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Pregnant Women Warned: Consent to Surgical Birth or Else

TeleKat

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Jennifer Goodall was about to have her fourth child when the ordeal began. Having given birth to three previous children through cesarean section—a surgical procedure that allows a baby to be delivered through a woman's abdomen—the Cape Coral, Florida, mother wanted to try a natural delivery now. But in early July, Bayfront Health Port Charlotte—the hospital where Goodall had been planning on giving birth in about two weeks—told her it wasn't permitted. A letter from Bayfront's chief financial officer said if she attempted a "trial of labor," the facility would report her to the state's Department of Children and Family Services, seek a court order to perform the surgery, and do the procedure "with or without (her) consent" if she stepped foot in the hospital.

snip

None of this means that Goodall's choice was necessarily better. But it was reasonable. This wasn't some particularly risky, out-there thing that she wanted to do. In a 2010 statement, even the National Institutes of Health (NIH) stated that "when trial of labor and elective repeat cesarean delivery are medically equivalent options, a shared decision-making process should be adopted and, whenever possible, the woman’s preference should be honored."

But federal District Judge John E. Steele disagreed. In denying Goodall's request, Steele wrote that she 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."

Pregnant Women Warned: Consent to Surgical Birth or Else - Reason.com
 
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Hmmm...interesting. I had 3 C-sections (no vaginal deliveries), and after #1 a VBAC wasn't even a suggestion.

I think they should let her try the VBAC if she's hell bent on it. They should make her sign a waiver that says she won't sue in the event her uterus bursts or the baby comes out with problems, etc.

If I wanted to be a doctor, I would never consider being an OB/GYN. Too much risk, which is which is why last I heard they carried the 2nd highest malpractice insurance costs.
 

Yea... I've heard bad things about Florida hospitals in general where this kind of thing is concerned.

I was born in one back in 1988, and, between the blatant bullying by the doctor, the casually abusive staff, and the unnecessary surgical intervention, they messed my mother up pretty bad, from what she's told me.

They apparently called CPS on a friend of hers while she was pregnant as well.
 
There's some else going on here that we're not party to. Why all the legal action when she can just switch hospitals in an instant? Heck, she can do home birth and hire a midwife. None of this makes sense, except well, it IS Florida.
 
There's some else going on here that we're not party to. Why all the legal action when she can just switch hospitals in an instant? Heck, she can do home birth and hire a midwife. None of this makes sense, except well, it IS Florida.

That was a question I had as well. Are they threatening to call CPS even if she goes somewhere else?
 
That was a question I had as well. Are they threatening to call CPS even if she goes somewhere else?

That would seem to be the case

From the OP
A letter from Bayfront's chief financial officer said if she attempted a "trial of labor," the facility would report her to the state's Department of Children and Family Services, seek a court order to perform the surgery, and do the procedure "with or without (her) consent" if she stepped foot in the hospital.

on edit: I read you post wrong. They are threatening her is she returned to the hospital; not if she went elsewhere

on edit a 2nd time: Actually it depends on how you read the sentence. I could mean that that were going to report her if she tried to have a "trial of labor" elsewhere, and perform a C-section if she returned to that hospital
 
From the source:
In a written statement Monday, Bayfront spokeswoman Marti Van Veen said the hospital isn't opposed to vaginal births after c-section unilaterally. "Each patient has unique circumstances, and we rely on the clinical judgment of the physicians who work with their patients to make sure the birth plan is safe and supports the best possible outcomes for both mother and baby," Van Veen said.
I strongly suspect there are details not in this article.
 

So, let me get this straight: this woman's doctors have recommended C-Section. Get new doctors. Hospital won't allow natural childbirth. Go to another hospital.

"I want you to cut off my leg without anesthetic." Any doctor or hospital should be able to refuse that request.

What's your problem with this? Hospitals aren't bound to allow what they believe is an unsafe procedure. Why do you think they should be forced into it?
 
So, let me get this straight: this woman's doctors have recommended C-Section. Get new doctors. Hospital won't allow natural childbirth. Go to another hospital.

"I want you to cut off my leg without anesthetic." Any doctor or hospital should be able to refuse that request.

What's your problem with this? Hospitals aren't bound to allow what they believe is an unsafe procedure. Why do you think they should be forced into it?

Makes sense, but there's an important difference here

She wasn't demanding that the hospital provide a service that was either not normally offered to its' patients or was not medically or ethically justifiable

She was asking that they *not* perform an (allegedly) unnecessary and unwanted surgical procedure

And though it's not clear, it appears that the hospital was going to call DCFS if she didn't have a c-section - even if she went to another doctor or hospital
 
Makes sense, but there's an important difference here

She wasn't demanding that the hospital provide a service that was either not normally offered to its' patients or was not medically justifiable or ethically justifiable

She was asking that they *not* perform an (allegedly) unnecessary and unwanted surgical procedure

That last is not so. The doctors there have said, in this case, it IS a necessary surgical procedure. And once again there is nothing preventing her from changing doctors, hospitals or even opting for home birth.
 
That last is not so. The doctors there have said, in this case, it IS a necessary surgical procedure.

Which is why I included the word "allegedly"

We don't know if it was needed or not.

And once again there is nothing preventing her from changing doctors, hospitals or even opting for home birth.

Except the bit about the hospital calling DCFS on her if she didn't have a c-section
 
That would seem to be the case

From the OP


on edit: I read you post wrong. They are threatening her is she returned to the hospital; not if she went elsewhere

on edit a 2nd time: Actually it depends on how you read the sentence. I could mean that that were going to report her if she tried to have a "trial of labor" elsewhere, and perform a C-section if she returned to that hospital

Agreed. It could really go either way given how the article is written.

For that matter, why would she need a restraining order if she could simply go to another hospital?

Either she's being completely unreasonable with regard to her choice of care provider, or the hospital and the courts are majorly overstepping their bounds here. It kind of makes a difference which.
 
So, let me get this straight: this woman's doctors have recommended C-Section. Get new doctors. Hospital won't allow natural childbirth. Go to another hospital.

"I want you to cut off my leg without anesthetic." Any doctor or hospital should be able to refuse that request.

What's your problem with this? Hospitals aren't bound to allow what they believe is an unsafe procedure. Why do you think they should be forced into it?

In my case, VBAC wasn't even an option. I knew that, and you're right...if it upset me, I was free to leave my OB/GYN group and find another.

I'm an old fashioned girl and think that on any given day, my doctors know more than I do about these matters. They went to medical school. I didn't. It's okay to ask, and it's okay to disagree (and then go elsewhere), but it isn't okay to force a doctor to do something he/she knows or thinks is dangerous and wrong.
 
Agreed. It could really go either way given how the article is written.

For that matter, why would she need a restraining order if she could simply go to another hospital?

Either she's being completely unreasonable with regard to her choice of care provider, or the hospital and the courts are majorly overstepping their bounds here. It kind of makes a difference which.

Yeah, we really only have one side of the story here, and I imaging the hospital is constrained about stating the details due to privacy laws.

It may be that there's something about the woman's condition that makes a natural childbirth entirely inappropriate. Therefore, reporting her to DCFS might be a reasonable thing to do.

But we don't know enough to say
 
I think the doctors are completely in the right here, although the statement attributed to them is worded very poorly. If she goes there to deliver, there isn't time to get her to another facility, so they HAVE TO operate. Saying "we'll tell on you and force you into it" skips all of the medical necessity and turns it into a power play. If she doesn't want surgery, she should be able to sign about 100 waivers and be willing to die in the process. Although, considering the baby.... yeah, there are a lot of ins and outs here that aren't being considered in full light.
 
This might shed some light: National Guideline Clearinghouse | Guideline Synthesis: Vaginal Birth After Cesarean (VBAC)
The American College of Obstetricians and Gynecologists (ACOG) and the Royal College of Obstetricians and Gynaecologists (RCOG) agree that that most women with a history of one or two uncomplicated low transverse caesarean sections, in an otherwise uncomplicated pregnancy at term and with no contraindications to vaginal birth, are candidates for and should be counseled about VBAC. There is further agreement that women at high risk for complications—including those with a history of one classical or T-incision, or prior uterine rupture—are not generally candidates for VBAC. RCOG also cites a history of three or more previous caesarean deliveries as a contraindication to VBAC. ACOG notes that data regarding the risk for women undergoing TOLAC with more than two previous cesarean deliveries is limited. With regard to prior low-vertical incisions, ACOG states that recognizing the limitations of available data, health care providers and patients may choose to proceed with TOLAC in the presence of a documented prior low vertical uterine incision. RCOG cites prior inverted T- or J-incisions and prior low vertical incisions as variants associated with an increased risk of uterine rupture.
Also: Ob Gyns Issue Less Restrictive VBAC Guidelines - ACOG
Attempting a vaginal birth after cesarean (VBAC) is a safe and appropriate choice for most women who have had a prior cesarean delivery, including for some women who have had two previous cesareans, according to guidelines released today by The American College of Obstetricians and Gynecologists.
Jennifer Goodall has had 3 C sections. Another article on the story from a more neutral source than the OP: Woman in legal fight over C-section delivers baby
 
This might shed some light: National Guideline Clearinghouse | Guideline Synthesis: Vaginal Birth After Cesarean (VBAC) Also: Ob Gyns Issue Less Restrictive VBAC Guidelines - ACOG Jennifer Goodall has had 3 C sections. Another article on the story from a more neutral source than the OP: Woman in legal fight over C-section delivers baby

Interesting.

Wow on that USA Today article. 6000 people are petitioning with her? I wonder how many of them are medical experts.
 
Still don't get the court involvement here when she ended up going to a different hospital to get precisely what she wanted anyway.

From the USA Today link:
I am grateful to the medical staff at another hospital who assisted us in a safe and healthy delivery."

I hope she had to pay full court costs and damages for the hospital who had to represent itself in court for this specious motion.
 
Still don't get the court involvement here when she ended up going to a different hospital to get precisely what she wanted anyway.

From the USA Today link:


I hope she had to pay full court costs and damages for the hospital who had to represent itself in court for this specious motion.

I thought she ultimately wound up with a c-section?
 
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I though she ultimately wound up with a c-section?

Here's the whole quote from the article:

"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," Goodall said in a written statement posted to Facebook. "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."
 
What happen to a woman's right to choose? Where are all her advocates?
 
Still don't get the court involvement here when she ended up going to a different hospital to get precisely what she wanted anyway.

From the USA Today link:


I hope she had to pay full court costs and damages for the hospital who had to represent itself in court for this specious motion.

Seriously. I agree. Was this all about making some sort of point?

"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," Goodall said in a written statement posted to Facebook. "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."

All she wanted was a failed effort at vaginal delivery, unnecessary labor, and ultimately a c-section?
 
I am glad I am a man.

No offense ladies.
 
Makes sense, but there's an important difference here

She wasn't demanding that the hospital provide a service that was either not normally offered to its' patients or was not medically or ethically justifiable

She was asking that they *not* perform an (allegedly) unnecessary and unwanted surgical procedure

And though it's not clear, it appears that the hospital was going to call DCFS if she didn't have a c-section - even if she went to another doctor or hospital

It's not clear because that's not what they said. What they SAID was that THEIR hospital wouldn't permit her to give natural childbirth; and if she was IN their hospital and refused a C-Section, they would report her.

This is a ridiculous story. Don't even know why it made the news.

She wants to try natural childbirth. It's the hospital's prerogative to find that risky in her circumstances and refuse her request. It shouldn't make the news . . . she should just find a hospital who will accommodate her -- if she can.
 
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