Creative Commons/Tammra McCauley

The GEM Debate:
Should A Hospital Force A Woman To Undergo A Cesarean Section?

In a move that should make all of us feel a little uneasy about the rights we have when it comes to our bodies, a Florida hospital has threatened to force a pregnant patient to undergo a cesarean section against her will or to report her to the Department of Children and Family Services.

Jennifer Goodall has had three previous pregnancies in which she delivered by c-section. She opted for a vaginal birth after cesarean (VBAC) with her fourth. Although VBACs carry some risk, 90% of women who have had c-sections are viable candidates and roughly 60-80% can successfully give birth vaginally.

In Goodall’s case because she decided to attempt vaginal delivery before agreeing to cesarean surgery in her fourth pregnancy, her prenatal care providers intended to report her to DCFS, seek a court order to perform surgery, and perform cesarean surgery on her “with or without [her] consent” if she came to the hospital.

Goodall had this to say in a statement:

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.

Goodall said that she would definitely consent to surgery if there were any indication during labor that it is necessary.

An attorney pointed out that 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.”

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I know very little about medicine or how the legal system should work in this case. We certainly don’t know too much about Goodall’s current and previous health history, so there is probably a lot of information missing from this story. However, there are some thoughts that come to mind:

1. Goodall has asked for the right to attempt a vaginal delivery and said she would consent to a c-section if things took an unexpected turn. Why does the hospital object to that?

2. I understand that hospitals are businesses and that they are constantly under the threat of being sued. But let’s keep in mind that the chief financial officer sent the letter to Goodall. It seems like the hospital is only worried about their bottom line and not the patient’s health. I wonder if the outcome here would have been different if the hospital had come from a place of compassion.

3. I have such a problem with a hospital forcing a major medical procedure on any person who has the mental capacity to make decisions about her health. Is that even ethical?

4. This hospital is more than willing to turn Goodall’s life upside down in order to make her have surgery. Why does DCFS need to be involved? Does the hospital feel that she is a threat to all her children or just the one she’s carrying?


What do you think? Should Goodall be forced to have a c-section? Is it necessary to report her to DCFS? Share your thoughts below.