Futuristic Childbirth and Court-Ordered Cesareans
Birth as an American Rite of Passage, a book written in 1992 by medical/cultural anthropologist Robbie Davis-Floyd, provides a feminist analysis of the American medical system as a microcosm of our society that seeks to indoctrinate birthing women into the technocracy of the dominant culture. In the following excerpt, Dr. Davis-Floyd summarizes a science-fiction/feminist essay written in 1979 about childbirth in the year 2000. Four years after Birth as an American Rite of Passage was written, a Florida woman was forcibly removed by sheriffs and taken for a cesarean surgery to which she did not consent, making Corea’s fictitious scenario not sound quite as extreme.
THE TECHNOCRATIC MODEL OF BIRTH:
In “Childbirth 2000,” Gena Corea (1979) presents a frightening view of the possibilities inherent in such a hegemony. She tells the imaginary story of a pregnant woman living in a remote rural area, who decides on home birth with a midwife for her first pregnancy. Unbeknownst to the woman, on her one and only visit to the obstetrician at the nearest regional health care facility, an electronic “homing device” was implanted in her uterus. As soon as she goes into labor, this homing device emits a signal picked up by the computers at this regional hospital. A short time later, a helicopter descends down out of the skies and whisks the bewildered and terrified woman and her husband off to the hospital. Labor “fails to progress,” fetal distress is diagnosed, and an emergency Cesarean is performed.
Could such an eventuality come to pass? A 1986 national survey of heads of maternal-fetal medicine teaching programs reported twenty-one attempts to obtain court orders to force obstetrical interventions on pregnant mothers, fifteen of which were for Cesarean sections (Kolder, Gallagher, and Parsons 1987). According to Beth Shearer (1989), four more court-ordered Cesareans have been ordered since then. For example:
In a 1981 Georgia case, doctors told the court there was a 99% chance of fetal death and 50% chance of maternal death unless a scheduled Cesarean section was performed, since two ultrasounds indicated a complete placenta praevia [a potential life-threatening situation in which the placenta lies under the baby, blocking the entrance to the birth canal]. The mother steadfastly believed in her ability to give birth safely. After the court order was granted, a third ultrasound showed no praevia at all. (Shearer 1989:7)
In Denver, in 1982, a judge and an attorney were actually summoned to the hospital room where an obese woman was in labor and was adamantly refusing a Cesarean. The baby still in her womb was declared a ward of the state until birth, the woman was anesthetized, and a Cesarean was performed. The doctor had insisted there was fetal distress, but the baby was born perfectly healthy. This incident, analyzed by Jordan and Irwin (1989) along with eight other similar cases, was reported to me in 1983 by one of the obstetricians whom I interviewed in Centertown. He said that the obstetrician who performed the Cesarean had been bragging about it at a recent obstetrical convention. Even more alarming, the Centertown obstetrician whom I interviewed did not personally see anything wrong with such an approach.
On January 13, 1996, two decades after Corea’s essay was written, Laura Pemberton of Florida experienced what might be the closest to the fictitious futuristic scenario in U.S. history. According to the National Advocates for Pregnant Women site, a lawyer was appointed to her soon-to-be born at home child and a cesarean ordered by the court. She was forcibly and violently removed from her home and taken to the hospital for unwanted, unnecessary surgery. [Emphasis mine]
Laura Pemberton scoured Tallahassee and the surrounding areas for an obstetrician who would attend her in a vaginal birth for her fourth child after a prior caesarean delivery. She was rebuffed by every doctor she contacted; the risk of catastrophic uterine rupture was too high, they told her. Believing in her body’s ability to give birth vaginally, Mrs. Pemberton decided to deliver at home rather than agree to what she viewed as unnecessary surgery. More than a day into her labor with no sign of complications, she nevertheless worried that she was becoming dehydrated. She reasoned that the best way to safely manage her labor would be to go to a hospital for intravenous fluids, and then return home. Mrs. Pemberton entered the hospital expecting to receive care and assuming that she, like other patients, had a right to informed medical decision-making, including the right to consent to or to decline recommended medical procedures. When she arrived, she was placed on a fetal monitor that showed that her baby’s heartbeat was strong, and that her labor was progressing, albeit slowly. However, when the obstetrician on call realized that she was attempting a VBAC, she refused to give the IV that Mrs. Pemberton needed—unless she consented to a caesarean. Mrs. Pemberton was alerted by a nurse that obstetricians were about to seek a court-ordered caesarean section. Without receiving the fluids and while still in active labor, she fled the hospital out of the back steps in her bare feet.
Mrs. Pemberton made it home to continue her labor, her confidence bolstered by the baby’s strong heart tones. Her progressing labor was interrupted by a knock at the door: it was a sheriff and the State Attorney. They entered her home and even her bedroom, following her throughout her house to make sure she did not flee again. They told her that she had to return to the hospital, because a court order forcing her to undergo a caesarean section had been granted. Neighbors looked on as she was removed from her home, still in active labor, with her legs strapped together on a stretcher. Once at the hospital, she was allowed a “hearing” in her hospital room, with an armed sheriff, the State Attorney, and obstetricians crowding her room. Although a lawyer was appointed to represent the fetus, no lawyer was appointed for her.She spoke between contractions, without the benefit of counsel, telling the judge about the extensive research that she had done to support her decisions. Despite the fact that she could already feel her baby’s head in the birth canal and neither she nor the baby showed any signs of danger, the obstetricians were convinced that she exposed her fetus to too much risk by continuing to deliver vaginally: the judge agreed. Laura Pemberton was sedated, and her baby removed via caesarean section.
Mrs. Pemberton left the state and went on to deliver four more children, including a set of twins, vaginally.
On the new(ish) blog, Dou-la-la, author Anne wondered in her post, The Mickey, whether or not a woman could really be anesthetized without her consent in labor so her baby could be removed by cesarean. The story Anne presented was dismissed on another forum as highly unlikely, but it sounds very similar to the case in Denver mentioned in the Birth as an American Rite of Passage excerpt, in which a woman was adamantly refusing a cesarean and her unborn child was declared a ward of the state until birth. The woman was anesthetized, a cesarean was performed and although the doctor had insisted there was fetal distress, the baby was born perfectly healthy.
In both of these cases, the women had their rights trumped by those of the unborn baby inside them. By making a fetus a ward of the state, the state conferred legal rights upon the future citizen that were equal to—and ultimately greater than— those of his or her mother.
New Jersey VM Case - A Victory of Sorts (National Advocates for Pregnant Women)
Does a Laboring Woman Have Any Rights? (Birth Activist)