Forced Csection??

Specialties Ob/Gyn

Published

The Citizens Voice

Woman hits hospitals' stance that she agree to C-section

By Lisa Napersky , Citizens' Voice Staff Writer 01/17/2004

A Plymouth woman who was ordered by a Luzerne County judge to consent to a Caesarean section delivery of her baby said Friday she was appalled by the treatment she received at two area hospitals.

While she was in labor Tuesday night, Amber Marlowe, Academy Street, Plymouth, said she spent hours defending her right to deliver her baby lady partslly.

She and her husband, John, drove to three different hospitals before she found a doctor who would respect her wishes.

"It was very upsetting," stated Marlowe, who gave birth lady partslly to a healthy baby girl Thursday morning in Moses Taylor Hospital, Scranton. "All this just because I didn't want an operation."

After Marlowe refused to consent to a C-section and checked herself out of Wilkes-Barre General Hospital Wednesday morning, the hospital took legal action against her.

Hospital workers claimed that an ultrasound indicated Marlowe's fetus weighed 13 pounds and the lives of the mother and the baby would be in jeopardy if the operation weren't performed.

At the request of Wyoming Valley Health Care Systems, Luzerne County President Michael Conahan signed an order Wednesday appointing the hospital as legal guardian for the unborn child.

Judge Conahan also ordered that the parents "are hereby temporarily restrained from refusing to consent to a C-section delivery of their unborn fetus if the professional medical judgment of WVHCS and the treating obstetrician is that such a procedure is necessary."

The preliminary injunction ordering Marlowe to submit to the C-section was delivered to her residence, but she never received the document.

"They kept wanting to cut me open to get the baby. I think they may have actually sent police to our house, but we weren't home," said Marlowe. "I kept telling them I've already had six kids, and the biggest one weighed 12 pounds and there were no problems."

Marlowe said when she started having contractions Tuesday night, she went to Mercy Hospital, Wilkes-Barre, because it was close to her home. After medical personnel performed an ultrasound, Marlowe said she was informed the baby was going to weigh more than 11 pounds and a doctor insisted that she undergo a C-section operation, even though there were no apparent problems.

"They told me there was no way they would let me deliver the baby naturally because the doctor didn't want a lawsuit," said Marlowe. "I had a friend who died during a C-section, and I was afraid to do it that way."

Even when the couple offered to sign papers promising not to file a lawsuit, the doctor refused, explained Marlowe. She said staff members at Mercy Hospital called security when she told them she was leaving.

She and her husband next drove to Wilkes-Barre General Hospital. Marlowe was admitted at 10 p.m., and a second ultrasound was done.

Doctors there reached the same conclusion as those at Mercy Hospital. They also refused to deliver the baby lady partslly, claiming it was too dangerous because of the size of the fetus.

Throughout the night, said Marlowe, nurses and doctors told her "horror stories" about how her baby was going to be handicapped if she didn't have the operation. She checked herself out at 11 a.m.

"I told them, forget it - I'm leaving. Then I came up here (Moses Taylor) and had my baby the proper way," she stated. "The doctor here never even suggested a C-section.

They did an ultrasound and blood work and continued to monitor me, and there was no problem."

In the civil complaint filed against the Marlowes, who are referred to as Jane and John Doe in court documents because of patient confidentiality, plaintiffs are listed as the WVHCS and Baby Doe.

"Even in the absence of present fetal distress and even with ongoing fetal monitoring, a lady partsl delivery of this size fetus could result in complications occurring during the delivery ... and result in unavoidable death or serious impairment to the baby," states the complaint. "Baby Doe, a full term viable fetus, has certain rights, including the right to have decisions made for it, independent of its parents, regarding its health and survival."

According to the suit, John and Amber Marlowe cited religious reasons for not wanting to have the operation. The complaint also states that during one of Marlowe's previous pregnancies, the baby suffered shoulder impairment because of the size of the fetus. The couple said neither allegation is true, and that the main reason for wanting lady partsl delivery was fear of having an operation.

Marlowe said she and her husband are contemplating filing a lawsuit against Mercy and General hospitals for causing them distress.

©The Citizens Voice 2004

www.zwire.com/site/news.cfm?newsid=10824225&BRD=2259&PAG=461&dept_id=455154&rfi=6

IMO, regardless of whether or not this woman had prenatal care, she has the right to refuse surgery. As any pt has the rightt to refuse treatment.

http://www.timesleader.com/mld/timesleader/7730516.htm

Posted on Sun, Jan. 18, 2004

Hospital faces fight in birth dispute

A now-moot Luzerne County court order for a Caesarian section will see a challenge.

By TERRIE MORGAN-BESECKER

[email protected]

WILKES-BARRE - Concerned his case could impact other pregnant women, a Plymouth man said Friday he's working with a national reproductive rights group to challenge a court order that sought to force his wife to undergo a Caesarean section against her will.

John Marlowe said he's pressing on with the case - even though the order is moot since his wife already gave birth to an 11 pound, 9 ounce baby - because he doesn't want other couples to endure the stress they did as they battled hospital officials regarding their decision.

"It's more than my wife. What happens to the next lady that goes in there?" Marlowe said. "If they get away with this, what it's telling people across the country is a hospital has a right to do what it wants, and the woman has no rights."

Marlowe's wife, Amber, checked out against medical advice from Wilkes-Barre General Hospital on Wednesday morning after physicians there insisted she have a Caesarean section because of concerns about the fetus' weight, which was estimated at 13 pounds. She later gave birth lady partslly at Moses Taylor Hospital in Scranton.

Unbeknownst to the Marlowes, after they left General Hospital, attorneys for Wyoming Valley Healthcare System sought a court order to gain guardianship of the fetus in case the Marlowes returned to their hospital. The order, granted without the Marlowes' knowledge, forbade them from refusing a Caesarean section if doctors there deemed it medically necessary.

Kevin McDonald, spokesman for the health-care system, said Friday the hospital stands by its decision to seek the order. "These were really unique circumstances. We did what we believed was in the best interest of the patient."

McDonald said as far as the health system is concerned the legal dispute is over.

"The injunction was only effective if she came to our hospital and we had to do a Caesarean section. Since that didn't happen, the order is moot," he said.

But Lynn Paltrow, an attorney specializing in women's reproductive rights, said the issue goes far deeper than the Marlowes.

"This is not a conflict between a pregnant woman and a fetus. It is a conflict between a pregnant woman and her fetus against the raw power of the state to impose an unnecessary surgical procedure on a woman's own body."

Paltrow, of the National Advocates for Pregnant Women in New York City, said she's working with the Marlowes to find a Pennsylvania attorney to fight Conahan's order. She said she believes the couple might also have a civil case against the hospital for violating their rights.

Marlowe said he and his wife are still considering their options and might file suit seeking monetary damages. But he said money is not the key factor motivating him.

"We're talking civil liberties issues, not suing for money," he said. "Right now you have a judge saying a hospital has the right to claim guardianship of an unborn fetus and guardianship after it is born. That's unacceptable. We need to set a precedent that a hospital cannot have higher rights than the parents."

ImaStork - You state that if she so wanted to deliver lady partslly she could have always opted for home birth.

Why should a woman with a high risk of labor complications be driven out of the health care system to avoid coerced treatment?

This was clearly a violation of her civil rights and I am glad that her husband is pressing on with the case.

l

Originally posted by fiestynurse

ImaStork - You state that if she so wanted to deliver lady partslly she could have always opted for home birth.

Why should a woman with a high risk of labor complications be driven out of the health care system to avoid coerced treatment?

Exactly! And that is the point behind trying to force people to be treated against their will. They will just not be treated. And which is more dangerous

We delivered a 10 lb 12 oz baby lady partslly last week, with no dystocia. It can be done.

Where does it end? What if a laboring woman refuses to be hooked-up to a fetal monitor? What if she refuses an IV? Why don't we just throw all those consent forms out and just hand all pregnant women who walk in the hospital door a card saying "your body belongs to us and we'll do whatever the hell we want to it"

Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

like someone said, refusal should be able to go BOTH ways however. I don't buy this story.

ah, but I have seen people refuse so many things. It' s their right. ABSOLUTELY no one I know would EVER assault a patient this way. NO doctor, no nurse, no one!

BUT if it's against best medical advice TO refuse, even after extensive explanation, too bad we can't be relieved of liability for injury and/or death that results from their refusal. Ah but we can't.

My favorite cases are failed home births where they (patients and midwives) show up VERY HOSTILE to begin with. RIGHT OFF THE BAT they are DEMANDING AND DIFFICULT before we even do ONE thing or explain anything at all. We have to take their care and honor their wishes no matter what. I respect that, but if medically they need treatment and refuse and a bad outcome results, who is responsible? Who will be sued? Who will be blamed? It's unfair to say the least. But I treat them like I would my sister or best friend, like they deserve to be. But do I worry in such cases? Oh yea, we know NOTHING about them and they show up emergent at 3:30a.m. it's tough to say the least....I DO worry. So do our doctors.

We still will be sued either way if a bad outcome is the end. It's sticky but the fact.

I don't believe the whole story is here. I just don't. I think there is MORE. Sorry, I do NOT believe EVERYthing I read.:rolleyes:

Deb - I'm definitely with you on this.

This is probably not the same thing at all but this couple sorta remind me of the breastfeeding while driving mom and her hubby.

steph

I know these types of stories are hard to believe in a civilized society, but it happens! Court-ordered c-sections are a particularly egregious abuse of state authority because this surgery tends to be carried out on society's most vulnerable, powerless women. In 1987 the New England Journal of Medicine published a study of court-ordered c-sections that revealed that 81 percent of the patients were low-income women of color.

How many more people does the Newspaper have to interview before you "buy this story?"

SmilingbluEyes - You say "Refusal should be able to go BOTH ways" and our main concern should be the risk of litigation.

So, we intimidate a laboring patient until she's forced to walk out the door. After all we know what is best for the patient. She's just some stupid, crazy woman. Her and her husband have to drive from hospital to hospital looking for someone who will deliver their baby lady partslly.

I have seen more nurses, doctors, and hospitals get themselves into worse legal trouble because of fear of litigation, than from doing what they feel is the right thing. This story is a perfect example. Now, the hospitals involved face a possible civil rights lawsuit in federal court.

Thank God for the nurses and doctors at Moses General Hospital, who respect the rights of women and for Linda Paltrow of the National Advocates of Pregnant Women.

By the way, it is not a "failed home birth" it is an "attempted home birth" Right off the bat your judging these home birth moms and labeling them as failures. I was a Maternal/Child Health Nurse for 12 years and my experience with home birth moms has mostly been positive.

Always remember your most important nursing role is being a PATIENT ADVOCATE!

the American Medical Association has advised its members that in the unusual instances when they encounter pregnant women who refuse a suggested treatment, they should respect their patients' wishes, without recourse to a court. Legal intervention will only result in scaring women away from prenatal care: "While the health of a few infants may be preserved by overriding a pregnant woman's decision, the health of a great many more may be sacrificed."

If I were this woman I would go after the doctor's licenses also and report them to the Medical Board.

With all the commotion about "patient's rights," I'm surprised that her refusing wasn't automatically respected.

Originally posted by fiestynurse

I know these types of stories are hard to believe in a civilized society, but it happens! Court-ordered c-sections are a particularly egregious abuse of state authority because this surgery tends to be carried out on society's most vulnerable, powerless women. In 1987 the New England Journal of Medicine published a study of court-ordered c-sections that revealed that 81 percent of the patients were low-income women of color.

How many more people does the Newspaper have to interview before you "buy this story?"

SmilingbluEyes - You say "Refusal should be able to go BOTH ways" and our main concern should be the risk of litigation.

So, we intimidate a laboring patient until she's forced to walk out the door. After all we know what is best for the patient. She's just some stupid, crazy woman. Her and her husband have to drive from hospital to hospital looking for someone who will deliver their baby lady partslly.

I have seen more nurses, doctors, and hospitals get themselves into worse legal trouble because of fear of litigation, than from doing what they feel is the right thing. This story is a perfect example. Now, the hospitals involved face a possible civil rights lawsuit in federal court.

Thank God for the nurses and doctors at Moses General Hospital, who respect the rights of women and for Linda Paltrow of the National Advocates of Pregnant Women.

By the way, it is not a "failed home birth" it is an "attempted home birth" Right off the bat your judging these home birth moms and labeling them as failures. I was a Maternal/Child Health Nurse for 12 years and my experience with home birth moms has mostly been positive.

Always remember your most important nursing role is being a PATIENT ADVOCATE!

feisty, that's all well and good, but in certain situations there are medical needs that conflict with patient's preferences. It is the same in every area of medicine. Do we let a baby in the NICU die because the parents don't want a transfusion? Do we let children die if their parents don't want to treat cancer with traditional medicine? Do we let a woman abrupting refuse an operation to save her life and that of her unborn child? Some will say "Of course, it is always the patient's choice!".... For me there are more areas of grey (and I am not talking about this case in particular).

Nurses can refuse to participate in abortions and other procedures they believe are immoral, so why should I be forced to provide semi-medical care to a woman if I know it will harm her and her unborn baby? Are you going to be defending me when we can't resus a dead child or mom bleeds to death? Should I have to subject myself to that as a part of the job? I just don't know all those answers. I wish I could be sure I knew what was right all the time like you, but I don't. I have never even heard of a woman being forced into a section anywhere I worked, and I just think the devil is really in the details of each situation.

Originally posted by fiestynurse

Now, the hospitals involved face a possible civil rights lawsuit in federal court.

By the way, it is not a "failed home birth" it is an "attempted home birth"

Always remember your most important nursing role is being a PATIENT ADVOCATE!

I totally agree with you. :) This hosp will be involved in a nasty civil rights lawsuit, when they could have easily respected her wishes, and avoided possible litigation by documenting that the pt was informed of the risks and benefits for CS versus lady partsl delivery and noting the pt's refusal for CS.

And about homebirths, yes these Moms probably are a little hostile. Not because they have a personsal issue with hosp staff, but because they feel like they have lost what control they might have had over their birth. Now they are afraid they will be judged for attempting a homebirth and they will be "told" how things have to be done once they are in the hosp. Not to mention the feelings of guilt and disappointment they must be feeling.

I agree with feisty. Even if we may not always think our pts make the "right" decision, as nurses, part of our job is to advocate for their wishes.

Specializes in OB, Post Partum, Home Health.

I must have missed something here, neither of the first 2 hospitals that she went to actually performed a c-section, so how can we say that her rights were actually violated? I believe that the primary care provider also had rights, he/she had the right to refuse to perform a lady partsl delivery if he/she was uncomfortable with the situation. I wonder how her labor was progressing and if there were other indicators of possible shoulder dystocia, was the baby at a high station for a long period of time? The article didn't say anything about whether or not the patient requested another doctor or a second opinion. As said before, it sounds like she probably had no prenatal care and even if she did, it sounds to me like her primary care provider didn't have privledges at the second or third hospital that she visited, therefore, the care providers that saw her at these hospitals would be seeing her for the first time, complicating things even worse.

The worst shoulder dystocia that I have ever had was a G3 P2, previous babies were 10 and 10 1/2 lbs each, delivered lady partslly , baby #3 weighed 13 1/2 lbs, severe shoulder dystocia, resulted in xaphenelli and emerg. c-section.

So, in summary, I would have to agree with what several others have said; there is more to the story than we know.

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