I would move.
By now most of you have probably heard of the story of the Utah mother who is being charged with murder in the death of one of her twins. If you haven't, you can read about it here. In short, doctors in Utah say that they advised Melissa Rowland to have a cesarean section to save the life of one of her babies; she refused, and the baby later died. The other twin lived, and was delivered by c-section.
Utah's law allows for Ms. Rowland to be charged with murder. From the BBC article:
In January, the Utah Supreme Court ruled that unborn children at all stages of development are covered under the state's criminal homicide statute. The law exempts the death of a foetus during an abortion.
This ruling was apparently part of an attempt to give the State of Utah the ability to punish drug users who killed or harmed their unborn babies through their drug use. It has never been used, and was apparently not intended to be used, for a case like this.
But now it has been.
According to that law, the State of Utah can prosecute you for murder for almost any reason your unborn baby may die; whether deliberate or through negligence. If they charge this woman with murder, this will set a terrible, terrible precedent.
Doctors are not gods. C-sections are not cure-alls.
The doctors in this case detected a slow heartbeat in one of the twins, and recommended an immediate c-section to save its life. Ms. Rowland refused, and left the hospital AMA (against medical advice). This is something we all have the freedom to do; doctors can tell us what they think we should do, but they cannot compel us to do so. Ms. Rowland apparently went to at least two other hospitals asking their opinion, and was told the same thing.
There are a couple of interesting things to think about here. The most important one is that there is no guarantee that a c-section done at that time would have saved that baby's life.
Would it have make it more likely that the child would have lived? Almost certainly. The baby was still alive at that point, maybe it could have been saved. The doctors are asserting that it would have been saved; they don't know that. They can't know that. Therefore, they cannot say with any certainty that Ms. Rowland murdered her child.
If Ms. Rowland can be accused of murder in this instance, what is next? If you follow this law to its logical conclusion, pregnant women in Utah, and any other state with this type of law, had better be careful to follow their doctor's orders to the letter. What if your doctor is a fan of routine induction, and you've done your homework and know the risks associated with routine induction? If your baby goes on to die for some reason, you could be liable for murder.
What if you smoke, and harm the baby's lungs? What if you eat soft cheese (a no-no for pregnant women) and get listeria, which kills the baby? What if you decline the beta strep test, and your baby contracts beta strep and dies after birth? What if you have a homebirth and the baby dies?
I couldn't handle that kind of pressure. I'd have to leave the state to be pregnant elsewhere. I would be far too busy worrying about my baby's welfare -- which at times necessitates an approach other than what the typical doctor will recommend.
It is a tragedy that that child died. However we do not want this kind of thing happening to women. Medical care must not be legally mandated. Birth must not be a matter for the courts.
This woman made a choice, and as a result she lost a child. I am sorry she lost her child; not nearly as sorry as she is, I am certain. Can you imagine how she must feel? But we must defend her ability to choose. We must. Calling this murder because she did not follow the doctor's orders is based on the assumptions that doctors are always right, and always save lives. Doctors are experts, and should be respected and treated as such; they are not always right. They do not always save lives. They lose babies too. Sometimes they even cause the complications that cause the babies to die. We don't tend to hear about that on the news. If a midwife loses a baby, that's big. If a mother goes AMA and loses a baby, that's big. It helps you to believe that those tragedies would never happen under the responsible care of a doctor. Not so. The media just doesn't report the babies the docs lose. All doctors lose babies, but that's okay, because they're doctors.
There is a saying, among the homebirthing community: Birth is as safe as life gets.
That saying means that the homebirthing community understands that there are no guarantees. You might get pregnant; you might not. You might carry past the first trimester, you might not. You might birth a life, full-term, healthy baby; you might not. When a homebirther loses a baby, the flack is huge; homebirthing parents have to be ready to accept that. The assumption is always that if the mother had been at the hospital, the baby would have lived.
It is just not necessarily so. It's just assumed, generally, that if you lose a baby at a hospital birth that it's the doctor's fault. Except that the doctor will have done all she could, so it's really nobody's fault. You, at least, as the parent, are off the hook, as long as you've been a good patient.
The rest of our society would do well to understand the truth that there are no guarantees. Even if you follow all your doctor's orders, even if you have a c-section when it is recommended, there is no guarantee that your child will live.
I think Ms. Rowland is probably a very confused woman. Some papers are reporting that she has a history of mental illness, and perhaps that contributed to her decision. I don't why she decline the initial c-sections, or why she finally consented to having one. But this is not murder, and she should not be convicted of such.
Body and Soul has some additional, interesting information on the case.
Posted by Steph at March 14, 2004 10:36 PMSteph, you handled this case with the great eloquence which I can always expect from you. DH was telling me a little more about the situation- Ms. Rowland evidently also has mild mental retardation, which throws a whole other factor into the situation.
I'm saddened by the increasing invasion of the gov't into the lives of our people. I'm also incredibly saddened by the absolute lack of humanity surrounding this case. Ugh.
Posted by: Dy on March 14, 2004 10:54 PMSteph,
I agree that this case could set a very scary precedent. Three hospitals all giving the same advice to the woman and she doesn't take their advice because she doesn't want a scar. I don't think she should be prosecuted for murder but I do think she should be investigated to see if she is truly capable of taking care of the surviving baby.
What a sad situation. *sigh*
Posted by: Beth on March 15, 2004 06:58 AMWhat if you do follow your doctor's advice and the baby dies? Women over 35 are routinely given amnios, but there is a risk involved. I had an ammio with my first child and would NEVER have one again. Would a woman who did follow her doctor's advice to the letter of the law still be responsible if her baby died?
In my case, the maternal-fetal doctor suggested an amnio based on ultrasound findings. My OBGYN was in Paris at the time, but when she came back she told me she would have recommended I NOT have it. Thankfully nothing happened in my case, but if something had I would have been damned if I did and damned if I didn't.
I would not move if I lived in Utah. There are extenuating circumstances here. Besides the possible mental illness, there is also substance use. I disagree with the law, however, I think that too much is going on here that we do not know about to make a decision, for me, wrt birthing issues in Utah.
Posted by: Susie on March 15, 2004 08:36 AMBeth, I agree with you. This woman apparently has a history of mental illness, and I have wondered about her ability to care for the surviving child. Apparently she has had children before; I don't know if they are living with her or not.
Alexia ... it looks like by the letter of that law a woman could be held responsible for the death of her baby; I'm sure that in practice you would be off the hook because you were under a doctor's care. You would have followed the rules and done what was "medically recommended." Your baby would still be dead, though.
If something had happened, you would have felt responsible for making the choice to go along with the doctor and have the amnio - in the end it was your choice. However if you had refused, you were facing the unknown (the health of your baby), and you had this professional expert telling you that it was the best thing for the health of your baby. Yes, definitely a damned if you do, damned if you don't situation.
I felt that way with our first baby. My doctor recommended/insisted on so many things that I didn't want and didn't feel was right, but we went along with it because she was the doctor. Connor had to stay in the hospital for three days after he was born because of the way my labor was managed.
I'm always fascinated by the fact that amnios are routinely recommended for over 35 year olds, pretty much disregarding the risks involved, while VBACs are seen as such a terrible, risky thing. The actual risks are about the same, with amnio often coming out as riskier. But you'll be told you need the amnio, and that you'll be risking your baby's life with the VBAC.
I am not anti doctors, or c-sections, etc. We need them. I just think that our society's relationship between pregnant women, OBs and personal responsibility is bizarre.
Posted by: Stephanie on March 15, 2004 08:54 AMSusie,
Whether or not there are extenuating circumstances with *this* mom, this is a scary law. This is a law that can be abused in the most horrible way. Think about it. This law could easily be used against homebirthing mothers, VBAC mothers whose doctors want a c-section instead, and especially uc birthers. This is a law I vehemently disagree with. The law stands apart from this woman and her particular situation. Take it apart and look at it on its own, apart from this woman. Is it a good law?
The whole point of having states with their own laws is so that you can move if you don't like them. I'm never going to have any more children, and I'm unlikely to live in Utah, so I'm indulging in a little bit of drama when I say that I would move. But I think it's a serious thing for women in Utah to think about. How far can they take it when a baby is harmed and the mother was AMA?
Posted by: Stephanie on March 15, 2004 10:02 AMuc birthing? You lost me there!
Posted by: Sarah on March 15, 2004 12:26 PMSorry, by UC I meant "unassisted childbirth." Women who choose to give birth without any doctor or midwife in attendance.
Posted by: Stephanie on March 15, 2004 12:44 PMhehehe, and following your train of thought I thought.....If *I* were pg and living in Utah.....well, I'd beg for you to shoot me :-)
Posted by: e on March 16, 2004 02:09 PMStephanie,
NPR ran a show about this story today. I wasn't able to hear all of it because I was in the car but it was very interesting.
One good point that was made was talking about the responsibility of the doctors and hospitals. Three different doctors and hospitals all told this woman that her baby was in danger and yet they let her walk out the door and the baby died. Now the woman is being charged with murder.
There are procedures that doctors and hospital personnel can follow that would allow them to detain the woman against her will and even to perform medical procedures if they thought the woman was not capable of making decisions for herself.
I'm not saying that this makes the situation any less scary but it is something to think about.
Posted by: Beth on March 16, 2004 02:32 PMOne other point - the surviving twin had cocaine and alcohol in her system. And honestly, I have a real problem with the idea of just letting a full term baby die. I agree that is seems like the doctors could have forced the procedure if she was mentally unfit - but can you image the uproar that would have followed if she was declaired mentally unfit and they did a c-section? It is a really tricky situation.
Posted by: Onyx on March 18, 2004 12:43 AMI guess I believe in the judicial system more than most. Coming from the person who scored a 62 on the Libertarian quiz, that is surprising, but I do. I agree that this is a terrible law. However, let us look at how often it has been used. Is the court abusing the law? Why was it passed in the first place? What is the precedent? These are all questions I do not know.
In this situation, I am having a difficult time separating the woman from the law. However, if forced, I can see that this law is not a good law in terms of being good for everyone. On the other hand, is there a way to help protect babies from dying? And thirdly, how do we let women make their own choices about their bodies? I can't seem to be able to put all of these things together and come up with a consistent response.
Posted by: Susie on March 18, 2004 01:41 PMYet another tragic example of life imitating art.
Posted by: damaged justice on March 21, 2004 08:48 AM