Do Not Force Jennifer Goodall Into Surgery
This petition had 6,668 supporters
Cheryl Tibbett, Chief Financial Officer
Bayfront Health, Port Charlotte, Florida
Dr. Amy Young and Dr. Nay Hoche
Comprehensive Women’s Health Care, Bayfront Health Medical Group
To whom it may concern:
We are deeply concerned and distressed to hear of the case of Jennifer Goodall, a Cape Coral mother of three, who has been threatened by your hospital and prenatal care providers that they will call child protective services, obtain a court order for a forced C-section, and perform Cesarean surgery with or without her consent.
We are writing to you today to ask that you immediately terminate this harassment of Ms. Goodall. We appeal to your sense of compassion, if nothing else, in lifting this undue stress on a woman who is now pregnant at term.
Your refusal to support Ms. Goodall’s decision about her and her baby’s care and your harassment of her has put her in an untenable position at the end of pregnancy. She has described feelings of terror, and of “deep distress, concern, and fear” for herself, her pregnancy, and her family.
It is a dangerous situation for mothers, babies, and care providers when someone other than the mother assumes responsibility for deciding when, how, and where she will give birth. Such an idea undermines a cooperative, trusting relationship between patients and providers, and places undue responsibility on care providers for health outcomes that they cannot possibly control or predict with certainty.
It also undermines the legal right and ethical concept of informed consent, in which the patient assumes responsibility for the risks he or she undertakes in the course of medical treatment, based on full information from those she or he has hired for their skill and expertise.
These protections include pregnant people as well as non-pregnant people. Pregnant women do not lose their rights to privacy, physical integrity, autonomy, informed consent, and the rights to refuse treatment and surgery. These rights are foundational in constitutional democracies, including the United States.
Further, the American Congress of Obstetricians and Gynecologists (ACOG) Committee on Ethics clearly states that “pregnancy does not obviate or limit the requirement to obtain informed consent.” ACOG goes on to state that “actions of coercion to obtain consent or force a course of action limit maternal freedom of choice, threaten the doctor/patient relationship, and violate the principles underlying the informed consent process.” The Committee also states, "In the obstetric setting, recognize that a competent pregnant woman is the appropriate decision maker for the fetus that she is carrying."
Bayfront Health’s flagrant disregard of a patient's right to informed consent is horrific, flies in the face of rationality, and must stop now.
In 2012, the Cesarean rate at Bayfront Health was 39.3%-- two and a half times higher than what the World Health Organization suggests as the highest rate of Cesarean surgery that is "safe" for mothers and babies. Research overwhelmingly points to extraordinarily high C-section rates, such as this, to be based on the preferences and practice patterns of doctors—not the needs or safety of mothers and babies in your area. In a March 2014 statement, ACOG and the Society for Maternal-Fetal Medicine voiced "significant concern that Cesarean delivery is overused," pointing to "clinical practice patterns." The Joint Commission has called on hospitals across the country to decrease their rates.
While Cesarean surgery can be life-saving for mother and baby, it is major abdominal surgery and carries significant health risks for both the woman and her child. The choice between repeat Cesarean and vaginal birth after Cesarean should be discussed and decided on together by both the mother and health care provider, not via force by the care provider—or by force from the Chief Financial Officer of the hospital.
We understand that this situation goes beyond Ms. Goodall, as there is virtually no obstetrician or facility in the three counties local to Bayfront that allows a woman to decide whether she will give birth vaginally or surgically, if she has had a prior Cesarean. Such policies and practices run counter to national guidelines from such organizations as the National Institutes of Health (NIH) and ACOG.
Healthcare decisions are for the individual to make, not for the care provider. When we as mothers contract with you—our providers—for your expert advice and skill, we do not trade in our basic rights to informed consent and refusal of treatment and surgery. CFO Cheryl Tibbett stated in her letter to Ms. Goodall: “We sincerely hope that you will trust your physicians and our staff to do the right thing for your unborn child, and family.” When Ms. Tibbett—a chief financial officer—removed Ms. Goodall from being the representative of her baby, based on an inaccurate and dangerous assumption that any care provider or hospital is more invested in the safety and well-being of a baby than its mother, we are deeply troubled and must call for accountability and correction.
In court documents, the judge implied that vaginal birth after Cesarean is a procedure, and that a provider cannot be forced to perform the procedure. We would like to remind you, as mothers, that vaginal birth is not a procedure. It is a normal biological process and the absence of a forced surgical procedure. Put another way: what Ms. Goodall and other mothers in your area seek with vaginal birth is the absence of a forced surgical procedure, so that a normal biological process may take place. If your hospital and your doctors are incapable of supporting a vaginal birth, we must ask that you reconsider working in the childbirth industry.
Such a situation begs the question about who really has the authority to make such decisions: businesspeople with financial, scheduling, and liability concerns, or the people actually undergoing the surgeries and treatments.
In this letter, we are publicly asking Bayfront Health to respect Ms. Goodall’s right to informed consent and informed refusal. Legal and medical opinions aside, she has stated that it is her personal, informed decision to attempt a vaginal birth after Cesarean, having weighed the risks and benefits of having surgery and of not having surgery. It is her right to make that decision – and to be supported in that decision – without fear of harassment or reprisals from a care provider, the court system, or from a hospital’s Chief Financial Officer.
Again, we call for your compassion and respect for her constitutional rights. The women of Florida, the United States, and all over the world are eagerly watching to see if you make the right decision.
International Cesarean Awareness Network
And all of the signed supporters on this petition
ImprovingBirth.org is a national nonprofit run by and for mothers, to advocate for evidence-based maternity care and humanity in childbirth. Last year, its first annual Labor Day rally to raise awareness around these issues brought out almost 10,000 women and their families in 46 states in the U.S.; this year’s rally is on track for twice as many locations and participation in other countries around the world.
The International Cesarean Awareness Network, Inc. (ICAN)is a nonprofit organization whose mission is to improve maternal-child health by preventing unnecessary cesareans through education, providing support for cesarean recovery, and promoting Vaginal Birth After Cesarean (VBAC). ICAN is the only international mother-to-mother support organization with chapters in over 200 locations worldwide, where we hold educational and support meetings for people interested in cesarean prevention and recovery.
For more information on Cesarean section, see Childbirth Connection’s comprehensive “Cesarean Section: What you need to know about C-section"
For petition signers/supporters: Follow the campaign for #jenniferisnotalone here on Facebook. Women will be gathering this weekend at the hospital to show support of and solidarity with Jennifer.
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