Wednesday, May 19, 2004

Whose Birth Is It?

I read this story on the internet today. Apparently a woman about to deliver her seventh large baby was told by the hospital that she had to consent to a c-section despite her history of successful vaginal births. She refused, checked herself out of that hospital and went to another where she had a quick and easy delivery. In the meantime the first hospital had taken legal action to obtain temporary guardianship of her unborn baby and were seeking to have her brought back to the hospital where surgery would be forced.

This terrifies me. Now, as a pro-life woman I believe in the rights of children before they're born, especially the right to life. And I respect action taken to preserve the lives of the innocent. This just doesn't seem to be one of those cases at all! This was a childbirthing pro. She knew her babies were big and she'd never had a problem. Why would they attempt to force her into a potentially dangerous surgery when she had such a good track record?

There are several things that I believe happen in unhappy childbirth scenarios. First of all I think a lot of mothers are underestimated. Especially if she appears to be poor or uneducated. But while education can make you better prepared for what's happening, it doesn't necessarily make you better at it.

I think many doctors are afraid of malpractice suits. There are many articles relating to the soaring costs for ob-gyns relating to malpractice insurance. It's forcing many doctors out of business, at the expense of the public. I know as a nurse we're taught the CYA rule (cover your a**) and you have to. This is a litigious society. But when that fear overrides your duty to perform what is in the best interest of your patient, then you are remiss in your duty as a physician.

I think most of all in a situation like this the ethics are not clear to many health care practitioners. Well, okay, for me they are, but I believe in the ability of women to deliver vaginally most of the time and I'm convinced we have WAY too high a cesarean rate. I believe that the medical staff was torn between whose health and wishes they had to look out for. In my field it's simple, if a patient refuses treatment only their body is affected. But for this team two people were affected and if they truly believed that she couldn't deliver vaginally, I suppose they had a duty to see to the health and well-being of the child.

What bothers me is that they shouldn't have assumed that she couldn't deliver the baby. She had successfuly completed the same task six times previously. Why are we teaching our ob-gyns that they haven't done enough unless they've intervened medically? Sometimes I think it's a tremendous challenge to doctors to put their hands in their pockets and let labor and delivery happen. And that is doing a disservice to laboring women everywhere. What terrifies me is that they could take legal action so easily. What if it were me? How many women have gone ahead and had the surgery? A girlfriend of mine had her first baby the same day Bridget was born, and she had a c-section at the ob's insistence. But she's not a small woman and the baby was only 8 lbs. something. I believe she could have delivered her. The CYA rule we in the medical profession have to remember should not be at the expense of the patients we are obligated to care for.

It's an interesting story with all sorts of ethical facets. What I see most of all is that we women must be proactive in our own care. How easy it would have been to have signed the papers and gone into the OR. But this woman bravely stood up for herself and her baby and went somewhere else. Bravo!

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