“No one can force you to have a cesarean” is false
“No one can force you to have a cesarean.” I see this all the time in message boards.
Don’t worry about
… the VBAC ban
…your unsupportive provider
… your provider’s 40 week deadline
… [insert other VBAC barrier here]no one can force you to have a cesarean.
That’s just not true.
Let’s start with what is ethical and legal: Yes, no one can legally force you to have a cesarean.
ACOG even says in their latest VBAC guidelines that “restrictive VBAC policies should not be used to force women to undergo a repeat cesarean delivery against their will.” So even if your facility has a VBAC ban, they still cannot force you to have surgery… legally or ethically.
But then you have reality: It happens all the time, but it may look different than you expect.
It’s often NOT a woman screaming “I do not consent” as she is wheeled into the OR, though that has happened.
It’s through lies. It’s through fear.
“The risk of uterine rupture is 25%.”
“Do you want a healthy baby or a birth experience?”
Hospital policy and provider preference are presented as superseding the woman’s right to decline surgery.
“No one attends VBAC here.”
“It’s against our policy.”
“We don’t allow VBACs.”
Or unreasonable timelines are assigned giving the woman the illusion of choice.
“You have to go into labor by 39 weeks.”
“Your labor can’t be longer than 12 hours.”
“You have to dilate at least 1 centimeter per hour.”
Or it can be a slow process where a seemingly once supportive provider quietly withdraws support exchanging words of encouragement with caution. Dr. Brad Bootstaylor, an Atlanta based OBGYN, describes how this can unfold at 4:00 in this video after a woman describes her experience:
Or, if the birthing parents don’t listen, it can escalate to calling social services, ordering a psychiatric evaluation, or even getting a court order for a forced cesarean.
It can be as simple as, “Your baby is in distress.” How do you know if this is true or not? Are you willing to take that risk?
Some people suggest that parents should learn how to interpret fetal heart tones so they can evaluate their baby’s status. But I think this is a wholly unreasonable expectation for non-medical professionals, especially when one is in labor. It is as much an art as it is a science.
In short, coercion frequently isn’t by physical force. It’s through manipulation. This is why it’s worth your time and effort to search for a supportive provider who you trust to attend your birth.
Don’t just think, “Well, I can hire anyone and simply refuse.”
Sometimes it’s not that simple as Rinat Dray, was forced to have a cesarean, and Kimberly Turbin, who received a 12-cut episiotomy while yelling “Do not cut me,” know all too well.
This is just one of many myths floating around. Download my free report on uterine rupture myths to learn more.
Update April 24, 2019:
A reader said, “This article is inaccurate. A judge in Wilkes-Barre issued an order forced C-section, against the patient’s wishes because of the size of the baby. You definitely CAN be legally forced to have a c-section.”
My reply: “Just as 994 rapists out of 1000 typically go free… so does that mean rape is legal? No. It means those judgement are wrong. Just like the case you mention.
Many judges and attorneys don’t really understand the concepts of informed consent and patient autonomy relative to maternity care.
This is why we need more attorneys who do like Hermine Hayes-Klein and Diana Snyder so they can educate the court on these issues so we don’t have more bad judgments/decisions.
Read this excellent post by Hermine for more detail.”
Diana Snyder replied, “Jen is right. Judges can get the law wrong. Happens a lot, actually.
To my knowledge no forced cesarean that has been litigated (meaning challenged by lawsuit later) has actually been upheld on appeal. They are overturned when the law is correctly applied by a higher court.
Ultimately though I think we are all saying the same thing, which is that just because something is illegal, doesn’t mean it can’t happen, because the law gets broken and misapplied all the time.”
ACLU. (n.d.). Coercive and punitive governmental responses womens conduct during pregnancy. Retrieved from ACLU: https://www.aclu.org/coercive-and-punitive-governmental-responses-womens-conduct-during-pregnancy
Cantor, J. D. (2012, Jun 14). Court-Ordered Care — A Complication of Pregnancy to Avoid. New England Journal of Medicine, 366, 2237-2240. Retrieved from http://www.nejm.org/doi/full/10.1056/NEJMp1203742?
Hartocollis, A. (2014, May 16). Mother accuses doctors of forcing a c-section and files suit. Retrieved from The New York Times: http://nytimes.com/2014/05/17/nyregion/mother-accuses-doctors-of-forcing-a-c-section-and-files-suit.html?referrer=&_r=0
Hayes-Klein, H. (2015, Jan 14) Amicus Brief for Rinat Dray v. Staten Island Memorial Hospital, 2014. Retrieved from: https://s3.amazonaws.com/birthmonopoly/Dray-Amicus-Brief-Jan-2015.pdf
International Cesarean Awareness Network. (n.d.). Your right to refuse: What to do if your hospital has “banned” VBAC. Retrieved from Feminist Women’s Health Center: http://www.fwhc.org/health/pdf_about_vbac.pdf
Jacobson, J. (2014, Jul 25). Florida hospital demands woman undergo forced c-section. Retrieved from RH Reality Check: http://rhrealitycheck.org/article/2014/07/25/florida-hospital-demands-woman-undergo-forced-c-section/
Kamel, J. (2012, Mar 2). Options for a mom who will be ‘forced’ to have a cesarean. Retrieved from VBAC Facts: https://www.vbacfacts.com/2012/03/02/options-mom-forced-repeat-cs/
Maryland Families for Safe Birth. (2015, Jan 28). The truth about VBAC: Maryland families need access. Retrieved from YouTube: https://youtu.be/C5nymk3IGqE
Paltrow, L. M., & Flavin, J. (2013, April). Arrests of and forced interventions on pregnant women in the United States, 1973-2005: Implications for women’s legal status and public health. Journal of Health Politics, Policy and Law, 38(2), 299-343. Retrieved from http://jhppl.dukejournals.org/content/early/2013/01/15/03616878-1966324.full.pdf+html
Pascucci, C. (2015, Jun 4). Press Release: Woman charges OB with assault & battery for forced episiotomy. Retrieved from Improving Birth: http://improvingbirth.org/2015/06/preview-woman-charges-ob-with-assault-battery-for-forced-episiotomy/
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As an internationally recognized consumer advocate and Founder of VBAC Facts®, Jen helps perinatal professionals, and cesarean parents, achieve clarity on vaginal birth after cesarean (VBAC) through her educational courses for parents, online membership for professionals, continuing education trainings, and consulting services. She speaks at conferences across the US, presents Grand Rounds at hospitals, advises on midwifery laws and rules that limit VBAC access, educates legislators and policy makers, and serves as an expert witness and consultant in legal proceedings. She envisions a time when every pregnant person seeking VBAC has access to unbiased information, respectful providers, and community support, so they can plan the birth of their choosing in the setting they desire.