Homework #42: Culminating Birth Project

            After having previously given birth vaginally and through cesarean section, a woman chose to have her baby at home with a midwife. During her labor, she found it hard to keep fluids down, resulting in dehydration. For fear of endangering her child with her dehydration, the woman went to the hospital to have an IV, in hopes of soon after returning back home. Upon arriving at the hospital the doctor asked if she had had a previous cesarean, when she had he wished immediately to admit her to the operating room for a c-section. When she refused he gave her an ultimatum: she would only receive the IV if she submitted to the c-section. While thinking this over a nurse came to the woman and offered her a back exit, so that she could flee the hospital and continue her birth at home. After learning of her escape the hospital called the court, which passed legal guardianship of the fetus to the hospital, ultimately forcing the woman into a c-section. Upon legal obligation, a sheriff showed up at the mother’s house, prepared to bring her to the hospital. The woman had no choice but to consent, as if she did not, she would be arrested. At the hospital a c-section was performed and the baby came out entirely healthy, the cesarean clearly unnecessary.

            Court ordered c-sections such as the story before are becoming more and more common as mothers refuse treatment. Instead of respecting the mother’s wishes, she is overthrown by the medical industry and the judicial court. This raises many questions as to who has the right to the woman’s body, the child she is carrying, or she herself, who has the power to decide: the doctors or the mothers? Court ordered cesareans raise many ethical questions that need to be addressed, however the most crucial point is that the government should not have control over another human being’s body. The government has no right to order a cesarean section on a woman except in the case that the mother cannot make an informed decision because of lack of a sound mind; the child is an extension of the mother during the gestational period, therefore a part of her body and a woman has the right to make decisions about her own body and health, ordered cesareans can pose significant health risks to the mother, and in any other situation, a human would not be forced to sacrifice their own life for another’s.  

            To begin, while it is clear that a woman should have the right to her own body and to make decisions about it, this is brought into question when with child. It must be understood that the fetus is not yet a separate being, but instead is entirely dependent on the mother. This idea is described here: “Some argue that the fetus has no moral status independent of the mother, but acquires moral status at birth. It is the emergence into the social world that is thought to transfer moral status [9]. This implies that a pregnant woman has the moral right to abort a viable fetus, but not to kill her newborn infant [3],” (Legal Rights and the Maternal Fetus Conflict). Here it is discussed that a fetus does not become an independent being until leaving the mother, meaning that the fetus would then be classified as part of the mother. They state that the mother has the right to abort her fetus, but not kill her newborn infant. In the case of birth, the baby is still considered a fetus while inside the mother, therefore giving the mother rights to make decisions about the fetus. If death unfortunately occurs because of the mother’s decision against cesarean, she cannot be prosecuted against, as it was still her right. Furthermore, the court should not have the power to interfere with the fetus, as the fetus is part of her body, thus under her control.

            Again this pattern continues, “The concept of health, as defined by the Supreme Court in Doe v. Bolton, includes ‘all medical, psychological, social, familial and economic factors that may potentially encourage a decision to obtain an abortion’ [5]. Thus, the mother’s life and health takes precedence over the life of the fetus right up until birth,” (Legal Rights and the Maternal Fetus Conflict). As ruled by the Supreme Court themselves, the mother’s life during the gestational period through labor is more highly valued than that of the fetus. Therefore a court ordered cesarean is implemented to save a life valued less than the one it could potentially harm. As the mother has the higher valued life, it is also clear that her rights be maintained throughout the birth process. After many rulings about abortion where the mother has the right to make decisions about her own body, it would only be expected that these rights continue until the child is out of the womb. A mother is still a person, “Those opposed to forced treatment of pregnant women argue that every person has a fundamental right to freedom of choice and control over his or her own life. Forcing a pregnant woman to undergo medical treatment against her will or to behave in ways she does not freely choose violates this right... Others have no right to impose on her their own judgments about what they think is best for her and her fetus, depriving her of her freedom to make her own choices and to control her own life,” (Maternal vs Fetal Rights). Clearly stated here is the violation of a woman’s rights when a medical treatment is forced upon her. While the fetus may one day be an independent being, at that point in time, it is dependent on the mother, therefore no surgery can be enforced on her to remove the fetus. While others can obviously think and say their own opinions about the mother and her decisions regarding the fetus, they have no right to make these opinions actions. Carrying child or not, a woman is a person, not an object carrying another life. Of course the child’s life is valuable, however it has not yet begun, while the mother’s has thrived for many years. In no way should the medical world be able to alter the developed life of a mother in order to save a life not yet started.

            Many doctors resort to court ordered cesarean because they believe the mother is endangering the child in the most extreme way possible. However it appears that the child in most cases is perfectly fine and could have been born successfully vaginally. In the cases where the mother escapes the court ordered cesarean, as in she has the child before the c-section is carried out, there is the reoccurring event that the child is birthed easily and healthily, “Data obtained on court-ordered obstetric interventions has suggested that in approximately one-third of the cases where court authority was sought for a medical intervention, the medical treatment was considered wrong or harmful in retrospect [11],” (Legal Rights and the Maternal-Fetal Conflict). Therefore ordering this generally unnecessary procedure on women is abuse and should not be a privilege of the court. This treatment is clearly harmful to the mother and child, especially used unnecessarily. These procedures are generally implemented to help people, but instead they are harming women’s bodies and creating unwarranted complications. Examples of this are discussed here, “But while the procedure is usually quite safe and can be potentially lifesaving for mother and baby, it also poses a number of potential risks, including severe bleeding, infection, injury to the fetus, blood clots, and even the mother's death in extremely rare cases,” (Collier, Could you be forced to have a c-section?). There are many risks that come with c-sections that the mother is submitted to when the fetus is forcefully removed. Of course there are risks to vaginal birth, however the mother chooses to submit her body to these risks, while with court ordered cesareans she is being forced into accepting them.

            Two cases in particular were discussed on websites to illustrate the traumatic effects of cesarean sections, both times having been court ordered: “Years ago, a Washington, D.C., hospital got a court order to perform a c-section on Angela Carder, who was gravely ill with cancer. Since the mom was in such poor health, the hospital's doctors believed that delivering the 26-week fetus immediately would give it a better chance of survival than waiting for a natural delivery. The result? Carder and her baby both died soon after the operation. Later, in a landmark 1990 ruling, an appeals court overturned the order, finding that Carder had a right to make medical decisions for herself and her unborn child,” (Collier, Could you be forced to have a c-section?). Despite the court ruling after her death ultimately granting her the right to make decisions for the fetus, this situation could have had a much better ending. While the mother was gravely ill, there were no present inflictions upon the child. The mother understood going into the birth process that she was sick and that it could pose a risk to her child, however she carried on. There is no evidence to support the idea that the child would not have survived if it had remained inside the womb for the full 41 weeks. Additionally, court ordered cesareans are implemented to protect the child, however in this case the child was not helped, but instead died along with its mother. The cesarean section most likely had an effect on the death of the mother and was clearly the reason for the child’s death. It in turn could have been more harmful than letting the child grow full term. There comes too many times where the mother and child are put more at risk than the natural birth process would have entailed.

            The next case involves a 300-pound woman and her experience with court ordered cesarean. Because of her weight, doctors felt that the baby was at risk and should be delivered through cesarean. When she refused they resorted to the court, which then issued a cesarean for the sake of the fetus. “The court found the fetus to be dependent and neglected, and ordered that a section be performed to safeguard the life of the unborn infant. Surgery was performed eleven hours after admission, more than six hours after the internal electronic heart monitor had indicated fetal distress. The baby was reported to be healthy; while the initial Apgar was two, the five-minute Apgar was eight.[v] Physicians admitted surprise at this good outcome; the woman, on the other hand, suffered from delayed healing of the incision wound (Annas 1982; Bowes and Selgestad 1981; Memorandum in Support of Petition and Order 1979),” (Irwin, Knowledge Practice and Power: Court Ordered Cesarean Sections). While initially the child was seen to be unhealthy, the reevaluation proved surprising to the doctors, as the child was actually extremely healthy. The fact that it shocked the doctors proves both the mistakes and misconceptions among the medical world. However, while the child was fine, it is stated that the mother suffered from “delayed healing of the incision wound.” Judging by the doctors’ surprise, the child would have been able to be born successfully vaginally. Therefore unnecessary pain was inflicted upon the mother with no benefit to the fetus. This is a crucial example of harm to the mother for no purpose, therefore supporting the elimination of court ordered cesarean. In no way should a mother have to suffer through a cesarean section when it does not significantly benefit the child.

            Not only must a mother suffer unnecessary pain because of court ordered cesarean, she is also required to sacrifice her body for another person, something that society does not ask of any other. There are no other cases in the medical world where one person is subject to surgery to save another person’s life. Of course there are cases where the person willingly gives up an organ, or donates blood, but that is their choice. A court ordered cesarean is a forced surgery enforced upon unwilling women. Why should they have to suffer for a child whose life has not yet any significant value? “Furthermore, forcing pregnant women to submit to medical treatment for the sake of their fetuses is to impose an obligation on them that we do not impose on others. And, justice requires that all persons be treated equally. In our society, we allow people the right to refuse medical treatment and the right to refuse to subordinate their desires or needs to the needs of others. We don't, for example, force some people to donate their kidneys, bone marrow or blood in order to benefit or even to save the lives of other people... To require this of pregnant women is to demand from them something over and above what we demand from the rest of society,” (Maternal vs Fetal Rights). In no other case would a woman be forced to go through surgery for another person. If everyone is to be treated equally, then society is in a violation of this right when court ordered cesareans are performed. It is stated here that the donation of kidneys, blood etc. is never required, even if it is necessary to save another person’s life. Thus a mother should not be required to sacrifice her body to save the life of her apparent endangered child.

            Performing the cesarean against the mother’s will is technically abuse. In any other situation the surgery would be seen as a direct violation of the mother and her privacy, ultimately abusing her body. This is illustrated here, “Once pregnant, a woman effectively cedes her right to autonomy and bodily integrity to obstetric staff who sometimes—on grounds of fetal welfare, self-protection from malpractice suits, or mere convenience—manipulate women into compliance in ways that would be considered fraud in any other venue. Without fear of being called to account for it, they can bully, coerce, humiliate, and threaten. And, yes, they can physically mistreat or even sexually assault them—imagine if the Illinois woman’s story occurred outside of an L&D unit,” (Goer, Why are women stripped of their rights during labor and delivery?). When the doctors gain control, they are able to manipulate a woman’s body as they please. This however would not be allowed in a school, where the teacher has control, or even in the home, where the parents have control. Therefore why should pregnant women be forced by the law to undergo a procedure to “save” their child, when no one else is being forced to sacrifice their body for another’s life? These women are experience assault, however the assaulter has no penalty; the people assaulting would have been the ones prosecuting the assaulter in the first place.

            Women give up a lot for their children, however there must come a point where the line is drawn, for women have rights. Court ordered cesareans are unfair to women and should be eliminated because of a woman’s right to make a decision about her body, the harm unnecessary cesareans entail, and the fact that such a sacrifice would never be acceptable in any other situation. A fetus is dependent on its mother; therefore it is subject to her rule, even if doctors feel she is endangering the child. Up until birth, the mother’s life is that for which society must look out for. By looking out for the mother, they should not be forcing unwarranted harm upon her body, which c-sections can bring. Blood clots, infection, bleeding, and injury/death to the fetus are all resulting risks of a c-section that might not have initially been needed. Lastly, the entire process is abuse and sacrifice that is not expected of any other person. Why should a woman’s right be sacrificed because she is with child? Cesareans are by no means bad, but they are harmful when unnecessary. Society needs to reevaluate its priorities and begin to value the life being lived, rather than the life that could live. Court ordered cesareans should be desisted, to ensure the well being of the mother and potentially the child she will bring into the world.

Bibliography

Collier, Lisa. "National Advocates for Pregnant Women: Could You Be Forced to Have a C-section?" National Advocates for Pregnant Women: Welcome to NAPW. Web. 05 Apr. 2011. <http://www.advocatesforpregnantwomen.org/main/publications/articles_and_reports/could_you_be_forced_to_have_a_csection_1.php>.

Goer, Henci. "Why Are Women Stripped of Their Rights during Labor and Delivery?" Blog | Double X. Web. 31 Mar. 2011. <http://www.doublex.com/blog/xxfactor/still-cruel-maternity-wards>.

Irwin, Susan, and Brigette Jordan. "Knowledge, Practice, and Power: Court-Ordered Cesarean Sections." Lifescapes.org. Medical Anthropology Quarterly. Web. 5 Apr. 2011. <http://www.lifescapes.org/Papers/COCS%20Hahn%201987.htm>.

"Maternal vs. Fetal Rights." Santa Clara University - Welcome. Web. 31 Mar. 2011. <http://www.scu.edu/ethics/publications/iie/v1n2/pregnant.html>.

"Pregnant Women Are Second Class Citizens." Stand and Deliver. Web. 06 Apr. 2011. <http://rixarixa.blogspot.com/2007/06/pregnant-women-are-second-class.html>.

"The Science Creative Quarterly » LEGAL RIGHTS AND THE MATERNAL-FETAL CONFLICT." The Science Creative Quarterly. Web. 31 Mar. 2011. <http://www.scq.ubc.ca/legal-rights-and-the-maternal-fetal-conflict/>.