Can you refuse C/S at the hospital? - Page 2

[birthgreeter]

[QUOTE=Mavournin;6240393]There have been stories of women refusing cesareans and hospitals obtaining court orders to do them.

But, that said, if you are planning another pregnancy, I would find a VBAC-friendly provider and birth location and go for it. Get involved with ICAN now. In most cases women who had a previous c/s for a breech baby are great candidates for VBAC.


If versions were so dangerous practioners wouldn't offer them or make referrals to those who specialize in them. In fact, external versions have become more widely used over the past 15 years or so based on their strong safety record and approximate 65% success rate. I can't imagine that a physician or midwife would refer a patient for a version if there was any question at all for that woman's personal safety or the safety of her baby. If a medical reason precludes attempting a version for a vaginal birth over a surgical one, I also imagine that would be explained in detail.
QUOTE]

I agree!

And thank you to who posted the ICAN site! I love the different links to share with my ladies!

[khaoskat]

Originally Posted by OnTheFence

The lone voice of dissent...

Be glad you were spared the version. They are dangerous. Crazy dangerous and you may have ended up with a csection anyway, an emergency one which would not have been cool.

I respectfully disagree about being spared a version. I have undergone one myself, after informed consent. I feel that a person has the right to choose, after being informed of the risks and benefits of a procedure, weather or not they choose to accept it. As you said, the worse outcome would be a c-section, but the poster was already going to end up being forced into a c-section because her child was breach.

My personal choice would be (and has always been) to attempt anything possible to prevent major surgery.

The most common problems with a version are 1) They can lead to fetal destress which could lead to a c-section; 2) that the version doesn't work and you will have to schedule a c-section; and 3) often times the babies turn back into breach.

Right now I am in the same boat, again, as the op. My midwife/OB's have done nothing and I am 40 weeks prego with a suspected breach. I also have a history of fast labor (usually under 2 hours from time of realizing I am in labor until delivery).

I fully understand where she is coming from. And I also understand questioning what happened at your birth after the fact.

As for weather or not they can force you - I have read that if you basically come in fully dialated ready to push that you are pretty much going to end up with a breach vaginal delivery. I don't know how true that is or not, but I may be one of those testing this theory. Right now, I think one good night of fun between DH and I and this baby would be here....

When you come into the hopsital you sign consent forms for treatment, one of such treatments includes a c-section if deemed medically necessary. If you are in early labor (ie not dialated beyond like a 4 or 5) and are in stable condition they can refuse to treat you. They actually do send parents home who are not in active labor.

But personally I would make them get a Court Order.

[InstinctiveMama]

Originally Posted by OnTheFence

Why didnt you just walk out? :

It's easy to suggest in hindsight a woman should have walked out. Yet when a woman is in labor and her children are being threatened, it's a whole new ballgame.

[Jilian]

Originally Posted by InstinctiveMama

It's easy to suggest in hindsight a woman should have walked out. Yet when a woman is in labor and her children are being threatened, it's a whole new ballgame.

I agree. Where would she have gone? We don't know how far along she was in her labor. Sometimes you just make the best of the situation and do what you can. I'm sorry to hear you were treated like that MITB

[OnTheFence]

Originally Posted by InstinctiveMama

Consider that the OBs not offering external versions simply prefer c-sections. C-sections bring in more money, they can be scheduled and often women can be coerced into repeat c-sections.

I think the most important thing to take from this discussion is to choose a care provider carefully. Finding someone who shares your view of birth can make all the difference.

I see a doctor who has no problems telling her patients her csection rate. Its over 30%. She's also one of a few doctors in town that will do VBACs and is pretty successful at it. She has a good bit of crunchy people seeing her for natural vaginal deliveries too, but she makes no bones about her csection rate and will give you the straight talk on why her rate is that high. (the majority of her csections are on repeats, multiples, and failed inductions) The thing is she did ECVs up until a few years ago, when she did one on a women who had 1)never had any uterine surgery 2)never had an abortion 3) had a healthy full term pregnancy and her uterus ruptures. She also said that the risks did not out weigh the benefits in her private practice. She said patients that were hell bent on them would be referred to a doctor who would and they would transfer there care. (this would be some of the same doctors who performed my own ECV that nearly killed me and my kid) My OB also does breech vaginal deliveries on women who have had previous vaginal births, but she makes it real clear that she does not do them on first time mothers.

ECVs also cost money. Two doctors are supposed to be present. Ultrasound technology is supposed to be used, and also medication that is normally given through IV (I had none), ECVs should be done in a hospital setting, and there is to be fetal monitoring before, and after the test. So its not like they are free.

[lrlittle]

[QUOTE=InstinctiveMama;6244556]Consider that the OBs not offering external versions simply prefer c-sections. C-sections bring in more money, they can be scheduled and often women can be coerced into repeat c-sections. QUOTE]

:

[AndreaBash]

If versions were so dangerous practioners wouldn't offer them or make referrals to those who specialize in them.

Doesn't that also mean that if c-sections were so dangerous and never safer than the alternative that practitioners wouldn't offer them or make referrals for them?

[khaoskat]

Originally Posted by OnTheFence

I
ECVs also cost money. Two doctors are supposed to be present. Ultrasound technology is supposed to be used, and also medication that is normally given through IV (I had none), ECVs should be done in a hospital setting, and there is to be fetal monitoring before, and after the test. So its not like they are free.

I can tell you how much my ECV cost me....

OB Fee (single OB in the room, but had 1 nurse and like 4 nursing students). $400

US - they do this to see where the baby is located before and after the ECV is done. Included in hospital bill.

Medication - I had Mag. Sulfate for the one we actually did. I was scheduled for a second one, but DS turned on his own on way in to have it done...and they would have used Tribute. These are both the same medications that are used to stop pre-term labor, because they help relax the uterine muscles. These are the two drugs that are used. I have heard some say that they will offer pain relief (ie epidural, but never known anyone who actually had this offered). Included in hospital bill.

Fetal Monitoring - They do this for about 30 minutes prior to and for about2 hours after. Usually the procedure takes about 30 - 60 minutes from the time medications are started. I believe that I was on the Mag Sulfate for about 20-30 mins, but cannot remember exactly, because she was about to start the Mag Sulfate but the OB made her wait, because he was heading in to assist in a twin delivery that was happening "NOW" vaginally. So, he couldn't tell how long he would be in there assisting his other partner with the delivery. Once he came in and started the procedure (ie begining US to ending US) I think it took like 5-10 minutes. This was also included in hospital bill.

Food - I was allowed to eat immediately after the procedure was completed. The OB had them bring me a tray of food (actually said when I asked for it, since it made me a little nasueas, but that went away about 15 minutes later). I was also allowed to drink water and suck on ice chips prior to and after the procedure. Included in Hospital Bill.


Hospital Bill - $750 if I remember correctly. Whole time in hospital (took longer than normal because the administering of the Mag. Sul. had to be delayed due to OB assisting in another delivery) was about 4-5 hours.

I was released and able to go home the same day. The only time they dicussed inducing was when at 41 1/2 weeks, DS1 decided to go breech again. But like I said, he turned on the way in for the version, the OB double checked with a quick US and sent me home to wait for natural labor to start.

[pampered_mom]

I just wanted to comment on a couple of things. First, you have the right to refuse whatever treatment you want to and they have absoutely no legal right to force you to do otherwise. There have been some court ordered c/s, but the courts have upheld a woman's right to refuse a c/s regardless of whether or not the doctors think it will put the baby in danger. Legal precedent is on your side.

Secondly, when you show up at a hospital in labor they cannot refuse to treat you - EMTLA says they can't.

It would be a good idea for every woman, pregnant or not, to make themselves familiar with their legal rights. There are a number of sites that do that and ICAN's is cerrtainly a good place to start. As is www.advocatesforpregnantwomen.org

[Ahappymel]

Not my personal experience but...
My best friend was a homebirth-turned-hospital-transfer. Her labor took 7 days. The hospital wanted to do a c-section for CPD. Her baby never showed signs of distress...she was just taking a long time to labor. She refused c-section.
She faced severe criticism in the hospital. Immense harassment and resulting PTSD. Her baby was finally born vaginally. She has gone on to birth two more children vaginally and unassisted at home.
When she retrieved her hospital records, she found that the hospital staff's comments/notes were greatly altered from the actual circumstances.
So, yes...you can refuse any treatment...and it would be wise to be prepared to arm yourself for subsequent harassment.

[InstinctiveMama]

Originally Posted by OnTheFence

I see a doctor who has no problems telling her patients her csection rate. Its over 30%. She's also one of a few doctors in town that will do VBACs and is pretty successful at it. She has a good bit of crunchy people seeing her for natural vaginal deliveries too, but she makes no bones about her csection rate and will give you the straight talk on why her rate is that high. (the majority of her csections are on repeats, multiples, and failed inductions) The thing is she did ECVs up until a few years ago, when she did one on a women who had 1)never had any uterine surgery 2)never had an abortion 3) had a healthy full term pregnancy and her uterus ruptures. She also said that the risks did not out weigh the benefits in her private practice. She said patients that were hell bent on them would be referred to a doctor who would and they would transfer there care. (this would be some of the same doctors who performed my own ECV that nearly killed me and my kid) My OB also does breech vaginal deliveries on women who have had previous vaginal births, but she makes it real clear that she does not do them on first time mothers.

ECVs also cost money. Two doctors are supposed to be present. Ultrasound technology is supposed to be used, and also medication that is normally given through IV (I had none), ECVs should be done in a hospital setting, and there is to be fetal monitoring before, and after the test. So its not like they are free.

That is the information you have received from your doctor. Not all OBs/midwives have the same policies. It is difficult to make a blanket statement about versions based on one person's experience with one OB.

Versions in a hospital setting are not free. But neither is a c-section.

[OnTheFence]

Originally Posted by InstinctiveMama

That is the information you have received from your doctor. Not all OBs/midwives have the same policies. It is difficult to make a blanket statement about versions based on one person's experience with one OB.

Versions in a hospital setting are not free. But neither is a c-section.

Do you think this is my ONE experience. O heck no! After having one in 1997, with not full information about the risks involved, that landed me in an OR with a ture emergency csection, that I felt for 75 minutes I decided to do a great amount of reading, research and reading on the subject. I found out that it was not uncommon to have a baby pass meconium during a version. Mine did. It is not uncommon for a baby to be bruised. My baby was bruised on one side of her buttocks and on her face and head. Not only was my baby bruised but so was I. My baby also went into serious distress, as did I, and my BP was all over the place. My only thoughts when I had my version was having a natural vaginal birth because I was so anti-csection, and so judgemental of others that had them, that I wasn't going to be one of those women.

I think you will find many midwives, ones that post here, that will strongly advise against ECV because of the risks. Maybe you should read about the risks, the perecentage of those babies that due turn that still end up as csections for various reasonsm and the risks to the mother and baby. In doing any research about ECV you will find that the proceedure was actually discontinued and advised against after fetal DEATH. I am sure the risks dont matter to some because its not affecting you. But I am sure for those few women who have uterine ruptures, placental abruption, cord prolapse or injury thats just alright, because its only a "low" risk right?

[GalateaDunkel]

Oh come on OnTheFence, don't you know that absolutely any negative outcome is infinitely preferable to the shame of Cesarean? [/sarcasm]

It's tiring trying to pierce the veil of denial and ideology....if you go through the archives here you can even find posts claiming that midwives can somehow magically get a baby around a full previa...whatever the problem is, you name it........ANYTHING BUT C/S!!

And I must say I find it positively Orwellian that telling a mom that her c/s may have been the best thing at the time is considered unsupportive.

[Brayg]

Originally Posted by Mavournin

If versions were so dangerous practioners wouldn't offer them or make referrals to those who specialize in them.

If *vaccines* were so dangerous, practicioners wouldn't offer them, right? Or *circumcision*? Or *gasp* C-sections themselves? Right?

[~member~]

Originally Posted by OnTheFence

Why didnt you just walk out? :

And go where? I was in full labor. I asked to be transfered to another hospital, and they told me they had police officers waiting to arrest me if I tried to leave AMA. : The nearest hospital was a 3 1/2 hour drive.

[~member~]

Originally Posted by Jilian

I agree. Where would she have gone? We don't know how far along she was in her labor. Sometimes you just make the best of the situation and do what you can. I'm sorry to hear you were treated like that MITB

Thank you, Jilian.

[khaoskat]

Originally Posted by OnTheFence

After having one in 1997, with not full information about the risks involved, that landed me in an OR with a ture emergency csection,

I found out that it was not uncommon to have a baby pass meconium during a version. Mine did.

First off - your horrible version experience was almost 10 years ago. Technology, practices and medical advancements have been significantly made in that 10 years. So, what may have happened 10 years ago, probably would be a different outcome today.

The reason they give you the Meds (Mag or Trib) is to relax your uterus so that the OB is not fighting your body to turn the baby. With the uterus more relaxed, the OB is not having to push so hard to turn the baby.

Second off - how do you know that the baby passed the meconium during the version. No one knows, scientifically, what causes a baby to pass meconium while in uteru. It is a common belief that the baby does it when under some form of stress, but that is not always the case. Neither of my children were ever in any type of stress or distress, but they both had passed meconium while in utero. So, unless we have a video camera with color picture inplanted inside us when we are pregnant, we will never know exactly what causes a baby to pass meconium.

Third - most midwife's don't recommend ECV's because it is a medical procedure. Most midwife's attempt non-medical or homeopathic/naturopathic methods of doing stuff prior to turning to the "medical" model. Most midwife's only resort to the "medical" model as a last resort.

Lastly, every person's experience is different. I had a wonderful ECV, by a very gentle, loving and caring OB. I have no clue what his c-section rate was (or that of his practice) as I saw their Midwife through most of my pregnancy. I went to this OB on the high recommendations of many people - my family DR, two of my fellow employees who use him (this was with my first child, they no longer have the Midwife in their office, so I switched to a different practice that does). They have also tended to go more towards high risk vs low risk pregnancies because of their knowledge, expereince, and directions that they want to take. Heck, he is one of the only OB's I know who will work with a mother who is 42 weeks and let her go up to 43 weeks. His kids were all 44 weekers, but his fellow partners are not comfortable with going much beyond 42 weeks.

When I had him do my version, he stopped 1/2 way through turning the baby, because I suddenly just started holding my breath. He wanted to make sure I was alright. I had held my breath because I got the urge to puke, and didn't want to do that. Then, when I was feeling better, he continued on with the procedure, reminding me to breather. After he was finished he made all the nurses (1 full and 4 students) get me lots of pillows, a food tray (since he knew I hadn't eaten all day), and even made sure they had plenty of water for me.

When I went in for them to try to ripen my cervix at 41 weeks, he knew I didn't want to be tied down to a bed, so he made darn sure that his orders included "ambulatory with mobile telementry unit immediately". With Cervadil, I believe I had to stay laying down for an hour or two, to ensure that it didn't slip out. But once that time was over, he wanted me up and walking. This really pissed off many of the nurses, because I wasn't readily available to them. I was also going to be discharged after 1 dose....even though the nurses kept telling me otherwise. After the 12 hour time period of having it inserted, it was removed, and the nurse was put into her place when she tried to hand him the next round of the meds. I was monitored for about 1 more hour, because I was having regular and strong contractions, then sent home.

He really was working with me, so I could avoid a c-section, so I could do a natural (non medicated) labor and delivery.

I think most of the OB's around here either do external versions, have a partner in their office that does them (2 out of the 3 OB's in this group did them), or there is a perinatologist group that does them that women are referred to.

I am not sure if my current practice's OB's do them (I am with the Midwife's, but their supervising physicians are the local Med School Teachers) or not. I think they might, so that they can be taught.

Everyone has a different opinion, and I for one, would attempt another version or do almost whatever it takes to turn a breech baby vs doing a c-section. Because at that point, my choices are just go for a c-section or attempt to do a vaginal delivery and worse case scenario end up with a c-section.

BTW - I was reviewing a thread on another message board I am on, where people were comparing the prices of their pregnancies. The average cost of a c-section (including hospital, ana, and OB) was around $30,000 - $50,000. Vaginal Delivery varried upon how long you stayed in the hospital, but was around $5,000-$10,000.

[khaoskat]

Originally Posted by MamaInTheBoonies

And go where? I was in full labor. I asked to be transfered to another hospital, and they told me they had police officers waiting to arrest me if I tried to leave AMA. : The nearest hospital was a 3 1/2 hour drive.

I am sorry you had such a horrible experience. Hospital staff really know how to get to people (even the most intelligent, knowledge people who know their rights). Women do not always remember our WITS while we are in labor and delivery.

Trust me, even though I am an attorney and know my rights, with DS1, I let them push a lot of unwanted stuff on me, because of their threats, or the fact that t hey caught me when I was 99% asleep (and so was my couch). They know when to push women (and their couches) to get what they want. Even having a well written birth plan is not a guarentee you will get your way, because they do not like them. The hospital nurses DO NOT like women who buck the norm (ie if the norm in the hospital is walk in, go to triage, labor for a couple hours and call for an epidural around 3-4 CM, anyone else bucks the norm and makes their job 100 xs harder).

Three of the worst threats that can be made: 1) We will have you arrested you if leave AMA; 2) We will call Children's Services if you do not do what we tell you to do, because you are harming your child; 3) We will get the Court to Order that you must submit to what we do...they claim to have the Judge's private numbers and able to reach them 24/7 to get their way.

[OnTheFence]

Originally Posted by GalateaDunkel

Oh come on OnTheFence, don't you know that absolutely any negative outcome is infinitely preferable to the shame of Cesarean? [/sarcasm]

It's tiring trying to pierce the veil of denial and ideology....if you go through the archives here you can even find posts claiming that midwives can somehow magically get a baby around a full previa...whatever the problem is, you name it........ANYTHING BUT C/S!!

And I must say I find it positively Orwellian that telling a mom that her c/s may have been the best thing at the time is considered unsupportive.

I've read those posts because I have been here for a very long time. (I had another user ID before this one) The thing is, I don't believe them. :

[ericswifey27]

Originally Posted by coloradoalice

If the doctors knew baby was breech I don't think it would have mattered if you signed consent or not. At some point they would have decided that it was an emergent situation and that the baby needed to be delivered. If they had policy against breech you were probably stuck. They can give you a c-section at almost any point in the birth, so they probably would have just waited til you were beyond being able to say no, and then done it. The majority or hospitals won't do vaginal breech. And in some states midwives are not allowd to do them at home. It's just one of those very unfortunate things.

Sad but true.

That wasn't always the case. My mom birthed my twin sister and I vaginally, 1 month+ premature and I was BREECH. That was in 1976.

Sigh.: