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Posted on 2008.15.09 at 10:43
where am I: windy, sunny tewksbury
How I feel about it all: pissed offpissed off
Tags: , , , , , ,
An excerpt from Marsden Wagner's book Born in the USA:

A woman in northern Florida we will call Ms. P had a normal vaginal birth with her first pregnancy. Her second birth, however, ended with a C-section that she believed was unnecessary, so when she got pregnant a third time, she sought a local midwife and signed on for a planned home birth.

Ms. P had a normal pregnancy, and when she went into labor, her mid­wife came to her home to attend the birth. The labor progressed nicely, but after some hours Ms. P was having a hard time keeping fluids down. Since the local hospital was only a couple of blocks away, her midwife suggested that they go over to the emergency room for a short time to get an intra­venous drip (IV) to hydrate her, and then return home.

In the ER, Ms. P told the staff that she was giving birth at home and would like an IV for a short time. She was put in a room and told to wait for a doctor. When the doctor arrived, he asked if she had had a previous C-section, and when she replied yes, the doctor said that he wanted to admit her for an immediate C-section. Ms. P said, "No thank you, I just want the IV, and then I'm going home." The doctor became adamant, telling her that she "must" have a C-section, and said that he would con­sent to give her the IV only if she consented to the C-section. When she refused his attempt to coerce her, the doctor said that if she did not con­sent to the C-section, the hospital would get a court order to do the C-section. The doctor then asked her to wait, and left the room.

As is typical in any hospital, word of what was going on in the ER spread among the staff. After a few minutes, a nurse ducked into the room where Ms. P was waiting and whispered, "If you don't want to have a cesarean sec­tion by force, you better get out of here quick. There is a back entrance to the ER if you go out and turn right."

Ms. P escaped by the back entrance and went home, where she contin­ued her labor without the benefit of an IV. (Note that the hospital never offered Ms. P the option of having a vaginal birth in the hospital with a staff doctor handy.)

Meanwhile, the chief of obstetrics called an emergency meeting with the hospital administrator and told him that the woman's baby was in grave danger of dying due to a ruptured uterus if an emergency C-section was not done quickly. What he said is not true. Studies have shown that Ms. P's C-section meant that she had a slightly higher chance of uterine rupture than a woman who had never had a cesarean, but the risk was still small—espe­cially since labor was not being induced with drugs—and the chance that the baby would die was even smaller. The hospital administrator, however, was not an obstetrician and had no idea whether or not the information was accurate. He called a local judge and told him to rush over, as it was a life-and-death situation. The judge came to the hospital and was told the same story by the obstetrician. He signed a court order for an immediate C-section—by force, if necessary.

Ms. P was continuing her labor at home when there was a knock on the door. She opened the door to the local sheriff, who was a friend of hers and a member of her church. The sheriff said, "I'm really terribly sorry, Ms. P, but I have here a warrant for your arrest." Shocked, Ms. P said, "What on earth for?" The sheriff answered, "I'm terribly sorry. I don't know what the hell is going on. My orders are to take you to the hospital, in handcuffs if necessary."

Against her wishes and the repeated objections of her husband, Ms. P was taken to the hospital, taken to the surgery ward, tied down on an operating table, and given a forced C-section.

The story doesn't end here. Ms. P and her husband sued the doctors and the hospital. However, in Florida a judge must decide if a case deserves to go to trial, and another local judge decided that Ms. P's case was not worthy of proceeding, so her case never went to trial—a shocking miscarriage of justice, given the serious violation of Ms. P's basic rights. Since then, Ms. P has had another baby, born vaginally at home with no problems. Needless to say, there was no visit to the hospital during the labor.

It is important that women in this country become aware of the danger to birthing women and join the movement to protect them. Ms. P's fam­ily's wishes were not honored, and her body was invaded against her will. Her human rights were violated.... Treating pregnant women in this manner goes against the Nuremberg Code and the Helsinki Accord, which explicitly state an individual has absolute rights over her or his own body and no medical treat­ment can ever be forced. Cases like this indicate a dangerous trend in U.S. maternity care toward totalitarian control of a woman's reproductive life by doctors.

Original blog article is here.

Ms P's whole name is Laura Pendleton. A link to the lawsuit ruling is here (.pdf file)

In summary: The hospital called the cops on her, and the GOVERNMENT took away her reproductive rights by forcing her to have MAJOR ABDOMINAL SURGERY against her will. Holy shit.

Obviously, neither the hospital nor the Florida courts have read this (taken from here):

The often quoted rupture rate of 2.2% for classical incisions is based on studies carried out more than 30 years ago. It is not known whether advances in surgical technology over recent decades will have affected this figure. Caesarean Birth in Britain points out that 'the classical incision was commonly done in days when anaesthesia was not so advanced and blood transfusions and antibiotics were not available, so that rapid surgery and wound infection led to a higher chance of a weak scar'.

Until LSCS became common, it was not unusual for women with classical scars to go on to have vaginal deliveries. Indeed, in 1968 in Kenya, Professor Wendy Savage delivered a woman by caesarean of her 13th child. In 1946 and 1947, her first two children had been born by caesarean and she then had ten normal deliveries.'

Even though the risk of scar rupture following a classical Caesarean is acknowledged as being greater, some women will consider a 97.8% chance of having no difficulties with their previous scar as good odds. Individual mothers need to be enabled to balance their own views of the risks and benefits of vaginal or Caesarean birth and come to their own supported conclusions about what is likely to be most appropriate in their individual case.

This may very well be the scariest thing I've read about birth, ever, and I've been reading about birth since I was a child, and about birth politics since I was a teenager. WTF, AMERICA? (well, okay, Florida, but last time I looked Florida was still a US state).

Okay, now I'm going to bed because I worked all night and I'm knackered.


effervescent at 2008-09-15 15:43 (UTC) ()
Oh my god, that's terrible. I mean, I know that a lot of it stems from the fact that doctors are afraid of being sued (though some say it's because performing a C-section pays more) but I can't believe that someone would DO that.
try to catch the deluge in a paper cup
primroseburrows at 2008-09-15 15:54 (UTC) ()
A 'classic' uterine scar (not used nearly as much as it used to be) does increase the risk of uterine rupture, but most outcomes are good.

I know that a lot of it stems from the fact that doctors are afraid of being sued (though some say it's because performing a C-section pays more)

I think it's both, actually, and C-sections are more bang for the buck because not only do they pay more, but docs can do more of them (they only take a few minutes vs. hours of attending a vaginal birth). Either way, it's about money.

I'm really not surprised at the hospital's behaviour because I've heard way too many stories about how medically managed birth is done (and had a couple of experiences of my own). But the state of Florida going along with it? That's downright draconian.

Edited at 2008-09-15 15:55 (UTC)
Really Happen? - (Anonymous) Expand
the day you left was just my beginning
patchfire at 2008-09-15 15:50 (UTC) ()
Not that it couldn't happen in other states, but from everything I have ever heard, I would not want to birth in Florida. Yeah, their CPMs are legal and everything... and subject to a huge host of "protocols" and regulations about what births they legally can and cannot attend. SUCK.
try to catch the deluge in a paper cup
primroseburrows at 2008-09-15 15:55 (UTC) ()
jenn_unplugged at 2008-09-15 16:01 (UTC) ()

That's so horrific that I can't begin to fathom what she must have experienced. Ugh.
try to catch the deluge in a paper cup
primroseburrows at 2008-09-15 16:07 (UTC) ()
I'm (thankfully) not qualified to say for sure, but I wouldn't be surprised if it felt a lot like rape.
Non-Recovering WoW Addict
heinous_bitca at 2008-09-15 16:20 (UTC) ()
Mind if I link your post to a friend? She has had 3 kids, and all ended up being c-sections, though not entirely by her choice. :(
try to catch the deluge in a paper cup
primroseburrows at 2008-09-15 16:23 (UTC) ()
Oh, gods, yes, link it everywhere. This is the side of reproductive rights that rarely gets discussed. The more people who know about it, the better.
(Deleted comment)
try to catch the deluge in a paper cup
primroseburrows at 2008-09-15 19:12 (UTC) ()
You'd think she would have appealed, but I can't find any evidence that she did. She stuck it to them another way, though, by going on to have another baby, at home, vaginally, with no problems whatsoever.
aingeal8c at 2008-09-15 19:01 (UTC) ()
That is awful.
try to catch the deluge in a paper cup
primroseburrows at 2008-09-15 19:13 (UTC) ()
Not to mention really scary. :/
the_antichris at 2008-09-16 00:37 (UTC) ()
That's terrifying. And it's a flipside to the choice issue that isn't often discussed: choice isn't just about whether to continue a pregnancy, it's about making your own decisions if you do.
try to catch the deluge in a paper cup
primroseburrows at 2008-09-16 11:54 (UTC) ()
I've always said that part of 'choice' is the choice to a. stay pregnant and b. have choices in birth. I rarely see it discussed by feminists, and it should be. It needs to be.
nos4a2no9 at 2008-09-16 02:40 (UTC) ()
That is truly horrifying. Jesus. And the fact that she had no legal recourse whatsoever is icing on the horrorshow cake.

That scares the living beejesus out of me, Prim. Thanks for posting about it. Wow.
try to catch the deluge in a paper cup
primroseburrows at 2008-09-16 11:58 (UTC) ()
It's hella scary. I don't know if it could ever happen in Canada, but then I never thought it could happen here, either. Canada's got regulations in some areas that we don't, and vice-versa, and both countries are big on Birth as a Medical Procedure.
i'm a lucid dreamer
lunarennui at 2008-09-16 05:16 (UTC) ()
i don't know what to say except WTF. so. WTF.
try to catch the deluge in a paper cup
primroseburrows at 2008-09-16 11:55 (UTC) ()
That was basically my first reaction.
One damn minute, Admiral.
trempnvt at 2008-09-16 07:13 (UTC) ()
Oh God. That's insane.
try to catch the deluge in a paper cup
primroseburrows at 2008-09-16 12:00 (UTC) ()
And should be illegal. No, it is illegal. The State of Florida never got the memo, or something.
suchthefangirl at 2008-09-19 21:35 (UTC) ()

I had a Vbac in a birthing center with no problems at all.

But this story is from Florida. Florida is the state where a cartoonist was convicted of making pornography and his punishment was that he was not allowed to draw again. Ever. At all. Even for his own amusement. He moved.

I hate Florida (I'm allowed to, I grew up there). There is much craziness there. So, while this horrifies me beyond words, the fact that it was in Florida, does not surprise me.

Maybe the attention it's getting will affect some change. We can hope.
try to catch the deluge in a paper cup
primroseburrows at 2008-09-19 23:23 (UTC) ()
Remind me not to move to Florida. Not that I ever would because yuck. Way too hot. Way too many milesandmiles of not much at all.

I don't know how much things will change with Florida, but nationwide the birth choice issue is hardly discussed except within the birth/midwifery community itself. But people like Ina May Gaskin are trying, gods know, so I'm not ready to give up yet. *crosses fingers*
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