A Florida mother gave birth to her fourth baby this past Friday amidst a hell of a controversy. Jennifer Goodall, who has had three previous C-sections, had been hoping to attempt a vaginal birth with her fourth delivery. However, her providers at Bayfront Health Port Charlotte were not on board with her wishes and went as far as saying that they would perform a C-section on Goodall against her will if need be. Earlier this month, Goodall received a letter from the hospital’s Chief Financial Officer informing her that they were going to seek a court order that would allow them to perform a C-section surgery on her without consent. Goodall also learned that the hospital planned to report her to the Department of Children and Family Services, threatening the custody of her other children.
At 41 weeks pregnant, Goodall and her lawyers fought back, but she was still frightened to enter a hospital that threatened to perform surgery on her against her will. In the end, she delivered at another hospital, one that honored her request to attempt a vaginal birth, despite it ending in a fourth cesarean. Goodall was not looking to go against best practices, and she wasn’t even against the idea of a c-section. All she wanted was a shot at birthing her baby vaginally.
Goodall issued the following statement soon after her son’s birth:
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.
The fact that a hospital was willing to seek a court order to bypass the patient’s request and, ultimately her bodily autonomy, is absolutely frightening. In fact, the American College of Obstetricians and Gynecologists Committee on Ethics supports the idea that a pregnant woman has the final say over what happens to her body: “Justice requires that a pregnant woman, like any other individual, retain the basic right to refuse medical intervention, even if the intervention is in the best interest of her fetus.”
While every case is different, a vaginal birth after cesarean (VBAC) is usually safer for both the pregnant person and the baby, as C-sections are major surgery that come with increased risks both with the actual surgery and during the recovery period. Yet, despite the known risks of cesarean births, the U.S. still has a 32.8 percent C-section rate, more than two times higher than the World Health Organization’s recommended 10-15 percent rate.
But this isn’t just about our high C-section rates, or the fact that we spend the most out of any other country when it comes to maternal care, yet rank only 60th out of 180 countries when it comes to global maternal mortality rates. This is about a person’s bodily autonomy and agency as a patient, and not worrying that you will be subjected to surgery against your will — especially when it isn’t necessarily best practice.
I should note that I am immersed daily into the world of pregnancy and birth, and this topic is one that I am incredibly passionate about. For the past year and a half, I’ve been part of a team that’s created an evidence-based prenatal curriculum — one that prides itself on providing the information, tools, and skills to allow those in the program a sense of agency and empowerment over their health care. And for me, that’s what it’s about: sharing information and allowing parents the opportunity to make an informed choice. In fact, I spoke with a colleague who delivers babies in a hospital setting to get her take on Goodall’s case. She said that they make recommendations based on facts and alert the patient to all known and potential risks, but that ultimately, it’s up to the patient to make the final decision.
And that’s what it comes down to: patients shouldn’t be frightened, bullied, threatened or coerced into any treatment. Pregnancy should not be treated as pathology. And the bottom line (or fear of being sued) shouldn’t override a patient’s desires when they align with accepted practices. We already have plenty of debates when it comes to vaginal versus cesarean births, there’s no need to add another, completely dehumanizing layer to it all.
[RH Reality Check]
[Facebook: National Advocates For Pregnant Women]
[American College Of Obstetricians & Gynecologists On Maternal Decision-Making Ethics]
[Centers For Disease Control: C-Section Rate]
[World Health Organization: C-Section Rate (PDF)]
Avital Norman Nathman blogs at The Mamafesto. Her book, The Good Mother Myth: Redefining Motherhood To Fit Reality, is out now. Follow her on Twitter.
[Image of surgery via Shuttershock]