Medical Ethics and Child Birth Rights Debate

by Xandria 7 Replies latest watchtower medical

  • Xandria
    Xandria

    Court cases revive childbirth rights debate. I saw this article and it got me to thinking.. which can be dangerous at times.

    But, this is a situation that would affect women and families terribly. What bothered me, about this story, is that the doctor went ahead and prompted the lawyer to go after this court order. The woman was not mentally incapable, she was rational and knew from prior experience what she wanted in child birth. When does it become the decision of the doctor or Judge ? And what would you do in this situation. The reason I ask, is my sister was extremely put upon during her time of birth for an cesarean proceedure. She got so much pressure, that she nearly walked out of the hospital. Only after she threatened to leave did they relent. I know having a birth plan helps, but you are basically at the mercy of the care giver. IT is scary to think they could do something to you when you are vunerable. Now to the Story: Let me know what you think.

    X.

    PHILADELPHIA, Pennsylvania (AP) -- Amber Marlowe was a seasoned pro at delivering big babies -- her first six each weighed close to 12 pounds. So when she went into labor with her seventh last winter, she brushed off doctors who told her the 11-pound, 9-ounce girl could be delivered only by Caesarean section.

    But the medical staff at Wilkes-Barre General Hospital wouldn't budge, not even with her track record. "All my others, I've done naturally," Marlowe recalled telling her physicians. "I know I can do it."

    So Marlowe checked herself out and went looking for a new doctor.

    While she was on her search, Wilkes-Barre General's lawyers rushed to court to get legal guardianship of her unborn child, giving the hospital the ability to force Marlowe into surgery, if she returned.

    The case is one of several in recent months that have revived a debate about whether mothers have an absolute right to choose when, where and how they give birth -- even if the health of their baby is at stake.

    A spokesman for the American Hospital Association wasn't immediately sure whether the organization has ever taken a position on the issue.

    Some groups representing doctors, including the American College of Obstetrics and Gynecology, have said that physicians should refrain from doing procedures unwanted by pregnant woman, and that use of the courts to resolve conflicts is almost never warranted.

    Marlowe ended up at another hospital, where she had a quick, natural birth she described as "a piece of cake." She didn't know about the first hospital's action until her husband was told by a reporter.

    "They don't know me from anything, and they're making decisions about my body?" she said. "It was terrifying."

    Officials with Wilkes-Barre General did not return calls seeking comment.

    Recent cases

    In Salt Lake City, Utah, an acknowledged cocaine addict with a history of mental health problems resisted having the operation for about two weeks before acquiescing. One of the twins she was carrying died during the delay. The mother was charged with capital murder but ultimately pleaded guilty to a lesser charge of child endangerment and was sentenced to probation.

    Last month, prosecutors in Pittsburgh charged an unlicensed midwife with involuntary manslaughter for failing to take a woman to the hospital when her baby began to be delivered feet-first. The child died two days later. The midwife said she had been trying to honor the mother's wishes to have the baby at home.

    And in Rochester, New York, a judge in late March ordered a homeless woman who had lost custody of several neglected children not to get pregnant again without court approval.

    Some women's advocates said the cases illustrate a newfound willingness by legal officials to interfere with women's choices about their pregnancies.

    "My impression is that we have a political culture right now that falsely pits fetal rights against women's rights, and that you are seeing a kind of snowballing effect," said Lynn Paltrow, of the New York-based group National Advocates for Pregnant Women. "We're at the point now where we're talking about arresting pregnant women for making choices about their own bodies, and that's not right."

    Legal experts and medical ethicists said attempts to prosecute women for pregnancy choices, or force them to undergo certain procedures for the benefit of their children, may be on shaky ground.

    "There are 50 years of case law and bioethical writings that say that competent people can refuse care, and that includes pregnant women as well," said Art Caplan, chairman of medical ethics at the University of Pennsylvania.

    In one influential case, a federal appeals court in Washington, D.C., ruled in 1990 that a judge was wrong to have granted a hospital permission to force a pregnant cancer patient to undergo a Caesarean in an attempt to save the life of her child. The mother and baby died within two days of the operation.

    Doctors' opinions on forced care for pregnant mothers have changed, too.

    A 2002 survey by researchers at the University of Chicago found only 4 percent of directors of maternal-fetal medicine fellowship programs believed pregnant women should be required to undergo potentially lifesaving treatment for the sake of their fetuses, down from 47 percent in 1987.

    Dr. Michael Grodin, director of Medical Ethics at the Boston University School of Medicine, said doctors should seek court intervention when a mother refuses care only if the patient is mentally ill.

    "Women have a right to refuse treatment. Women have a right to control their bodies. It is a dangerous slope. What's next? If someone doesn't seek prenatal care, what are we going to do, lock them up?"

  • exjdub
    exjdub

    Xandria,

    It is quite frightening, and maddening, to have medical rights and decisions ripped away. Years ago, when my wife was pregnant, we found out that caesarians were being performed at a record rate in our state. We were told that this was because the doctors wanted to control when the births occurred so they could schedule them during normal business hours. Many woman at that time were scheduled for inducement as well. Of course the party line was that it was for the good of mother and baby. Fortunately my wife had an OB/GYN who was married to a midwife, so his views were completely pro natural labor and delivery and she delivered naturally. But if we had chosen the wrong doctor I think we would have had a battle, because my wife was carrying twins.

    She got so much pressure, that she nearly walked out of the hospital. Only after she threatened to leave did they relent.

    Your sister is very brave. I have never heard of that, but I am tucking that one away. My daughter is due late July, early August.

    exjdub

  • Cicatrix
    Cicatrix

    When I had my first child, the staff tried to pressure me into signing papers for a cesarian. The birth was going well, baby was moving and responsive between contractions, and my contractions were strong, but the doctor and nurse were not happy with my progress (although twelve hours of labor for a first child is actually very good progress)and were concerned about the baby's heart rate (it decelerated during contractions but went back up in between them-this is normal. The nurse literally stood by my bedside with the form and yelled at me to sign it while I was having a contraction. I refused, as I could feel that things were progressing just fine. My daughter was born healthy and gorgeous less than two hours after I refused to sign the paperwork, but I was labeled a "problem patient" and treated pretty badly for the rest of my hospital stay (I get the feeling that being a couple weeks shy of eighteen didn't help me much).

    Later, the doctor told me that when she had given birth two months before, she had a very rough time with it, and she was trying to "save" me from what she went through!She evidently didn't believe me when I told her I was doing fine.

    The politics surrounding birth simply amazes me. One doctor insisted that I provide medical "proof" as to why I wasn't having my son circumcised ( I did). Another didn't bother to show up at the hospital until the baby was crowning, despite the fact that the nurse called him repeatedly (he's the same guy that tried to hurry placenta removal by pulling on the umbilical cord, causing me INCREDIBLE pain). My last doctor insisted that, despite the fact that my first three births had been straightforward and uncomplicated (the last two births were only four and two hours in duration), that I was going to have routine ultrasound exams,and I was to gain no more than fifteen pounds(my average gain was forty pounds, all of which I lost). I did some major research, fired him, hired a midwife (after carefully interviewing her), and had my last two children at home.Home birth isn't for everyone, but it was the best decision I ever made for myself.

  • TrailBlazer04
    TrailBlazer04

    It's all about control by the medical community. My daughter HAS to deliver by c-section...due to an accident a few years ago. However, after the last baby, she signed herself out of the hospital AMA after 48 hours. They were more than interventionist. Kept doing blood sugar levels on the baby because she was allegedly "large for gestational age"...8lbs 9oz full-term baby girl. Gimme a fricken break...They were NOT supportive of my daughter's choice to breastfeed. She finally kicked the so-called "lactation consultant" out of the room telling them "my mother nursed the 3 of us and she damn sure knows what she's doing"...(let's hear it for good old mom). The LC was PISSED as hell.

    My first birth...pitocin, internal monitoring...second and third...nope. My longest labor was 3 and a half hours...by the time I got to the third baby, just over an hour and a half (don't hate me, please???). IF I had had more babies, they would have been born at home, probably unattended...I despised the thought of paying thru the nose for some "doctor" to come catch the baby after I had done all the work.

    Birth has been medicalized...no more "baby will come when baby is ready"...and the harm that's being done to mothers and babies is UNREAL. Don't get me wrong...medical intervention in pregnancy has saved many moms and babies, but for a routine, low risk pregnancy and birth, it really isn't needed.

    TB of the "crunchy" birth crowd.

  • avishai
    avishai

    OK, we have two TOTALLY seperate issues here. Mothers right to deliver how they want, which i think is fine, necessary, etc. Too many C- sections, episiotomies, etc. Western med. sux that way.

    "My impression is that we have a political culture right now that falsely pits fetal rights against women's rights, and that you are seeing a kind of snowballing effect," said Lynn Paltrow, of the New York-based group National Advocates for Pregnant Women. "We're at the point now where we're talking about arresting pregnant women for making choices about their own bodies, and that's not right."

    BUT I disagree with this statement. The article brings up Drug addicted mothers who give birth. I have worked with the products of these pregnancies, FAS, Fetal Drug Affect kids for years. Many of them are quite literally ruined. For life. NOONE has the right to do this to a child. In that case, womens "rights to choose " should be moot, they should get a 20 to life sentence, because that is what theyve given a child. Period.

  • exjdub
    exjdub

    Well said Avishai, and you are right, they are seperate issues...however...I think what drives people crazy is that when discussing the cases that you (Avishai) see as a counselor, it becomes very clear that intervention is needed, and I understand where you would have a problem with a crack addict deciding health issues for their baby, especially because you see the end result. The problem is the government or the hospital/medical community has a tendency to take those cases and run way overboard with it. They think they have authority to do what they want with ALL expectant mothers and their babies.

    The case is one of several in recent months that have revived a debate about whether mothers have an absolute right to choose when, where and how they give birth -- even if the health of their baby is at stake.

    Notice this paragraph does not say anything about drug addicted mothers or alcoholic mothers that damage their children. They include all mothers. When the powers that be start deciding "whether mothers have an absolute right to choose when, where and how they give birth--" that makes me nervous. Before long they make it illegal to deliver anywhere except a sterile hospital room. That is infringing on an individual's rights to do something natural, just because the government thinks they know what is best for everyone.

    Sorry for the soapbox...I just have real issues with government (and yes religion) always trying to decide what is best for us.

    exjdub (who was born a few years late and should have grown up in the 1960's instead of the 70's)

  • Xandria
    Xandria

    Exjdub, Cicatrix, Avishai and Trailblazer:

    Each of you made vaild points. Yet, here we go to the point of doctors, law makers, government, and even religion over stepping the bounds of reasonablity.

    Exjdub: My sister Rachel was very determined to have her child naturally. Especially since this was to be her last pregnancy. With my first niece she had C-section and it was horrible for her. She was stampeded into it and it affected her bonding time with her child.

    The one thing that pisses me off in all of this, is the behaviors of the some of the doctors and even some of the nurses. You all gave examples. Yes, there is good and bad in everything. My mother had some horror stories with births. Rachel, Mike and Myself were tough deliveries. Because the doctors were not proactive. Things must change.

    X.

  • avishai
    avishai

    I think that birth needs to be looked at as a natural thing, rather than a medical emergency. That's why my daughter was born in a hospital with a midwife, in the room, and did'nt go to a baby room. The other area hospital looks at it as a thing for doctors.

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