Refusal of Cesarean Leads to Loss of Custody in NJ

Saw this and almost shit myself. This is one of the hospitals that my OB has privileges. . .

The Superior Court of New Jersey upheld the decision that a woman who refused an unnecessary cesarean at St. Barnabas Hospital, which boasts a 49.3 percent cesarean rate, will not receive custody of her daughter. The judge claims the Superior Court of New Jersey’s decision is not based on the defendant’s refusal of a cesarean, but on “other substantial additional evidence of abuse and neglect that supported the ultimate findings.”

A Quick Summary

On April 16, 2006, V and B, a married couple, went to Saint Barnabas Hospital after V began experiencing contractions. V is described in court documents as a 42 year old, college educated woman who was thirty-five weeks pregnant and in labor upon arrival at St. Barnabas Hospital in New Jersey, which boasts a 49.3 percent cesarean rate. V signed the consent form for the administration of intravenous fluids, antibiotics, oxygen, fetal heart rate monitoring, an episiotomy and an epidural anesthetic. However, she refused to the blanket consent forms for c-section or fetal scalp stimulation. According to the court documents, hospital personnel explained the “potentially dire consequences of not allowing a c-section in the event of fetal distress.”

In the hospital records, V is described as “combative,” “uncooperative,” “erratic,” “noncompliant,” “irrational” and “inappropriate” while in labor. V requested that the obstetrician leave the room and called the Livingston Police to report that she was being abused and denied treatment. She exercised the right to refuse to wear an oxygen mask, would not consent to fetal heart rate monitoring and “thrashed about to the extent that it was unsafe for the anesthesiologist to administer an epidural,” but records do not indicate whether or not she had requested an epidural. While yelling loudly, she exercised the right to refuse a bedside ultrasound.

Dr. Mansuria, the obstetrician, explained the possible complications that could occur if the fetus went into distress and a c-section was not performed, such as brain damage, mental retardation and fetal death. Mansuria claimed that “an examination” revealed a nonreassuring fetal status. B said that he understood the risks and V would not consent to the procedure.

 

The legal findings show that the “hospital responded appropriately to confront V’s mental state and her refusal to consent to the c-section.” The staff requested an emergency psychiatric evaluation to determine V.’s competency. Dr. Devendra Kurani spoke to V for approximately one hour and while Kurani was there, the anesthesiologist was able to administer an epidural. V informed Kurani that she had a “psychiatric history” and had been on medication prior to getting pregnant. B confirmed that V had been treated by a psychiatrist for post-traumatic stress disorder and had been prescribed Zoloft, Prozac and Seroquel.

 

Dr. Kurani concluded that although V was anxious, she was not psychotic and had the capacity for informed consent with regard to the c-section. The staff called in a second psychiatric evaluation from a Dr. Jacoby.Before the second psychiatrist was able to complete the examination, V gave birth vaginally to J without incident in spite of Dr. Mansuria’s repeated claims that V’s baby was in distress and could suffer brain damage, mental retardation or fetal death without the recommended cesarean.

 

A social worker at Saint Barnabas Hospital contacted the Division of Youth and Family Services on April 18, 2006, two days after J’s birth to report concerns over releasing the baby to her parents’ care. Caseworker Heather Frommer went to the hospital, interviewed staff and spoke to V and B, who denied that V “had ever received psychiatric treatment, had ever refused to consent to a c-section or had ever been evaluated by a hospital psychiatrist.”

It gets deeper the court findings can be found here in full, and a summary found here.

 Source: the unnecesarean.com