Aug 27, 2009 at 01:39:26
“Congrats on your new edition!
The cesarean rate hasn't been 24 percent in the U.S. for years. It's risen for the eleventh straight year and is now 31.8 percent. Of the 4,317,119 babies born in 2007, 1,372,844 were delivered by cesarean section.”
hp blogger Grant Cardone on Aug 27, 2009 at 11:08:41
“I thought is was closer to 30% but couldn't find the data to support it. I would love to know what percentage of all births use some type of drug....if you know.”
“lcrown: " I can completely understand their judgement to try and deliver this baby in the safest and least chaotic way."
The court docs read that Dr. Mansuria testified that an examination revealed a “nonreassuring fetal status.” According to the doctor, the recommendation of the cesarean was to avoid "brain damage, mental retardation and fetal death."
However, you believe that the doctor was ACTUALLY just trying to get the baby out in the "safest and least chaotic way" because the patient was, what, behaving too wildly? Did you see that the baby was born safely without incident? She was healthy. V was not subjected to unnecessary surgery and the baby was fine. Vaginal birth was the safest way to give birth in this case.
Your scenario proposes that it is ok for health care professionals to lie to their patients in order to coerce them into unnecessary procedures. This places the self-interest of the physician before the bodily autonomy and rights of the patient. Surely you're not advocating that this practice is acceptable.
lcrown: "In fact, she was being evaluated by a hospital psychiatrist to determine her capacity for making an informed decision when she gave birth."
You say you read the findings. You probably saw that V had already had a psych consult during labor and was found to be competent! She was on the SECOND psych consult (because they apparently didn't like the first opinion) when she gave birth normally.”
lcrown on Jul 31, 2009 at 12:43:26
“That the baby was born naturally without incident was a miracle, rather than the basis of this blog's entire argument that the docs/hospitals have some nefarious intention to control women's bodies.
You don't think that a woman refusing O2 and refusing fetal heart monitoring while thrashing about when it was determined that the baby was already in distress is sufficient for doctors to decide to "ACTUALLY" try and deliver the baby in the safest and least chaotic way???? I do. I mean, please, put yourself in the position of the delivery room staff. A woman who has a long history of psychiatric treatment is losing it and the baby is in distress. They want to do a c-section and she refuses and they evaluate her to make sure she's competant. What is the problem here? Nobody was forcing her to have a c-section.
They took the baby away bc they couldn't determine the competancy of the family, not because she refused a c-section, and if YOU read the court transcripts you'd know that. The judge in this ruling expressed his frustration by saying that he's trying his best to reunite this family but the family's inaction is snatching defeat from the jaws of victory.”
I'm also still perplexed by how many people see this as an example of the legal system doing a great job and not related at all to the refusal of a cesarean. In fact, Louise has been accused (me, too) of being misleading in saying so because the appellate court said that the previous trial judge shouldn't have factored it into his decision.
It seems to me that some people have a very strong need to believe that the system works. Doctors don't push unnecessary cesareans, the word of CPS and social workers always trumps that of the parents, mental health can be accurately assessed and babies are always protected from these mentally ill people who bore them. Are you sure about that?”
“Dana, you have done a wonderful job bringing this to the forefront. Thank you.
So V now allegedly suffers from symptoms of paranoia after a doctor repeatedly tries to coerce her into an unnecessary cesarean by lying to her about the health of the fetus and engages the hospital staff, including psychiatrists, in disrupting her bodily function (labor) by forcing unnecessary interventions on her that are NOT in woman's interest but ARE in the interest of the doctor and the hospital. This would be an upsetting situation to anyone, let alone a survivor of abuse.
A social worker then tells them they are going home without their baby. “The system” violates her one more time by bringing past psych history into question even though a psychiatrist found her to be cured and no longer in need of treatment in 2005. She lies repeatedly, most likely to protect herself from having her rights violated yet again, but an appellate court cites her non-compliance and a new psychiatrist’s diagnosis of paranoid schizophrenia and NOT the cesarean refusal as the main reasons why her parental rights were terminated. She never even went home with her newborn baby.
One psychiatrist stated that it would be dangerous and reckless to return the child to the parents, because “[t]hese are parents who live in a world that has nothing to do with the world that we live in..."
I WONDER WHY THEY ALLEGEDLY WANT NOTHING TO DO WITH THE WORLD WE LIVE IN.”
“Although the appellate court judge disagreed with the previous trial judge’s findings that refusing a cesarean constitutes abuse and neglect, the patient’s refusal to sign the blanket consent form to a cesarean which would have allowed St. Barnabas Hospital to perform a cesarean at will started the entire chain of events.
1. The patient also refused continuous electronic fetal monitoring (EFM) and the staff questioned her competence and ordered not one but TWO psych consults during her time in labor. The patient was actually demonstrating great concern for the wellbeing of the fetus and herself. The best evidence on EFM is a BMJ meta-analysis which showed that EFM has only one significant statistical effect- EFM increases the rate of cesarean section. Nothing beneficial to fetal health, just more cesareans. No one questions the hospital staff’s competence in trying to administer a standardized, unnecessary piece of technology which has been unequivocally proven to increase the rate of unnecessary cesareans.
2. The patient was told her fetus was in distress and needed a cesarean. She refused and her competence was questioned. ST. BARNABAS HOSPITAL HAS A 49.3 PERCENT CESAREAN RATE and by the time the patient’s second psych consult was over, she had given birth vaginally without complication to a healthy baby. The attending obstetrician, Dr. Shetal Mansuria, was wrong and nobody seems to be questioning Mansuria’s competence in trying to force a totally and completely unnecessary major surgery on a patient.”
GBGB on Aug 4, 2009 at 17:56:52
“"the patient"s refusal to sign the blanket consent form to a cesarean which would have allowed St. Barnabas Hospital to perform a cesarean at will started the entire chain of events."
That is not true. The patient's hysterics and demonstration of psychologically abnormal behavior started the entire chain of events. The hospital staff (which obviously sees women in labor everyday) recognized that this women was acting beyond the norm even for a woman in labor.
"She refused and her competence was questioned."
Wrong again. She flipped out and (among other things) called the police. That is why her competence was questioned.
I completely agree with you that doctors and hospitals appear to be recommending c-sections more often than they should. But distorting what happened in this case hurts your credibility and ultimately hurts what you are trying to accomplish.”
Ameya on Jul 22, 2009 at 21:41:25
“"The attending obstetrician, Dr. Shetal Mansuria, was wrong and nobody seems to be questioning Mansuria"s competence in trying to force a totally and completely unnecessary major surgery on a patient."
EXACTLY!! So incredibly infuriating.
I can not believe ANY hospital can have such a HORRIBLE record & still be allowed to practice obstetrics! More infuriating!”
“This is my favorite part "[Overheard the] judge tell V in one of her hearings that he felt she would be'too argumentative and that would wind up hurting her child. For instance, she would argue with teachers and receptionists at the dentist office.' "
Argue with teachers and receptionists. How DARE she? Let's take her baby.
I argued once with the cashier at Barnes and Noble. They should probably come take my baby, too.”
“How is it realistic? If it's realistic then that's a pretty sad statement on the state of maternity care in your country, Angela. Is it normal for a laboring woman to be screaming in terror while surrounded by strangers who are ogling, taunting and humiliating her?
I agree with karela. Teaching girls (by the way, that father of the baby is where in this video?) that sex leads to birth and birth is a humiliating, traumatic event to be avoided is pathetic.”
“Of course they would support the Carder decision. They probably wanted that baby OUT so it could be baptized. RCC support of dangerous cesareans is not new according to the U.S. National Library of Medicine:
"Religion has affected medicine throughout recorded history and, as noted earlier, both Jewish and Roman law helped shape early medical practice. Later, in early to mid-nineteenth century France, Roman Catholic religious concerns, such as removal of the infant so that it could be baptized, prompted substantial efforts to pioneer cesarean section, efforts launched by some of the country's leading surgeons. Protestant Britain avoided cesarean section during the same period, even though surgeons were experimenting with other forms of abdominal procedures (mainly ovarian operations). British obstetricians were far more inclined to consider the mother primarily and, with cesarean section maternal mortality over fifty percent, they usually opted for craniotomy."
“If you replace the word "abortion" with the words "cesarean section" or "induction" in the Missouri House of Reps bill, parts of it are very interesting.
The physician performing or inducing the (cesarean section or induction) or a qualified professional must: ...
(3) Explain that coercing a pregnant woman to get (a cesarean section or induction) is illegal and she is free to withhold or withdraw her consent to the (cesarean section or induction) anytime without fear of losing treatment and assistance benefits
Women are coerced into unnecessary cesareans and inductions everyday by physicians and hospital midwives who downplay the risks of the procedures and grossly exaggerate the risks of vaginal birth and vaginal birth after a previous cesarean.
Abortions and cesareans are not the same obviously. While there are spontaneous abortions, there are no spontaneous cesareans. Yet both are medical procedures that will end a pregnancy—one with a dead fetus and one with a live baby. Vaginal birth is not a medical procedure, however. It is a spontaneously occurring event. Maybe it should be illegal to misinform pregnant women of the risks of vaginal birth, thereby coercing them into unnecessary procedures.
These new abortion laws want to show women how alive their fetus is and that they are about to kill it by consenting to treatment. When pushing unnecessary cesareans and inductions, doctors shower women with tales of how they are about to kill or maim their baby by giving birth vaginally unless they consent to treatment.”
Becky Coolidge on Apr 28, 2009 at 10:26:18
“I am with you on the main points, but since when are midwives known for "downplaying the risks of procedures and grossly exaggerating the risks of vaginal births"? "Midwives coerce women into unnecessary cesareans and inductions everyday?" Really? Midwives by definition are the guardians of normal, and practice exactly the opposite of each of these statements. Perhaps you are witnessing situations where a hospital-based midwife is compelled to adhere to certain protocols called for by her back-up OB, which, if she did not, would not even be able to practice there, thus forcing all birthing women at that facility to have only the "choice" of an OB. This is a problem better addressed by lifting the restrictive nature of back-up relationships (a litigation/malpractice insurance driven problem) so that the midwife may practice more freely within her established scope-of-practice of midwifery. Throwing midwives in the same boat with physicians, as the driving force of the problem, alienates an enormous pool of the very like minds you are trying to gain support from. Watch it it sister!”
Apr 20, 2009 at 10:37:44
“"The breastfeeding advocacy blogger, laurelhed, commented, "I do believe this is the very first time I've seen someone accused by a lawyer of defamation for claiming that an organization was more ethical than it actually is."
The blogger's name is actually Lauredhel and she writes at Hoyden About Town- http://viv.id.au/blog/ - in case anyone is interested.”
Apr 2, 2009 at 10:11:09
“You left a comment on your own article’s thread that ended with “If that baby that Muhlhahn delivered at the maternity center were injured today, what recourse would the parents have to get help with longterm [sic] care of their kid with Erb’s palsy?”
Birth injuries happen. Is insurance or our government failing disabled persons and those caring for them so much that malpractice insurance has become a financial safety net? That’s the bigger issue. Why would it be a midwife's responsibility to carry malpractice insurance?”
Andrew Goldman on Apr 2, 2009 at 11:23:41
“It's not the midwife's responsibility to carry malpractice; I believe it's her responsibility to tell prospective patients that she doesn't carry it, which, according to my reporting, this particular midwife does not as a matter of course. When the doctor made the point that he/she wished that Muhlhahn was more accountable, the point was that in that event that a mistake is made--and we all make mistakes--that the fact that she doesn't carry insurance essentially makes her immune to law suits. I spoke with a malpractice attorney who said that she would never ever take a case that involved suing a doc or midwife who was bare of malpractice insurance because it would be unlikely that they'd ever be able to collect on a judgment, and how would an injured child benefit from this? Yes, birth injuries happen, and your question is valid about why the government doesn't take responsibility, but again, this was sort of beyond the scope of the story I wrote. Whether or not this midwife made a mistake in that Erb's palsy case, by settling for 950K, the insurance company obviously didn't want to leave it up to a jury to decide.
And thanks for pointing out my mistake in grammar. I need all the help I can get.”
Apr 2, 2009 at 09:55:34
“How many of these fast trackers do you actually know? Primary c-sections scheduled for convenience are like a little insta-controversy button for editors to press when they need readers. It comes down to trying to get people riled up and ready to shame women for the loss of “traditional values.” Example: They work full-time, vote, demand things and now they don’t even want babies to come out when and how Mother Nature intended? Oh brother! The women these days are crazy!
It’s the trend that isn’t.
On the other hand, how many women do you know who were bullied, scared or strongly encouraged to schedule an unwanted prophylactic c-section? Or women who wanted to give birth in a hospital but couldn’t because the hospital “doesn’t do VBACs?”
And “mommies?” Why the diminutive of “mommy” instead of “mother” or “woman?””
“I feel concerned that many of the commenters below are missing the big picture in a few ways.
The question is: Are you ok with court-ordered and coerced c-sections?
As a woman who was bullied in her last trimester of her first pregnancy and in the delivery room by a midwife and several doctors because they thought the baby would be too big to deliver normally without injury or death, I want to know if you think it would have been an appropriate course of action for the doctors to call a judge and get a court order for an unnecessary c-section against my wishes and judgment? This is not just a rhetorical question or an impossible extreme—court-ordered c-sections happen! Google it. Paltrow is not an alarmist.
I’m white, middle-class and had access to medical journals. I called them on their BS and lack of evidence. What happens to women who don’t have access, privilege or English language skills? Forced surgery? A CPS call?
In the Personhood scenario, if doctors have any reason to believe that they could be held liable for injury to the baby at birth AND if they either believe that a c-section is a) safer or b) will demonstrate that they did *something*, they will be justified in getting a court order.
Frankly, I don’t think doctors would feel comfortable with this scenario and they are the authority to which many appeal. Why should they bear this responsibility?”
“Reasonableperson197, I agree that it's not a black or white issue. Paltrow doesn't claim that it is.
Respectfully, I wish to point out that your appeal to authority is horribly patronizing. Women's health is, in your scenario, left to the capable hands of doctors and "our legal system." Would you like to know who's judgment you have not considered in your Doctor (or Judge) Knows Best system?
The pregnant woman's.
Women combat attitudes like yours EVERYDAY.
Planning a home birth or an unmedicated birth in the hospital? Trying to avoid a c-section? Hoping for a VBAC (vaginal birth after cesarean)? Might as well kiss those hopes goodbye. If the doctor on duty doesn’t trust in the process of normal birth and sees vaginal birth as dangerous to your baby REGARDLESS of whether his judgment is evidence-based or not, you’re getting rolled to the OR.
You probaby didn't realize that you had left out a woman's judgment and authority over her own body, so I thought I'd help you by pointing that out.”
“The concept of personhood is already in play in reproductive health. Due to factors including reliance on standardized technologies, unrealistic cultural attitudes that every pregnancy and birth should have a perfect outcome and hospitals’ and doctors’ self-perpetuated mythology around litigation, pregnant women are already expected to subject themselves and their fetuses to many interventions in the name of safety.
Safety sounds great, but there is no evidence that women and babies benefit beyond a certain point from these record-high induction and cesarean rates. Severe maternal morbidities have risen significantly in the last decade and researchers correlate this with the rise in the cesarean rate (currently 31.8%).
Criminalizing women for their “treatment” of the fetus in their uterus would be based on what set of standards? Hard scientific evidence or arbitrary clinical judgment and fluffy obstetric mythology?
Opinions on what is harmful vary greatly. The unproven claim that a planned c-section is as safe as or safer than vaginal birth is snowballing right now in obstetrics. In the absence of evidence, doctors are trying to sidestep any threat of litigation by performing c-sections on healthy women because they believe that a) they will have proven that they intervened as much as possible to “save the baby” and b) because many actually believe that c-sections are superior to vaginal birth.
Thanks to Personhood, hospitals could just get a court-order for your c-section rather than trying to scare you into compliance.
“The unproven claim that a planned c-section is as safe as or safer than vaginal birth is snowballing right now in obstetrics. In the absence of evidence, doctors are trying to sidestep any threat of litigation by performing c-sections on healthy women because they believe that a) they will have proven that they intervened as much as possible to "save the baby" and b) because many actually believe that c-sections are superior to vaginal birth.
leaving me to wonder why women don't come equipped with zippers.”