I read an article in the Huffington Post which made me wonder about the repercussions of refusing a c-section. The article describes how a New Jersey woman’s refusal of a Cesarean Section began a series of events eventually resulting in the termination of her parental rights. While the woman’s baby was ultimately taken away because she and the baby’s father did not show the courts that they were capable of caring for the baby, I still began to wonder; is a woman guilty of child neglect and abuse by refusing a cesarean section?
The courts say no, however a cesarean can be court-ordered, meaning the judge finds that one may be performed if the doctor says it is necessary. This happens when a woman refuses a cesarean or another intervention and the judge declares the intervention may be carried out despite the woman’s choice. While the woman is not usually accused of abuse or neglect, the simple judgment against her wishes is a non-verbal statement that she was not doing what she should for her child.
If the doctor was always correct that the baby needs to be delivered via surgery I believe that there would be less frustration over the practice. However, there have been several instances where the baby was born vaginally before the cesarean was preformed or the concern that required the cesarean was unfounded. In the instance of the New Jersey mother that first piqued my interest, as the doctor waited for a second psychiatric evaluation the baby was born vaginally. Similarly, Amber Marlowe of Pennsylvania was told she needed a c-section to birth her baby. An ultrasound showed the baby to be about 13 pounds. Marlowe had birthed large babies before and was not convinced. The hospital received a requested court order for a “medically necessary” c-section. In the meantime, Marlowe and her husband had left the hospital against medical advice and traveled to another hospital where she gave birth vaginally.
One reason given for a c-section is a large baby. Despite the fact that women have birthed babies as large as 15 pounds or more and that a woman can attempt a vaginal birth and still have a c-section if the baby is too large, c-sections are still recommended frequently for babies in the top 10% of birth weight, around 4000g or 8 lbs 13 oz. Birth weight estimates are frequently off by as much as two pounds, so often the “large baby” isn’t so large.
Consider this: the World Health Organization estimates the c-section rate in developed countries is between 10% and 15%, yet in the US the rate is nearly 32%. In some states over a third of the women give birth via c-section. There is no medical reason that would account for so many more women in the Us needing c-sections than other countries and the US has one of the highest infant mortality rates in the developed world. Want to know your local hospital’s cesarean rate? Once resource is a local ICAN leader. They often keep track of cesarean rates for hospitals in their area.
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