Thursday, November 05, 2009

A Parent's Rights vs a Woman's Rights

I was reading a great pregnancy resource book called 'Pushed' the other day and I just had to comment on something that was brought up in the book. The author (who has a website here: ) is clearly on the 'liberal' side of women's rights. Thankfully she didn't really go off on any long winded tangents during the book, but, multiple times, it was mentioned, sometimes naturally in passing sometimes somewhat forced into the conversation, that pro-lifers are hurting a woman's right to labor and deliver as they want since they are trying to give the baby individual rights. So the hospitals/doctors/states are using the baby having rights to force the woman to have c-sections, birth in hospitals, or otherwise be forced into unwanted intervention that the doctor thinks is 'better' for the baby. She references cases where court orders were obtained where the woman was forced to have a c-section against her will. One in particular stands out where the judge (while the woman was in late labor) told her 'the state has taken custody of your unborn child, and we are delivering the baby safely. You are having a c-section, now.' In that case the woman was attempting VBAC (vaginal birth after Cesarean) and, after having been told by doctors that her scar was 'sure to rupture' and refused the right to even try vaginal labor at the local hospital, had decided to try to have the baby at home.
Now, I will state on the outset that I am one of 'those' people who think the hospital is NOT the proper place for labor and delivery of a normal low risk pregnancy (which over 90% of pregnancies are). My reasons are varied but mostly come down to one point. Study after study since the 70s (and as recently as this year) show that home birth with a midwife is safer than hospital birth with a physician. The main reason is because physicians consider labor and delivery a medical problem that has to be fixed and midwives consider labor and delivery a normal course of life that should be allowed to take its natural course unless something goes wrong. For a physician in a hospital that 'something goes wrong' happens when the first contraction hits. Because of this the average c-section rate in America today is around 40%. Midwives have around a 4% c-section rate. A c-section is a major operation where is is 'expected' a woman will loose twice the blood as during a normal vaginal delivery, where the mother and baby will be separated for hours afterwards, and where a woman is 4 times as likely to die as during a vaginal delivery. It is also more dangerous for the baby. C-section babies are more likely to need help breathing, including tubing and resuscitation, more likely to have a low 1 and 5 minute apgar score, and more likely to require time in the NICU. Even assuming everything goes correctly, you still have a mother who has to take care of a newborn (not to mention any other children) healing from a serious abdominal surgery.
Now I could spend the next several pages going over research the has proved midwives/homebirth is safe, but the information is pretty easy to find, and that isn't want this blog is supposed to be about. I will offer two good books on the subject for anyone who is interested. The first was the one that was previously mentioned, "Pushed" by Jennifer Block and "The Thinking Woman's Guide to a Better Birth" by Henci Goer.
That being said I'm going to get back on point. I can understand that, from a pro-abortion standpoint, the issue of a woman's right to kill her baby in utero could seem similar to a woman's right to choose how to bring that baby into the world. But, as usual, they have missed the point entirely. Just like abortion isn't about a woman's right to privacy or authority over her own body, neither, in the most important aspects, is where/how to give birth.
As I've said previously choice always comes before action. A woman's right to choose to have a child happens BEFORE she has one, not after. The moment of conception is a moment of life. When two separate entities, nothing more than parts of individual people, join and create a new, distinct individual, with a new, unique, and separate DNA, the ability to grow, consume, respond, and produce (the four biological requirements for life). The woman is now a mother, the man is now a father. Their choice to enter into the mother/father relationship has already been made. Unfortunately the current law allows that mother/father to then choose to kill that baby. To become parents of a dead child, instead of a live child. Thankfully (for now) the law does not allow parents of older children to make that choice. Once a child can be easily seen by the society (the only real difference between a baby in the womb and a baby out of the womb) they are protected, by society, from extremely bad parenting choices. And I say 'extremely bad' because, under most situations, it takes more than a lapse in judgement or even what most people would consider bad parenting. As well it should. Parents should be free to raise their children as they wish, only expecting the society to step in and save the child if their actions pose a persistent and real danger to the child, like extreme or long standing abuse or neglect. This allows people who differ wildly in parenting styles to co-exist within a society.
I think you'd be hard pressed to find someone who takes the stance that to kill, maim, or starve their child is covered under their 'right to privacy' or their right to do as they wish with their own body. Its absurd. It is a parent's right, as the parent and guardian of an underage person, to use appropriate physical, social, or monetary punishment or reward. It is the parents choice where and how to educate, care for, dress, and monitor their children.
A woman's right to have a baby at home, in a birth center, in a hospital, to accept/refuse any/all intervention during the labor is not really a right to HER body, its her right, as a parent, to choose what is best for her child, taking into account, as parents do everyday, her own person as well. For instance, lets discuss VBAC for a moment. VBAC is 'vaginal birth after c-section', and many doctors refuse to even attempt them. Why? The stated medical reason is because there is a slightly higher risk for uterine rupture, which is dangerous to both mother and child. The real reason, however, is insurance. Insurance companies (remember all doctors are supposed to practice only with malpractice insurance) have declared an injury to baby after VBAC is 'indefensible'. So doctors who will perform VBAC will not be covered by their insurance carriers. The insurance company's position isn't due to any medical facts or even proven case law, instead it is their assumption that, since VBACs are rare, anyone who decides to sue for an injury during VBAC will be able to find a doctor to state it isn't 'standard medical practice' to perform one. "Standard medical practice" is the gold standard for medical malpractice suits. In order to conceivably win a medical malpractice suit the injured party must have been injured during a procedure or by an action that stands outside 'standard medical practice'. (this is meant to protect the doctor from frivolous lawsuits where the person was injured during the normal course of medical practice, there are side effects after all and no everyone who is injured during surgery is injured due to medical malpractice. In reality it just as often protects the doctor from legitimate lawsuits since not all medicine as it is commonly practiced is GOOD medicine. No where is this more evident than in the abortion industry. Since standards of practice are so low even woman who were injured or killed by what the average person would consider gross malpractice has no recourse in the courts since that 'gross malpractice' is actually common enough to be considered 'standard medical practice'. The case that jumps immediately to mind is the woman who suffered serious injury, including an emergency hysterectomy, because the doctor left fetal parts inside her and then refused to return her calls or reexamine her. Read the book 'Lime 5' for more specific examples of this) We've all heard of those absolutely ridiculous lawsuits, and, somewhere in there we can probably remember one of two against doctors. But, unfortunately, most of the time when someone brings a ridiculous lawsuit against a doctor we never hear about it, because the insurance companies just settle. Ultimately its usually cheaper to settle, even cases without any basis, than it is to go to trial. Since doctors must follow the mandates of these companies who are too removed from real life to understand that settling bad cases sets bad precedence, the doctor's patients end up suffering. Taking a step backwards lets look at the so called 'medical' reason for refusing VBAC. The standard statistic given is that 2% of VBAC births will end with a ruptured uterus. A ruptured uterus is deadly to the baby about 10% of the time. We are going to accept those statistics even though studies actually done on VBAC birth points to lower percentages. Now, a standard vaginal birth has around a 1% rupture rate. So, that means that a VBAC baby has approximately a .1% greater chance of death than does a standard vaginal birth baby. Now, I admit when we are talking life and death even .1% is something to be considered. But, since a baby is around twice as likely to die during a c-section delivery (its a little under 50%, numbers vary depending upon study and which pregnancies/births are counted and which are excluded) than a low risk vaginal birth, and the mother is 4 times are likely to die, how is that .1% somehow a reason to force a c-section? It isn't, at least not logically or medically. And certainly, given those odds for mother and baby both, it should be within a parents rights to choose which situation is better for their family. After all, you are 37 time more likely to die riding a motorcycle than you are while driving a car, but we allow parents to ride with their children as passengers in either a car or a motorcycle. It is, after all, the parents right, on behalf of the child, to make that choice and take those odds if they so choose. So go the so called 'medical' reasons for denying a woman the right to birth outside of a hospital, without intervention in a hospital, or any combination thereof. For instance it is a medically sound choice for a mother to refuse continuous electronic fetal monitoring (called EFM) because it has been shown in repeated studies to have no benefit over frequent manual monitoring with a Doppler or fetoscope. Hospitals, however, usually require this continuous EFM because 1) it frees up nurses, allowing a 2:1 or 3:1 patient:nurse ratio instead of the previous standard of 1:1 2) it is required by their insurance coverage as a 'paper trail' to be used in case of lawsuit and 3) its considered 'easier' than charting manual readings. EFM, however, isn't just not superior to manual monitoring, its actually worse for both mother and baby. If the baby or mother shifts the EFM can lose the heartbeat or signal a false decrease in heart tones for the infant, this can lead to intervention that is unnecessary and dangerous. EFM requires the mother to remain still and on her back, both of which are unnatural during labor and tend to slow or stall labor progress. The back lying position also can put stress on the baby. (all through pregnancy woman are told not to lay on their back as the weight of the baby can depress the blood flow thus potentially lowering the oxygen to the baby then, when we are trying to deliver, hospitals put us...on our backs)
So why can't a mother choose? Partially its because many doctors, in the role of making more money and running the hospital are more interested in seeing as many patients as possible than they are in giving quality care to the patients they see. It isn't hard to find a story of a momma overhearing the doctor who just coerced or scared her into a c-section to say something like 'great, I can make it home by dinner' or 'I'll be out of here in time for my tee time' (I'm NOT joking, I've read the quotes, they are NOT hard to find in you read pro-birth sites/books, but I will be happy to help you if you are curious and can't find them yourself). Partially its because doctors are legitimately afraid of lawsuits if something happens. But they are mostly to blame for this. They agree to settling ridiculous lawsuits when they happen at the advise and pressure of their insurance companies, and they set a women's expectation that since the birth is taking place in a hospital with the 'best medical' technology and access available, they can expect a perfect outcome. They don't want to admit they aren't perfect, that no one can guarantee a perfect baby, birth, or mother. Partially its the insurance companies fault, who are so out of touch with the real world that they pressure those doctors to 'admit' fault (even if only passively) by forcing them to agree to settlements when they are not at fault for an injury or death during a labor/delivery. Partially its the parent's fault, who don't do the research, put their complete trust in a broken system that treats a normal act of life as a medical emergency, and comply, even if its only under stress, to interventions they know they don't need, don't want, have already said no to, and know it is not evidence based medicine. I know its somewhat harsh to put any blame on the parents, they are made to have so little choice, frequently the nurses or doctors preform interventions against their will and/or without their knowledge. But every patient that puts up with it, who doesn't transfer care, birth elsewhere, complain to the medical authorities, or yes, even sue for non evidence based medicine regardless of if it is 'standard medical practice' (insurance companies get enough threats of legal action against a practice evidence proves is medically poor, they will start to treat them the same way they treat those 'frivolous' lawsuits now, and they might stop putting so much pressure on doctors to practice bad medicine.) who even goes so far as to contact the police for assault (regardless of if they listen or prosecute) when a doctor does something against their will or without their consent, only perpetuates the situation, only makes it seem like the behavior is agreeable and encourages it to continue. Men can even be more to blame for this than the women, after all, the father isn't in the middle of labor. He should be advocating for his wife/mother of his child. So should every other member of the birth team the mother chooses. So moms, if you are pregnant and considering birth in a hospital, first, consider again. Find the info, look into the facts, read the material, make an informed choice. And, if you still feel most comfortable in the hospital after you've been fully informed (which, certainly is both your choice and a valid choice for you to make as a parent), choose your birth party carefully, expect them to warn you if the nurse/doctor is about to do something you haven't consented with, expect them to advocate for you. Consider a doula, who is more familiar with the situation than you or your family may be. Mostly, be adamant, YOU are the parent, it is YOUR choice how your dependant child is treated, even in birth. Don't let yourself be bullied, coerced, or terrified into something you know is wrong. Write it down, try to stay calm, avoid even the little unnecessary intervention that will lead to larger ones which will be more difficult to decline. It will take time, doctors and nurses are accustomed to running roughshod over women in labor, they are accustomed to being god in the delivery rooms and doing whatever they want, bullying women 'arrogant' enough to disagree with them, frequently forcing them when it doesn't work. But every shift in policy needs its head runners. Every civil rights issue needs its forerunners, even its martyrs at times. Stand and be counted, not just so that you can have a better birth next time, but so that our daughters and granddaughters can as well.

Some good websites to check out for more info:


Blogger Christina said...

Very good blog.

I must say that NOT every doctor feels like labor is something that needs to be "fixed. Just because the doctor delivers in a hospital does not mean that they try to force medical intervention on a laboring mother.

I dont know much about home birthing because there is no way I could ever have a baby at home because my pregnancies are high risk, this is my four viable pregnancy and already I dont have a choice of home birthing.

I do know that the OB I had for my two sons' deliveries was very much of the opinion that I could do what I wanted unless the baby or I were in danger, they did not push epidurals unless I wanted one, the only thing they asked is that I get my blood pressure taken in regular intervals, the baby was monitored and that I have an IV if I got an epidural. With my first son I could deliver in any position I wanted as long as it was not in the jacuzzi tub.

I think that many of the restrictions that docotrs do place on VBACS (if they even choose to do them) have a lot to do with law suits that they have recieved from women who wanted that vaginal delivery and refused to have a csection. I do think that if a baby is showing stages of being in severe distress or that there is proof the mother is in danger that the state SHOULD have the right to take custody of that child if the mom is not willing to do the right thing and deliver her child safely.

I have been to almost 20 deliveries, my own, friends and family members and even a few strangers to do birth photography and on more than one occassion I have heard a mom say she did not want a csection because she did not want to ruin her stomach muscles or she did not want a scar from the surgery....I mean come one if the baby is truly in danger, you do what is best for your child.

3:12 PM  
Blogger Jespren said...

I know that not EVERY OB forces things upon women, but enough do to make it 'common' instead of 'uncommon'. I think, Christina, since you live in a small town (I know compared to Prairie its not, but in general it is) that is fairly conservative, doctors are probably more interested in protecting their patient base by listening to them. For a high risk pregnancy there isn't a better place than a good hospital to give birth! I'm glad you've had good experiances so far (and hope you do again!) The lawsuits I mention specifically, and have heard about both specifically and generally, where the hospital used the law to force a c-section upon a women the baby wasn't in any distress. In the cases you mention where a women says she doesn't want a c-section because she doesn't want her stomach ruined, I bet that mom would immediately change her mind if her baby was actually in distress. I am referring (as is everyone else I've seen write on the topic) to the approximately 30% of c-sections that happen in the US that are NOT medically necessitated by fetal or maternal distress. Good luck on your forthcoming birth!

6:34 PM  
Blogger Jenne said...

Have you heard of the Parental Right's Amendment ( You may find that they are working to secure just your point of this article.

2:05 AM  
Anonymous Anonymous said...

I'm posting anonymously due to lack of a Google account. ;-) You make some excellent points. The abortion rights spin on the forced-cesarean issue is somewhat tunnel-visioned in that it pits a mother against her child. The *intent* of going to the hospital to give birth is to have a healthy mother and healthy baby. Both are passengers on this ride. A cesarean delivery involves risk to both of them, and a mother should have a right to decide for her own body and her baby's. Admittedly, it is also tunnel-visioned on the part of judges who consider *only* the baby and, worse yet, take the doctors word as almighty gold.

Fortunately, legislation such as the Unborn Victims of Violence Act often contains clauses forbidding the law to be used to prosecute pregnant women. Pro-lifers, in my view, have every obligation to insist on these clauses in order to ensure that these laws aren't misinterpreted to force women and babies into medical interventions. (Amazing as it sounds, abortion and childbirth are two *very* different things!)

If pro-lifers don't stand against the practice of court-ordered cesareans, then they will need to accept court-ordered medical interventions on *born* children, as well. (After all, we don't discriminate between born and unborn). One example happened recently when that boy in Minnesota was forced into chemotherapy. If we continue down this slippery slope, what's to stop court-ordered vaccinations?

To state the obvious, judges are not doctors. Yet it's frightening how many of them rule based on the whims of individual physicians.

8:48 AM  
Blogger LadyLeslie said...

I've thought about this for a long while as well, and I'm in the camp that doesn't believe abortions should be as readily supported a "solution" as they are.

My personal choice would never (I believe, though there are many very hard and unlikely circumstances which COULD make me eat my words) choose to abort a child.

But that also stands for killing. I would rather not step on spiders.
I would rather have no war.
No soldiers to send out and kill others.

That's another topic entirely, isn't it?

Anyways, Rixa's blog Stand and Deliver has a lot of interesting material on maternal rights vs. fetal rights, court ordered C-sections, and the politics of birth.

Definitely check out also.

11:16 AM  
Blogger Jespren said...

Thanks all for the comments, I've got some new names up there that haven't posted before, its always really nice to see! -anonymous if you check back, leave me a post to let me know if its not letting you also sign in as an openid, or name/url, cuz its supposed to! Also I absolutely agree that unborn victim bills should include protection for the woman. I understand why that is sometimes considered odd, after all, we (prolife) seek to charge the doctor who killed the baby during an illegal abortion with murder, but not the mother who 'let' or even 'asked' him. But I think that 1) so very many women who end up with abortions are either cohersed into it by mental, intelectual or even physical force, or 2) are blatently lied too about the situation, so enter into the situation ultimately unaware. (Anyone else seen the recent undercover video where Planned Parenthood employees state the heartbeat doesn't occur until "17 or 18 weeks"??) Also I fully agree that the courts shouldn't get in the middle of what treatments a 'born' child should receive (unless, as mentioned in the post, the parents have been shown to be unfit in general to parent).
LadyLeslie- I do hope you didn't actually mean to put killing spiders in the same category as killing humans! Since it doesn't seem like something you'd do I'm going to assume not. As for your hedge that there would be "many very hard and unlikely circumstances which COULD make me eat my words" not to be overly crude but you have a child, can you think of even ONE very hard situation where you would kill that child? Why would it make a difference if the child was in your belly and not your arms?Thanks to both who recommended the parentalrights website!

8:55 AM  
Anonymous Wendy said...

Hi Jespren, I had the previous "Anonymous" comment but figured out how to enter a user name. :-) I post occasionally on "My OB Said What," where I found a link to your blog. This issue of court-ordered interventions is not going to go away, and pro-lifers are doing themselves no favor by not discussing it in the open. You would think from reading PUSHED or Lynn Paltrow's blog that you either you can support abortion rights (for any reason and at any time during pregnancy) AND oppose court-ordered cesareans....OR you are pro-life AND find court-ordered cesareans acceptable. Yet the issue is much more complex than this either-or scenario. Most pro-life birth advocates will comment on how screwed up our court-system is to allow almost unfettered abortion access while using court-ordered cesareans to turning around to protect those "unborn children." Anyway, I look forward to reading more of your blog!

8:33 AM  
Anonymous Anonymous said...

through the course of this life, the author of this blog and myself have crossed paths a few times, as well as a few members of her family. I am not here to call names, just to point out a little background that the author herself failed to mention. As is well known, she is a mother of a baby boy. What is not known is the fact that the same baby boy nearly died during child birth in the author's appartment, due to multiple complications including asphyxiation from fecal matter, which could have been easily dealt with had they been in a hospital, as well as the author's own personal medical problems. When the ambulance made it on the scene, the appartment was in such a disaster that it was nearly imposible for the parimedics to do their jobs. Now she is pregnant with a second baby, and once again complaining about having the baby in a hospital. The phenominal stupidity of the author of this blog is so incredible, it is in the very real sense of the word "amazing". GO TO THE HOSPITAL TO HAVE YOUR BABY BEFORE YOU KILL IT AND BLAME IT ON SOMEONE ELSE, WHICH IS EXCTLY WHAT YOU WILL DO.

10:19 PM  
Anonymous Laura said...

Dear anonymous: F**K YOU and your opinions.

12:04 PM  
Blogger Jespren said...

@laura: thanks for your support, although I do not condone curse words. :)

For the record, my first child was born at home, did have a mec asp that caused a great deal of short term issues. There was no medical indication of mec asp before he was suctioned at the hospital, no mec in my water, no mec in the prebirth, on baby, or in afterbirth. And I do mention the whole story in a previous post, so those of you who are interested, can peruse my birth story at your will, look back a few to find it, William Orion Part 1 and part 2 (part 3 still forthcoming). The paramedics had no trouble gaining access to home or baby. They did have trouble proforming care because they 1) did not have an infant face mask and had to borrow the midwife's and 2) did not have an infant back board and had to use a clean cookie sheet we had there to hold the midwife's supplies. Unfortunately much of my family (I can only guess at which once posted the anon comment but it would almost have to be from a family member)does not fully understand the situation, and thinks that there was something 'missed' that would have been caught in the hospital. Unfortunately there wasn't. We had a fully healthy pregnancy (my medical issues were not risk factors to the pregnancy and were in fact checked out by a high risk OB before I sought midwife care to make sure they weren't) and a baby that tolerated 23 hours and 45 min of labor extremely well, unfortunately in the last 7-10 mins of labor things went down hill. It took less time to get baby birthed and to hospital via midwife/ambulance once the issue was identified than it would have taken for the '30 min from decision to incision' crash c-section that could have conceivably been done in a hospital setting.
@anonymous: I have never blamed anyone for what happened/could have happened at the birth of my son. And, as nice as it is to think that a severe mec asp can be 'easily dealt with' at a hospital...that wasn't/isn't the case. The hospital we were transported to (which is where I would have given birth had a chosen a hospital) could not deal with the severe mec asp, which he would have had regardless of where he was born, he had to be transfered to a specality children's hospital. They didn't have it 'easily dealt with' either, he needed ECMO to help his lungs heal. Where he was born was and continues to be completely inmaterial to the complications surrounding his birth trauma/NICU stay.

10:00 PM  
Anonymous Anonymous said...

I'm looking forward to getting more information about this topic, don't worry about negative opinions.

8:56 PM  
Anonymous Fightdiabetes said...

donot know much about legal stuff but i think women's safety should be priority than her will

7:49 AM  
Anonymous Write About Birth said...

That was a great post, thanks for writing that. I identify as a feminist but am anti-abortion. I happen to believe that the vast majority of abortions are carried out as a result of social pressure, economic pressure, or male pressure. While it is ironic that women have the right to decide to have abortions, yet are denied the right to choose where and how to give birth a lot of the time, I agree that the two really can't be compared. Homebirth is a safe and viable option, and the choice to have a homebirth is generally made to increase the safety of the baby, not in spite of dangers.


4:05 AM  

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