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You Try Saying No to a C-Section

Posted by on Apr. 24, 2009 at 9:56 AM
  • 11 Replies

Last year Idaho passed a law making it a crime to coerce a woman into having an abortion. This year, legislators in twelve states, including Missouri, have passed or are considering bills that they claim would enhance informed consent measures for pregnant women seeking abortions and ensure that women are not coerced into having unwanted abortions. Although it is hard to disagree with legislation that purports to ensure free and informed medical decision-making, I have to wonder why legislators who profess to care so much about pregnant women are only willing to protect some pregnant women - the ones who plan to end their pregnancies - but not the ones who intend to go to term.

While approximately 800,000 women end their pregnancies each year, a far greater number of women, 4.3 million, go to term. By focusing exclusively on abortion, this kind of law also dangerously implies that pregnant women who are going to term are fully and adequately informed and that their medical decisions are never pressured or coerced.  

Instances of poor communications, failure to fully inform, and coercion in hospital delivery rooms, however, are increasingly being documented in popular books, films and collections of first-hand accounts. Allegations of abuse have prompted one organization to provide a guide for filing complaints.  Rigorous peer-reviewed research, moreover, has found that pregnant women are routinely subjected to interventions during labor and childbirth that have been proven ineffective, or are appropriate only in limited circumstances.  Pregnant and laboring women are often deprived of information about and access to a range of good practices that have been shown to work.    

For example, an increasing number of women in the United State now give birth by cesarean surgery. According to the World Health Organization the rate of births by cesarean surgery, based on actual medical need, should not be more than 15% of all deliveries. Yet, today approximately 30% of all US births are cesarean surgeries. Some providers and hospitals have even higher rates (40-50% of all births). This rise in cesarean surgery rates has not been accompanied by overall improvements in maternal or child health and creates risks to pregnant women and babies that do not exist with vaginal births.  

According to Listening to Mothers II, the largest survey of women's experiences during pregnancy, childbirth, and the postpartum period, one quarter of the survey participants who had cesareans reported that they had experienced pressure from a health professional to have cesarean surgery, and 73% of women who experienced episiotomy, or vaginal cutting, during delivery, reported that they had no choice at all in the matter.  

Supporters of so called abortion coercion laws claim that these laws protect pregnant women and unborn children. Certainly, if that were really the goal the legislation would not focus on abortion exclusively, but rather would make it illegal to pressure or coerce a pregnant woman to have any medical intervention. This would include policies that force pregnant women who have had previous cesarean surgery to have repeat surgery whether they need it or not.  

The best available evidence supports vaginal birth after cesarean surgery (VBAC) for most women who have had this surgery.  Nevertheless, the International Caesarean Awareness Network has documented over 800 hospitals with explicit policies that require women to undergo a planned repeat surgery. These women are deprived of both the right to give or withhold informed consent, and they are coerced into having repeat major surgery if they want to deliver in any of these hospitals.  

The Missouri bill requires that women be provided with  "medically accurate information that describes the proposed abortion method, medical risks, alternatives to the abortion, and follow-up care information."  While such information is routinely provided in the context of abortion, there is significant evidence that critical information is not provided to women regarding childbirth delivery methods.  Indeed, only two states in the whole country, New York and Massachusetts, have Maternal Information Acts that require health care providers to give expectant parents information about their cesarean surgery rates and rates of births using medical interventions such as labor induction and episiotomies. These laws give families the information they need to avoid providers who are not willing to or who are not trained to support vaginal birth.  

Each year, state legislators introduce hundreds of bills that focus on abortion while ignoring serious health and consent issues affecting the millions of women who become pregnant and go to term. Legislators who are truly concerned with protecting pregnant women would ensure that all of them, not just those seeking abortions are guaranteed informed consent and freedom from coercion.  

by on Apr. 24, 2009 at 9:56 AM
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Replies (1-10):
Raintree
by Ruby Member on Apr. 24, 2009 at 10:24 AM

Having worked on a perinatal services department for three years- and documenting for the state each birth- this is a very evident problem. Our hospital didn't have an anti- VBAC policy- but most of the doctors did. And about 4 in 5 labors were augmented or induced- and of those 4- 2 would end in a section.

Stand up, this is comedy. The DNA lotto may have left you smart, but can you stand up to beauty- dictator of the heart. I can stand up for hope, faith, love but while I'm getting over certainty. Stop walking God across the road like a little old lady. - Bono

provincialfoot
by Bronze Member on Apr. 24, 2009 at 10:49 AM

Thanks for this post.... this is a very important topic that needs to be examined.

lbranta
by Bronze Member on Apr. 25, 2009 at 2:09 AM

Good post.  And here I have been wondering why almost all the births around this area where I live anymore is by C-Section and all of them unless they are early are already planed out  when they well go have the baby by induction.  I thought it was for the conviniance of the doctors.  I am a firm believer in letting the baby come in its own time ( if possible ) and see if they can be born normally first.  But thanks for this post it does answer alot of the questions I have been having regarding this.

hsteele
by on Apr. 25, 2009 at 5:27 AM

I can't say for sure that I was coerced into a C section, but I feel like I didn't receive clear info before I went in for surgery. I think though the problem isn't just Drs.  I have heard many women say that they would rather have a c section than have their nether regions stretched from giving birth, or that c section babies are more beautiful. Both are ridiculous. I know that even though I had a c section with my daughter, I am going to fight like hell for a VBAC in August.

Heather
Proud Pagan Mama


" No teacher, preacher, parent, friend or wise man can decide- What's right for you -- just listen to the voice that speaks inside." ~Shel Silverstein~

Check out my Group especially for Pagan Families
http://www.cafemom.com/group/paganfamilies

PurdueMom
by Sherri on Apr. 25, 2009 at 8:20 AM

Here's how I see it: 

We have taken a natural human event and turned it into a medical procedure. 

To some - physicians and moms-to-be alike - labor is inconvenient time-wise and pain-wise.

We are a litigious society, and physicians fear being sued.  At the first sign of fetal distress, they plan a c-section -  then refuse to do a VBAC  with the next pregnancy because of the increased risks of scar rupture (risks, by the way, that research does not support).    Malpractice rates are so high, many OB-GYNs and family practice docs no longer deliver babies because when something goes wrong - and even when it's no one's fault - we sue.

Women need to be more informed when choosing their OBs.  Every mom-to-be needs to ask the "what if this happens" questions when deciding on an OB.  If he/she is not on the same playing field as mom-to-be, she needs to find another physician who is. 


 

Quoting the OP:

. . .only two states in the whole country, New York and Massachusetts, have Maternal Information Acts that require health care providers to give expectant parents information about their cesarean surgery rates and rates of births using medical interventions such as labor induction and episiotomies. These laws give families the information they need to avoid providers who are not willing to or who are not trained to support vaginal birth.  


 

Kudos to New York and Massachusetts.  The Maternal Information Acts in these two states should be passed in ALL states.  I would definitely support this bill in my state.

    

Sherri
ministrymom
by Member on Apr. 25, 2009 at 9:24 AM

thank you for this post. It was an interesting one. I think that we moms do need to be informed on what does and could happen with our bodies. i had three normal deliveries, although with my first they lost the heart beat so wanted to get the baby out ASAP, if they couldnt they were planning my C-section. He was perfectly fine coming out, breathing, crying, So i am glad that they didnt have to do a c-section. Thank you again for the info, we need to know what is going on.

provincialfoot
by Bronze Member on Apr. 27, 2009 at 7:25 PM

bump

sweetie00
by on Apr. 27, 2009 at 7:34 PM

Thank you for this post. I was coerced into 2 c-sections, and my visits w/my OBGYN were about 2 minute apiece. I will be changing docs. Cesareans  are  major surgery, and the second one was very difficult to recover from.

rnjMOM
by Rachel on Apr. 27, 2009 at 7:44 PM


Quoting sweetie00:

Thank you for this post. I was coerced into 2 c-sections, and my visits w/my OBGYN were about 2 minute apiece. I will be changing docs. Cesareans  are  major surgery, and the second one was very difficult to recover from.


Mine too! They cinched a nerve bundle with the second one and HOLY COW! The scarring is minimal, but on certain days my leg still twitches! LOL! (It has been 2.5 years).  I really wish I would have done a natural the second time!

che_bad
by on Apr. 27, 2009 at 10:40 PM

bump

 

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