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Arizona woman fights her hospital on forced cesarean section

Arizona woman fights her hospital on forced cesarean section

An Arizona woman is fighting back against her hospital, which is attempting to force her to deliver her fourth child by cesarean section.  Joy Szabo, 32, is protesting Page Hospital’s ruling prohibiting vaginal births after cesarean sections (VBACs); she had an emergency cesarean section delivering her second child, but the hospital allowed her to deliver her third child naturally two years ago.  Now pregnant again, the hospital is forcing her to have a cesarean because of lack of hospital staffing.

This story is sadly common – it doesn’t appear in the news because it’s rarely protested.  But according to the International Cesarean Awareness Network, over 31% of US births are now by cesarean section, although a 5% to 10% rate is best for mothers and babies.  Szabo is using a common but compelling defense, asserting that the method of delivery is a pregnant woman’s right to choose.  The hospital is refusing to budge, saying that it is purely an economic choice – there are not enough physicians who can be available, should an emergency occur during the birth.

Szabo’s husband, Jeff, places their case within a healthcare system that fails to recognize personal integrity and instead privileges convenience to the physician over the preferences of the patient: “My wife’s plight,” he told the Lake Powell Chronicle, “is indicative of the health-care system in the U.S. They make money off of people’s suffering.  Consequently, medical care is dictated by cost and insurance companies and not by what’s best for the patient.”  I would add that this is also a system that places authority for a woman’s reproductive choices in the hands of her doctor and denies her fundamental agency in deciding how she wants to give birth.  If the surgery is unnecessary, she should not have to undergo the inherent risks – this is not even a case of medical, but rather economic authority.  One could argue that Szabo can’t force the hospital to hire more physicians, but then again, how is the hospital justified in requiring her to undergo a medically unnecessary surgery?  Why does the hospital have more rights than the patient?

This reminds me of the segment of the Today show from about a week ago titled “The Perils of Home Birth” (yes, they actually called it that).  In the segment, they compared home birth to a “spa treatment” – suggesting, perhaps, that birth is supposed to be clinical and unpleasant (to sign Choices in Childbirth’s petition demanding accurate reporting of all childbirth options, go here).  I haven’t watched the piece, so I’m not going to comment on it extensively, but what I’ve been hearing simply confirms what I know from classes and reading on this topic: that in this country, birth is not considered a matter of female agency or choice, that it is not respected or “safe” unless it is medical and preferably surgical, and that it’s more about the physician’s choices than the birthing mother’s. 

The case of Joy Szabo only highlights these sad truths – that under any other circumstances, unnecessary surgery would not be sanctioned by a hospital.  Why is birth a separate category?  And why is convenience and expense to a hospital privileged above the health and well-being of a mother-to-be?

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Photo courtesy of flickr.com/photos/11043981@N00/3771530250

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56 comments

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7:08PM PDT on Jun 11, 2012

it is purely an economic choice of course it is a c-section cost a hell of a lot more than a natural birh. it is purely an economic choice

7:41PM PDT on Jun 10, 2012

You don't even want to hear the horror stories I could tell about my two births so I feel Joy Szabo's frustration in dealing with an institutionalized hospital administration. She has every right to determine the type of birth she wants as long as there is no unreasonable danger to the baby. That doesn't seem to be the case here. What is more puzzling is the hospital's claim they don't have the personnel. How is it they can handle any births if they don't have adequate personnel for emergencies? This case definately deserves a careful analysis by the media and Joy should hire an attorney right away to manage her case.

3:00AM PST on Jan 22, 2010

An infuriating nightmare. We must stand up against doctors and hospitals that dole out this reprehensible joke of medical treatment for the sake of money and convenience, The US should be ashamed that the process of childbirth has been so degraded in this country.

Please check out http://www.theunnecesarean.com/ for more useful info.

Thanks for the article! :-)

9:37PM PDT on Oct 24, 2009

Judith - What makes you think that a major surgery is safer than a traditional birth and why are they unprepared for an emergency c-section? That event can become necessary for any woman at any time. If they are unprepared for that event , they have no business allowing any births at their hospital.

9:26PM PDT on Oct 24, 2009

Unfortunately, I believe the hospital has a fair argument. Wouldn't she feel horrible if their was a birthing complication simply because of her unwillingness to get a cesarean section? But yeah, it's her right to choose. I guess it'd be nice if she looked at if from both perspectives. I'm obviously a safer than sorry kind of person.

7:05AM PDT on Oct 22, 2009

Please don't generalize about doctors NOTbeing as caring as a midwife. I spent 10 hours at my patients side yesterday--cancelled my afternoon office--all to make sure she got the vaginal birth she wanted--and believe me--she came close to being sectioned when the fetal heart dropped to 55 .a couple of times--that would make anybody pucker!!
Good outcome! I still do VBACs, because I had one myself, and I did breech breech vaginal twins last week. They turned out well.

Remember--every woman wants to have the perfect birth but we live in the reality of a lawyer on every street corner, and I don't care how close you are to a patient--if there is a less than perfect outcome they will sue!--so to do this kind of OB puts ME at risk too! 20 years under my belt and so far so good and a C. Section rate that has never gone over 8.6%

Imagine this scenario. You have a good friend and you decide to car pool---we all do it. What if she said---Do you have car insurance in case there is an accident? You would-be truthful- immediately feel uneasy about taking her kid to school. What if you found out that another woman was sued and lost her entire life savings because she too was giving a kid a lift to school and she was rear ended and he got injured---would you still drive them to school?

We are under tremendous pressure to give a woman a perfect birth experience---but at same time as we try to honor her wishes, we know that by doing so could invite a lawsuit. All she wo

12:39PM PDT on Oct 9, 2009

Stacie, What a horrible experience--I hope that maybe you can get some counseling to deal with the PTSD you undoubtably have--and I wonder if you have consulted with an attorney? The nurse saying you need to feel the pain sounds like grounds for a lawsuit!

1:05PM PDT on Oct 8, 2009

Parrish Medical Center in Titusville FL is as bad as the hospital in this article. I had my son there and I was subjected to a forced pelvic exam, having my water broken without permission, ane being forced to wait an hour for my epidural because the nurse insisted I should be forced to experience some of the pain. I felt very violated and almost like I had been raped.

9:27AM PDT on Oct 8, 2009

Guys,I'm in the administrative side of healthcare,and this is a no-brainer.All she has to do is get an attorney,and sue the hospital for attempting to force an invasive treatment on her.Hospitals have to have adequate staffing,both present and on-call,to meet the patient-care needs.Your attorney can step right in with a restraining order so the hospital can't get away with bullying you into any medically-unnecessary procedure.Lots of issues here,but the first thing to do is make sure she has a legal advocate.It works wonders.

7:37PM PDT on Oct 7, 2009

There is no doubt in my mind that much of what occurs in maternity wards in hospitals is totally about the convenience for the doctor and I have personal experience with being induced to prove it!

I hate to say it Deb R., but I don't believe universal healthcare will make this better. I believe it will make it worse! There will be even less choice, more rationing of what the government thinks is the appropriate approach to take and if doctors are making less money, they are going to work less hard and want to make their lives even easier. Universal healthcare just takes the decision from the insurance drudge and gives it to some government drudge. That's really improvement.... NOT!

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