28 July, 2009

WOW. Refusal to have C-section = child abuse and neglect?!

Women take note! Especially those of you of child-bearing age.

I cannot believe this report, but it's true. Sort of. On the surface, a New Jersey woman's newborn child was removed from her custody because she refused a C-section and "behaved erratically" while in labor.

Show me a woman who is not erratic while in the throes of labor. Seriously, the baby was born vaginally and was fine, yet still removed from the mother's and father's custody at birth. Also, the hospital in question apparently has a C-section rate of 44%, while the national average is around 30% (and of which as much as half may be medically unnecessary). Hmm...

Not being a legal expert, I can only imagine what kind of precedent this case might set for women across the country, if these were the only facts in the case. However, there is more to this story than meets the eye (isn't there always?). While the lower court judge sided with the state of New Jersey that the mother's refusal to cooperate (i.e., have a c-section) was evidence of child abuse and neglect, upon appeal the court reiterated that there was "substantial additional evidence of abuse and neglect."

Nonetheless, one of the issues before the appeals court was the question of whether the refusal of a C-section is tantamount to child abuse/neglect/endangerment. And on this question, I believe the appeals court, in its majority opinion, fucked up punted:

Where we part company is his discussion of whether V.M.'s [the mother's] refusal to consent to a cesarean section (c-section) can, as a matter of law, be considered an element of abuse and neglect.

On the record before us, we do not agree that the issue need be decided.

I guess I can't say I am surprised by this or that I blame them for dodging the question. But I wish they'd had the balls to address it, like Judge Carchman did in a concurring opinion:

I concur in the result reached as to both V.M.[the mother] and B.G. [the father]. I am of the view that even with the limited concession of DYFS as to the narrow utility of V.M.'s refusal to have a c-section, the issue remains extant and requires a level of judicial scrutiny.

Consideration of V.M.'s refusal to submit to a c-section, in my view, is improper and beyond the legislative scope of the child protective statutes.

Here is the post from Momlogic; you should also check out the post at the NY Times blog Motherlode. As a rule, I don't generally read the Huffington Post but this is actually a pretty good analysis. And here is the New Jersey court ruling (pdf) for those so inclined to read.

Regardless of the details in this case, what this illustrates to me is the vast geographical differences in doctor's attitudes and hospital procedures. The approaches to birth and the predominant medical attitudes are not uniform across the country in the least. Meanwhile, the U.S. has one of the highest C-section rates of any developed nation. Bottom line: PREGNANCY IS NOT AN ILLNESS OR A CONDITION NECESSARILY WARRANTING TREATMENT. Delivering a baby (or babies as may be the case), for a great many women, is a natural process that requires minimal-to-no intervention.

1 comment:

  1. Did you read this: http://www.dailykos.com/story/2009/8/5/762172/-Who-Gets-to-Make-Medical-Decisions-for-Pregnant-Women

    Samantha Burton, a mother of two in Florida was 25 weeks pregnant when she was hospitalized against her will due to pregnancy complications. When she requested a transfer to another hospital so she could get a second opinion, the state refused because it was not in the fetus' "best interests at the time." After three days in state-mandated confinement, Ms. Burton lost the baby.

    (Just doing my best to increase your comments stats!)