Can you refuse C/S at the hospital? - Mothering Forums

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Old 10-10-2006, 04:33 AM - Thread Starter
 
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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!

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Old 10-10-2006, 04:42 AM
 
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You can refuse anything. They cannot turn you away in active labor.
Good luck!

~Marie : Mom to DS(11), DS(10), DD(8), DD(4), DD(2), & Happily Married to DH 12 yrs.!
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Old 10-10-2006, 11:12 AM
 
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I don't have personal experience with this, but some women use this as a way to get a vbac. I have heard lots of horror stories about this too. They have to take you, if you say no to the c-section they aren't supposed to do it. If you sign any of their blanket consent forms (or your husband does) it gives them the OK though. I just read a story about a mom who was given "oxygen" and they actually put her under general anesthesia and did a c-section. She was pushing at the time. They had to push the baby up the birth canal (he was crowning I think) to get it out for the c-section. The only reason for this was that hospital policy did not allow VBAC.
So yes, you could do this, you may be faced with them telling you that you will kill your baby, and they may physically assault you to force you to have a c-section. Some women have succeeded at this though.
www.ican-online.org is a great site for c-section information and they have an email group where you could find more stories.
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Old 10-10-2006, 12:05 PM
 
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Originally Posted by EviesMom View Post
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!
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. Your baby chose to be breech for a reason, trust that your baby knew what he/she was doing.
Also, think about this, maybe a csection was the best option for you at that time based on your previous choices. Many OBs are not trained in vaginal breech deliveries, and if they are untrained, well that could have been a dangerous situation for your child. There is a good amount of risk to first time mothers having breech babies, but its glossed over here.

Frankly, you could have demanded no csection and been handed a resident to attend you had you been at a teaching hospital all the while while they harrassed you into consenting to a surgical birth. You would have entered into a hostile enviroment, and maybe even a legal one. You also could have left AMA and gone to a second hospital or just gone home to tough things out on your own.

Personally I would play the what "if" game because what is done is done, but you can make different choices, more informed choices before you bring another kid into the world.
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Old 10-10-2006, 12:26 PM
 
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Originally Posted by EviesMom View Post
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!
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.
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Old 10-10-2006, 12:28 PM
 
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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.


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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.
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.

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Also, think about this, maybe a csection was the best option for you at that time based on your previous choices.
What a horrendous statement. Why on earth would you try and make this mother feel guilty for wanting to attempt a vaginal birth? Maybe her "previous choices" were what was best for her. Who are you to stand and make judgement?
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Old 10-10-2006, 12:49 PM
 
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[QUOTE=OnTheFence;6240234]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. Your baby chose to be breech for a reason, trust that your baby knew what he/she was doing.
Also, think about this, maybe a csection was the best option for you at that time based on your previous choices. Many OBs are not trained in vaginal breech deliveries, and if they are untrained, well that could have been a dangerous situation for your child. There is a good amount of risk to first time mothers having breech babies, but its glossed over here.
QUOTE]

What an offensive thing to say! Do you have any RESEARCH to back up your theory that external versions are "crazy dangerous"? That is an incredibly irresponsible statement to make.

Also, you cannot tell another person what her baby chose to do in the womb. You have no idea! And some babies do not "choose" to be breech. My breech baby was in that position because his cord was wrapped around his torso and leg. Do you think he did gymnastics in my womb to get the cord just right so he would be breech?

You are right on one thing. Not enough OBs are trained to help a mother manage a vaginal breech birth. But no one can tell a mother "maybe a c-section was the best thing for you". Birth is personal.

I am shocked to find this kind of totally unsupportive and offensive post on MDC.
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Old 10-10-2006, 12:51 PM
 
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Originally Posted by turtlewomyn View Post
www.ican-online.org is a great site for c-section information and they have an email group where you could find more stories.
I second this. ICAN is a wonderful source for research-based information on c-sections and VBACs. You can even talk online with mothers in your area who can give you the scoop on local OBs, midwives and hospitals.
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Old 10-10-2006, 02:34 PM
 
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Originally Posted by Mavournin View Post
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.

What a horrendous statement. Why on earth would you try and make this mother feel guilty for wanting to attempt a vaginal birth? Maybe her "previous choices" were what was best for her. Who are you to stand and make judgement?
Actually many private practice OBs do not offer ECV any longer. I know of two locally that do not. They do not have a 65% success rate either. Each doctor has their own success rate in turning, a percentage of those that do turn still end up as surgical births due to other complications: cord issues, distress, etc. So while there may be more than a 50% success rate in turning the baby, this doesn't me a vaginal birth will happen. Most EVCs are followed by induction.
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Old 10-10-2006, 02:36 PM
 
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Yes I support the choice of Cesarean just as I support a woman's right to homebirth or have a natural vaginal birth.
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Old 10-10-2006, 06:28 PM
 
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Old 10-10-2006, 06:34 PM
 
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Mod hat off :

Quote:
If versions were so dangerous practioners wouldn't offer them or make referrals to those who specialize in them.
I don't exactly see this as a valid reason why just because doctors either DO something or refer women to doctors who do makes them less dangerous though. I know a good number of allopathic practitioners in my area who practice some forms of non-evidence-based medicine that medical research has either shown to be potentially dangerous or of questionable benefit. Just because it's done doesn't mean it's "safe." I have a feeling we agree on this

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Old 10-10-2006, 06:59 PM
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Originally Posted by EviesMom View Post
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!
I refused, they cut me open anyways and called CPS on me and tried to take my children from me. It was hell.
Yes, I contacted lawyers, posted about it on MDC, etc. Nothing ever happened.
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Old 10-10-2006, 07:22 PM
 
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I refused, they cut me open anyways and called CPS on me and tried to take my children from me. It was hell.
OH my word! I cannot believe that! Now, I was under the impression (since I used to work in L/D), that anyone can refuse ANYTHING. Of course they may try to convince you otherwise with manipulation, but if you do not sign the CONSENT for surgery, I don't believe they can do it. Now, that is my understanding. I remember a gal that refused a C/S when she really needed one. Since she refused, the doctor did not do the section but tried to assist her vaginally as best as she could. Unfortunately, the baby did not survive. The reason why I bring this up is to let you know that some (I can't speak for all) doctors do respect a patient's refusal.

I think everyone on this forum knows this: Everything has a risk. The freedom to acess those risks and make the best decision for you is the best way to go. Some of us would rather be in a hospital, some of us would rather stay at home, etc. We take the risks and take responsibility of the outcome. That's the beauty of being able to take control of our health.
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Old 10-10-2006, 07:26 PM
 
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What a horrendous statement. Why on earth would you try and make this mother feel guilty for wanting to attempt a vaginal birth? Maybe her "previous choices" were what was best for her. Who are you to stand and make judgement?
Thank you! OTF, that was SO not helpful.

~Marie : Mom to DS(11), DS(10), DD(8), DD(4), DD(2), & Happily Married to DH 12 yrs.!
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Old 10-10-2006, 07:31 PM - Thread Starter
 
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MITB How horrible!

I know ICAN, and I'm not pregnant but am talking to some different midwives etc. for down the road.

As for the version, well, I recall that at the time, I had intuition? the baby? something... telling me it didn't matter if I scheduled a version or not. And indeed, it didn't matter at all in the end. Risks and benefits of one are a matter for another thread, imo.

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Old 10-10-2006, 07:40 PM
 
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I refused, they cut me open anyways and called CPS on me and tried to take my children from me. It was hell.
Yes, I contacted lawyers, posted about it on MDC, etc. Nothing ever happened.
Why didnt you just walk out? :
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Old 10-10-2006, 07:46 PM
 
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i dont know if this makes you feel better or not, but ime/imo a preterm breech baby is SAFER w/a c/s. in preterm babes thier heads are so much bigger than their butts and they run a real risk of head entrapment.

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Old 10-10-2006, 07:47 PM
 
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I had a c-section with my first because she was breech. At the time, the midwife I was seeing (in a practice with OBs) said that if I had a "proven pelvis" (meaning that I had given birth vaginally before) they would have considered it, but that no doctor there would consider it for a first-time mom. They also didn't do versions because they did not feel that the benefits outweighed the risks. Looking back, I regret not doing more to try to have a vaginal birth, but, like another poster said, what's done is done. Technically, I think that doctors can be sued for battery if they do surgery on you without your consent, but the blanket consent form they make you sign pretty much covers them to do anything in case of "emergency." I don't think I would have shown up at the hospital and refused a c-section in any event because I would not have wanted to be in the care of someone who has never done a vaginal breech birth, which I imagine a lot of younger doctors probably haven't. The good news for us is that women with first c-sections for breech babies have the highest rate of successful VBACs as long as the second one is not breech, and I had a successful VBAC in April 2004, and am planning another one next February.

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Old 10-10-2006, 07:50 PM
 
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Actually many private practice OBs do not offer ECV any longer. I know of two locally that do not.
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.
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Old 10-10-2006, 07:51 PM
 
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[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!

Midwife, Wife, Mother of 5 (6) and "Ga-Ma" to 5 adorable grand children...
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Old 10-10-2006, 07:51 PM
 
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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.
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Old 10-10-2006, 07:52 PM
 
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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.
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Old 10-10-2006, 08:19 PM
 
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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

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Old 10-10-2006, 08:19 PM
 
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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.
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Old 10-10-2006, 08:26 PM
 
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[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]

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Old 10-10-2006, 08:49 PM
 
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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?
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Old 10-10-2006, 08:55 PM
 
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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.
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Old 10-10-2006, 09:30 PM
 
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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
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Old 10-10-2006, 09:40 PM
 
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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.
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