Hysperia sent me a link to this story by Louise Marie Roth at the Huff Post, detailing the latest case where a woman was forced to undergo a cesarean section:
In the case, New Jersey Division of Youth and Family Services v. V.M. and B.G., the New Jersey appellate court found that V.M. and B.G. had abused and neglected their child, based on the fact that the mother, V.M., refused to consent to a cesarean section and behaved erratically while in labor. The mother gave birth vaginally without incident, and the baby was “in good medical condition.” Then she was never returned to her parents, and the judge in the case approved a plan to terminate their parental rights and give custody of the child to foster parents.
(Read the rest here for Roth’s full explanation of what’s wrong with forced cesareans.)
I agree with Roth that any forced or coerced cesarean – including this one – violates a person’s basic bodily integrity and right to informed consent. I’ve made this argument myself.
But here’s the thing. Roth fatally distorted the appellate court’s decision, as Kate Harding reports at Broadsheet. Harding quotes the appellate court’s reasoning:
The decision to undergo an invasive procedure such as a c-section belongs uniquely to the prospective mother after consultation with her physicians. To allow such a decision to factor into potential charges of abuse or neglect requires a prospective mother to subjugate her personal decision to a governmental agency’s statutory interpretation creating a scenario that was neither contemplated nor incorporated within the four corners of the relevant statutory language. Her decision on matters as critical as this invasive procedure must be made without interference or threat. V.M.’s decision to forego a c-section had no place in these proceedings.
Harding notes that the appellate court did uphold termination of V.M.’s parental rights, and that this would likely not have happened if her refusal of a c-section hadn’t already been framed as negligence and triggered scrutiny by the state. But once V.M. and B.G. were in the system, no court could ignore evidence of their unfitness. The couple failed to show up for a custody hearing, a psychologist was allegedly assaulted during a home visit, and another psychiatrist eventually found V.M. to be suffering from paranoid schizophrenia for which she refused medication. For these reasons, the appellate court ruled that the baby belonged in foster care. Harding is agnostic about whether the higher court decided correctly, and I agree that we don’t know enough to judge the case, ourselves.
But reporters and bloggers need to acknowledge that this case isn’t solely about forced cesareans. In our zeal to defend reproductive rights, it doesn’t help to fudge the facts. We can condemn the doctors and the lower court for violating V.M.’s basic right to bodily integrity and autonomy. At the same time, we can and should celebrate the appellate court’s clear judgment, which reaffirms that women enjoy those basic rights – even when they’re pregnant.
Patron cat of Kittywampus (1985-2001)
Ewwww. I don’t like this one at all. I’ll try to track down that appeal decision and read it but one of the frustrating things about appellate court decisions is, as you note, there just aren’t enough “facts” left about what happened for us to judge for ourselves. That used to frustrate the hell out of me when I was teaching law. Occasionally I went to a fair amount of trouble to track down the historical records. Then I’d have students read the appellate decision without the extra context and say what they thought before considering “the whole story” and comparing their view of the case after so doing. It’s an education in itself and, somehow, it is even more edifying in cases like this.
Because of those experiences and my own knowledge of the “child welfare system” in Canada, I remain highly suspicious about the chain of events here. Of course there’s a big problem with what was decided by the lower court – if this woman was mentally ill, there are likely provisions under mental health legislation that ought to have been invoked if the woman was thought unfit to make decisions for HERSELF, never mind her unborn child. If she WAS fit they sure had no business violating her physical integrity – she could sue them for assault.
Once people get involved with child welfare agencies as happened here by mistake, lots of stuff can happen – like getting righteously peeved with the authorities. I remain deeply sceptical of the ability of government agencies to deal humanely with people suffering from mental illness. I sure hope the return of her child will be considered if she gets treatment for her illness.
Meanwhile, I sure do take your overall point about how this case was reported. I thought it sounded fishy and I’m grateful to you and Kate for following up.
I’m glad you posted this. I’ve seen several blog posts about the original reporting – where only the mother’s refusal to have a C-section is mentioned and is left as the sole reason for the child being removed – as well as the sole reason for the child not being returned immediately.
This is the only post I’ve seen where the appellate court’s decision is referenced, and the other mitigating factors are addressed. (Though, to be fair, the appellate decision was referenced in comments, it still didn’t derail the original idea of refusing unnecessary invasive surgery = neglect of the child.)
I agree with your stand on a woman’s right to choose NOT to have a Cesarean, and at first glance, this case is a clear violation of a woman’s right to her own body. But as the appellate court states, there was more involved. And even after ‘disregarding’ that original premise, there was still evidence of neglect, and everyone needs to consider that.
There was evidence of neglect?
I, too, would like to see the source for “evidence of neglect”. Because another psychiatrist eventually found V.M. to be suffering from paranoid schizophrenia for which she refused medication is NOT a reason to remove a child, especially when the mother has a partner and co-parent living in the home.
Women with mental illness, even unmedicated mental illness, can be parents. And I would be immensely sceptical of a diagnosis of a delusional OR paranoid form of schizophrenia made that close to a birth (with no prior diagnosis) that doesn’t take post-partum effects into account.
Well I read the case and I must say I hate it from start to finish, pretty much. There would appear to be one shrink from among four who concluded that this woman suffered from paranoid schizophrenia while others felt she had PTSD or panic disorder or bipolar illness etc.
I’m also pretty shocked that the court found that a this woman neglected her child when the child was never in the her care. This is a “legal fiction” used to prevent the child from coming to harm but we really shouldn’t say that she actually was guilty of neglecting the child in literal terms. I think all this confusion arose because the statute is written poorly and the court, as well as child welfare officials and medical personnel felt that something had to be done to protect the child but really had no idea how to accomplish that end – through no real fault of their own.
There’s also an inkling about possible discrimination here, though it doesn’t get much play. Without question this mother and her partner had big problems. So did the people dealing with them – and the methods they had for so doing are pathetically inadequate.
Hysperia, thanks for doing the legwork. I didn’t have time to track down the original decision, so I relied on Harding’s summary, which pretty well accords with what you found.
I’ve never had any personal encounters with children’s protective services, but I’ve read some harrowing accounts by people who were innocent but got drawn into the system. There commonly seems to be a presumption of guilty-until-proven-innocent that certainly would piss *me* off. It would also terrify me.
In my post I was careful not to take a stand on whether it was right to revoke custody from these parents. This was partly because I don’t know enough, but also because I realize – as you point out, Hexy – that mental illness should not automatically disqualify someone from keeping custody of their child.
The term “neglect” really would seem to lead us back to the mother’s situation in labor, wouldn’t it? Because as you say, Hysperia, the bio parents never had the child in their care. So either it’s totally a legal fiction, or it implies that her choices during childbirth disqualified her as a fit parent.
One common denominator in these forced-cesarean cases seems to be that the mother is in terrible circumstances. Angela Carder was terminally ill; poverty is often in play as well. In the end, even though the court ruled correctly on the c-section issue, it’s hard to feel celebratory, knowing that the bio parents and their baby have all suffered a great loss – even if denying custody was the right thing to do (and again, I’m agnostic on that).
I was torn about some of the details in the case, too. However, the keystone of the snowball of events that led to the termination of parental rights was the refusal of an unnecessary cesarean and then the refusal to turn over the baby.
I can only imagine what that would do to someone who has mental illness with any elements of paranoia or anxiety. I can only consider this is the framework of being horrified at either prospect, the forced surgery or the removal of the baby. Many, many people with mental illness are parents, It is just unfortunate that the series of events got triggered the way they did.
Even the sanest parents have trouble dealing with social services. Someone with mental illness should have advocates in the system, and it sounds like she had adversaries.
I totally agree with you that none of this would have happened if she hadn’t refused the cesarean. And I can definitely see how the cascade of events would have made even the most mentally stable person anxious, paranoid, and pugilistic. Truly, the only good news here is that the appellate court reaffirmed the right to refuse a c-section. The rest of the story just makes me want to cry for everyone involved.
Really, the system needs to be reformed so that parents do have an advocate at all times. Whether that’s a social worker or a psychologist or someone else – I don’t know what the ideal would be. But the idea that new parents are left with potentially *zero* support is part of the problem, as well. When I had my first baby, I was in Berlin, Germany, and I had the right to have a midwife visit me at home daily for the first week or so, and then several more times over the subsequent weeks. We also had a routine visit from a social worker. Where you have a network of trained support like that, it also functions as an early warning system for families with serious maladjustment problems. So the hospital (or midwife, for a home birth) wouldn’t face an all-or-nothing choice of either discharging the baby to parents who are perhaps dangerously unstable, or taking away custody.
And somehow, the German system manages to provide this aftercare routinely, while spending considerably less than the U.S. on medical care as a percentage of the GDP. I’m not saying the German system is perfect, but it certainly provides much, much better support to new mothers and fathers.
We’d also need a system where a woman seeking care for postpartum mental health crises wouldn’t be immediately discharged again (as happened with Otty Sanchez). It seems as though the only tactic available in this country is the punitive one of removing custody – there’s little to no help for mothers in crisis unless they’re already affluent.
[...] 5, 2009 by Sungold Following up on the recent discussion of forced cesareans, Hysperia drew my attention to this case in Florida, where a pregnant women’s rights were [...]
[...] Some Cautious *Good* News on Forced Cesareans posted at Kittywampus. [...]