009, 9:00am | 37 comments

Recently I’ve been caterwauling rather loudly about the medical establishment and its seemingly endless need to dictate to women what we should and shouldn’t do with our uteri. Now the judiciary’s teamed up with them, as described in the latest post from from Lisa Belkin’s excellent “Motherlode” blog on the New York Times website.

But now comes news that a New Jersey court has…ordered a child (identified in court papers as V.M.G.) to remain in foster care, where she has apparently been for two years, because her mother (V.M.) refused a C-section while in labor and demonstrated “combative and erratic behavior.”

Doctors thought the C-section was necessary; the laboring mother did not. As it turns out, she was right, because the baby was born vaginally, and healthy. But the court has upheld the original petition by the New Jersey Division of Youth and Family Services (NJDYF) that by refusing the mother “abused and neglected” her child. (The court reversed similar charges against the father, B.G.)

Y’all, this is so obviously a big stinking bag of bullshit I’m surprised the court even heard it, much less upheld it. This woman did absolutely nothing wrong, legally or ethically. She’s being punished for not co-operating with her doctors when they decided–they, not her–how she should give birth, and this despite the fact that, as it turned out, she was right and they were wrong:

There are details in the court documents describing those other factors. In investigating the referral from the hospital, the NJDYF learned that “V.M. had been under psychiatric care for 12 years prior to V.M.G’s birth.” But the mother’s mental health was not the reason given for placing the child in foster care in the first place. The refusal of the C-section, and the behavior around the actual birth, were.

First of all, a history of psychiatric care isn’t in and of itself a reason to take a child away from its mother: we all know perfectly sane, competent people who have been under long-term psychiatric care. The court clearly understands this, and is punishing her for her sane decision not to have a c-section. As for combative and erratic–I’d be pretty fucking combative and erratic too if I were in labor and doctors were trying to strong-arm me into having unwanted, invasive major abdominal surgery.

V.M. was an adult, conscious and legally sane. She had the absolute right to make medical decisions for herself. Even if she had been treated for mental illness, Rennie v. Klein–a case decided in the Federal District Court of New Jersey, the same state where this occurred–established that even an involuntarily committed mental patient has the right to refuse treatment unless they were legally non compos mentis (which V. M. absolutely was not). In the Rennie case, the plaintiff’s right to refuse medication was upheld. In  V.M’s case, she chose to refuse surgery. So having exercised her civil right and with no harm done, why the hell is the state of New Jersey punishing her and her child? Unless the judge knows something that wasn’t made public, there’s no child abuse here. At all.

Did the mother take a risk in refusing the treatment? Perhaps. But the doctor treats a pregnant woman, not her fetus. He must respect her right to veto surgery if she so chooses–her being pregnant does not change that right. It’s also worth noting that–according to a watchdog group cited by one of the commenters from Belkin’s article– the hospital where this incident occurred has a 43.9% Caesarean rate, which is extremely high, even when compared to the high rate of c-sections nationally (in 2006, the c-section rate was 31% of live births in the US. The World Health Organization recommends that the rate of c-section births not exceed about 15% in any country.) Unless they exclusively handle high-risk pregnancies, it’s safe to assume that doctors at this hospital frequently opt to cut women open even when they could safely deliver vaginally. If they do this as a matter of course, it’s no wonder some women are going to say no.

I’m troubled by the rate of unnecessary Caesareans in this country–they’re a product of soaring malpractice costs and fear of litigation–but I believe a woman has the right to have an elective c-section if she chooses. She also has the right to refuse one. When a doctor tells a woman she needs a Caesarean, most women would agree unquestioningly. We nearly always default to trusting our doctors to make decisions in our best interests. But doctors are not God. We are legally and morally entitled to disagree with them, including when it comes to decisions about our reproductive systems and our unborn children. Or so we thought. Apparently in New Jersey exercising that right makes you a child abuser and gives the state the right to take that child from you.

37 Responses to “Warning: Not Having A C-Section Is Child Abuse”

  1. emilyanne says:
    July 29, 2009 at 9:52 am

    While I agree with your post I would like to say that in the UK where it is near impossible to get a c-section and you have to fight for the right to an epidural so strong is the natural birth and midwife culture I know plenty of people who would rather doctors had more of a say in births. I wish there was a happy medium between the overly medicalised culture in the US and the endless shaming of those who end up with c-sections in the UK but right now there just isn’t and as someone who has been insulted by people who are supposed to be my friends for the fact that my second child is being born by elective c-section for medical reasons this is probably no longer a subject i can comment on with either clarity or dispassion.

    That said this case is terrible but as someone whose first child was in fetal distress and being deprived of oxygen I personally was more than happy when my doctor told me I was going to have an emergency c-section, 32 hours of labour and no real progress plus a distressed baby will do that for you. It is ultimately a woman’s choice but I worry about the growing tendency to demonise doctors where childbirth is concerned.

    Midwives are not perfect, in the UK they can be bullies – my sister wept through both her pregnancies because of the way the midwives treated her because she didn’t want a completely drug free birth.

  2. BeckySharper says:
    July 29, 2009 at 10:02 am

    Emilyanne, I hope you told those friends to fuck right off. As if it’s any of their business which way your child comes out!

    I think you’re talking about the flip side of the same issue–the medical establishment’s need to impose itself on how women choose to deliver. I remember reading that in Finland, for example, the use of painkillers during labor is so stigmatized that 90% of women give birth with no pain relief. Whether that’s truly their choice–I don’t know. It’s very hard to fight with your doctor, particularly when you’re giving birth. In this case the woman fought to give birth the way she wanted, and was punished for it.

  3. emilyanne says:
    July 29, 2009 at 10:17 am

    Oh absolutely – but i want to point out that in places like Finland and the UK that fighting is with midwives not doctors. In the UK you don’t choose your doctor, you don’t see a doctor when pregnant, you will have your baby delivered by whoever is on call, your entire communication is through the midwives and use of painkillers is very stigmatised. My sister said that she was so relieved this time around when the midwife she was dealing with (who happened to be male) told her just to let him know when she wanted pain relief as her previous two pregnancies that relief had been denied her by the midwives on duty – one of whom told her after 35 hours that she was a silly little girl to want an epidural, yes really.

  4. Spark says:
    July 29, 2009 at 10:36 am

    Thanks for writing about this case. So frightening. This case isn’t about cultural pressure to give birth in a certain way. It’s about women being treated as adults under the law. When we get pregnant in the US, we become second-class citizens.

  5. emilyanne says:
    July 29, 2009 at 10:40 am

    But Spark my argument is that it’s not simply a US phenomenen. There are huge issues surrounding childbirth in other countries too and while this case is frightening I am very wary of kneejerk reactions along the lines of the ‘medical establishment in the US is preventing women from giving birth how they want to’ (which is not what you are saying but which I’ve read elsewhere) because to be honest plenty of other less medicalised cultures also infantilise women and treat them as second class citizens they just take a different angle when they do so.

  6. Rachel_in_WY says:
    July 29, 2009 at 10:44 am

    The appeals court ruling is here, and in it they clearly rule that refusing the c-section was not a valid reason to terminate parental rights, but that her history of mental illness and the fact that she didn’t disclose it to doctors is a valid reason. The thing is, nobody would have even questioned her history of mental illness if she hadn’t refused the c-section. The doctors in this case were so pissy about her refusal to cooperate (i.e. be docile and passive and let them do whatever they felt like) that they used her history of mental illness against her. Apparently during labor they called a psychiatric consultant to determine whether she was competent to give informed consent (and thus informed refusal), and the consultant spoke with her and declared her competent. They didn’t like this and requested a second opinion from another psychiatric consultant, but before that one could get there, the baby was born. In other words, they wouldn’t accept the diagnosis of the psychiatric consultant until it agreed with their view. A similar thing happened in the court case, where several expert witnesses said she had been treated in the past but had not required any further mental health treatment for some time and appeared to be competent, but the state trotted out a couple who claimed the opposite. In cases like these, you just keep going until you find someone who will say what you want to hear.

    So the evolution of the case looks like the medical professionals who were involved in the birth called child protective services because they were pissed that she rejected a c-section. But when it came time to go to court they realized that there’s a precedent that allows women to decline c-sections regardless of the alleged risk to the fetus. So instead they used the “history of mental illness” charge, which has better success in the courts. Absolutely infuriating.

  7. afteriris says:
    July 29, 2009 at 10:47 am

    Emilyanne – when I gave birth 4 weeks ago in the UK, they were sooooo much better than they were 2 1/2 years ago when I had my eldest. Apparently there is a nationwide audit on aneathetists at the moment so if a woman asks for an epidural they have a target of delivering one within 30 min, like a delicious pain relieving pizza.

    Like emilyanne I experienced more pressure from the natural birth movement than the medical establishment with all 3 of my pregnancies (possibly because the natural birth professionals like doulas, yoga teachers etc) practice privately and their income is dependant on your choices, whereas NHS doctors and midwives get paid the same regardless of how you choose to give birth – in fact it’s a lot cheaper for NHS trusts if you have as little intervention as possible.

    Also, if anyone feels like experienceing some righteous indignation on this fine morning then why not check out this thread on Glow in the Woods, a website for bereaved parents: http://www.glowinthewoods.com/home/2008/5/5/birthday-take-two.html#comments

    In a discussion about natural birth, a commenter chides grieving mothers for believing that a healthy baby is the mark of a successful labour and argues that the process is more important than the outcome… even if your baby dies. What a peach.

  8. BeckySharper says:
    July 29, 2009 at 10:49 am

    @Rachel: I just saw this morning that you wrote about this too. Thanks for the background. It’s absolutely infuriating. There’s also a larger issue here about how we treat people with a history of mental illness. Legal precedent clearly protect the rights of the mentally ill, but this seems to be a case of the system just disregarding a woman’s wishes and punishing her because she had a history of mental illness, even though she was by no means non compos mentis.

  9. mischiefmanager says:
    July 29, 2009 at 10:51 am

    Reproductive choice extends to birth, for those who may be unclear on the concept-say, doctors and those who are in the position of doctors, like midwives in the UK. The stories already on this thread are just infuriating. It’s the very beginning of the whole “mothers can do nothing right” attitude we have here. If you want a vaginal, drug-free, intervention-free birth, you’re selfish and endangering your child. If you want a section, you’re selfish and cowardly. If you work you’re selfish, if you stay home you’re wasting your talents and not being a good feminist, blah blah blah. I say let’s not play. Any reasonable choice is a good, valid one, so let’s support each other.

    As for this case in particular, I bet there’s a backstory. I bet that this woman was a “difficult” patient all the way through, so that when she arrived in the delivery room, the staff already had a hostile attitude towards her. If the woman and her doc had worked out a healthy relationship well before the birth, this situation may never have arisen.

    The lesson may be that doctors are like any other employee. If you hire one you need to be clear on your expectations, and if the doc can’t meet them, fire him or her and find one who will. We have the right to speak up about what we want in pregnancy and childbirth, with the proviso that once we find a doctor/midwife with whom we can work, we should listen carefully to their advice.

  10. Rachel_in_WY says:
    July 29, 2009 at 11:06 am

    emilyanne, it does seem that this pressure can go both ways, and it’s evident in the breastfeeding debate as well. But in my experience the over-medicalization of childbirth is a unique U.S. thing, and can be taken to truly frightening levels. My midwife was out of town when I went into labor early, and I had to fight the nurses and doctor all throughout my labor and delivery to prevent them from using interventions that I never agreed to (like a completely unnecessary episiotomy) even though my labor was relatively short with no complications. None. But I had to practically get up off the bed and take the (giant and scary-looking) knife out of her hands. She only put it down when I scooted back on the bed out of her reach and said “I did not consent to this, and if you cut me I will sue you” (with a few obscenities mixed in), as I was crowning. Natural labor was hard but totally doable; the trauma of having someone come at my genitalia with a knife with no warning while I was struggling to complete one of the hardest projects I’ve ever taken on took some time to recover from. Compare that with the experience of friends and family who had truly woman-centered midwife care, and it’s like a whole other world. So I think that’s the issue – whether the care is woman-centered or not.

    And there are all kinds of issues concerning informed consent (most women are misled and not told all the facts about the medical interventions used during childbirth in the U.S.) as well. And the cultural cosntruction of childbirth is significant as well. My cousins in Sweden tell me that childbirth is viewed very differently there, and is not portrayed as the terribly dangerous, scary, and painful thing it is here. So women don’t go in expecting the same awful experience, and therefore many of them don’t experience it as painful and scary. Everyone’s experience of the pain varies, and they adjust to it as they go, but when you’re not feeling threatened and a complete loss of control, the stress level is much lower, and generally the amount of pain you experience is exacerbated by the stress you’re feeling. So I think there are a number of complex factors involved, and women in other cultures may not experience childbirth in the same way we do, thus changing the amount of pain medication and other interventions they need.

    Super long comments today…sorry.

  11. AuntieEm says:
    July 29, 2009 at 11:08 am

    afteriris – (congrats on Moe!!!)
    I had no idea that the UK attitude was so different than here, that’s strange and facinating. (pain relieving pizza, love it) This natural birth culture and stigmatizing of painkillers sounda like the breastfeeding thing. I really don’t get how any of that is anyone else’s business than the parents.

    Also that discussion you linked, I have no words for the stupidity and calousness of that comment . . . just wow.

  12. Spark says:
    July 29, 2009 at 11:33 am

    emilyanne, I’m not demonizing medical intervention. I’m frightened that doctors can get away with ignoring a woman’s legal right to refuse treatment (or choose treatment, like painkillers or chemo) because she’s pregnant. My comment is US-specific because I don’t know how these situations play out legally in other countries.

  13. Vicariousrising says:
    July 29, 2009 at 11:34 am

    Women are also given excessive unnecessary hysterectomies, something like as many as 85%, partly because doctors are not up to date on procedures on how to treat certain medical issues like fibroids (which I was just just diagnosed with). I’m in my 30s and I dared utter the words that I didn’t think I wanted to have another child, and the gyno I saw insisted that the uterus must go. I believed her until I did some very basic research on fibroids and discovered that I really should get a second opinion.

    I find it upsetting that women’s bodies are often treated so dismissively. I want what will be best for me longterm, not just what is easiest for the doctor and cheapest for the insurance company — and, well, if I’m not going to be a babymaker anymore then just toss me in the trash.

  14. Rachel_in_WY says:
    July 29, 2009 at 11:39 am

    AuntieEm, I can understand the passion that natural birth and breastfeeding advocates bring to the situation, because it is truly infuriating to find out that women are being lied to by entire industries soley based on maximizing profits. And I think if we backed off the obsession with “parents choices” and instead focused on the environment in which they make the choices, and what would be required to make truly informed consent possible, this would be far more productive. I mean, if you’re going to give birth in a hospital that performs c-section in almost half of the deliveries, you oughta know that going in. You should also be told that having an epidural and pitocin significantly increase your chances of having a c-section. But women are not given this info as it currently stands, and are often misled about the risks, and we exist in an environment which portrays childbirth as terribly risky and painful and scary, so their “choices” are hardly autonomous and uncoerced. And breastfeeding should be made a real, plausible option for mothers rather than the giant inconvenience and hassle for everyone involved that it is now. Most moms who choose not to breastfeed do so because of the hassle, and because they’re told that formula-feeding is essentially the same. And I think anytime people are misleading women and pressuring them to conform to a capitalist system that does not benefit them or their child in the long run, it’s grounds for feminist concern.

  15. Hill Rat says:
    July 29, 2009 at 1:28 pm

    I think you’re talking about the flip side of the same issue–the medical establishment’s need to impose itself on how women choose to deliver.

    Having just watched my wife deliver a whopping 10 lb 12 oz baby at home, this is a subject that’s been on my mind lately. There are so many things about the way we deal with health care in the US that are totally fucked and this is one of them.

    In our case our shitty insurance dictated that in order to go the midwife practice of our choosing, we had to spend a few thousand out of pocket dollars. We came to find out the reason that Birth Care (They fucking rock my world! Much love to Katie for bringing us our second child!) wasn’t in their network was that (ZUT ALORS!) they attend home births. Obviously this is a decision that’s driven by paranoid bean counters and a medical establishment that’s actively hostile to non-medicalized births.

    I’ll be honest with y’all, I wasn’t really down for the home birth at first. But in the fullness of time, after consulting with our mid-wife and birth assistant, my wife and I were able to decide that a home birth was right for us. That’s the way it should be. A family, in whatever form it takes, should be allowed to decide for themselves how to bring their children into the world. Fuck anyone who says different.

  16. BeckySharper says:
    July 29, 2009 at 1:55 pm

    @HillRat: Hooray! I was wondering if BabyRat had arrived since we hadn’t heard from you for a while. Big congrats to you and your wife, and much respect to her for pushing out an almost 11 lb baby!

    I was a home birth, delivered by a nurse-midwife who later in life became one of the directors of the American College of Nurse-Midwives. I’m not sure I’d do it myself, but MamaSharper was absolutely sure that’s what she wanted and it was a very positive birth experience for her and my father.

  17. x. trapnel says:
    July 29, 2009 at 2:39 pm

    Unfortunately, the idea that we should have control over what happens to our bodies just isn’t particularly sacred; the exceptions are so huge that they swallow the general principle. The drug war exacerbates this–especially when you talk about painkillers–but the bottom line is that actually living up to the principle of bodily self-ownership would be a radical change.

    Sigh.

  18. emilyanne says:
    July 29, 2009 at 2:55 pm

    afteriris, congratulations and i’m glad the experience was so different – my sister who is due in five days is hopeful that this one will be less fraught than the other two due to these changes.

    Rachel – oh it’s crazy I agree. And i do think people need to know more and don’t get me started on insurance issues in this country.

    My actual experience in the US despite the emergency c-section was overwhelmingly positive and I do feel that i have to stress that. The hospital I attended has the lowest c-section rate in Manhattan and I had a female ob-gyn who didn’t push me at any point until it was clear many hours later that a c-section was clearly necessary, the nurses at the hospital and the lactation consultant and the midwives were all great and nobody told me anything other than that everything was my decision.

    Even with the c-section my doctor was very clear about why she would prefer to operate and very detailed in her explanation because she was aware that I was a bit phobic about the whole idea that US doctors pushed for unnecessary c-sections. Certainly I have no doubts that it was carried out for anything other than health issues.

    That said I also do agree that this is often a minority experience and that there is a marked tendency to ignore women’s wishes. It’s simply that I feel that women’s wishes after often ignored elsewhere for the sake of different agenda. And i agree with everyone who has pointed out that really this is something rotten at the heart of the childbirth industry.

    Spark – no I never meant to imply that you were, sorry my comment was badly worded, just that some people (i stress not you) see the issue in terms of all US intervention bad, everywhere elsewhere good and it’s not quite that clearcut.

  19. Rachel_in_WY says:
    July 29, 2009 at 3:07 pm

    HillRat,
    Delivering a 10lb 12ozer naturally is quite the accomplishment. Mine was exactly half that size (they tend to come early at this altitude), and once it was clear she was breathing and nursing just fine I was like “thank god she’s so little and has such a tiny little head!” Although I have a friend who’s delivered both a 10-pounder and a 6-pounder naturally, and she says there’s not that much of a difference. Kinda hard to believe.

  20. Av0gadro says:
    July 29, 2009 at 3:35 pm

    mischiefmanager, I’m a little nervous about your supposition that the woman was a difficult patient and that she should have forged a better relationship with her doctor to begin with. First, there’s really nothing wrong with being a difficult patient. I’m scared of needles, have a science background that leads me to question everything, and am generally pretty difficult. My OB holds my hand when there’s a needle involved, answers my questions, and doesn’t mind when I argue with her. Doctors should be treating patients, not conditions, and not all patients need the same thing. Your suppositions seem a little victim-blaming to me.

    Maybe she should have found a different doctor, but she probably didn’t know it was a problem until she’d already been going for months, and it seems like a really big deal to switch doctors mid-pregnancy. Maybe it isn’t, but the perception is there. And regardless, when she disagreed with her doctor, the doctor’s response shouldn’t be trying to prove she’s crazy. No matter how difficult she was, that’s not how the Hippocratic oath works.

  21. Hill Rat says:
    July 29, 2009 at 3:38 pm

    @BeckySharper

    Thanks for the kind words. It took me a while, but I did a write about it.

  22. Kari says:
    July 29, 2009 at 3:40 pm

    What an infuriating case. I view this under the aegis of my strongly pro-choice stance: women should be supported, educated, and allowed to choose for themselves in every aspect of their reproductive lives.

    Normally my party line is something like, “It should be between a woman and her doctor.” But it seems like so many doctors (and other healthcare providers, like midwives) don’t actually support the women they are supposed to care for. Certainly not in this case!

    There are so many dynamics going on here, between healthcare autonomy, medical intervention in pregnancy and birth, shaming and blaming parents, mental health stigmas…. It really makes me think twice about wanting kids of my own some day. Scary stuff.

  23. Angela Willis says:
    July 29, 2009 at 3:42 pm

    The real child abuse was that the child was taken away from her Mother.

  24. BeckySharper says:
    July 29, 2009 at 3:54 pm

    @HillRat: Sounds like it went just like it should have! Although I laughed when you said you fell asleep holding her leg. I would have pulled back that leg and given you a little wake-up kick.

  25. mischiefmanager says:
    July 29, 2009 at 4:50 pm

    @HillRat-Congratulations to all of you! Parenting is, imho, THE great adventure of life. I hope your experience will be as good as ours has been.

    @Av0gadro: I think you’re misreading me a bit. I put “difficult” in quotation marks to suggest that I was using the term with skepticism. For too many doctors, “difficult” means not being totally obedient, asking too many questions, having personal concerns or constraints that may prevent the doc from taking his or her preferred course of action. You’re exactly right, doctors treat people, with all their imperfections and variations, and if they can’t do that, they’ve chosen the wrong profession.

    I do think, though, that if we want to be treated as full human beings, we need to communicate. We hire the doc, not the other way around, and it’s up to us to make our expectations clear. When doctors and patients communicate with each other effectively, everyone’s happier and we’re more likely to get the treatment we want. I agree that it’s not optimal to leave an OB mid-pregnancy, but in retrospect, I imagine that the woman in question wishes she had done so. Nevertheless, the doc’s actions were way, way out of line.

    Not having been pregnant for quite a while, I wonder how you choose a doc these days. Are there pregnancy planners the way there are wedding planners, with questions to ask and options to consider and so forth? It does seem like having a script when you see a prospective doc or midwife would be helpful, especially the first time around.

  26. Av0gadro says:
    July 29, 2009 at 5:34 pm

    There are, in fact, pregnancy planners with lists of questions to ask your prospective OB! I confess, I went with the practice closest to my work and got really lucky with my doctor. I really can’t imagine being treated badly (or like I have no autonomy) by a doctor. And I wonder how many women don’t stand up for themselves just because they’re in shock.

  27. emilyanne says:
    July 29, 2009 at 5:50 pm

    Av0gardro – really? I never knew. I have to admit I picked the hospital and not the doctor and got lucky as well, coming from the UK doing it the other way felt a bit odd like a doctor was a consumer choice and I cared that I liked the place and the staff where I was giving birth rather than just the person carrying out the delivery. I agree with you about women being in shock and not standing up for themselves.

    Angela Willis, you are absolutely right.

  28. Ista says:
    July 29, 2009 at 6:18 pm

    Well, after reading this, I at least understand why it’s meant to be funny that Susan wants an epidural.

  29. Spark says:
    July 29, 2009 at 6:53 pm

    emilyanne, it sounds like you had a great doctor. I’m curious which hospital you used… I just learned that the hospital my doctor is affiliated with has a very high c-section rate, and it’s a little alarming when I think about staying with her for future childbearing. As for the knee-jerk reaction (I’ve seen it too), I think it’s in response to how out of control some women feel/are. At some point you have to trust your doctor to make the right decision for you, and when you know that many doctors make the best decision for THEM, it’s tough.

  30. Miss Pinot says:
    July 29, 2009 at 7:29 pm

    Once again, thank you, home state for getting in the news for bad things.

    This whole situation shocks and angers me in ways that I can’t fully vocalize, since I’m pretty freaked out by the thought of pregnancy and birth to begin with. To have your body subject to another’s will and an unnecessary surgery would terrify me, so I cannot imagine how frightened this woman had to be. The doctors were asses, but I’ve read a few articles on this case, and the family has not been cooperating with DYFS to get their child returned to them. Should the baby have been taken away in the first place? No. But now that he/she has been, the family should have cooperated with the case worker, and basically bent over backwards to get their infant back. The husband related concerns to the second shrink regarding his wife’s mental state, which I thought was interesting as it sheds light on this whole case.

    Court documents:
    http://www.judiciary.state.nj.us/opinions/a4627-06.pdf

  31. Miss Pinot says:
    July 29, 2009 at 7:30 pm

    Pages 5, 6, and 7 seem to be the pertinent ones on the mother’s mental state.

  32. Miss Pinot says:
    July 29, 2009 at 7:39 pm

    Amendment on the page numbers: if yu go by the page numbers at the abode scroll bar at the top, it’s page 15 onward. If you go by the numbers at the bottom of the page, it’s the ones I mentioned above.

  33. emilyanne says:
    July 29, 2009 at 8:06 pm

    Spark – St Vincent’s in Manhattan – oddly when I tell people they often turn their noses up at it (I have yet to forgive Tim Robbins for saying that he would never allow a child of his to be treated there when he and Susan Sarandon were lobbying for the hospital to be moved), possibly because it also has a large medicare clientele and a big A&E department. I have nothing but praise for all the staff there they were fantastic and nearly two years down the line the nurses still remember my daughter and say hi.

  34. Spark says:
    July 30, 2009 at 10:03 am

    Thanks, emilyanne. I’m passively doctor-shopping. Oh for the days when we all lived in one place our whole lives and didn’t have to play insurance roulette.

  35. TVille says:
    July 30, 2009 at 11:52 am

    Ok, so first I’m going to wear my medical apologist hat. OB/GYN is an unforgiving specialty. Tons of them are dropping their OB practice because of the difficulties they face practicing. (Disclaimer – I have family members who are doctors, I handle insurance billing for several different specialties in Virginia, I’ve taken a dozen classes in bio-medical ethics, specifically informed consent and access, and I’m obsessed with the current state of health care delivery in the US.) OBs are under pressure from the hospitals they work at, as well as their malpractice carriers (who, as with health insurance payers, have an inordinate amount of influence over the way medicine is practiced), to “facilitate” healthy babies, and alive mommies. When something goes “wrong” (i.e., no perfectly healthy baby, and mommy) in a pregnancy, or a delivery the doc gets sued. Babies are incredibly emotionally charged. So, docs aren’t perfect, but they’re also not all assholes. Most of them, that I’ve encountered, are reasonable people who are absolutely willing to listen to and work WITH their patients.

    I do think there is a systemic cultural consideration that women aren’t encouraged to assert themselves, which plays into the dynamic of women being pushed around. I don’t know how to say, “Stand up for yourself” without sounding like I’m blaming the victim. As soon as I figure that out, I’ll be back.

    I will add that I think the steamroller phenomenon exists everywhere in health care – my dad has a cascade of medical problems that require an enormous amount of interaction with providers, and he often has a hard time being heard, and having processes, and options thoroughly explained to him. He’s felt railroaded on a number of occasions, and bounced from doc to doc as a result, also earning him the label of ‘difficult.’

    Ugh, I haven’t even touched on the case – but I did read the court docs and while the c-section refusal was discussed, the courts seemed pretty clear that that wasn’t the reason they terminated custody. Patient and her husband don’t sound as though they’ve been at all cooperative in attempting to get their baby back – they failed to appear for their first court date. Also, the medical system didn’t take the baby away, DCFS did. The hospital might have gotten the ball rolling, but ultimately, DCFS did the removing.

    And finally, taking the medical apologist hat off – I’m having a home birth. When I found out I was pregnant I had no desire to fight with anyone to have the birth I want (minimal / no intervention, no pressure to produce a baby in someone else’s timeframe, leave me the hell alone, I’m having a baby).

    I should get my own blog, so I can stop hijacking other people’s blogs…

  36. Azumanga says:
    August 6, 2009 at 8:11 am

    What if the doctors had been right (they tend to err on the side of caution) and not having the C-section had killed the baby?

    She had no medical training, she decided her want for a natural birth over-ruled the doctor’s professional opinion, and put her baby at risk as a consequence.

  37. BeckySharper says:
    August 6, 2009 at 9:20 am

    @Azumanga: Doctors don’t have the legal right to force treatment on anyone. To say that “she had no medical training”–do you really want to go down that slippery slope? The next time your doctor says you need a procedure, should he/she be able to force you by saying “you have no medical training, so you’ll have to do as I say.”?

    And despite her lack of medical training, she was right and the doctor was wrong. She clearly knew her own body better than he did.

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