In what could be termed a violation of the most basic of feminine, or even human, rights, a Staten Island woman was forced, against her will, to undergo a cesarean section, and she is fighting back with a lawsuit filed against the hospital and the physicians.
When Rinat Dray learned that she was pregnant with her third baby, she began looking into her options. Her first two children had been born via c- section, but the recovery period was difficult and prolonged, as is commonly reported with cesarean births. According to RHReality Check, Dray decided to try for a VBAC - Vaginal Birth After Cesarean, after researching her options. She never anticipated the medical tyranny that she encountered when it was time for her baby to be born, nor the injury that she would sustain from the forced cesarean surgery.
Based on current VBAC and cesarean guidelines and her own specific situation, Dray "believed she might be a successful VBAC candidate." She interviewed various maternity care providers and found a group that seemed supportive of her wishes to avoid another cesarean and that, according to Michael Bast of the law firm Silverstein and Bast, "gave her a positive response without a guarantee, which is a good response. It's all you could expect."
Though there are no guarantees with VBAC, as well as any birth, there is plenty of research available that shows that VBAC is overall less risky to mothers and babies than repeat cesarean section. The group ICAN, International Cesarean Awareness Network, points out that the guidelines for VBAC have improved as of 2010 according to ACOG, the American Congress of Obstetricians and Gynecologists:
"The updated guidelines state that VBAC is a safe and reasonable option for most women, including some women with multiple previous cesareans, twins, and unknown uterine scars. ACOG also states that respect for patient autonomy requires that even if an institution does not offer trial of labor after cesarean (TOLAC), a cesarean cannot be forced nor can care be denied if a woman declines a repeat cesarean during labor."
However, when the much-anticipated day came for Rinat Dray's baby to be born, those guidelines were ignored. The staff of Staten Island University Hospital began pressuring Dray to have a repeat cesarean when she arrived at the hospital in labor. She refused.
A few hours later, the attending physician informed her that he would no longer examine her unless she consented to a repeat c-section. She again refused. But that didn't stop the physician, who consulted with the hospital's legal department and made the decision to violate her will and her right to refuse surgery by the forced cesarean. The following notation is written in Dray's medical records:
"The woman has decisional capacity. I have decided to override her refusal to have a c-section."
The lawsuit charges medical malpractice for forcing the cesarean against standard of care. ACOG's own guidelines state: "Restrictive VBAC policies should not be used to force women to undergo a repeat cesarean delivery against their will."
The Patients' Bill of Rights for New York State (and other states) clearly asserts that "patients have a right to refuse treatment," a right which the suit alleges was violated in ignoring and overriding Dray's refusal for cesarean. This may be the first time that a patient has fought back in court using the Patients' Bill of Rights.
The concept of "informed consent" was designed to protect patients' rights, but many mothers and doulas have reported that "informed consent" is largely a myth, rarely seen in hospital birth settings. Be that as it may, it remains the law. In Dray's case, it was "no consent," as she was forced into a procedure she refused.
As difficult as it may be to believe, forced cesareans do happen, more frequently than most would believe. As recently as February 2014, a Brazilian mother was forced into a repeat cesarean. Birth Anarchy wrote her story of the police literally showing up at the woman's home while she was in labor and dragging her to the hospital for the forced cesarean where they cut her baby out of her, even though neither she nor her baby were in any actual danger.
Forced cesareans have happened, and made the news, in Florida, in the UK, in Georgia, and more, though they remain rare. More common are providers who tell women that VBAC is not an option at their facility, thus women often reluctantly submit to repeat cesareans, not forced but coerced.
Increasingly common are threats that amount to blackmail, where hospital staff threaten parents with calling Child Protective Services to investigate or even take their baby from them if they do not submit to a repeat cesarean, or even to vaccines, as was the case recently in Birmingham, Alabama, as reported by The Inquisitr.
Last year, a Florida woman was threatened with arrest and the state-sanctioned kidnapping of her first-born child if she did not report to the hospital for her scheduled c-section.
Farah Diaz-Tello, a birth justice activist and staff attorney for National Advocates for Pregnant Women, states that such actions are "not the appropriate use of the child welfare system, which is designed to protect children from neglectful parents, but we have seen cases in which women have been investigated and even had parental rights terminated based on proceedings that started with a refusal of cesarean surgery."
That reality has birth and women's rights activists alarmed.
Carla Hartley, founder of the Trust Birth Initiative, says that:
"Mothers do not need to ask anyone's permission to exercise sovereignty over her own births."
The World Health Organization maintains that no hospital should have over a 15 percent cesarean rate. Yet women are increasingly having them. Some women want them; some need them; some believe they need them; others are lied to in order to compel them to submit. Others, like Rinat Dray, are forced into them.
In 1993, a Massachusetts woman won a $1.5 million judgment for her forced c-section.
"There are absolutely human rights and constitutional implications to cases like these, which treat women as separate and unequal to other people," Diaz Tello told RHReality Check. "All people who are conscious and competent have the right to make decisions about their own health care, even in emergency situations. In this situation, they acknowledged that she [Dray] had the right to make this decision, and unilaterally decided to take it away from her. They didn't even believe that they needed legal authority to do so."
How is this possible under Constitutional assurances of "life and liberty"? Her life was risked and her liberty was taken from her.
What do you think needs to be the consequences for her doctors and hospital? Are lawsuits like this one the appropriate action? And how can forced cesareans sections be prevented from happening again?
[Images via bing]