Here’s one of the tough questions. (Lots of parenthetical explanations, too.)
I believe that the doctors should have gotten the best informed consent that they could obtain and allowed an attempt of vaginal delivery. I can’t bear the idea of “tying down” a mother for forced surgery while she begs me to stop. However . . .
We weren’t there and don’t know from this report the condition of the baby or the mother at the time that they wheeled them into the operating room.
It appears that they did wait “several hours.”
We have precedent that mothers in labor may not make life-changing and -threatening decisions. For instance, the law doesn’t allow Medicaid to be billed unless a mother consents to tubal ligation at least 4 weeks prior to delivery. Even with private insurance or cash-pay, few doctors will perform a sterilization without consent obtained in advance. (I understand that the purpose of this law is to prevent coercion and eugenics, but the one-size-fits-all seems patronizing to all mothers.)
I’ve assisted several women who became hysterical at the end of labor. (One woman stood up on the gurney several times, even as her baby was “crowning” and we were trying to prep her for the imminent delivery. I was a resident in training, and my supervisor ordered the sedation and restraints to protect her from falling from the bed, and the baby from a free-fall delivery from over our heads. She delivered her baby almost immediately after the last time we got her on her back – before the restraining orders could be followed.)
The mother in this story did present herself at the hospital, implying (and possibly signing) consent to the treatment by her attending obstetrician. If she had stayed home for the delivery, there would be no dispute in the first place.
#Stand4Life: As only a woman with first-hand experience can tell us:
If a woman tells her doctor she wants to have a double mastectomy, the doctor won’t assume she’s made a sound decision. He or she will want to review her health history, get a detailed family history, find out if the woman has tested positive for the gene that will put her at increased risk, and so forth.
Similarly, when a woman expresses her desire to have an abortion, the health care provider should not assume she’s making a sound decision. It is their duty to make sure she understands her Carbaby’s development, including a way for her to see an image of her baby. And if that’s not possible, at least an image of a baby at the same developmental stage. Pregnant women deserve exposure to as much information as possible. I would argue that there is no more serious matter than the creation of a new life, save the destruction of it. This is no time to withhold vital information and resources.
As a point of comparison, several years ago my routine screening mammogram showed something abnormal. The immediate follow up diagnostic mammogram confirmed an abnormal mass. The radiologist brought me into her office to discuss the images with me. She showed me the area of concern. Explained the difference in color and shadow and what that meant. She also discussed why the image suggested a mass that was hard, and why that added to her concern. She recommended we move forward with an ultrasound and a fine needle aspiration. Throughout the entire discussion she checked in to make sure I understood everything. She invited questions. During the fine needle aspiration, she showed me the image on the monitor as she was guided with the needle to the area in question. When she withdrew the contents of the mass, she showed it to me and explained, to our great relief, that it appeared that I had nothing more than a benign cyst.
Looking back, I now realize that I knew more about the cyst in my breast than the 3-month old baby who once grew inside me. And that is dreadfully wrong. Not because I knew too much about the cyst. But because I knew too little about my baby.
Edited – title for typo – 8/1/13 at 7:45 AM — BBN