Caesarean

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Police threat for refusing c-section

A pregnant woman was shocked when her doctor sent an email demanding that she either have a voluntary caesarean or he would call the police.

Lisa Epsteen, of Spring Hill, Florida, had given birth to her four children via caesarean. When pregnant with her fifth baby, she decided to try for a VBAC (vaginal birth after caesarean).

The 35-year-old researched local doctors who were VBAC-friendly, and came across Dr Jerry Yankowitz. The chair of the University of South Florida's obstetric and gynecology department, Dr Yankowitz also specialises in genetics, maternal foetal medicine and ultrasound diagnostics. He took Epsteen on as a patient.

But as Epsteen's pregnancy progressed, Dr Yankowitz grew concerned about her wish for a VBAC. The baby wasn't in a good position, and Epsteen had developed gestational diabetes. These factors, in addition to her previous caesareans, led him to recommend another c-section.

Epsteen wasn't convinced. Then, during a visit to the doctor's office last Tuesday, it was discovered that the baby - who was a week overdue - was possibly in distress. Staff advised Epsteen to have an immediate caesarean but she declined, explaining that her husband wouldn't be able to leave work to attend the birth, and that she had no one to help care for their two-year-old, who was with her at the appointment. She suggested she come back on Friday for the procedure.  

When Dr Yankowitz learnt that she'd gone home, he sent her an email demanding she return.

"I am deeply concerned that you are contributing to a very high probability that your fetus will die or your child will incur brain damage if born alive," it read.

"At this time, you must come in for delivery. I would hate to move to the most extreme option, which is having law enforcement pick you at your home and bring you in, but you are leaving [the hospital] no choice."

According to a police spokesperson, the law states that the only possible legal grounds would be if the doctor established that the baby's life was in immediate danger. Patient confidentiality regulations would also make the case difficult to follow through on.

After reading the email Epsteen panicked, later telling the Tampa Bay Times that she started thinking "in a couple of hours there are going to be cops on my doorstep taking me away from home - in front of my children -  to force me into having surgery".

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But as the panic subsided, she became angry. She found a lawyer, who replied to Dr Yankowitz, and contacted the group National Advocates for Pregnant Women (NAPW).

"Honestly, I feel abandoned," she later said. "It's circumstances like this that make women feel like they have no options but to birth their babies on their own - and put themselves in more dangerous circumstances - because they feel bullied."

Epsteen says believes the hospital "really [did] have the best interests of my child and myself at heart ... On the other hand, this is not the way to go about protecting my baby or me."

After receiving a letter from Epsteen's lawyer, Dr Yankowitz seemed to back down, sending her an email that read: "I personally recognize and respect your right to make the medical treatment decisions for both you and your unborn child ... In that regard, please understand my frustration as I truly believe you and your child are in jeopardy."

While the story does have a happy ending - Epsteen gave birth to her son via caesarean on Friday, and he's reported to be healthy - it has stirred further debate on the rights of pregnant women.

As Farah Diaz-Tello, the NAPW staff attorney, said in a statement, "Women do not lose their rights to medical decision making, bodily integrity and physical liberty upon becoming pregnant, or at any stage of pregnancy, labour or delivery."

In a similar case, an Irish hospital had started proceedings to force a pregnant woman to have a caesarean just a few days before Epsteen's ordeal. The woman had had a caesarean with a previous child and was around two weeks overdue, causing concern among her medical caregivers. Before the case was heard in court, however, she agreed to the surgery. 

- Essential Baby

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