Monday, November 24, 2008

Free Legal help for a VBAC

An attorney interested in working on VBAC ban lawsuits is considering using MS as a test state. Do you have any VBAC ban affected women up your sleeve right now? The criteria for the WA lawyer is:

-currently pregnant
-no complications in current pregnancy
-no VBAC options around including homebirth either because homebirth VBAC isn't allowed in your area or because the individual woman finds homebirth not to be an option for her
-no involvement in social services (child custody, neglect charges, etc.)

I'm a lawyer with the Northwest Women's Law Center in Seattle. I'm investigating possible legal responses to bans on vaginal birth after cesarean at hospitals in the northwest states - Alaska, Idaho, Montana,
Washington and Oregon. If you are currently pregnant and want to have a VBAC, but are facing a hospital policy that would require you to have a c-section regardless of whether you want it and whether it is medically necessary, and are willing to consider working with a lawyer on this, we'd like to talk with you. Please email us at Our services will be provided free of charge.
Mailing Address:

Northwest Women's Law Center
907 Pine Street, Suite 500
Seattle, WA 98101

Legal Information & Referral ( 206 ) 621-7691

* Toll Free ( 866 ) 259-7720
* TTY ( 206 ) 521-4317

Administration ( 206 ) 682-9552

Tuesday, November 4, 2008

Refusing a Cesarean

Today I sat in a NJ court to listen to a case argued regarding DYFS vs [Parents whose names have been withheld, even during the hearing]. (DYFS = Division of Youth and Family Services; NJ's Child Protection Services)

Apparently 2.5 years ago a woman in her early 40s entered St Barnabas Hospital in Livington, NJ to deliver her first baby. She was asked to sign a consent form for a potential c-section [note; there was no medical indication for a c-section]. She refused and the staff got mad. They repeatedly tried to get her to sign. Mother signed the consent for IV fluids, fetal monitoring, an episiotomy and an epidural.

Let's get something straight here.... St Barnabas does nearly 7000 births a year. They are by far, the largest maternity hospital in NJ. They also have a nearly 50% cesarean rate which CANNOT be justified.

Staff claimed that the woman became argumentative. [I guess that's why the word "labor" is a misnomer; it should be called "picnic"]. Male judges and male lawyers even entertained a short debate on what is appropriate behavior for a laboring woman.

So DYFS found the woman and her husband (who agree with his wife and her refusal to sign this consent form) to be guilty of abuse and neglect. That was the original basis for the argument though DYFS tried to change it in the hearing to make it more about the fact that the woman had a history of pyschological problems (not well defined) and has been in the care of a therapist for years. Quite frankly, there would be a heck of a lot more kids in the foster care system if "under the care of a therapist" disqualified someone from parenthood. They also talked about the mother's refusal to consent to scalp stimulation (whatever the heck that is); but it constituted abuse and neglect. There was mention of the woman having a history of Post Traumatic Stress Disorder. NEWSFLASH: Here's a good way to re-ignite PTSD: force a laboring woman into an unnecessary c-section. She also "went off her meds" in 2005 [which would be about the time she got pregnant, so perhaps - just perhaps - she was trying to protect her baby]. It was stated that the mother was never arrested and never caused harm to others. One lawyer tried to claim that the mom only consented to the non-invasive procedures. Luckily, one of the judges called him out on that; the judge knew that an episiotomy and an epidural needle are invasive.

In the end, the woman delivered a healthy baby without complication. Vaginally. The potential for c-section was unncessary. St Barnabas was just trying to bully this woman into consent so that they could have their way with her.

This woman obviously wanted to have a normal birth. I won't even call it a natural birth with all the interventions. She didn't want a c-section and didn't want to give the staff the free will to do one. And she paid for it by losing her baby. Why does a woman have to consent to surgery the moment she arrives at the hospital? In a true life-threatening emergency, isn't consent implied?

This is a dangerous precedent that could be set by our state's largest maternity hospital. There were arguments surrounding a woman's right to refuse any kind of testing whether it's invasive or non-invasive (even talk about the implications of refusing a sonogram).

The National Advocates for Pregnanct Women filed an amicus brief on behalf of the rights of the birthing mother. They submitted (and were given the opportunity to argue) that refusal of a c-section CANNOT play a role in this issue. They questioned whether mom's refusal to sign this blanket consent form led the staff to believe that everything she did after that was "crazy?" Medical professionals MUST lay out the costs of benefits of invasive and non-invasive medical procedures.

Monday, November 3, 2008


ICAN Responds to the Coalition for Childbirth Autonomy's Statement on the Cesarean Rate
Oct 28 2008

The Coalition for Childbirth Autonomy (CCA) released a statement today questioning the World Health Organization’s recommended cesarean rate of 10 - 15%. CCA suggests that a woman should be able to request a cesarean without medical indication. While ICAN supports both updated research on this topic and an increase in patient education and autonomy, we maintain that many women who are choosing a cesarean are making that decision without full informed consent.

Research shows that cesareans introduce additional risk in dozens of areas when compared to a vaginal birth. For the mother, these increased risks include death, hysterectomy, bood clots, increased pain & recovery time, infection, and post-partum depression(1). For the infant, additional risks include respiratory problems, breastfeeding problems, asthma in childhood(1), and type 1 diabetes(2). In addition, there are increased risks in future pregnancies, such as infertility, ectopic pregnancy, placenta abnormality, uterine rupture, preterm birth, and stillbirth(1).

ICAN does not believe that cesarean should be the typical solution for fear of childbirth. With appropriate counseling, most women who fear childbirth are comfortable attempting a vaginal birth (3, 4). Most show long-term satisfaction with their decision to change modes of delivery (4), and with intensive therapy, labor times were shorter (3).

ICAN will continue to work to improve maternal-child health and to protect a woman’s right to ethical and evidence-based care during pregnancy and childbirth.

(1) Maternity Center Association. 2004. What Every Pregnant Woman Needs to Know about Cesarean Section. New York: MCA.
(2) Cardwell, CR et al. Caesarean section is associated with an increased risk of childhood-onset type 1 diabetes mellitus: a meta-analysis of observational studies. Diabetologia. 2008 May;51(5):726-35.
(3) Saisto, T et al. A randomized controlled trial of intervention in fear of childbirth. Obstet Gynecol. 2001 Nov;98(5 Pt 1):820-6.
(4) Nerum, H et al. Maternal request for cesarean section due to fear of birth: can it be changed through crisis-oriented counseling? Birth. 2006 Sep;33(3):221-8.