Refusing a C-Section, Losing Custody of a Baby

By Lisa Belkin
July 28, 2009, 1:11 pm
In Motherlode- Adventures in Parenting/New York Times

Daniel Hauser, the 13-year-old Minnesota boy whose parents supported his refusal of chemotherapy until the court stepped in, had another meeting with the judge in the case and, based on reports that the treatment continues to be working, the order to continue with chemo stands.

We’ve talked about Daniel often on Motherlode, and while there was some disagreement in the comments, most of you seemed to believe that it was the right of the authorities to step in when parents are making unwise medical choices. I agree. But now comes news that a New Jersey court has, under this same theory, ordered a child (identified in court papers as V.M.G.) to remain in foster care, where she has apparently been for two years, initially because her mother (V.M.) refused a C-section while in labor and demonstrated “combative and erratic behavior.”

Doctors thought the C-section was necessary; the laboring mother did not. As it happens, she was right, because the baby was born vaginally, and healthy. But the court has upheld the original petition by the New Jersey Division of Youth and Family Services (NJDYF) that the mother “abused and neglected” her child. (The court reversed similar charges against the father, B.G., and also said their reason in upholding was not the c-section per se, but rather other factors brought to the bench by authorities.)

There are details in the court documents describing those other factors. In investigating the referral from the hospital, the NJDYF learned that “V.M. had been under psychiatric care for 12 years prior to V.M.G’s birth.” But the mother’s mental health was not the reason given for placing the child in foster care in the first place. The refusal of the C-section, and the behavior around the actual birth, were.

Reaction to this case across the Web (there is an excellent analysis over on Momlogic.com) is that authorities here went too far. That was my gut reaction too. Personally, I can’t imagine refusing a C-section if my OB told me it was necessary. But isn’t everyone “erratic” when in labor?

There are many differences between ordering life-saving cancer treatment and ordering a woman to have a C-section. The most obvious is that of the mother’s medical autonomy — it is her body being anesthetized and cut. Here the mother is also the patient, unlike the Hauser case, and with that comes all the messy, slippery slope questions of the abortion debate.

Second, the data in the Hauser case is stronger. The treatment doctors were urging for his cancer has a remarkable record of success. C-sections, on the other hand, have been shown to be widely over-used, and while the details of any given labor vary, and we do not know those details here, women can be forgiven for thinking that too many doctors are too quick to cut.

On the other hand, the basic parallel holds. In both cases doctors, believing that one path risks a child’s life and the other has great odds of saving that life, ask the courts to step in. Where do parent’s rights end and the court’s responsibility to children begin? What is the difference, if any, between Daniel Hauser and V.M.G.?

Edited to make it clearer that the court ruled that the c-section refusal was no longer the reason that custody is being denied, and also to add details of the mother’s history of mental illness.

Refusing a C-Section, Losing Custody of a Baby - Motherlode Blog - NYTimes.com

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