Forced Csection??

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

Originally posted by imenid37

There is no gurantee, but no one should have to pay money and waste their time hiring lawyers to address accusations when you have folks who so blatantly go against medical advice, esp. in a high liability area like obstetrics where the health and safety of two people are on the line. Just because pt. delivered lady partslly and baby seems ok, it doesn't mean she did the right thing.

Though she deserves medical care, I think when you flagarantly defy medical advice like this, you should lose all rights to file a suit. Lots of unanswered questions here. Who provided prenatal care? was there any?

If you read one of the first articles, it mentioned that the parents were willing to sign papers releasing the hospital of liability. And since there is no mention of no prenatal care or homebirth, I'm assuming there was prenatal care and they were planning a hosp birth. Otherwise, IMO, the press would have taken that ball and rolled with it. The suit was filed by the second hosp she went to. In all likelihood, the first hosp was where her OB was. I know we have LOTS of pts who receive prenatal care and are due to deliver at another local hosp but end up coming to ours for some reason or another. If the parents were willing to release liability, and the education of the pt is well documented, I don't understand why this hosp felt the need to gain a court order over this woman's body.

"Just because pt. delivered lady partslly and baby seems ok, it doesn't mean she did the right thing."

Is this the birth is normal only in retrospect theory? And how can we determine what was "right" for this pt?

Originally posted by SmilingBluEyes

NO we DO NOT TRY TO INTIMIDATE PEOPLE WHEN THEY WALK IN OUR DOORS. there you are wrong; the nurses and doctors I work with are EXCELLENT patient advocates, and respectful of their rights/desires. I would NOT work there if this were NOT the case.

Where do you get in my posts I am not an advocate for my patients......? My wording bothers you? Hmmm...Did you bother to read and even understand what I am saying?

Oh well no matter, we don't see eye to eye on this and that is ok. We can agree to disagree and respectfully. Or, We can go round and round forever. I choose the first option.

I, fortunately, don't answer to you. And I don't need your cautionary words to remind me to do what I do best, *advocate for my patients*. You have a Good night now. :kiss

Deb, I don't think this reply was meant to infer that your facility intimidates pts. I think feisty was implying "we" as in general. Obviously, there will be some disagreements, but we can keep it respectful as you mention. Please don't take these posts as personal attacks against you, since they are referring to a "system" rather than a specific person.

Originally posted by fiestynurse

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.

Please explain how the health of many more could be sacrifiecd????

Originally posted by tamrnmomof4

Please explain how the health of many more could be sacrifiecd????

"Legal intervention will only result in scaring women away from prenatal care"

That's how.

Unfortunately women also suffer when the legal systems (and the insurance premiums) scare doctors out of practice as well.

Originally posted by fergus51

Unfortunately women also suffer when the legal systems (and the insurance premiums) scare doctors out of practice as well.

Someone mentioned PA - this is happening in MS as well. I'm all for tort reform!

I too would like to know the rest of the story, Like for instance why were they doing an ultrasound in the first place because they suspected macrosomia or for some other reason (like no prenatal care).

I did a lot of searching last night and the majority of studies I came upon stated that the most common birth injury from shoulder dystocia is brachial plexus injuries and that the majority of those resolve on their own within two months, and that death of the newborn is EXTREMELY rare.

Most also state there is no better outcome with C/S vs. SVD of suspected LGA babies, and that ultra sound is not a reliable method of estimating birthweight that it is usually within 500g of the actual birthweight.

The mortality rate is significantly higher with C/S as are other serious complications.

This woman had a right to refuse treatments. The judge attempted to take those rights away and that is wrong period.

http://www.collegeofmidwives.org/prof_articles01/SD_UK_ARM_01.htm

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9764620&dopt=Abstract

http://www.aafp.org/afp/20010115/302.html

Originally posted by BRANDY LPN

I did a lot of searching last night and the majority of studies I came upon stated that the most common birth injury from shoulder dystocia is brachial plexus injuries and that the majority of those resolve on their own within two months, and that death of the newborn is EXTREMELY rare.

How many of those studies were done with 12 and 13lb babies????? I am sure not many!

Carla, I don't think we can assume anything here re. prenatal care or anything except pt. refused c.section for large baby and the hospital got a court order. There may have been a variety of things going on here. I just wonder and speculate and that is all it is. I live in PA, but not N.E. PA where this occurred, but it is pretty unusual for us to get a walk-in who gets prenatal care somewhere else, unless pt. is very active and can't make it to the other facility. We don't have lots of hospital hoppers who get something they don't like at one place and hop on over to another. Our walk-ins are usually from out of town, can't make it to one of three other hospitals w/in 20 miles of us where they are registered, or no pre-natal care. I think (again my own speculation) that HIPPA and the hospital's lawyers prevent the providers in this case from coming forth w/ more of the story. Again, I don't think anyone should have a surgery forced on them, but I don't want myself or anyone else who is practicing in a reasonable fashion to be dragged through the legal muck when things go bad for a patient due to his/her own choices. I saw an article today that stated the dad "might" seek a monetary settlement from the hospital.

Originally posted by imenid37

. I saw an article today that stated the dad "might" seek a monetary settlement from the hospital.

Wow that is a surprise!

The doctor should be sued...after all he was looking out for the best interest of the baby...the nerve of him!!

You know I don't agree w/ the position that the hospital and doctors took, but I have to say I do admire them for having the courage to take one. They had to know they would take a lot of heat for it and I am sure that they were looking out for the baby and maybe mom too, so I do admire their courage. I just think we can't be forcing pt's to have medical procedures against their will and that it is not always our job to protect pt's from their own poor judgement. It must be hard when you really believe that harm would come to the baby to have the pt. just refuse and refuse the treatment reccomended at two separate facilities by two different sets of doctors/nurses.

Again just because she "seemingly" had a good outcome (hopefully everything is fine and dandy for both mother and baby), doesn't mean she did the right thing. I would liken that situation to letting a older toddler swim alone or a mother knowingly allowing teenage girl to date a 40 year old man. Just because the worst does not happen, doesn't mean the parents acted responsibly. It is the mother and father of the child who above everyone else need to protect the child's interest and well-being. I don't want surgeries forced on patients because we should not set that precident in our free society BUT if this were a born child that the parents were placing at high risk, they'd find themselves in hot water. Everyone knows that. That is why I can really see the dilemma here. A live lady partsl birth is a wonderful miraculous thing. It is an experience like no other. I've had 3 myself. However, most parents would agree a c/s for a healthy child beats a SVD of an injured or deceased child any day, anytime. In today's legal environment, I know of no OB/ GYN who would voluntarily happily deliver a suspected 13 lb'er SVD. Maybe the staff at hospital #3 felt like the pt. deserved to be cared for despite her choice and I aslo say I admire them too.

Like I said before. out of curiousity, I'd love to know more details, but I am glad I was not in the middle of this situation or in the delivery of the 11+ lb'er she went on to have.

Specializes in Maternal - Child Health.

Carla,

You mention that the parents offered to sign a document releasing the doctors and hospital of liability should a problem arise with a lady partsl delivery.

That sounds good, but is not supported or allowed by our legal system. You can not sign away your right to sue in advance in medical cases.

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