"Face of Birth": A documentary on the battle for birth in Australia

I cannot wait to see this, and of course cannot wait until the weekend to share it with you. We have our maternity care struggles in America, that's for sure, hence my very existence here, but Australia has its own unique situation. Here, though there are still states where midwives cannot legally hold licenses, the choice to birth at home is, at least, still protected for the family. In Australia, that choice is at risk of becoming illegal, period. Here's the trailer for "Face of Birth":



Choice in birth is a human rights issue. How can we in the U.S. best stand with the women of Australia on this? I'd love your thoughts.

Wordless Wednesday: "Lactation Locations" - What's wrong with this picture?

The NIH VBAC Conference: Could have used more Shrimp

(With a side of egg, as in: on my face.)*


It'll all make sense in a second.

As most of you reading this blog know, the NIH Conference on VBAC just wrapped. I tuned in to various bloggers' reports, got their updates and summaries on Facebook and Twitter, and was generally pleased, as were all the attendees I know of, with the overall optimistic and supportive tone of the conference. If hospitals and care providers actually put what's being said into action, a real turning of the tide is imminent.

However.

There was a moment at the end that is sticking in a lot of craws at the moment: a panel was pressed on the matter of informed refusal, and whether or not a pregnant woman has the same rights to informed refusal as any other citizen. The response was less than satisfactory, to say the least. Briefly, from The Unnecesarean's transcript:

SJ: [I]n spite of Dr Lyerly’s ethical presentation yesterday, the panel is unwilling to affirm the ethical necessity of recognizing that a woman has an absolute right to informed refusal of a surgical procedure that may cause harm to her?

Laurence B. McCullough: This is Larry McCullough, the ethicist on the panel.

SJ: Yes

LM: The claim that the right to refuse is absolute is a controversial claim, it’s not at all settled in the law or medical ethics.

Here's what I don't understand. I am not a lawyer or even a law student, but I do know of a precedent that seems, to my admittedly unprofessional eye, to establish this matter quite thoroughly. The case is McFall v. Shrimp, 1979 in Pennsylvania. McFall was suing one of his cousins, Shrimp, for a bone marrow donation that would have saved his life, as they were blood type matches. Shrimp refused. The court ruled in Shrimp's favor on the basis that society could not forcibly, against Shrimp's consent, invade his body even if it would save another person's life.

Again, total layperson. But it seems to me that the court has thus established bodily integrity as a key, undeniable factor of personhood, including situations where another person's life is affected.

This case has been invoked in abortion debates, and I don't mean for this post to start getting into "fetal rights". But the debate currently going in the comments on Unnecessarean, as well as other places on the internet, keeps bringing me back to this precedent. Some people do feel that a woman has a right to refuse surgery as long as it only affects her, but in cases where a cesarean would clearly save a baby's life, her right to refusal gets trumped. I personally think it's unlikely to incredibly rare that a mother would refuse a cesarean for a clear-cut contraindication to vaginal delivery (though I did read of one case of c-section refusal with a placenta previa; both did survive, though very much against the odds). And I always find it galling, on a personal level, that anyone ever presumes to think they care more about the safety of a baby than the baby's mother.

But these arguments seem beside the point to me, with a legal precedent like McFall v. Shrimp. If we do not grant full informed refusal to pregnant women, that means that we lose personhood, bodily integrity and the ability to consent as basic human rights once we become pregnant. If we decide that pregnancy takes away your personhood because another human life is involved, then it follows that we have to overturn decisions like McFall vs. Shrimp and people can start harvesting organs from each other, just for starters.

Legal-stuff-minded birth advocates, what are your thoughts? I say we start ordering the Shrimp.

*And with that, I am compelled to point out my mistake - which would normally be a run-of-the mill typo had I not gone overboard with the jokey title, final line, and pic for comic effect. As Courtroom Mama points out, the defendant's name is Shimp - NOT SHRIMP.

In my feeble defense, I swear on a stack of scripture that the message board post from which I originally learned of this case spelled it Shrimp, and I had copied and pasted a few key facts into a word document (the post was otherwise very well-written by a sharp, articulate member), including the names as written. I had even looked it up online and found it cited in quite a few places, also as Shrimp. I stand behind my overall point, of course, but I should have triple-checked, especially before getting cutesy. Blog and learn!

Breastfeeding Laws, State by State. All of 'Em!

I just have to share this fantastic resource far and wide. Here it is, a comprehensive, state-by-state listing of all the breastfeeding laws on the books. If you have a nursling or are pregnant, look up the laws for your state, and consider printing it out to carry in your purse, just in case. Pass it on to anyone you know who has a baby or is pregnant! Bookmark it for future reference when traveling, too.

You'll see that most of the laws deal with protecting a mother's right to nurse publicly (also known as a baby's right to EAT). Some states also have specific laws regarding providing for pumping breaks and adequate facilities in the workplace, and some address exempting nursing mothers from jury duty. Note that in NO state is nursing in public prohibited in any way, but there are three places that don't have any specific protective laws on the books. Everybody give dirty looks to American Samoa, West Virginia, and Guam.

Thanks to Colleen from Thoughts from a Doula for the link!

Two births, two mothers, two vicious legal battles.

Two stunning stories revolving around birth and legal rights are currently in the news, each from unique yet equally enraging situations.

First, the somewhat, kinda sorta good news: there's a update to the outrageous case of Catherine Skol, a mother who was mistreated, verbally abused, and I would say physically abused as well, by her obstetrician during her labor last March. She filed a civil suit against Dr. Scott Pierce in December, and while that has yet to transpire, he has been suspended by the medical center, and the the Illinois Department of Financial and Professional Regulation has fined him $500 and put him on one year's probation. He was also required to attend various continuing ed courses, including a class on physician-patient communication - though it's unclear whether he will actually attend these, since he resigned in February this year.

This consequence is pretty petty, if you ask me. As one commenter pointed out, fines for parking tickets can be higher than that! But let's remember that this is not the consequence of the actual lawsuit yet. I can only hope that the upcoming civil suit will serve up some more serious consequences. I'm a little unclear on whether he resigned only from this particular hospital or is giving up medicine permanently. If it's only the former that is true, then I hope the civil suit forces him to lose his license forever. This is not a person who should be practicing medicine. Anyone can have a bad day, but if you read the details in the link to Unnecesarean above, you'll see that this is so over the top that there's no other conclusion to be drawn. Anyone who is capable of treating just ONE person this way should never, ever be allowed to care for another patient. Period. I'll be eagerly awaiting the civil suit.

Now for the indubitably bad news: after three years of struggling with custody issues, a mother who refused to consent to a cesarean in April 2006 ago has now had her parental rights terminated. The details of the case over the course of time are convoluted and full of conflicting opinions and versions of events, but one thing is crystal-clear: the custody challenge began when she refused to sign the consent form for a c-section. It should be noted right here and now that the baby was then born vaginally, without incident.

Read the case for yourself. I find the precedent to be nothing short of terrifying. Mothers beware: if you have ever been on any antidepressant medication, and then have the temerity to stand up for yourself when pressured to submit to an unnecessary c-section, it is now established that you can be declared an unfit parent and your child can be taken away from you. I cannot imagine the nightmare of waging this battle for three full years, even if the ending were a happy one. To lose in the end, too? I don't know how I could go on.

All props to the mighty Unnecesarean for information on both of these stories.