Why aren't women suing for OVERUSE of interventions??? - Mothering Forums
Birth and Beyond > Why aren't women suing for OVERUSE of interventions???
candiland's Avatar candiland 04:30 PM 12-02-2003
It seems that most obstetricians practice "just in case" obstetrics. It's a well-known fact that the majority of what is done to mothers and babies in hospitals is done to help prevent malpractice suits.

So would it work if women started suing for the OVERUSE of technology and unnecessary cesarean births? I mean, money talks, and if those women who experienced unnecessary interventions that caused trauma and complications to themselves and their newborns sued the doctor's butts off, it might make them think twice before hooking them up to all those iv.s, drugs, monitors, etc........

Eman'smom's Avatar Eman'smom 08:58 PM 12-02-2003
I agree however I think the problem is how do you prove that you didn't need the intervention. Sure most women can birth normally if given the chance, but how can you say that in "your" case you didn't need X,Y, or Z. How do you really prove that your c-section was unnecessary? KWIM

Oh and I mean you in the general sense.
Greaseball's Avatar Greaseball 09:00 PM 12-02-2003
It's hard to sue a doctor. You sometimes have to go out of state to find a lawyer who will take the case, and if you can't afford a laywer, it's not the kind of thing they will do pro bono.

Too many people are brought up to believe that medical institutions are what save us, and that anything they do to us is surely for our own good. The people who know interventions are harmful are probably going to be those who will give birth at home or somewhere else where interventions are not widely used.

People are still raised to have blind trust in doctors. I know women who have had c-sections and when I ask them why, all they can say is "The doctor said I had to." They were never given a reason, it was just because-he-said-so. Other people don't even know the names, dosages or purposes of their medications - they just take them "because the doctor said to."

I think when people are encouraged to question those in charge, things may change. Too many people are afraid to question or challenge. "The hospital won't let me room-in." So that's it? You're going to let them take your child away? Do you even know these people? "Everyone here gets an epidural." Even you? Why?

People need to not be afraid to be just plain rude! Be demanding! Tell them your baby stays with you even if all the others don't get to be with their moms. Tell them if the rules are continuous monitoring, that obviously the rule-makers have not met you. You can eat whenever you want. You can have visitors whenever you want. You can bring your pets to your birth in the hospital! You have the right to push your baby out even if the doctor isn't there! Order a pizza!
applejuice's Avatar applejuice 04:06 AM 12-03-2003
The reason women cannot sue or cannot find a personal injury lawyer to file a malpractice suit against a doctor for overuse of interventions and technology is because of our American culture and the attitudes of a judicial system in which a doctor is held to be negligent if he does not use everything at his disposal according to the standard of care.

One hundred obstetricians will always line up to back up a fellow practitioner, no matter what happened.

The goal of modern obstetrics is to have a live mother and baby at all costs no matter how that is accomplished; no matter how many drugs, machines, instruments, procedures, tubes or injections are given, it is still considered to be the best that can be done.

Malpractice is measured on damages to the person and future suffering from the malpractice. There is always a medical expert who can testify that everything that should have been done was done. So quit your complaining!

A woman in Ventura County, CA a few years ago sued her doctor for doing a Caesarean Section. The reason given was that it was not entirely necessary to do that surgery, and it complicated her future reproductive and gynecological life.

She lost. There was no real permanent damage to her or her baby, as far as the court could determine.
Tanibani's Avatar Tanibani 05:16 AM 12-03-2003
I agree with what has been said so far. I would just add one more con to suing... it takes a LOT out of you: emotionally and financially. In the end, is it really worth it? It would depend on "how bad" the damage was....

Quote:
Originally posted by applejuice
A woman in Ventura County, CA a few years ago sued her doctor for doing a Caesarean Section. The reason given was that it was not entirely necessary to do that surgery, and it complicated her future reproductive and gynecological life. She lost. There was no real permanent damage to her or her baby, as far as the court could determine.
Now in that case... I knew it would have been an uphill battle... I would lose and I would have wasted my energy. Worth it? IMO no. Maybe it was for them, that's OK. But not for me.

I'm in VC and I thought of that case too when I read the OP. I seem to recall that the couple felt the OB rushed it because he had some sort of vacation plans. I was not pg or a mother when I read about this case in the paper, but my first thoughts were that I felt the parents were making a big deal out of nothing. Sad, but true. Of course, now that I have been "through the mill" I have a far different perspective (though I was never one to bow down to medical gods in the first place).

T I have been comtemplating starting a new thread about the following, but I really don't want to. I'm just going to get this off my chest since you ladies will understand.

I had the most depressing conversation over the holiday weekend. My DH's cousin (mid 20s) is a brand new OB/GYN. She just finished her 3 yr medical school - she's at John's Hopkins. She's * very * bright and accomplished. She wanted to focus on women's reproductive health. She's been doing the rounds - long, long LONG days 18 hours or more... dealing with all types of issues/patients.

She was very tired... and part of her rant was a reflection of being overworked and fed up. Anyway she was describing how so fed up she was with mothers who brought in birth plans. She said that they wanted to control their births. And it's always those moms who end up with C-sections.

She said a bunch of other things I can't remember.... basically on the one hand she admitted that EVERYTHING done in the hospital is for malpractice.... and she felt it was stupid and she hated it... yet at the same breathe, she blamed mothers for wanting more "control."

I was sitting there listening to her in silent despair. I tried to talk to her (I forget what the hell I was saying) but her only question to me was "Oh Tanya, please don't tell me you are one of those birth plan mothers."

(No, I'm worse... I'm earthy-birthy.... And for a second I thought I was found out. But I don't think she's ever met earthy-birthy!)

I could not sleep that night thinking about what she said and her POV. It is SO SAD that this is what is coming FRESH OUT OF MEDICAL SCHOOL!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! American women (specifically, normal, healthy moms giving birth in hospitals) are in big trouble. I don't know what the hell it's going to take for OBs to change.

She admitted that childbirth is probably not her thing... she'd probably focus on reproductive issues. She knows for sure she never wants to have her own private OB practice because those docs are on call 24/7.

There I was... hoping to talk to her and tell her about the Midwifery Conference in March near her. No, I know you don't want to be a midwife, but it might be worth your while.

Well, actually, I do know what it's going to take for OBs to change. Each birth mother has to hold her OB by the hand and EDUCATE THEM. I just read on MDC that a mom shared her info on DELAY CORD CLAMPING with her OB and now that doc routinely delays cord clamping.

http://www.cordclamping.com/

But that is obviously not what is being taught in medical school. Because if it were, then it wouldn't seem like such an "out there" request.
kofduke's Avatar kofduke 12:29 PM 12-03-2003
Quote:
Originally posted by Greaseball
It's hard to sue a doctor. You sometimes have to go out of state to find a lawyer who will take the case, and if you can't afford a laywer, it's not the kind of thing they will do pro bono.
The vast majority of med/mal cases are done on a contingency fee - i.e., if you recover the attorney gets a certain percent depending if the recovery was during settlement or during trial; and gets nothing if you don't. Of course, lawyers who work on contingency fees typically therefore only take cases they think will be winners, and that's the problem with suing for routine interventions. The first problem is proving that what was done was against the standard of care in your community. Since this is measured by other doctors, and what other doctors would do, it would be very difficult to find a testifying expert to say that the intervention you had was against the standard of care. The court isn't going to listen to a h/b midwife come in and say so, KWIM? It needs to be another doctor in the same area of expertise. This means that MOST doctors would practice non-intervention except in cases of true emergency, which as we know is far from the case. The second problem as was mentioned is proving damages -- that you have a specific physical problem resulting from the intervention. It would be a long, long road for any mom.
tinyshoes's Avatar tinyshoes 02:39 PM 12-03-2003
ooooooooooh good thread!

I don't know how many episodes I've seen of A Baby Story, Maternity Ward, Labor and Delivery, and Birth Day and have been stunned that the footage of the hospital's outrageous interference is not only on TV, but not Exibit A of a Major Lawsuit!!!!!!!!!

Seriously...stuff like "we have to perform an emergency forceps delivery on you, unwed minority mother," and then you see the OB who decided on this emergency procedure methodically showing a resident how to perform the delivery.

I guess I wonder how is that such an emergency that there's time to have a teaching moment all calm between this agonizing woman's legs.

And of course, we're just SO THANKFUL that baby's ok, though mom has severe internal vaginal trauma, which was STATED on the show (I am not infering this logical fact.)

* * * * *

I think the answer to the OP is that it's really hard to do. I have contemplated suing my OB for my episiotomy w/ my 1st birth, and I espeically wanted to sue his @ss when my 'husband's stitch' gave way during birth #2 and so I had a tear (emotionally recieving the SAME EPISIOTOMY twice, don't cha know).

How could I really prove the 1st was unnessesary? Will all of ya'll be on the jury for me? :LOL We're screwed because of the 'standard of care' bit mentioned before.

Tanibani, ohhhhhhhhhhhhhhh I soooooooo know that med school grad angle....so cool for you to share the terrifying 'inside scoop.'

Personally, I'm waiting for my cousin to graduate med school, and I'll see where she is....and I don't think she'll be in the same place she was when I last spoke to her 22-year-old critical mind about birth and needless interventions, and she recalled with horror the showy nature of the head OB/GYN showing her classmate a c/sec, in progress, as if the woman weren't there birthing her baby.
AmyB's Avatar AmyB 03:31 PM 12-03-2003
I was so upset by the unnecessary interventions that after the birth of my baby I was just lying in the hospital bed crying. A parade of medical folks came in and did their damndest to convince me that "as long as the baby is healty, that's all that matters."

When I talked about this later I got the same stupid line from "civilians". Public opinion is that as long as the baby is basically OK, it doesn't matter how much extra physical torture, incompetent "help", drugs, needles and emotional abuse they heaped on you.

I was injured totally uncecessarily because I was under the care of a grossly incompetent nurse, but since the injury was a tear I don't suppose any lawyer would take the case.

--AmyB
pamamidwife's Avatar pamamidwife 03:53 PM 12-03-2003
Quote:
Originally posted by AmyB
A parade of medical folks came in and did their damndest to convince me that "as long as the baby is healty, that's all that matters."

Why oh why do people say this? It pains me the most when I hear mothers say it about their own birth. I look at them and ask, "is that really all that matters?"

So sad. You can be grateful for a healthy baby and your health, but you can also grieve for the loss of a birth experience that you wanted.

I wish more people would validate women's grief over birth issues. It's so sad.
Pigpen's Avatar Pigpen 04:50 PM 12-03-2003
I understand the reason behind saying women need to sue doctors for overusing interventions but, I think the litigious attitude of so many is part of the reason the docs use more and more interventions. I'm probably totally naive but it seems to me the answer would be women educating themselves about childbirth. Knowing that the first intervention is going to lead to many more. My friend shocked me by telling me she was going to try to do a natural child-birth in the hosp. (she's the last person I would've expected that from) because she researched the cocktail of drugs that is the epidural. She knew the chances of having a c-sec were increased, the baby might have trouble nursing afterward, etc. But, once she got there (labor wasn't all that long) she decided to go ahead with the epidural and it was down-hill from there. Ended in a c-sec!!!! If more women start saying no to the first intervention, MAYBE, it would send a message. Of course that would require effort on the part of the woman. I think I can say without a doubt, most of my friends are more interested in shopping than learning anything about childbirth. It's been made so scary by docs and other moms. I think they prefer the head in the sand approach.
Artisan's Avatar Artisan 11:26 PM 12-03-2003
Quote:
Originally posted by omegamama
I understand the reason behind saying women need to sue doctors for overusing interventions but, I think the litigious attitude of so many is part of the reason the docs use more and more interventions. .
I WHOLEHEARTEDLY agree! Suing is what got us the interventions in the first place. The OPs are right -- the mentality is "healthy baby at any cost to the mom".

In addition, you have to prove that you have had serious, long-lasting consequences as a result of the doctor's NEGLIGENCE or WILFULL misconduct. Doctors, while they perform too many interventions, are doing what they're taught, following hospital protocol and insurance protocol. OB malpractice insurance costs $50,000+ a year, and they can't afford to lose it.

Sad, but true. It's really the insurance companies who are driving all of this.
greenluv's Avatar greenluv 07:46 AM 12-07-2003
Yep, you have to prove injury.
My nightmares and scarred uterus don't count. Neither does laying awake and paralyzed during the worst part the surgery and then being tossed out the door the day after the c/s. It's not an injury to have an incision that is gaping open. I can't claim any damages from the hospital threatening to not discharge my baby unless I filed for medicaid.

I DON'T have the right to make medical decisions for myself, especially as a pregnant woman. I don't have the right to a second opinion because one hospital will call and tell the other to look for me to show up. They will release my medical records without my consent AFTER they refused care to a woman in labor. No, I don't have any rights at all.

This is what I've learned.
applejuice's Avatar applejuice 12:30 PM 12-07-2003
As long as doctors have done the delivery of the baby to the standard of care in the community, they have done nothing wrong. A thousand of their medical colleagues will line up to say it is so!

Who the he** are you to say he injured you?


That is why I always tell mothers to stay at home, please. The doctors do not know a thing about normal, natural birth. thye treat everyone the same.
gurumama's Avatar gurumama 12:56 PM 12-07-2003
When you think about how things have changed in American regarding childbirth over the last 60 years or so, it's remarkable.

My grandmother had her first in 1944. They put her on a gurney, tied her ankles and wrists down, and told her to scream for them when she felt the baby's head coming out. This was during the war and there was a shortage of doctors.

When someone came as the baby's head was crowning, the knocked her out with gas, pushed hard on her abdomen, forced my mom out with forceps, and grandma came to a day later or so. She was actively discouraged from breastfeeding because formula was "better". They gave her a shot to dry up her milk.

When my mom had me in 1970 it was a military hospital. My dad wasn't allowed there (but he was 5 years later, for my sister's birth--there's a quick change in 5 years!). They did the enema, shaving, stirrups, flat on your back positioning. She nursed me for 3-4 months.

When I had my first son in 1998 (wth an OB) I went in when my water broke 1.5 weeks early. I got Pit after 12 hours of low-level labor, an epidural 45 minutes before he was born (argh...) and DH was with me the whole time. My son nursed within 5 minutes, roomed in with me the entire time (as did DH).

With my second, in 2002, I walked into the hospital at 10 cm. Had a doula. Used CNMs. Refused everything except the EFM, which was "required". Pushed him out 45 minutes after we arrived. I refused all pain medication except Motrin (after the birth), left him intact, breastfed on demand, and roomed in. Half the staff was shocked (you waited too long to come in! blah blah blah) and thrilled half the staff (a drug-free birth! an empowered mama!).

I think it's education on the part of the parents--how much you learn about childbirth. I also think after having your first you learn SO MUCH and go into the subsequent pregnancies as a much better advocate for the birth experience you want. But if all these first-time mothers are getting c/s, then being told they can't do VBAC with a midwife or an OB in a hospital/birth center setting, that's stripping them of the right to shape their second and subsequent pregnancies.
member234098's Avatar member234098 05:24 PM 12-07-2003
I agree with Omegamama!

Use the Nancy Reagan method to get Natural Chldbirth in a Hospital.

Just say, "NO " to the first intervention.

The problem though is often the first intervention is the EFM which is a requirement by all hospitals and their insurance companies. Being confined to your bed is not good for a healthy laboring woman.

Furthermore, actually, the very first intervention for most healthy laboring mothers is the trip to the hospital itself.
lollaleeloo's Avatar lollaleeloo 06:10 PM 12-23-2003
Quote:
Originally posted by miriam
I agree with Omegamama!

Use the Nancy Reagan method to get Natural Chldbirth in a Hospital.

Just say, "NO " to the first intervention.

The problem though is often the first intervention is the EFM which is a requirement by all hospitals and their insurance companies. Being confined to your bed is not good for a healthy laboring woman.

Furthermore, actually, the very first intervention for most healthy laboring mothers is the trip to the hospital itself.
ITA. We talk about suing doctors for performing unnecessary interventions but we're forgetting it's the lawsuits that brought us here in the first place. The average obgyn pays more in malpractice insurance than I make in two years (ok, 3 yrs). How many women sue their doctor for childbirth events that studies consistently show the doctor cannot possibly control, like most stillbirths for example? Because they've bought into the fantasy of a hero using the latest technology to predict the exact moment a baby might die in childbirth, and thus dive in and cut him out just in time, that's why. That's not even plausible, much less proven, and in fact, has been disproven in study after study. That's a myth, a fantasy, 20/20 hindsight, and nothing more. Yet in court, they'll say that if only he monitored every heartbeat, he would have seen the baby was in trouble and cut him out sooner. Even though they've already done the studies that show conclusively that monitoring doesn't have an effect on infant survival rates AT ALL, and serves only to subject them to more surgical births (which ironically, has been shown to *negatively* affect infant survival rates). Still, now they have to monitor all babies. And when doctors & nurses study that strip for the next meaningless reading that galvanizes the c-sec machine into action, they hold in their hands all the justification they need to cut a perfectly healthy child from your perfectly healthy womb and tell you they just saved your baby's life. They also know that if it goes the other way, that strip becomes exhibit A, with exhibit B being your scarred body, proving they did all they could as soon as they could.

Enough with the suing. It's working against us. Yes, lawsuits cost them money, but you know what else costs them money? Competition. Boycott them. Take our business elsewhere. Choose a birth center if that's an option, or better yet -- stay home and have the baby. It's way past time to question the rationality of going to a hospital and expecting, no -- demanding -- that the staff not do what it's trained to do, which is INTERVENE. If a woman checks herself into the hospital with a diagnosis of 'acute pregnancy', she shouldn't be at all surprised if they treat her condition like an illness instead of a normal life event, because after all, who goes to the hospital for a normal life event? As far as I'm concerned, going to the hospital to have my baby would be like going to the hospital to have my period. It's totally buying into the bumper sticker mentality that says Never trust anything that bleeds for a week without dying. Look, if my body bleeds for 4-5 days a month without dying, it's beyond trustworthy. If they could build a machine that could support a pregnancy start to finish with anything near the success rate of the average womb, you can bet they would have done it by now, believe me.

*begin Bitter Paranoid Rant
Sometimes I imagine they already have, but that the fetal survival rate for the mechanical womb is only a pathetic 65% or so, so they artificially tinker with birth statistics using an inflated c-section rate to downplay the effacacy of their strongest competitor: the human female reproductive system. Women are already used to the 1 in 4 your-baby-almost-died rate, so it wouldn't be that much of a stretch for them to up their campaign of discouraging VBACs by framing it in terms of "choice" and "safety", and where possible, outright banning, until the c-section rate is up to 1 in 3. At that point, they have the news conference announcing the invention of the full-term incubator touting its relative safety as comparable to the human womb. In no time, it'll be found in hospitals all over the country and billed as a high-end "treatment option" for "at-risk" pregnancies. At first. Eventually though, it becomes the method of "choice" as more and more women weigh the "risks" of a 1 in 3 c-section rate vs the externally incubated infant survival rate and decide that pregnancy/childbirth is not worth the risk to their bodies or their babies. Of course there's always going to be a fringe element of hippies, technophobes, feminists given to selfish displays of autonomy and the like, but once insurance companies begin global coverage, it's only a small step to mandate, et voila! Another stupid cultural norm is born.
*ok end BPR

Um, as you can see, I might still have a few lingering issues (insert wry, rueful smilie here). I had an HBAC in March, a beautiful healthy baby boy, and it was awesome. I didn't come to this decision lightly of course (as if anyone ever does). I wrestled with all the nagging what-if scenarios, but when it came down to it, no medical condition can justify, nor any random childbirth event compete with, the 1 in 4 c-section rate, and that's general population odds (hospital VBACs run something like 2 to 1 against). Deciding to have my baby at home instead of a hospital wasn't gambling; it was stark, simple arithmetic. But that was my lightbulb moment, and that, coupled with a wholly unnecessary c-sec and hospital vbac that was a nightmare of interventions, enabled me to penetrate the hum of cultural white noise "just in case never know what if could have maybe if never know fault lies blame truth cause effect other power knows more knows best dedicated experienced smarter faster sooner cleaner safer..."
with: ONE! IN! FOUR!

To bring it back to the OP, my view is that doctors believe in the efficacy of the interventions they do despite evidence to the contrary, in pretty much the same way pregnant women believe in the safety of a hospital birth despite evidence to the contrary. It's simply a reflection of our cultural attitudes toward childbirth in general. We cannot reduce the incidence of unecessary medical intervention by doctors without addressing the mind-set that sends healthy women to the hospital to have their babies in the first place.
Greaseball's Avatar Greaseball 06:24 PM 12-23-2003
T
I hear the only hospital to be designated woman-friendly is no longer doing VBACs. I hope that makes them lose their status, because any woman-friendly hospital would offer that choice about 97% of the time!

Forced surgery in the absence of any medical reason is not friendly.
Pigpen's Avatar Pigpen 06:55 PM 12-23-2003
lollaleeloo said..."Enough with the suing. It's working against us. Yes, lawsuits cost them money, but you know what else costs them money? Competition. Boycott them. Take our business elsewhere. Choose a birth center if that's an option, or better yet -- stay home and have the baby. It's way past time to question the rationality of going to a hospital and expecting, no -- demanding -- that the staff not do what it's trained to do, which is INTERVENE. If a woman checks herself into the hospital with a diagnosis of 'acute pregnancy', she shouldn't be at all surprised if they treat her condition like an illness instead of a normal life event, because after all, who goes to the hospital for a normal life event? As far as I'm concerned, going to the hospital to have my baby would be like going to the hospital to have my period..."
I couldn't agree more!! Unfortunately I don't see that happening. After my next homebirth (any day now!!!) I'm not planning on having any more children. This is what I see for the future of homebirth here in California... It will be made illegal to have a homebirth, be a midwife, use a midwife, etc. You will be able to use a birth center as long as there is a back-up physician. But to be a back-up doc would require more liability insurance than anyone could afford which would mean NO back-up physician's would be available, meaning no birth-center births. I know, very negative thinking on my part, but greed...that's the bottom line. I would love to think that my daughter will have real choices when the time comes...I can dream.
Reminds me of what I just read in "Birthing from Within", a man who's wife just had a homebirth (after bad hosp. experience) was explaining thier decision saying "It's almost as if you're not having a baby at the hospital-they are waging some kind of war at the hospital. They have all of these sophisticated weapons and trained people over there, and if you know anything about war, when one side has weapons, there's a tendency to use them and there's gonna be problems".
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