Statement from Jennifer Goodall: “Thank you to everyone from around the country and the world for the outpouring of support. I welcomed my son into the world after laboring, consenting to surgery when it became apparent that it was necessary because labor was not progressing. This was all I wanted to begin with. I am grateful to the medical staff at another hospital who assisted us in a safe and healthy delivery. Now, my family’s focus is on welcoming our newborn into our family with love, and on my physical and emotional recovery from the intensity of the last few days.”
Jennifer has a healthy baby, but was not forced into surgery. There is an enormous difference between agreeing to a cesarean when it is evident that it is necessary, and being forced into a cesarean surgery, or other intervention, such as induction of labor, against a mother’s will.
One is liberty; the other tyranny.
Do Constitutional Rights no longer apply to pregnant women? That is what some are asking in the case of a Florida mother whose hospital is trying to force her to have a cesarean section, even though it is not medically required.
The National Advocates for Pregnant Women (NAPW) today issued a press release, saying, “Florida Hospital Says It Will Force Pregnant Woman To Have Cesarean Surgery.” The hospital is also threatening to report Jennifer Goodall to child protective services if she doesn’t comply with their demands.
Jennifer Goodall is a mother of three from Cape Coral, Florida, who wants to have what is known as a trial of labor (TOL) with the baby that she is due with now. She has reached her decision after much study and research into the benefits and risks of VBAC (vaginal birth after cesarean) versus repeat cesarean. Her previous three children were born via cesarean, and Ms. Goodall has decided that she wants to give this baby and her body the benefit of a normal birth, “unless and until medical complications during labor necessitate medical intervention.” She plans to give birth at a hospital that is well-equipped in the relatively small chance that a complication should arise.
According to NAPW, the Chief Financial Officer of Bayfront Health Port Charlotte sent a letter to Ms. Goodall on July 10, 2014, informing her that:
“because she decided to have a trial of labor before agreeing to cesarean surgery, her prenatal care providers intended to report her to the Department of Children and Family Services, seek a court order to perform surgery, and to perform cesarean surgery on her ‘with or without [her] consent’ if she came to the hospital.”
This decision by the hospital is a violation of medical ethics, as well as of ACOG’s own standards of ethics. ACOG is the American Congress of Obstetricians and Gynecologists. The ACOG Committee on Ethics made the following statement in 2010:
“Court-ordered interventions in cases of informed refusal, as well as punishment of pregnant women for their behavior that may put a fetus at risk, neglect the fact that medical knowledge and predictions of outcomes in obstetrics have limitations.”
Additionally, the Committee stated:
“[Even if] a woman’s autonomous decision [seems] not to promote beneficence-based obligations (of the woman or the physician) to the fetus,… the obstetrician must respect the patient’s autonomy, continue to care for the pregnant woman, and not intervene against the patient’s wishes, regardless of the consequences.”
The standards of care and obstetric protocols and recommendations are binding upon doctors, but not on the patient. In recent years, some physicians have forgotten that patients do, indeed, have the rights to informed consent and informed refusal. Constitutional rights do not end at the front door of the hospital. It appears that some believe that medical protocols and recommendations are actually laws that apply to patients, as in the case reported by The Inquisitr of the mother blackmailed into a vaccine for her newborn. They are not laws, and patients, and their parents, still retain the legal right to refusal.
However, the position of ACOG on medical ethics, as well as a number of Constitutional principles, is being ignored and violated at present in the case of Jennifer Goodall. It was also ignored in the case of Rinat Dray, a Staten Island woman who was forced into a cesarean. The Inquisitr reported her story of abuse from the medical system that has resulted in a lawsuit against her doctor and hospital.
Cases like this are often taken to a judge by the doctor or hospital in search of a court order to force the mother into a cesarean, or force a family to abide by a medical decision that the family disagrees with. As an example, consider FOX‘s analysis of Justina Pelletier’s situation. Usually, these “emergency hearings” result in the judge siding with the doctor.
That is what has happened in Ms. Goodall’s case. In what NAPW is calling “one of the most perplexing” parts about the judge’s decision, the judge has twisted around the difference between “normal” and a “procedure.”
On June 25, attorney Patricia E. Kahn filed a complaint in federal court on behalf of Goodall seeking a restraining order to prevent the hospital from forcing the cesarean. “Judge John E. Steele denied the request, stating, in part, that Ms. Goodall has no ‘right to compel a physician or medical facility to perform a medical procedure in the manner she wishes against their best medical judgment.’”
But that is not what is happening at all in this case. Normal labor and birth are not “procedures” at all. Carla Hartley of the Trust Birth Initiative says that “birth is a normal function of biology.” It will happen with or without assistance. It is life.
“[O]ur client is the one trying to avoid a compelled medical procedure,” argues Farah Diaz-Tello, Staff Attorney for NAPW. “Deciding whether and when to consent to surgery is a constitutionally protected right.”
The judge is neither a doctor, nor, in most cases, a mother who has done the extensive research into the issue, as this mother has. In these quickly-held hearings, the mother is not typically allowed to present evidence in her defense.
However, when the cases are appealed, the mother, or her representatives if the procedure resulted in her death, is allowed to have legal representation and to present evidence on her behalf. When that happens, invariably the mother wins. However, it is a hollow victory at that point, because her rights have already been violated, and she has already been forced into a cesarean that she neither wanted, needed, nor consented to. It is a post de facto victory.
Diaz-Tello explains that:
“every appellate court to rule on this issue on a full record has held that pregnant women retain their constitutional rights, including rights to medical decision-making and bodily-integrity. ‘No woman should fear that because she’s pregnant, she can be threatened, coerced, or deprived of her constitutional rights.’”
The actions of the hospital are “troubling,” according to Mary Faith Marshall, PhD, Director of the Center for Biomedical Ethics and Humanities at the University of Virginia School of Medicine. “Given the clear statements from ACOG’s Committee on Ethics and other professional groups that coerced or court-ordered medical procedures are not ethically justified, it is stunning that a hospital would threaten such an action.”
It is important to note that Ms. Goodall believes that her decision is a sound one, based on research and evidence:
“My decision to allow labor to proceed before consenting to a surgical intervention is based on years of research, careful consideration of the risks to me and my baby, and my family’s needs. All I want is to be able to go to the hospital when I’m in labor and have my medical decisions respected – and my decision is to proceed with a trial of labor and not have cesarean surgery unless some medical complication arises that makes cesarean surgery necessary for my or my baby’s health. Instead of respecting my wishes like they would for any other patient, my health care providers have made me fear for my safety and custody of my children. The people who are supposed to be caring for me and my baby have put me into an even more dangerous situation. I know I’m not the only one to go through this; I’m speaking out because pregnant women deserve better.”
Her situation is still very precarious. Her complaint filed in an attempt to prevent the hospital from literally holding her down and cutting her open has been denied. She has not yet had her baby, but is due at any moment.
Improving Birth has set up a petition here to support Ms. Goodall in her fight against the forced cesarean, which says, “Do Not Force Jennifer Goodall Into Surgery.”
She is being denied “due process of law,” the “right to liberty,” and “equal protection under the law.” (See the Constitution of the United States). The fact that she is pregnant does not negate her Constitutional rights, although that is what is happening currently to Jennifer Goodall as she faces being forced into a cesarean.