The controllers of pregnant women are at it again. In this case, however, it is not clear whether the controllers are seeking to protect the fetus, the woman, or both. They may even be seeking to protect the hospital against potential liability. The case is taking place in Florida, where doctors have ordered the woman to undergo a cesarean section against her will. According to a press release issued by the National Advocates for Pregnant Women (NAPW), the hospital has threatened to force a pregnant patient to have cesarean surgery against her will and to report her to child welfare authorities. The woman, who is 39 weeks pregnant, had three previous cesarean sections and based on those experiences, she chose to have a trial of labor for a normal vaginal delivery before agreeing to a c-section if it becomes necessary. The Chief Financial Officer of Bayfront Health Port Charlotte sent a letter to the woman, Jennifer Goodall, with the threat of reporting her to the Department of Children and Family Services, seek a court order to perform surgery, and to perform cesarean surgery on her “with or without [her] consent” if she came to the hospital.
There are risks to repeated cesarean sections, as well as risks to women who have a vaginal birth after having had cesarean sections (known as VBAC). According to guidance issued in 2010 by the American College of Obstetricians and Gynecologists (ACOG), “Attempting a vaginal birth after cesarean (VBAC) is a safe and appropriate choice for most women who have had a prior cesarean delivery, including for some women who have had two previous cesareans.” It is interesting to note the history of VBAC. ACOG reports that before 1970, VBAC was rarely performed, but the practice increased steadily reaching 28% of women who had had previous c-sections by 1996. After that the practice steadily declined, reaching 8.5% only a decade later. The apparent reasons for the decline are restrictions placed by hospitals and insurers on a trial of labor following previous cesarean sections. This shows that it is not only physicians that try to control pregnant women, but also hospitals and insurance companies.