PRESS RELEASE: Florida Hospital Says It Will Force Pregnant Woman to Have Cesarean Surgery

July 25, 2014

Contact: Farah Diaz-Tello
(212) 255-9252; (347) 829-4226

Florida Hospital Says It Will Force Pregnant Woman to Have Cesarean Surgery
Federal Court Won’t Issue Emergency Order to Prevent Forced Surgery

Ft. Myers, FL – A Florida hospital has threatened to force a pregnant patient to have cesarean surgery against her will and to report her to child welfare authorities for exercising her right to medical decision-making. The threats were made in a July 10th, 2014 letter from the Chief Financial Officer of Bayfront Health Port Charlotte to Jennifer Goodall, a Cape Coral, FL mother of three who was nearly 39 weeks pregnant. The letter informed her that because she decided to have a trial of labor before agreeing to cesarean surgery, her prenatal care providers intended to report her to the Department of Children and Family Services, seek a court order to perform surgery, and to perform cesarean surgery on her “with or without [her] consent” if she came to the hospital.

Ms. Goodall had three previous cesarean surgeries, and based on that experience and careful informed consideration, seeks to avoid additional surgery if possible and to allow labor to proceed in hopes of having a vaginal birth after cesarean (VBAC). According to medical research, both VBAC and repeat cesarean surgery carry risks. The risk of uterine rupture increases for women who labor after having had previous cesarean surgeries, but the risks associated with another surgery also increase. In fact, undergoing a cesarean surgery for the fourth time carries a 1 in 8 chance of major complications. The American College of Obstetricians and Gynecologists indicates that 60-80% of women who attempt VBAC are successful. “I would definitely consent to surgery if there were any indication during labor that it is necessary,” Goodall emphasized, “I am trying to make the decision that will be safest for both me and my baby, and give me the greatest chance at being able to heal quickly after my child is born so I can care for my newborn and my three other children.”

Pregnancy Justice, with Florida attorney Patricia E. Kahn, filed a complaint on behalf of Ms. Goodall in federal court on Friday seeking a temporary restraining order preventing the hospital from carrying out its threats. Federal District Judge John E. Steele denied the request, stating, in part, that Ms. Goodall has no “right to compel a physician or medical facility to perform a medical procedure in the manner she wishes against their best medical judgment.” Farah Diaz-Tello, Staff Attorney for Pregnancy Justice, expressed disappointment in the ruling: “The process of labor and delivery isn’t a procedure; our client is the one trying to avoid a compelled medical procedure. Deciding whether and when to consent to surgery is a constitutionally protected right.” Ms. Diaz-Tello explained that every appellate court to rule on this issue on a full record has held that pregnant women retain their constitutional rights, including rights to medical decision-making and bodily-integrity. “No woman should fear that because she’s pregnant, she can be threatened, coerced, or deprived of her constitutional rights.”

According to declarations of medical experts filed with the lawsuit, the hospital’s actions violate medical ethics. Mary Faith Marshall, PhD, Director of the Center for Biomedical Ethics & Humanities at the University of Virginia School of Medicine called the hospital’s actions “troubling. Given the clear statements from ACOG’s Committee on Ethics and other professional groups that coerced or court-ordered medical procedures are not ethically justified, it is stunning that a hospital would threaten such an action.”

Diaz-Tello acknowledged the hospital’s concerns about malpractice liability, but noted that there is no legal or ethical authority that supports managing liability concerns by forcibly performing unwanted surgery. “The Florida Supreme Court has said health care providers are protected from liability when they respect and follow the decisions of a competent and informed patient to delay or refuse a proposed treatment, even when there are risks involved. Ms. Goodall has explicitly and carefully documented her informed decision to proceed with a trial of labor; there is no justification for forcing her, or any person, to have unwanted surgery to protect a hospital’s bottom line.”

The following statement can be attributed to Jennifer Goodall:

My decision to allow labor to proceed before consenting to a surgical intervention is based on years of research, careful consideration of the risks to me and my baby, and my family’s needs. All I want is to be able to go to the hospital when I’m in labor and have my medical decisions respected - and my decision is to proceed with a trial of labor and not have cesarean surgery unless some medical complication arises that makes cesarean surgery necessary for my or my baby’s health. Instead of respecting my wishes like they would for any other patient, my health care providers have made me fear for my safety and custody of my children. The people who are supposed to be caring for me and my baby have put me into an even more dangerous situation. I know I’m not the only one to go through this; I’m speaking out because pregnant women deserve better.