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My Ob-Gyn Threatened Me With a C-Section

Photograph by Twenty20

I came to my ob-gyn halfway through my pregnancy. My husband had moved to a new job, which meant a new location and different insurance. While this doctor wasn't my top choice, she seemed capable, and I felt reassured by the photos of moms and babies—former patients—on her office wall during my first visit with her. I wanted as natural a birth as possible, so I asked her about interventions.

"We'll only have interventions if you consent to them," she told me.

Informed consent is in the news, this time with a mom who is suing her doctor, claiming she was bullied into having a C-section. Lindsay Scarborough Switzer disputes the medical necessity of her C-section. When she resisted the procedure, she says her doctor asked her to sign something that said, basically, that she doesn't care if her baby's brain damaged or dead. In the end, she had the surgery and describes the trauma she experienced afterward.

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Flash-forward to my own pregnancy: I'm now overdue at 40 weeks and 3 days. We've been visiting my doctor's office every day this week. Today she tells me, "We need to talk about inducing you." I was surprised, because my pregnancy had been uncomplicated and there are no signs of distress. I ask if we might look at that as an option in a few more days.

She looked me in the eye and says, "Oh no, in a few more days, you're looking at a C-section."

It didn't feel like a careful prognosis. It felt like a threat. I'm not a doctor, but I know there has to be a basis on which a C-section is recommended. Without a basis on which one is necessary, the suggestion is reckless. What she accomplished by using the "C-word" was frightening me. She frightened me into agreeing to be induced. I had to sign papers saying I accepted the increased risks of induced labor, including the increased risk of C-section.

The story doesn't end there though.

It didn't feel like a careful prognosis. It felt like a threat.

That was a Thursday. I was scheduled to be induced Saturday evening. I went home and searched the Internet for stories about overdue pregnancies. I found some accounts of using acupuncture to naturally induce labor. Right away, I searched for places in Los Angeles, found a highly reviewed location and called to make an appointment. I received pregnancy acupuncture on Friday afternoon (which was incredibly relaxing) and went into labor naturally at 5 a.m. the next morning.

I thought I was in the clear.

When my doctor saw me, she said was surprised I had gone into labor naturally. At about eight hours into my labor, she said she wanted to amplify it with a pitocin drip and also recommended an epidural. Once again, the "C-word" was dropped. But this time, it was framed as something to avoid.

At this point, I started to feel frightened again. What if I couldn't handle the pain? Would I be unable to push and thereby need a C-section? Was my labor not advancing as it should? My doctor never mentioned any risks in using pitocin. Now that I look back on the situation, I wonder if the onus was on me to ask. Without knowing the risks, could I really give informed consent?

We have doctors for the same reason we have lawyers—to guide us through situations about which they have specialized knowledge. It's a relationship built on trust.

Women in labor are in a vulnerable state, and this brings into question whether the consent obtained is real consent.

I accepted the interventions my doctor recommended and, a few hours later, pushed my baby into the world. Right away, there was a concern that she wasn't getting enough oxygen, so she was taken from me and held under observation for five hours—the most distressing five hours of my life. She was returned to me, apparently in good health, and started breastfeeding right away.

I'll never be sure if the interventions that I accepted contributed to her condition upon birth. I know a number of factors could be at play. Only later did I read about pitocin and fetal distress. It's true that, ultimately, I had a healthy baby. I'm tempted to think "all's well that ends well," but our injuries and birth traumas matter regardless of whether we are OK in the end.

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Consent is a blurry subject in the context of labor and delivery. We can be unfairly swayed with any suggestion of harm to our baby—even if that harm is extremely unlikely, as Scarborough Switzer alleges in her case. Women in labor are in a vulnerable state, and this brings into question whether the consent obtained is real consent.

Without informed consent and, in the absence of an emergency where it cannot be obtained, an ethical line is being crossed.

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