Is A Forced C-Section Akin To Rape?

hlnbabe
wrote on October 19 2009 @ 11:37 am: [report]

Every once in awhile, general rules and policies in hospitals can really screw over the little person.

BUT what people forget, is that Obstetrics is a dying profession as doctors and hospitals are constantly paying more and more and more in insurance policies. A doctor can be sued until someone is 18. There are doctors with pristine records decimated because a mother INSISTED on a vaginal birth and they held out too long before going to cessarian….

This woman may want a vaginal birth, but tough luck sweetheart, you live in the middle of nowhere and your hospital refuses. That is their policy to make since they are the ones offering the service. That’s what you get with privatized health care, people making decisions based off money and resources.

Crys
wrote on October 19 2009 @ 11:42 am: [report]

It most likely is an effort to control costs by eliminating the VBAC.  Money is tight all around and they may have to do this so they can direct funds elsewhere.  Perhaps to hire more nurses or to replace outdated equipment.  If she really is opposed to getting the c-section, she should look into alternatives such as an at-home birth, a midwife or making sure she gets to another hospital that will allow her to deliver vaginally.  If it is a private hospital they are well within their rights to make such decisions just as she is well within her rights to go elsewhere.

Jillybean
wrote on October 19 2009 @ 11:47 am: [report]

Not pregnant, not a mother myself - but in my opinion, whatever’s best for baby is the best situation to take. The hospital, for funding reasons, can only offer caesarian births to her because of previous complications.

I am highly sceptical of calling this ‘rape’. Next you’ll be telling me that taking blood from an unwilling child to check for allergies/giving a scared child a vaccine/etc. is rape too. I don’t particularly want a smear test, but am pressured into it by fear. Fear of cancer. Is the nurse raping me by this woman’s logic? She’s completely undermining real rapes.

My gut reaction is that she’s doing this to draw attention to her cause - rape is provocative, people will talk about it. Well played, lady, I’m now talking about it.

joyy
wrote on October 19 2009 @ 11:49 am: [report]

Given what the CEO told her, I can see where the rape comparison is coming from. 

However, //American College of Obstetricians and Gynecologists has said that they are OK, so long as the OB and an anesthesiologist are present for the birth. In theory, Szabo’s hospital’s policy decision was unnecessary, likely an attempt to cut corners as many smaller hospitals are having funding issues and are eliminating costly VBACs to save money.//

Um, I fear it’s entirely possible that they wouldn’t have a spare OB and/or anesthesiologist present for the birth.  If that’s the case, the policy might not be “unnecessary.” Have you been to Page?  I have.  It’s tiny, and it’s remote - hlnbabe has it right.

If she really wants a vaginal birth though, why doesn’t she get a midwife or do a home birth?

bethlynn00
wrote on October 19 2009 @ 11:55 am: [report]

Um, yeah her argument is waaayyy off-base.  It sounds like this is a very small hospital and their policies probably are in place because they don’t have the staff or funding to have and OB and anesthesiologist on call for her procedure and unless she is going to pay the cost out of pocket for that to be done, then she has to go by their policy or find another hospital who will fund her VBAC. 

The recession has taken away alot of people’s freedom and that’s sad, but things like this really do further attribute to financial issues with medical institutions and by allowing her to pursue this procedure means they have to find other ways to cut corners which could have a negative effect on other aspects of medical care for other individuals. 

I would wonder why she had a C-section with her 3 child? Was it medically necessary or elective? If it was medically necessary then of course the hospital would be concerned with going back to vaginal birth and if not then the VBAC would default to being elective, so they don’t have to agree to performing the birth.  Like hinbabe said, privatized health care is a bitch, she just has to suck it up and go somewhere else.

Claireific
wrote on October 19 2009 @ 11:57 am: [report]

Melodrama to the max. She’s angry at the wrong thing. It’s unfortunate that her hospital doesn’t have the resources to accommodate her request, but that’s reality for tiny rural hospitals. They’re offering her a safe method of childbirth that’s within their limitations. I wouldn’t be surprised if a hospital like hers has only one anesthesiologist, and he’d be tied up for the entirety of her labor. I have to say, this policy sounds perfectly reasonable. The hospital could hire a slew more physicians, and make up for it by charging their poor rural patients more than they can afford. It’s a balancing act. If she’s really that stubborn, she can hire a midwife and deliver vaginally at home.

_jsw_
wrote on October 19 2009 @ 12:00 pm: [report]

I agree that this isn’t in any way rape. The hospital has stated its policy clearly, well in advance, and the reasons for the policy are obvious - they can’t afford to have the personnel in place in case something goes wrong. And, as a hospital, they have to plan for what could go wrong, not for what is the most likely outcome. I think it’s responsible of them to have this policy, given their resources, and to let her know of it ahead of time.

SCRMOM
wrote on October 19 2009 @ 12:01 pm: [report]

...likely an attempt to cut corners as many smaller hospitals are having funding issues and are eliminating costly VBACs to save money.

A c-section is so much more costly than a VBAC.  In a c-section, not only is the OB and anesthesiologist in the room the entire time, but a lot of nurses and assistants.  When you labor (including a VBAC), most of the time it’s just you and your husband (or birth partner) in the room until it’s time to push.  This decision by the hospital (which is not uncommon) is because of the risk of malpractice suits if something goes wrong. 

I went through labor with all of my kids, but all three ended in c-section even after attempting a VBAC with the last two.  I never had any feelings of disappointment or regret with the c-sections, but I know a lot of women do.

_jsw_
wrote on October 19 2009 @ 12:07 pm: [report]

@SCRMOM: Definitely, the malpractice concerns are huge. I simply meant that the VBAC requires additional staff on hand and on call, whereas most C-sections are planned and scheduled. Obviously, births intended as vaginal can go bad, and hospitals must plan for that, so perhaps the additional costs are minor. But the potential malpractice costs are significant.

I think that malpractice suits have done far more harm than good because they’re overused and pay too much. Yes, if someone cuts off the wrong leg, you deserve a lot of money in compensation. Yes, if someone is grossly incompetent, you deserve compensation. But if a doctor makes a choice in the middle of a complex delivery that turns out to not have been perfect, to hold that doctor accountable for doing the best they could reasonably have been expected to do is crazy.

Too many greedy freeloaders have corrupted a system which originally had an excellent purpose. Sort of like a lot of unions.

OutOfLine
wrote on October 19 2009 @ 12:20 pm: [report]

Maybe this is a silly question, but why does she want a vaginal birth so badly?  Is there an advantage to it?  I’ve never been pregnant, so i don’t really know these things.

_jsw_
wrote on October 19 2009 @ 12:25 pm: [report]

@OutOfLine: a vaginal delivery, without complications, has less recovery time than a C-section. A C-section, without complications, has less recovery time than a vaginal delivery with complications. So, when complications are unlikely, vaginal deliveries frequently mean you’ll be up on your feet faster.

lea322
wrote on October 19 2009 @ 12:33 pm: [report]

@joyy: She probably doesn’t want to do a home birth because, in the case of a VBAC, you have to be prepared for a C-section. If you’re not already at the hospital, you’re risking your own life and your baby’s if you do tear.

@OutOfLine: There is usually less recovery with a natural birth (with the exclusion of those who need an episiotomy). And many people prefer it because it is the natural way to give birth.

SCRMOM
wrote on October 19 2009 @ 12:35 pm: [report]

@_jsw_: I wasn’t responding to you directly.  I hadn’t read any of the responses when I wrote mine.

@OutOfLine: Speaking from experience, there is a lot of pressure on pregnant women to have a natural, drug-free childbirth, if possible.  The second option is a childbirth using drugs (usually an epidural).  A c-section is seen as the last option and a “failure” by some.  I never felt this way, but I definitely felt that expectation in what I read and heard all throughout my pregenancy. 

Motherhood is one big (attempted) guilt-trip.  Once you have the baby, then there’s the whole breast vs. bottle, pacifier vs. no pacifier, sleep in a crib vs. sleep with parents, etc.  Those are just the decisions made in the first week - I don’t think it ever ends.  Fortunately, now that my kids are a bit older, they are the ones to tell me that I’m the worst mom in the whole world. 

SCRMOM
wrote on October 19 2009 @ 12:37 pm: [report]

Oops - “pregnancies”

OutOfLine
wrote on October 19 2009 @ 12:45 pm: [report]

Thank you everyone, that makes a lot more sense.

workerbee
wrote on October 19 2009 @ 12:51 pm: [report]

I think it’s better that they accommodate VBAC’s as opposed to forcing these women to labor at home and possibly end up with more complications.  I had a birth how I wanted and chose and cannot imagine anyone else imposing their beliefs on how they felt I should birth my child. If someone tried to tell me I couldn’t have the VBAC I wanted I’d risk laboring at home until it’s too late to have a C-Section forced upon me.  That just opens up a whole bunch of risks right there but I’ll be damned if someone forces me to do something with my body that I don’t want.  This is also why I’ll never have a hospital birth if I can help it.

resullins
wrote on October 19 2009 @ 01:12 pm: [report]

@OutOfLine: My mother was a midwife, not a doctor, so take this for what you will, but there is a lot of research that says the actual act of giving birth naturally puts needed pressure on the baby’s skull to promote brain development. Yup, you heard me, the baby’s head being squeezed through a hoo-ha actually makes them develop better.

resullins
wrote on October 19 2009 @ 01:13 pm: [report]

Oh yeah… and I don’t buy the rape thing… if she was rushed to the hospital with a burst appendix and they saved her life, would she be spouting the same BS? She’s wanting the publicity.

SCRMOM
wrote on October 19 2009 @ 01:20 pm: [report]

I don’t think she is trying to compare it to rape literally - it’s just that she felt violated.  Rape is an attention-getter word so people pay attention.

writergirl
wrote on October 19 2009 @ 01:29 pm: [report]

She’s carrying this a little too far.  I can understand her frustration—after all, who wants to recover from a c-section with two children to care for?—but calling it rape?  Nope, that’s just hoping the out-lying community will be so incensed, they’ll pressure the hospital to change the policy.

pragmatryst
wrote on October 19 2009 @ 01:53 pm: [report]

“In theory, Szabo’s hospital’s policy decision was unnecessary”

In theory, hospital assisted births are unnecessary.  She could have this baby in her own bathtub with a doula if she wanted.  Clearly she is aware that a VBAC has an increased risk of complications which might require an emergency C-section and apparently she is fine with that as long as the hospital tries the VBAC first and assumes the financial responsibility of having an OB and an anesthesiologist on call even if they aren’t needed.  Let’s see…“Allow someone to enter your body with permission as long as they make a sizable financial investment first…Sounds like prostitution to me.”

retro chic
wrote on October 19 2009 @ 02:21 pm: [report]

Pardon me, but she should have planned better and far earlier (before even), doing what she’s ending up doing now by switching hospitals/medical groups since this is so important to her. The outcome might be the same anyway.

I wanted delivery of my kid to go a certain way, but, hey, it didn’t happen. That’s the way it goes sometimes.

I’m thinking the only thing she accomplished by “sending a message” to the hospital with a painted windshield crying rape-lite is that she is looking really good as a candidate for meds and a new PR manager. One sure sign of a happy child – presumably the one who matters here *ahem* – is a happy parent who can roll with the punches. Something she should focus on more for her baby’s and family’s sake. But again, preparing apparently is not one of her fortés.

Jenn27549
wrote on October 19 2009 @ 02:31 pm: [report]

I’m all for letting people make medical decisions that may or may not be dangerous.  Its their own (and their own child’s) life to harm and/or end.  BUT…the problem is that the doctors are liable, as someone previously mentioned.  If we weren’t so sue happy and stuck to the policy that your decision is YOUR decision and YOURS ALONE, then let her do whatever she wants.  Since that’s not the case, then I guess they need a policy.  What about a waiver?  Even though they aren’t iron-clad, its a middle ground option.

scylla
wrote on October 19 2009 @ 02:38 pm: [report]

It doesn’t matter whether her rights were violated.  Well, of course it matters, but Szabo went too far by making an incredibly offensive comparison, and all she’s managed to do is distract from the very real issue that she purports to champion.  I lost much of my sympathy for her because of her word choice. 

She made the discussion about something else entirely (see the title of this article, for example—not “Is a Forced C-Section Abusing Women’s Rights?” but “Is a Forced C-Section Akin to Rape?”).  Advocating for women’s rights is a noble cause, but she has made a mockery of two serious issues—both important, but not at all comparable.  Rape is like the Holocaust: almost no comparison is a fair one, and it ultimately detracts from your ethos if you try to go that route.  Comparing her situation to a violent crime is disrespectful and sensationalist.

Oh Kathryn!
wrote on October 19 2009 @ 03:01 pm: [report]

I’m a year away from an MD (I already have my RN) and let me tell you, sometimes a woman is so dead set on delivering vaginally that she is willing to endanger herself and her baby. In that case I do think a forced C-section is a pretty damned good idea. I’d much rather she someone be pissy that their “rights” were violated than see a woman and/or her child die a preventable death.

By the way, that was the stupidest analogy I’ve ever heard.

LiciMama
wrote on October 19 2009 @ 05:08 pm: [report]

Whats the big deal? The whole point is to have a healthy baby in a safe way. Besides I would much rather have a cut on my abdomen than a cut on my lady bits. Trust me that cut does not heal for a while.

When I was pregnant with my son there was always someone in my face about what I should or should not do with my child. I was accosted by the la leche league, told by a woman in the grocery store that children who sleep away from their parents become killers. One old woman told me I was a failure as a mom if I used drugs during delivery. I consider that unsolicited advice more an invasion than a hospital saying “hey we arent equipped to do it your way safely.”

And you know what, every time they said I could have drugs for pain I said hell yes. Though,  I was in labor for 23 hours. I breastfed until my boobs gave up (2 weeks). Everybody is different and has access to different things. Women are so bombarded with the perfect ideal of birthing and raising kids, its just an enormous burden. Frankly sometimes it gets quite crazy.

papayalily
wrote on October 19 2009 @ 09:23 pm: [report]

@bethlynn00 Her first c-section was medically necessary.

SusanJ
wrote on October 20 2009 @ 06:53 pm: [report]

What most of those who have commented are missing here is that it is unconstitutional to force someone to have surgery.  The Supreme Court has ruled that no one can be forced to accept medical care without their consent.  Ms. Szabo does not consent to cesarean surgery.  What you need to also know is that, according to reliable medical studies that no one disputes, a woman is four times more likely to die as a result of a c-section than a vaginal birth, while the baby has a three-times higher risk of death from c-section than from a vaginal birth.  Good well-documented studies have also established that babies born by cesarean surgery also have much higher rates of asthma and other respiratory disease and are less likely to breastfeed as well as vaginally-born babies,  Women who insist on vaginal birth if at all possible do so for valid reasons, not because they simply want the “experience” of vaginal birth.  Ms. Szabo had her last baby at this same hospital in Page and it was a vbac and the hospital had no problem with it.  She had no reason to suspect that there would be a problem this time, since her doctor was more than willing to let her try for a second vbac.  Speaking of medical studies, there have been several in the last couple of years that have shown that the risk from vbac is greatly exaggerated and is, in reality, relatively low.  And even lower for someone, like Ms. Szabo, who has had one successful vbac already.
Think about this?  Why would the hospital need to have another OB and an anesthesiologist in house for vbac delivery?  Because of risk of an emergency requiring a c-section, they will answer.  But, what about all the other women who give birth at that hospital, small as it is?  What if one of them has an emergency and needs a c-section?  Where will the hospital get the anesthesiologist and OB surgeon?  Why, they will call them on their pagers and they will rush to the hospital, which is exactly what they could also do for Ms. Szabo if she ended up with an emergency. 
Bottom line:  if a hospital provides a labor and delivery service for vaginal births, then women who want to vbac should also be able to labor there, but if the hospital believes that the risk for an emergency c-section requires an OB and Anesthesiologist in-house, then it should have to provide these professionals 24/7 for everyone, since the risk of a uterine rupture for a vbac is the same as the risk of a uterine rupture in a woman who is having her first baby.  If the Page hospital does not believe it is safe for vbacs to labor there, it shouldn’t be accepting ANY L & D patients.

hbacmom
wrote on October 20 2009 @ 07:13 pm: [report]

Her first was a vaginal birth, her second was a c/s, her third was a VBAC at the hospital that now insists she have another cesarean.  So, the hospital was safe enough for a VBAC a couple of years ago but isn’t now.  This is about money—making it through billing higher procedures and easier staff scheduling (not to mention keeping your office hours from being interrupted by an inconvenient labor) and not losing it through litigation.  The “safety” (from a corporate standpoint) of VBAC changed in 1999 when the ACOG guidelines for VBAC changed one word—from “readily available” to “immediately available”—the wider OB community then interpreted this to mean an OB and anesthesiologist had to be in the hospital during the entire trial of labor.  If they weren’t then they could be accused of not following the “best recommendations of their own professional organization”.  (as an aside, of the 7 summary recommendations in the most recent ACOG VBAC bulletin, 2004, only 2 are based on “level A - good and consistent scientific evidence, the first summary being “most women with one previous cesarean delivery and a low-transverse incision are candidates for VBAC and should be offered a trial of labor”.  3 summary statements are level B - based on limited or inconsistent scientific evidence and the last 3 are level C - based primarily on consensus and professional opinion [emphasis mine]).  Because Ms. Szabo has already had a VBAC, the scientific evidence shows that her risk of a uterine rupture is almost equivalent to that of a woman who has never had uterine surgery.  This is NOT about what is safest for her or her baby, it is about money, period.  If that’s ok with people, for money to drive substandard medical care, then so be it.  It is certainly the system we currently have.  There are no easy answers to the problem of increasing cesareans (which have some very serious short- and long-term sequelae, especially as women have more and more repeat cesareans) and decreasing VBACs.  What is certain is that neither are in the best interest of the women and their babies.  It isn’t about making women feel guilty, its about providing the best possible care.  Women are misled and there are a multitude of factors involved.  If anyone is interested in learning more about this, I’d recommend you check out http://ican-online.org for more information.  It is well known that OBGYN has the least evidence-based practice of all specialties.  We just have to decide as a society if we are ok with that.  And ask yourself—if a hospital can not handle the potential complications of a VBAC labor (which are only different from any other labor because of the low risk of uterine rupture, about 0.5% within the hospital setting [that includes the use of induction and augmentation agents, which raise the risk]) then can they handle the potential complications of any other labor?  Abruption, severe cord compression, cord prolapse, undiagnosed placenta previa or accreta…these are at least as potentially deadly as a uterine rupture and require immediate surgical intervention.