Do American women have a 'right' to choose how and when they give birth? Or is that 'right' another casualty in the pro- v. anti-abortion battle?
According to the World Health Organization, nothing above a 10 to 15 percent Cesarean section rate is justified. A C-section is major surgery, where doctors slice open a pregnant woman's abdominal wall and uterus to extract an infant. Currently in the United States, nearly 30 percent of babies are delivered by C-section (the rate in 1970 was 5 percent). Disturbingly, our high rate is partly due to hospitals and physicians coercing mothers into such surgery. Coercion means lack of consent, and cutting someone without their consent is not surgery. It is assault. In turn, this means that pregnant women's rights and autonomy are under assault.
Perhaps the most widespread coercive practice is the ban on vaginal birth after C-section (VBAC), by which women who have already had a C-section are denied the option of vaginal delivery. Despite studies showing more than 70 percent of women can give birth vaginally after a C-section, more than 300 hospitals and thousands of doctors nationwide have banned VBAC due to cost concerns and fears of medical liability, according to a Medical News Today report. Moreover, the American College of Gynecology and Obstetrics' guidelines on how physicians and hospitals must regulate VBAC are nearly unattainable. Such restrictions on VBAC mean that some women are forced into surgery they do not want and might not even need.
More disturbing still are cases of court-ordered C-section. For instance, in 2004 Wyoming Valley Health Care System doctors recommended that a pregnant woman with an overly large fetus (macrosomia) undergo a C-section. She refused. According to constitutional and common law, not to mention medical ethics, any adult can refuse surgery'we are in charge of our own bodies. In a society that recognizes individual autonomy, her refusal should have been the end of it.
But it wasn't. Because there was a fetus involved, the hospital filed suit and a Pennsylvania court not only awarded the hospital system custody of the woman's fetus before, during and after delivery, but also gave the hospital the right to take the woman into custody and forcibly perform a C-section. It's clear that this woman was stripped of her rights because she was pregnant. This particular woman defied the court order and fled the hospital with her husband, giving birth to a healthy baby vaginally. Other women have not been so lucky.
Melissa Rowland, delivering twins, refused a Cesarean section against her physicians' advice. One baby was stillborn, and the other lived after Ms. Rowland later consented to a C-section. On March 11, 2004, the state of Utah charged Ms. Rowland with homicide, stating that she murdered her fetus by initially refusing a C-section. Ms. Rowland avoided a murder trial by pleading guilty to child endangerment.
Rowland's case essentially sanctions any state to subjugate a pregnant woman's rights to those of her fetus. That both weakens women's rights'Rowland was denied the right to refuse surgery and the right to speak for her child'and grants the unborn greater rights than the born. Utah's reasoning is applied nowhere else in medicine: If you refuse to donate a kidney to a needful person who later dies of kidney failure, you would not be charged with homicide or any other crime.
Though 'consumer demand' is certainly a large part of the increased C-section rate, it's equally clear that the increased rate reflects a legal movement to a universe where fetal rights weaken or even obliterate the rights of the pregnant woman. As Tonya Jamois, president of the International Cesarean Awareness Network, puts it, 'Women ... are having their choices trampled because hospital administrators and doctors are favoring cost-effectiveness and liability protection over basic patients' rights.'
Such issues may seem remote here at UW-Madison. But don't doubt it'given the opportunity, the same politicians up on Capitol Square who banned UHS from distributing birth control pills would like nothing better than to restrict pregnant women's rights in the same way the state of Utah or that Pennsylvania court did. We should balance a fetus' rights with those of the mother, but in a society valuing autonomy and equality, that balance must not coerce pregnant women into surgery.
