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Can you refuse C/S at the hospital?

4K views 74 replies 36 participants last post by  georgia 
#1 ·
Short story: DD was breech, and I'd been planning a version and doing accupuncture, etc., but went into labor early. And ended up with a c-section. I'm past it, but I was looking around in here contemplating VBACs and UC and I started wondering about dd's birth... Although it was 2 1/2 years ago!

What would have happened if I went to the hospital but said "no" to the c-section or refused to sign the consent forms. Would they tell me they wouldn't let me birth there? Kick me out? Would I have been able to try for a vaginal birth? Has anybody done such a thing? What was the reaction and outcome? I'm curious!
 
#30 ·
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.
 
#31 ·
Quote:

Originally Posted by OnTheFence View Post
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.
 
#32 ·
Quote:

Originally Posted by InstinctiveMama View Post
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?
 
#33 ·
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.
 
#34 ·
Quote:

Originally Posted by Mavournin View Post

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?
 
#35 ·
Quote:

Originally Posted by OnTheFence View Post
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.
 
#37 ·
Quote:

Originally Posted by OnTheFence View Post
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.
 
#38 ·
Quote:

Originally Posted by MamaInTheBoonies View Post
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.
 
#39 ·
Quote:

Originally Posted by GalateaDunkel View Post
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.
:
 
#40 ·
Quote:

Originally Posted by coloradoalice View Post
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.
:
 
#41 ·
Well, just a quick reply...nak...but refusing a c/s can end you in trouble with cps, the law, and give you postpartum depression and post traumatic stress disorder. Labor is not the time for lots of negative vibes/pressure/threats, etc.

We have an example around here of a woman who wouldn't consent after being brought in by her midwife for failure to progress, doctor walked out, wouldn't take her on as patient, woman was transported to another hospital by ambulance after midwife called around trying to find someone to help her.

So, while in theory, you can refuse any procedure, it can be made very difficult for you. And miserable and sometimes downright dangerous.

About versions...we do them a bit different and try all kinds of alternative methods too. We are gentle and if baby doesn't want to turn, we don't force baby. If all else fails, we deliver the baby breech. And have a good success rate.

OK, this isn't such a quick response. Having said all of the above, I don't think that c/s are the absolute evil and sometimes do exactly what they are designed for: to save lives!

But if you truly don't want a c/s, then you must do whatever it takes to seek out a supportive midwife, or if you can find one, doc. Maybe even going out of state, travelling, etc.

So, there's my lengthy two cents. I hate to see people going into labor with a "fight" mentality and ready for controversary or argument, just doesn'tmake agood laboring environment for mom or baby.
 
#42 ·
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.

Obviously, I can't speak about all hospitals, but I know for a fact our local hospital does, in fact, have the judge's private numbers on speed dial. Indeed, they do routinely get court orders for whatever they want, and they are rather smug about it, I might add. I know this from a very reliable source.
 
#43 ·
Quote:

Originally Posted by pamered_mom View Post
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.

]
The only thing that they can do something KNOWING that later they are going to have to pay, but it isn't going to stop them.

On the version vs. cesarean thing. I don't know much of the statistics myself. I wouldn't be suprised if version is statistically more risky than a cesarean. But I believe one thing. HCPs should know how to vaginally deliver breech babies instead of making women make a choice like that. I would never ask someone who doesn't know how to deliver a breech vaginally to do it for me. I would probably go unassisted or fly my happy butt to The Farm for a few weeks. But, hey, that's just me.
 
#44 ·
Quote:

Originally Posted by OnTheFence View Post
"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."

LMAO. I frankly find this FUNNY and don't believe it for one moment. My emergency csection was nearly $20,000 and I was in the OR for 75 minutes (highly unusual) and nearly died. I can tell you right now that my past two csections, INCLUDING my prenatal care and ultrasounds was less than $10K.
A friend of mine who was at a high risk hospital with HELLP syndrome who had a csection with GA was not even 15K last year. I sure would like to see some REAL factual information, and surely there is some online that says a surgical birth with a spinal or epidural was 5OK.
just randomly jumping in here to say...she DID say average, not "every single case across the board"..

her figures are correct..look them up.

back to your regularly scheduled debate
 
#45 ·
Quote:

Originally Posted by OnTheFence View Post

I believe I know, since there was no stress at all until that moment. My baby had significant distress, bruising, etc.

LMAO. I frankly find this FUNNY and don't believe it for one moment. My emergency csection was nearly $20,000 and I was in the OR for 75 minutes (highly unusual) and nearly died.
Again, neither of my children had any stressors in the pregnancy. Both were low risk pregnancies. And BOTH of my children were born with meconium. Today meconium is not as "big of a deal" as it used to be. Baby's are routinely suctioned out after birth to clear the airways of any and all material (be it amniotic fluid or meconium). Neither of my children suffered any side effects from the meconium.

I know for a birth center birth, with aprx. 29 hour stay after delivery (baby born at 4 am. and I left next day at 9 a.m).... Midwife $2,200. Hospital/birth center - apx. $3,700; Baby's charges - $1,500.

I know someone who is paying 100% out of pocket for her birth (OB, Hospital, Ana, etc). They are look for just a vaginal delivery at around $10,000 out of pocket.
 
#46 ·
Quote:

Originally Posted by khaoskat View Post
Again, neither of my children had any stressors in the pregnancy. Both were low risk pregnancies. And BOTH of my children were born with meconium. Today meconium is not as "big of a deal" as it used to be. Baby's are routinely suctioned out after birth to clear the airways of any and all material (be it amniotic fluid or meconium). Neither of my children suffered any side effects from the meconium.

I know for a birth center birth, with aprx. 29 hour stay after delivery (baby born at 4 am. and I left next day at 9 a.m).... Midwife $2,200. Hospital/birth center - apx. $3,700; Baby's charges - $1,500.

I know someone who is paying 100% out of pocket for her birth (OB, Hospital, Ana, etc). They are look for just a vaginal delivery at around $10,000 out of pocket.
They are getting ripped off then. That or its really cheap (seriously doubt) here.

Note that none of my other children born by csection passed any meconium at all. None. The only one that did was the one that was severely bruised and manipulated.
 
#47 ·
average cesarean cost in the Us per childbirth.org $7186 1989
average cesarean cost in the Us per womensenews.org in 2005 $11361

here is the average cost for 2001-2002 in Texas Hospitals:
Amarillo; 2 hospitals. C-Section rates 19-23% Avg 21.3% Avg cost; $8,500.

Austin; 7 hospitals. C-Section rates 19-27% Avg 23.4% Avg cost; $7,000.

Beaumont; 7 Hospitals. C-Section rates 26-48% Avg 36.6% Avg cost; $11,700. (Jefferson Co.)

Corpus Christi; 7 Hospitals. C-Section rates 25-37% Avg 33.5% Avg cost; $10,000 (Nueces Co.)

Dallas Ft. Worth; 44 Hospitals. C-Section rates 17-35% Avg 26.6% Avg cost; $8,000

El Paso; 5 Hospitals. C-Section rates 23-37% Avg. 32.6%. Avg cost; $14,000.

Houston; 39 Hospitals. C-Section rates 14-37% Avg. 27.9% Avg cost; $9,000

Longview; 5 Hospitals. C-Section rates 23-35% Avg 27.9% Avg cost; $11,000

Lubbock; 3 Hospitals. C-Section rates 22-39% Avg 31% Avg cost; $7,600

Midland-Odessa; 4 Hospitals. C-Section rates 19-27% Avg 24.45% Avg cost; $6,750

Rio Grande Valley; 8 Hospitals. C-Section rates 27-47% Avg 36.1% Avg cost; $10,800 (Starr and Hidalgo Co.)

San Antonio; 13 hospitals. C-Section rates 15-32% Avg 27.1% Avg cost; $6,700

Victoria; 2 Hospitals. C-Section rates 30-36% Avg 33% Avg cost; $7,500

Waco Temple; 5 Hospitals. C-Section rates 18-27% Avg 24.7% Avg cost; $7,600

Witchita Falls; 1 hospital. C-Section rate 28% Cost; $6,000

And you may find this interesting to add to the book of knowledge about the COST of elective surgical births: http://pt.wkhealth.com/pt/re/ajog/ab...856144!8091!-1

"Results: The average cost of an attempted vaginal delivery without oxytocin (Pitocin) or epidural anesthesia was 15.1% lower in nulliparous women and 20% lower in multiparous women than with elective cesarean delivery. However, in nulliparous women, the addition of Pitocin nullified any cost differences; if epidural anesthesia was also used, total costs exceeded the cost of elective cesarean delivery by almost 10%. The cost of a failed attempt at vaginal delivery was much higher than elective cesarean delivery for both groups. The average cost for all women who attempted vaginal delivery was only 0.2% less than the per-patient cost of elective cesarean delivery.

Conclusion: The adoption of a policy of cesarean delivery on demand should have little impact on the overall cost of obstetric care."

So can someone provide me with the proof of those $30K-50K csections?
 
#48 ·
Quote:

Originally Posted by OnTheFence
average cesarean cost in the Us per childbirth.org $7186 1989
average cesarean cost in the Us per womensenews.org in 2005 $11361
Are the charges your listing including all the carges or just part of them? Something definitely seems a little off there. My c/s was in the mid $20k range. It was an "elective" scheduled cesarean and not in the least bit an emergency or a rush.

Quote:

Originally Posted by Synchro246
The only thing that they can do something KNOWING that later they are going to have to pay, but it isn't going to stop them.
No one ever said the cost of standing up for your rights was an easy one...history shows it never has been.

Quote:

Originally Posted by Maggi315
So, while in theory, you can refuse any procedure, it can be made very difficult for you. And miserable and sometimes downright dangerous.
Still doesn't mean that you should consent to whatever procedure they want to do just to avoid difficulty or "danger".

Quote:

Originally Posted by SundayinSeptember
Obviously, I can't speak about all hospitals, but I know for a fact our local hospital does, in fact, have the judge's private numbers on speed dial. Indeed, they do routinely get court orders for whatever they want, and they are rather smug about it, I might add. I know this from a very reliable source.
Sad that this is ever consider something that is a good SOP... Reprehensible that we treat pregnant women like criminals, invalids, or just disposable vessels to grow babies. Again www.advocatesforpregnantwomen.org is a good resource to have bookmarked.

Quote:

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?
Is the converse true? Any cesarean is preferable in order to avoid the potential negative outcomes? In my case I would have rather had all the information I needed to give real informed consent and chose the potentially risky option than be duped into making the "safer" choice.

FWIW - I don't find my cesarean "shameful", but that doesn't minimize the feelings of remourse and loss that I have as a result.

Quote:

Originally Posted by GalateaDunkel
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 guess that depends on whether or not you are dismissing her feelings of loss or remorse about her experience. It would also depend on whether or not you were trying to minimize her experience. In those cases then yes, it would be unsupportive.
 
#51 ·
Anyone who has received a hospital bill, even when you have insurance, gets fees from everyone: the hospital, the anesthesiologist, the surgeon...

Plus, paying out of pocket usually means paying much much much more than someone pays with insurance.

Friends here in Houston have paid with insurance around $15K for c-sections..all totaled. None of which were emergent.

Also, out of pocket per person varies so much from plan to plan, company to company, state to state.

The insurance system in the US is a form of social violence. Just like having judges' phone numbers on speed dial to get whatever they want.
 
#52 ·
Quote:

Originally Posted by mamaverdi View Post

Plus, paying out of pocket usually means paying much much much more than someone pays with insurance.

Also, out of pocket per person varies so much from plan to plan, company to company, state to state.

.
I disagree with your first sentence. IME most medical care providers will give out of pocket people a lower rate than what they charge the insurance companies. They also almost always charge the insurance companies more than the company is going to pay.

I don't really understand your second sentence there.
 
#53 ·
pampered mom- all I was saying that even if a woman does not consent that doesn't mean that she will avoid the procedure. If it's really important to her to avoid a procedure she might be better off not going to the hospital at all. Hopefully there isn't care tfrom which she *would* benefit because then she's in between a rock and a hard place.
 
#54 ·
Alot (maybe all?) of the cities posted in OnTheFence's C-section cost post were in TX, where I believe the cost of living, and thus the cost of hospital procedures, is lower than some areas (like California and many of the northeast states). I also notice that OTF is located in AL, which also has a low cost of living (I'm in AL too). My vaginal birth and 5 day hospital stay (PPROM at 29 weeks, kept me pregnant in the antepartum unit for 4 days and then "let" me deliver naturally after pumping me up with steroids) was less than $10k, but I have a friend who had to pay out of pocket for her hospital birth in VA, and she was quoted $10-12k for a non-complicated vaginal birth (normal 2 day stay). So she had to pay more than I did for a pregnancy complication involved birth with a longer hospital stay. It's just a difference in what part of the country you're in. So yes, I could see that some emergency C-sections might cost $30k+. I wouldn't expect it to happen here in AL though, because our cost of living is alot lower than some parts of the country.

(note that my cost posted above does NOT include cost of baby care... that's a separate NICU bill, and was much, much higher!)
 
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