Louise Marie Roth: Is a Woman in Labor a “Person”? New Assaults on Pregnant Women’s Civil Rights in a NJ Case
Yet another ruling is providing legal support for the false belief that obstetricians are infallible and stripping pregnant women of basic civil rights that are then accorded to other individuals. In the case, New Jersey Division of Youth and Family Services v. V.M. and B.G., the New Jersey appellate court found that V.M. and B.G. had abused and neglected their child, based on the fact that the mother, V.M., refused to consent to a cesarean section and behaved erratically while in labor. The mother gave birth vaginally without incident, and the baby was “in good medical condition.” Then she was never returned to her parents, and the judge in the case approved a plan to terminate their parental rights and give custody of the child to foster parents. What, beyond the obvious, is wrong with this picture? [SNIP] The decision cites hospital records that describe the mother, V.M., as “combative,” “uncooperative,” “erratic,” “noncompliant,” “irrational” and “inappropriate.” Also, her husband indicated that the way she was acting was not her “normal manner and that she is not as ‘tranquil.’”
[snip]
While the court opinion also focuses on the parents’ psychiatric diagnoses (which are fallible medical judgments) and their history of care in determining their fitness as parents and abrogating their parental rights, their psychiatric state would never have been questioned if the mother had not refused invasive abdominal surgery — which was entirely within her rights.
SOURCE
A woman loses custody of her child because she refuses a cesarean section and behaves erratically – the court finds her guilty of abusing and neglecting her unborn child. Never mind she ended up delivering the child vaginally without incident or harm to the child. The court cites her erratic, combative and irrational behavior as part of the reason she should not have custody of her child. I have to wonder if the judge making this decision has ever been in a delivery room. I was my sister’s birth coach twice and both times she could be described as being less than rational and less than a shining beacon of serene behavior.
It seems to me that since she delivered the child safely vaginally the doctor’s call for a cesarean section was either wrong or premature. Cesarean sections have been on the rise and now 1 in 4 women deliver via a cesarean and there are many who believe the use of cesarean is out of hand and many are done for reasons that have nothing to do with the health and well being of the mother or child. ¹
Are women now required to be nothing but willing vessels for conception, gestation and delivery with no rights to determine their own health care? Cesarean sections are major surgery and carry with them many risks for both mother and child. Informed consent carries with it the implication that one has a right to refusal. When did women relinquish their rights to make decisions for their own body? I’m pretty sure nobody took a vote as I wasn’t asked and I’m a woman.
Surely, surely, there is more to this story to justify a judge removing parental rights. Well, yes, there is more to the story.
On April 16, 2006, V and B, a married couple, went to Saint Barnabas Hospital after V began experiencing contractions. V is described in court documents as a 42 year old, college educated woman who was thirty-five weeks pregnant and in labor upon arrival at St. Barnabas Hospital in New Jersey, which boasts a 43.9 percent cesarean rate.²
No, you didn’t read that wrong. The hospital has a 43.9 percent cesarean rate. In 2005 the national average was 25%, well below St. Barnabas’ 43.9%. ³ So, how did the hospital respond to this woman’s refusal? Well, a psychiatric evaluation of course. Of course the woman had a psychiatric history *horrors* and had been on Prozac, Zoloft and Seroquel before her pregnancy. The psychiatrist determined that she was anxious but not psychotic and was capable of understanding the informed consent. So what did the hospital do next? Call for yet another psychiatric evaluation of course. Meanwhile, the baby was safely delivered vaginally. 4
As the case progresses other findings come out. Psychiatrists disagree over the mental state of the woman and things get very murky, BUT, regardless of her mental state, her refusal to agree to a cesarean section should never have been an issue of neglect. You can read the court’s findings HERE where it is noted that V.M.’s refusal to consent to a c-section factored heavily into this decision. If this were an isolated incident it might not be particularly newsworthy, but unfortunately it isn’t:
Health activists say their biggest concern about C-section is the growing number of reports that women are having the procedure forced on them against their will. They offer the example of Amber Marlowe, a Plymouth, Pa., woman who wanted a vaginal delivery during her 2004 pregnancy even though tests showed her infant would likely weigh in at more than 13 pounds. Concerned that Marlowe’s choice could endanger her safety, hospital officials filed to become the legal guardians of her unborn baby and won a court order to perform a “medically necessary” C-section if Marlowe returned to their facility. Marlowe had an 11-pound baby girl through a successful vaginal delivery at another hospital, but stories like hers are becoming more common. To date, hospitals in 12 states have obtained court orders mandating that patients with high-risk pregnancies undergo C-sections in their care. SOURCE
Why are c-sections on the rise? According to Childbirth Connection there are a number of reasons, some of which have nothing to do with the health and well-being of the mother and child:
Why is the c-section rate rising?
Many factors are driving cesarean rates up, including:
- providers’ fear of lawsuits: given the way our legal system works, even when scientific evidence supports vaginal birth, providers may feel that performing a cesarean reduces their risk of being sued or losing a lawsuit
- forced cesareans: more and more women who have had a previous cesarean or whose babies are in a breech rather than head-first position are unable to find doctors and hospitals willing to offer vaginal birth due to fear of lawsuits
- casual attitudes about surgery: our society is more tolerant than ever of surgical procedures, even when not medically needed
- growing belief that c-section is “safe” and vaginal birth is “harmful”: these opinions began to form before a careful look at the relevant research, and the research does not support them
- side effects of other common procedures: attempts to start labor artificially (labor induction) and use of electronic fetal monitoring to see how a baby responds to labor interventions are on the rise, and both increase the likelihood that a woman will have a c-section
- failure to support normal physiologic labor: care that promotes normal vaginal birth processes – such as continuous labor support from a doula, or use of hand movements to turn a breech baby to a head-first position (external version) – greatly lowers the likelihood of c-section. SOURCE
I think we are treading on very dangerous ground when a woman’s refusal to have a c-section is cause for having her child taken away from her. Quite frankly, I’m glad I’m not able to have children as the atmosphere in this country concerning childbirth and parenting has become frightening.
¹ SOURCE
² SOURCE
³ SOURCE
4 SOURCE
that is horrible.
Any decent politicians in NJ willing to stick up for her? Seems like a Senator or a congressperson would be good. Can you contact one or find one that should have start a campaign for people to contact them regarding this?
Sage Reply:
July 25th, 2009 at 1:11 pm
I can do some checking. I don’t know much about NJ politics. I certainly didn’t know until I started doing research for this that doctors were trying to force women to have c-sections.
jess Reply:
July 25th, 2009 at 4:24 pm
Maybe someone at the confluence knows, i think the mod is from NJ. If you guys can get something together maybe you and she can come up with a list of people and both post it on your sites with a list of people we can all email about the issue.
jess Reply:
July 25th, 2009 at 4:25 pm
Maybe someone at the confluence knows, i think the mod is from NJ. If you guys can get something together maybe you and she can come up with a list of people and both post it on your sites with a list of people we can all email about the issue.
Although that might be easier said than done, i know. Maybe figure out the congressperson in the district that the hospital is in.
Sage Reply:
July 25th, 2009 at 4:45 pm
Senator Frank R. Lautenberg
Newark
Phone: (973) 639-8700
Toll Free: (888) 398-1642
Camden
Phone: (856) 338-8922
Washington, DC
Phone: (202) 224-3224
TTY: (202) 224-2087
Senator Robert Menendez
Contact form: http://menendez.senate.gov/contact/contact.cfm
Rep. Bill Pascrell
Contact form: http://pascrell.house.gov/contact/
blake Reply:
July 28th, 2009 at 4:41 pm
I encourage you guys to read the case study before writing to your senators. You may actually agree with the judge that the lady is indeed psychotic and it is an unfit home for the child. Click on the first PDF file locate here:
http://www.google.com/#hl=en&q=New+Jersey+Division+of+Youth+and+Family+Services+v.+V.M.+and+B.G+&aq=f&oq=&aqi=&fp=5TZlSg8c0wI
Telling quote: “[The judge] emphasized that although he
believed that [the baby] was in imminent danger, he did not base his
finding solely on V.M.’s reluctance to consent to a c-section.
In fact, he observed that there were probably many instances
where a mother’s refusal to accept a c-section would not
constitute abuse.”
Sage Reply:
July 28th, 2009 at 6:29 pm
The judge also said that her refusal played heavily in his decision.
This is what I said:
Well My freind had a c section. Not sure what they gave her, I don’t know but when they wheeled her out, she told me she had a litter of kittens, that her husband hates cats and would probaly drown them. Then she laughed. They let her baby go home with her. LOL
My husband said I was pretty entertaining with some of my language and during one delivery, I discovered they had restrained my hands, supposedly so I wouldn’t reach “down there” during the birth. This was all natural child birth. It hurts, there is very little you can control about the process and when you do loose control of your breathing. I had my first baby before lamaze had really taken hold. Some of the women in the other rooms were screaming for their lives it sounded like.
I don’t get the rational of NJ.
Sage Reply:
July 25th, 2009 at 2:32 pm
I wonder if the c-sections are being pushed because they cost about twice as much as a vaginal delivery.
The decision cites hospital records that describe the mother, V.M., as “combative,” “uncooperative,” “erratic,” “noncompliant,” “irrational” and “inappropriate.”
This, ALL OF MY LIFE, is how I’ve been taught to believe women in labor are supposed to act…………..
I mean, it is well known and movie after movie after book after joke has been made about how erratic and irrational women in labor are.
These NJ doctors had never experienced these emotions before?
W T F !!!!!
Sage Reply:
July 25th, 2009 at 4:33 pm
It sounds to me like that hospital does c-sections for reasons other than the mother or child’s health. A 43.9% c-section rate is outrageous.
Sage Reply:
July 25th, 2009 at 2:32 pm
I wonder if the c-sections are being pushed because they cost about twice as much as a vaginal delivery.
………………………………….
Sage this is curious to me . It goes back to the health care reform issue and why you would be so behind the current reform program when you even ‘ might’ think that a surgery would be pushed for pure profit. This is exactly the kind of ‘reform ‘ I am for. The kind that cuts unnecessary costs before addressing any kind of universal care.
And BTW I had 2 c sections.
Loved them . But my first kid was 42 weeks gestation when I was induced and after 36 hours of labor ZERO progress. That kid never wanted to come out, zero dilation, etc. So the next time I was pregnant I had the option and I jumped on it. Doc’s said a repeat of first labor was probable, not necessarily the way it would go, but probable was bad enough for me to avoid.
Sage Reply:
July 25th, 2009 at 5:34 pm
I’m not sure what me being behind the reform has to do with this. I’m confused. Plus, I’m not sure I’m behind the reform as written. I just believe we need reform and am waiting to see what the Senate comes up with.
AliSilver Reply:
July 26th, 2009 at 7:45 am
Sorry Sage, I misunderstood. I thought you were pro this health care reform lock,stock and barrel. My bad
Sage Reply:
July 26th, 2009 at 11:53 am
Well, we really don’t know what it is yet. The Senate isn’t going to pass what the House did with no changes. Not going to happen.
But, I still don’t understand what my belief that they make being doing c-sections for money has to do with supporting the reform.
Wizcon Reply:
July 25th, 2009 at 8:47 pm
Geesh, I thought 26hrs was bad. Everyone of mine, they gave me oxytocin (?) because labor would stop.(My hubby told me it was what they gave pigs for labor on the farm) I went thru 3 shifts I know. One Dr had everyone manipulating the mattress to try to position the baby better. I really don’t recall if they talked C section. All of them were early. The biggest being 6 lbs and the littlest 4 lbs 12 oz.
AliSilver Reply:
July 26th, 2009 at 7:50 am
Ok this is what has changed in 15 years. In fact, TODAY is my son’s long awaited 15th bday. So 15 years ago YESTERDAY I was in agonizing forever never ending labor, contractions hard and heavy and no progress. WEIRD ~ But the doc’s never once even suggested a c section. I think because m yself and baby were never in any ‘distress’. There was just no progress. I would not have even been having contractions without the induction of labor via “petocin” i think it was. They were talking about all kinds of crazy stuff like sending me home mid labor or inserting a balloon to cause dilation, etc. Lots of strange stuff to me. Then around 11 pm the SECOND night, i said “COME ON GUYS WTF < CANT I HAVE A C SECTION" and the docs and nurses are all like :O U want a c? I'm like well I don't want to just lay here in labor FOREVER ( note irrational, nonsensical behavior
) I cannot tell you how quickly I went into an OR and had a baby before 12. So at THAT time 15 years ago in TX, I was under the impression they were not allowed or encouraged to suggest a c UNLESS there was risk or trauma or distress. But after nothing else seemed to work and it was MY suggestion, they whisked me right in and we had him pretty quick. The speed of things was unreal. So I wonder had I never brought it up, what might have happened. Looks like the opposite is true today !!!!!
AliSilver Reply:
July 26th, 2009 at 12:18 pm
WEirdo! My post disappeared before I could post this this morning and I could never retrieve it. I’m glad it showed up because I was not going to try to re write it.
Sage Reply:
July 26th, 2009 at 12:47 pm
It went into the spam folder for some reason. I retrieved it.
Cool, thanks for the contact info of the Senator and Congressperson. I will write them and hope all readers of this entry write them as well.
Sage Reply:
July 25th, 2009 at 11:10 pm
You’re welcome. I’ll write them as well.
New Jersey C section rates are outrageous. The stats go up to 2006 where its 42,600 out of 115,593 births. Thats about 37% of all births!
http://www.auction.com/auction_details_online.php?page=1&auctionID=O-003&showFields=&showFields=&pagegroup=1
Sage Reply:
July 26th, 2009 at 12:48 pm
St. Barnabas’ is 43.9%. That’s outrageous.
Wizcon Reply:
July 27th, 2009 at 8:37 am
I think that it is a matter of liability and money. One of mine was in distress and they zipped me into the delivery room. There stood the last obgyn I wanted to see in there. In fact I had told my husband that if that guy was in there to get me out of there. The guy was being sued for crushing a baby;s skull with forceps during delivery. Tearing in right after us was my pediatrician who knew I had reservations about this guy. There was a lot lot of consulting going on which I did not hear but saw the hubby involved.They apparently decided that it was to late for a c section. Forceps were used under the pediatricians supervision and the baby aspirated some fluid which the pediatrician dealt with. This is one of the liabilities Drs face with vaginal births.
They also tell you C Section babies are “prettier”. Meaning better shaped heads which can get reshaped during vaginal births. That fixes itself when it happens.
Hey Sage… interestingly enough I just read an article on this very subject a few days ago.
One of the things not mentioned above, but was mentioned in the article I read, is time.
With a C-Section, comes the following…
1. The hospital can plan time of delivery (meaning hospital can fit/schedule more deliveries in on a day = more money)
2. The delivery rooms are not needed for nearly as long and are needed for a relatively predictable amount of time (meaning hospital can fit/schedule more deliveries in on a day = more money)
3. The Doc only has to work a fraction of the time (meaning doctor can fit more deliveries in on a day = more money OR the same money with less work)
Nice, huh?
Sage Reply:
July 27th, 2009 at 3:43 pm
Hi, THC,
One of the articles I read when doing research said that some doctor’s are blaming the high c-section rate on women asking for them but in fact only 2% of c-sections are at the request of the pregnant woman.
The baby was taken away because the lady was freaking nuts, NOT because she refused a C Section. Read the case study. Her actions after leaving the hospital only prove her psychotic state (everything from assaulting a psychiatrist to refusing to show at court appearances). The judge even said he “wanted desperately to reunify this family,” but the parents kept “snatching defeat from the jaws of victory.”
Sage Reply:
July 28th, 2009 at 6:29 pm
I stated that regardless of whether or not she was mentally ill her refusal to have the c-section should never have been an issue. The judge stated that her refusal to have a c-section played heavily into the decision.