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The 'Secret' Hospital Policy That Pregnant Women Need to Know About

Photograph by Twenty20

From the moment an expectant mother’s water breaks until her baby is born, life is a spontaneous series of controlled chaos—unless, of course, she is scheduled to have a C-section.

But not all surgical deliveries are planned. On rare occasions, when complications arise during childbirth, doctors might be called in to order an emergency cesarean section.

What happens if Mom refuses to get one?

Rinat Dray of Brooklyn, N.Y., wanted to deliver her baby naturally after having had two previous C-sections, but finding the right hospital was a challenge. Turns out, not all hospitals allow women who have previously undergone abdominal delivery to give birth vaginally—a process known as VBAC—but the Staten Island University Hospital (SIUH) in New York does, and their low cesarean rates were a great selling point to the third-time mother, which is why she chose their facility.

However, once in labor, Dray claims that her doctor began pressuring her to have another caesarean. “I don’t have all day for you,” she recalled the doctor saying. “If you don’t let me do a caesarean section, the state is going to take your baby away.” (The hospital declined to comment on whether this happened, according to The Guardian.)

According to a lawsuit filed against SIUH, doctors used a "secret" internal policy—permitting them to overrule a pregnant woman’s medical decisions—to perform an emergency C-section against her will.

Doctors at SIUH are given step-by-step instructions for performing procedures and surgeries without a pregnant woman’s consent, according the news outlet. This “secret policy” is used when doctors are unable to persuade a patient to give them permission to perform a C-section, and several doctors agree that the treatment carries a “reasonable possibility of significant benefit” for her fetus that “outweigh[s] the possible risks to the woman.”

If doctors believe there is a threat to the fetus, they are permitted to override a pregnant woman’s wishes without consulting anyone else.

Though officials at SIUH do not deny forcing Dray to have the unwanted procedure, a note in her chart, written by the head of obstetrics moments before she was wheeled into surgery, suggests that it might have saved her newborn son’s life.

“The probable benefits of C-section significantly outweigh the possible risk to the woman … I have decided to override her refusal to have a C-section.”

SIUH has yet to answer questions or comment on whether the policy is still in effect, but the policy contradicts the ethical recommendations of both the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists, which do not sanction procedures performed without a mother's consent.

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