Are women and newborn babies being denied basic human rights in hospitals in the United States? Legal advocates say yes.
In recent years, there has been a global movement toward increased recognition of women’s rights during childbirth in regards to informed consent/refusal and respect for bodily autonomy.
These rights go beyond simply the right to survival of the woman and her baby, said Hermine Hayes-Klein, a lawyer and the founder of Human Rights in Childbirth (HRiC), at an event at Cedars-Sinai hospital in Los Angeles on Sept. 21.
“Hospital policies don’t trump human rights,” said Hayes-Klein. “The patient has the right to refuse everything.”
The United States spends more than any other country in the world on health care, but maternal and fetal outcomes are among the worst of developed nations.
In 1970, cesarean sections made up about five percent of births in the United States. Today, about one third of women give birth by c-section. However, a 2015 study of 194 countries found that a c-section rate of about 19 percent was ideal for the health of both women and newborns.
Clearly, many c-sections performed in the United States are unnecessary, said Hayes-Klein.
“Around the world, the highest intervention rates occur in for-profit medical settings,” said attorney Alessandra Battisti, based in Italy, in a video for HRiC. “When doctors routinely recommend surgical birth for reasons other than immediate clinical need of the women they are paid to serve, the human right to refuse surgery becomes especially important.”
In June, the American College of Obstetricians and Gynecologists’ (ACOG) Committee on Ethics released a statement on the Refusal of Medically Recommended Treatment During Pregnancy.
“Pregnancy is not an exception to the principle that a decisionally capable patient has the right to refuse treatment, even treatment needed to maintain life,” according to the ACOG statement. “Therefore, a decisionally capable pregnant woman’s decision to refuse recommended medical or surgical interventions should be respected.”
However, many doctors and hospitals in the United States have policies that inherently violate pregnant woman’s human rights, says Hayes-Klein, such as not treating a woman attempting a vaginal birth following a previous c-section (VBAC) or not treating a woman with a breech baby who has refused a c-section. There is no informed consent if a patient doesn’t have the right to say no.
“The law’s not being respected in maternity care, and it’s not going to be until women understand their rights and then demand them,” said Hayes-Klein via a telephone interview with Epoch Times.
At Cedars-Sinai, Hayes-Klein told the story of a woman who was kicked out of a Los Angeles hospital—while she was pushing—for refusing a c-section for a breech birth. She went to another hospital, which did not force her to leave, but doctors there refused to assist with the birth, saying that as soon as the baby got stuck, they were going to perform a c-section anyway.
The woman’s midwife then helped the woman to get into a semi-squatting position to easily deliver the baby herself onto the bed.
“Too frequently, even in wealthy countries, women experience disrespect and abuse during childbirth,” said Dr. Nicholas Rubashkin, an obstetrician-gynecologist and researcher who works in the United States and Hungary, on a video for HRiC. “Doctors wanting to provide women-centered, evidence-based care in this environment often find their hands tied by policies that are outside their control. A pregnant woman can’t fix this broken system alone, but her human rights can shield her against disrespectful care.”
But even if a woman demands her rights, a doctor may still override them, which is illegal, says Hayes-Klein. The only recourse is legal action, which can be difficult.
“Often women’s damages aren’t recognized as likely to result in a big verdict, and so it’s really hard to find lawyers for those cases,” said Hayes-Klein.
The World Health Organization (WHO) released a statement on “The prevention and elimination of disrespect and abuse during facility-based childbirth” in 2015, which states, “Health-care providers at all levels require support and training to ensure that childbearing women are treated with compassion and dignity.”
Hayes-Klein again spoke at the Human Rights in Childbirth Europe Summit on October 19 in Strasbourg, France, the home of the European Court of Human Rights. She and other advocates discussed their work to expose women’s healthcare experiences during pregnancy and childbirth and provide support and education to human rights lawyers and others involved.
“We’re working on a Know Your Rights campaign globally to develop for each country materials that will help women know what their rights are, understand how they can exercise their rights, know where they can turn if their rights are violated,” said Hayes-Klein.
“There’s so much confusion about what women’s rights are, not only for women themselves but also for the providers.”