Reproductive rights and amendment 48

–This may not be a post for pregnant mamas–

This issue is extra sensitive for me right now, because one of my very dear friends is dealing with it head-on. I was present at her HBAC, and she inspired me to have my own homebirth. She is being told that she won’t be able to have another homebirth because she is currently living in a country that doesn’t allow VBACs. I don’t normally make posts about political issues, but this is really frustrating me. Grrrr.

I just finished Pushed: The Painful Truth About Childbirth and Modern Maternity Care by Jennifer Block. Its really well-written. I highly recommend it. She does the best job that I’ve seen in explaining the modern maternity system. I could write dozens of posts based on this book, but I want to focus on the last chapter because it relates directly to an issue that is on the ballot here in Colorado this November.

Amendment 48 is being billed as a pro-life initiative, although I don’t think that a lot of the members of the pro-life community understand the way that similar amendments have been used in other states. Case law is an important thing, and I fear that the Focus-on-the-Family-backed initiative may do way more harm than they intend.

Jennifer Block devotes her last chapter to the reproductive rights of women. She’s not talking about abortion, contraception, or any of the issues that are typically called “reproductive rights”. She’s talking about the right to decide what is best for your baby and your body when it comes to giving birth. The current system leaves many moms in a position where they are forced to make riskier choices because the hospitals and doctors don’t want to deal with liability issues. Women should have the right to birth as they want. Women don’t choose dangerous births just for the sake of it. Women will choose what is best for themselves and their babies if they aren’t forced between two options that they don’t like (such as a repeat c-section vs. an unassisted home birth after Cesarean). In those kinds of cases, many moms are left to choose between two options that are not statistically their safest. If hospitals don’t allow VBACs, then what shall they choose?

Well, for many moms, the choice isn’t really a choice at all. Many moms have made the choice to attempt a VBAC, based on the statistics and the worldwide recommendations, and yet the hospitals have forced them to make different choices by getting an emergency court order demanding they have a c-section.

Block opens the chapter with the stories of several women who have been through this experience. She starts out with the story of Laura Pemberton. (You can read more about her story, including the legal decision). Laura decided to attempt a VBAC, and initially found a doctor who was supportive. The doctor changed his mind when she was about halfway through her pregnancy. Her only option was a repeat c-section, or an unassisted HBAC. She decided to try it at home alone.

Laura labored for 2 days, and was starting to get dehydrated. She decided to go to the hospital for IV fluids and then to return home. The nurses reassured her that she was doing well. The baby’s heart tones were great, she was dilating, her blood pressure was great, and the baby was descending. The attending physician insisted that she have a c-section though. He refused to give her the IV fluids unless she agreed to a c-section.

The nurses helped her to get dressed and showed her a back door for her to escape. She drove home, feeling reassured from the nurses, and confident about having her baby vaginally. When they arrived home, the police were after her. The sheriff and state attorney were at her house, and they had a court order issued by a judge. They strapped her onto a stretched by her wrists and ankles, put her into the ambulance, and took her to the hospital.

At the hospital, a nurse led her to a room and gave her a hospital gown to put on. She and her husband went into the bathroom and locked the door. Pemberton remembers squatting there, bearing down as hard as she could, willing the baby to come. “I reached up and could feel the baby’s head in my hand,” she says. She pulled at the water bag, still intact. It slipped out of her grasp. They were knocking at the door, and finally she opened it.

Two doctors, the sheriff, two attorneys, and a judge crowded into the small exam room, with Pemberton in a hospital gown on the exam table, and conducted a hearing… At no time was Pemberton offered an attorney.

In between contractions, Pemberton argued in her own defense. She said this was an informed decision based on months of research and preparation… The judge said that my unborn baby was in the control of the state and that it was the state’s responsibility to bring that baby into this world safely,” says Pemberton.

…Pemberton’s obstetrician did one final exam before he began operating. She was 9 centimeters dilated, the baby was literally inches from being born, yet the surgeons went ahead with the surgery.

Laura Pemberton is not alone. Women are often forced to have a repeat c-section when they want to attempt a VBAC.

Some women will labor in the parking lot of a hospital known to be anti-VBAC, arriving on the L&D floor just in time to push the baby out. The “showing up pushing” strategy is discussed in full on the ICAN list. Fully aware that the hospital would have required them to plan a repeat cesarean, they try to time the birth so that when they get to L&D it’s too late. This doesn’t work for everyone, though. Susie Nalbach showed up at a Coral Springs, Florida, hospital ready to push in 2003. Instead, she was pushed into a wheel chair, separated from her husband, and taken into the operating room. Then she remembers two nurses arguing with each other. “The younger one was telling me to push, and the older one was telling me not to push. I kept pushing because I couldn’t help it,” she recalls. “I remember being told to breathe into an oxygen mask. But it wasn’t oxygen, it was general anesthesia. I did not consent to it. I never signed anything. I woke up later with a son.” She says on her medical chart, the indication for the cesarean was “failure to progress.”

Amber and John Marlowe were attempting a vaginal birth to their seventh child. All of their children had been delivered vaginally. A triage nurse did an ultrasound and decided that the child was too big, even though their previous kids had been large – one 12lb 4oz, and she had never had a problem. They tried a second hospital, and things became even worse.

Marlowe spent 14 hours at this hospital, refusing a cesarean section. Meanwhile, unbeknownst to the couple, hospital attorneys were petitioning a local judge for custody of Marlowe’s fetus so that the hospital could legally compel its surgical extraction–and they won.

Before anyone could execute the order, however, the Marlowes were in their car driving to yet another hospital, Moses Taylor Hospital in Scranton, where Amber swiftly pushed out a perfectly healthy 11lb, 9oz baby girl, with nary a tear.

Hospital attorneys are able to petition for custody of your fetus, and can legally compel you to have a c-section if they decide it is in the child’s best interest. A 2003 survey of directors of maternal-fetal medicine programs found that 14% of them had used the court system to compel women to have cesareans. That’s really disturbing. What’s more disturbing, is that many of these hospitals get their powers from amendments like #48, which give rights to the fetus.

The campaign for fetal rights, led by those intent on re-criminalizing and stigmatizing abortion, has been a detriment to women who decide to carry their pregnancies to term.

The states that have had these kinds of initiatives have also been the ones to decide that a woman is not acting in the best interest of her child when she decides to give birth at home (or even just a hospital vaginal birth, as in the case of the Marlowe’s). The statistics disagree with these judges and hospitals, and some courts have later gone back and said that the judges were wrong in most of these cases, but it keeps happening.

I want to be clear that I don’t think that these cases are the norm. I understand they are rare, and Jennifer Block is very clear in her book that these are not normal cases. The fact remains that hospitals and states are using poorly worded legislation and amendments to take away the rights of women to birth as they choose. For amendments like 48, I just don’t think there are enough benefits to be worth the risk.

Joe and I were talking last night, and I was telling him that its not like I think that amendment 48 will make abortion illegal in Colorado. Its a federal issue right now, and I don’t think amendment 48 is the right way to go about abortion reform. I plan on voting against amendment 48, even though I am pro-life. I encourage everyone to look at all of the possible ramifications of this amendment and to weigh it against the possible benefits.