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What do you think of women being forced into c-sections by their doctors?

by Jennifer Muirhead (follow)
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caesarean section, pulling out the baby
Photo from Wikimedia Commons.

Most pregnant women probably expect to be allowed to choose where and how they give birth. However, in recent years there have been several cases of women being forced into caesarean sections against their will.

In 1987 cancer patient Angela Carder was denied chemotherapy which might have harmed her fetus, and forced into a ceasarean section without her consent in an attempt to save the fetus. The baby died within two hours of birth and Angela died two days later.

In 2004 Melissa Rowland refused a caesarean when it was recommended by her doctor and when one of her fetuses was still born she was charged with murder. A case like hers sets a precedent which means that pregnant women can be threatened with the possibility that they will go to jail if they do not consent to surgery.

Is it ever acceptable for a woman to be forced to have a caesarean section without her consent? If so, when? Are there any other circumstances when you would consider it acceptable to force someone into surgery without their consent?

#Women's Health
#Medical ethics
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What an interesting question Jennifer. Before I had the context that's within this question I was all ready to go with an answer, but you've looked at it in a really interesting way. I think that there need to be a clear distinction for when a C Section is medically necessary to save the life of a child, and where a obstetrician is wanting to do a C Section because it better suits their schedule (this does happen). For when a fully grown and viable baby's life is at stake and a C section is urgently required, I'm not sure why a parent would refuse. Whilst natural births are the preferred choice for most mothers, a healthy baby is surely the driving force. Not knowing these individual cases well enough, I would image that it is something that needs to be considered on a case by case basis but I would be in favour of preserving the life of the unborn baby.
It's very common for there to be disagreement between doctors, or between doctors and midwives or between doctors and the patient as to whether a cesaerean is medically necessesary or not. It's not always simple, and a doctor might weigh up the risks differently from the woman whose body is at stake. But that's beside the point. A woman's body doesn't stop being her own once there's a baby inside it. No-one has the right to cut another person against their will.

Agree that a woman's body remains her own its a really interesting question to pose and definitely one with so many considerations.
Thanks for your thoughtful response. It is indeed a tricky one.
There are risks to childbirth no matter how it happens, be it vaginal or surgical. The question here is who decides what those risks are? Who decides which risks are the greater threat to the mother and her baby?

Many studies have shown that women are extremely good at navigating their way through the risks and choosing wisely, women don't choose options that endanger their babies. Women are MORE than adequately qualified to make good choices in birth when they have access to good information and support free from bullying.

Surgeons come at birth from a different angle to women. Surgeons are generally working under the orders of a hospital whose insurance policy dictates their birthing protocols. A part of the decision making process requires women to be fully informed about what is the hospital policy vs what is the actual evidence based response to any given situation. Unfortunately the wider community has no knowledge of the fact that what is hospital policy is NOT evidence based. If it were evidence based then hospitals from Hobart to Darwin would all have the same policies, the same rates of interventions and caesarean, the same rate of VBAC, yet the stats vary significantly.

This societal misunderstanding often means that women are bullied into surgery, not just by surgeons but by other people in their lives (partners, parents, friends, churches etc).

We have NOT come to have a 1 in 3 caesarean rate (much higher in many venues across Australia) because surgeons are following evidence based practice, we have that rate because birth choices are created for hospitals to avoid legal action rather than individual women in relation to their health.

We frequently see women being forced into caesareans by the simple limits on information and physical options during labour (can she move freely, can she drink or eat, does the room feel safe to the part of her brain that controls hormone release etc etc). I recently wrote an article about it that included some examples of forced caesareans, however when I was seeking stories I received well over 70. I'm thinking I might turn it into a book to give these women a voice.

It's never ok to force surgery on a woman. If we force caesareans on women do we then have the right to force mastectomies on mothers who have breast cancer? Colostomy bags for fathers with bowel cancer? At what age do we stop this practice, when the kids are 18?

Bodily integrity remains the sole dominion of women. We can trust mothers to care for their babies, we know this for a fact because study after study has shown the same thing. Mothers have the most to lose if things go wrong, surgeons lose money, mothers lose everything they hold dear and even their lives are on the line with forced surgery.
Well said!
I was not aware of cases like this. I think it is disgraceful and a breach of human rights. It is the woman's body, and she has every right to decide give birth - and she is definitely has the right to chemotherapy.

Although not the same, it reminds me of a recent case in Ireland when a woman was denied an abortion because her life was at risk. Both the parent and baby died.
The cases that you mention are rather interesting. I believe that the parents should ultimately make a decision after being presented with the facts by the doctor. If they choose to do or not and mother or baby dies it will be because of a decision they made and will have to live with.
by Gia
I don't believe it is ever acceptable for a woman to be forced to have a caesarean without her consent. Either women own their own bodies... or they don't. I like to believe that we women aren't anybody else's property but with some of the things I hear about it seems a lot of the systems still in place operate from the archaic notion that women are property, vessels for men's children (who are also property).
Her body, her choice.

The doctor's role is to provide information, benefits and risks for all scenarios.

If a person does not have 'capacity', then if they have a contingency birth plan, that should be followed. Otherwise the next of kin makes the call.

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