Freedom of choice in birthing?

Pregnant woman

Pregnant woman

So there she was, in the land of the free, about to give birth to her fourth child.

Jane Goodall, of Cape Coral, Florida, had already given birth to three children - all via Cesarean surgery. According to the Mayo Clinic, an attempt at vaginal birth, referred to as VBAC, would be the safest way to go. If vaginal birth would not work, then a Cesarean surgery would be the back up plan.

Here's the quote, as posted by Reproductive Health Reality Check:

“The risks associated with a vaginal delivery are lower than the risks associated with a C-section overall, as long as you can deliver the baby at a facility equipped to handle a C-section in case of emergency,” Roger W. Harms, an obstetrician at the Mayo Clinic in Rochester, Minnesota, and medical editor-in-chief of, said in a statement. And the recovery time is faster. Undergoing a cesarean surgery for the fourth time carries a 1 in 8 chance of major complications. In short, VBAC deliveries are safer for both the pregnant person and the fetus and lead to fewer complications."

Now, this is where things become bizarre.

Prior to giving birth, Goodall's intended hospital for delivery sent her a letter letting her know that the hospital had no intention of allowing the mother-to-be to make her own decision concerning her method of giving birth.

The threats were made in a July 10th, 2014 letter from the Chief Financial Officer of Bayfront Health Port Charlotte to Jennifer Goodall, a Cape Coral, FL mother of three who was nearly 39 weeks pregnant. The letter informed 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.

Appalled yet? There's more.

That last quote is from a Press Release issued by the National Advocates for Pregnant Women.

Truth be told, I was unaware that such an organization existed - and kinda wondered why pregnant women need organized advocacy in the Land of the Free.

Imagine my surprise then, when I discovered that the oldest blog entry by the organization is titled "C-Sections, Forced, Coerced, or On Demand?", and it was posted on, wait for it, March 27, 2006.

So Jane Goodall in Florida was not the first.

And despite the organized support offered by the National Advocates for Pregnant Women, the hospital was not put in its place.

Instead, amazingly, the courts sided with the hospital. From RH Reality Check:

A complaint on behalf of Goodall was filed in federal court last week by National Advocates for Pregnant Women (NAPW) and Florida attorney Patricia E. Kahn, seeking a temporary restraining order to prevent the hospital from carrying out its threats. Federal District Judge John E. Steele denied the request, stating in part that 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.”

So why is it exactly, that a male judge, and a male Chief Financial Officer of a hospital, think they know know best on an issue affecting giving birth?

And, moreover, that the woman actually giving birth have no say in the matter.

What is flabbergasting to an outsider, is that the
the US has chosen a market solution to health care. So you would think that the "consumer" of health services, ie. the pregnant woman, would be at the center of decision making. Isn't the customer always right?

Instead, decisions seem to be guided by bottom line considerations - even over better health outcomes!

Just a few months earlier, another mother faced a similar coerced cesarean delivery in New York.

In Rinat Dray's case however, she had no advance notice. It was only when she walked into the Staten Island hospital, in labour, that the coercion began.

And again, threats were made that her children would be taken away from her.

Rinat is suing the doctors and hospitals for malpractice.

Ironic isn't it, when the justification for the Florida case of Jane Goodall was fear of a malpractice suit?

Now, here's another aspect to chew on...

According to the New York Times story on Rinat Dray,

Across the country, nearly 33 percent of births, or almost 1.3 million, were by cesarean section in 2012, according to the Centers for Disease Control and Prevention. The World Health Organization recommends that the rate should not be higher than 10 to 15 percent.

Now why would a more complicated, riskier and more expensive procedure be three times as likely in the US?

Could it be the click ka-ching?

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