A forced episiotomy – why a woman is suing the hospital where she gave birth

A woman named Kelly (not her real name) is suing a California hospital for performing an episiotomy on her during labour without permission.

You can read an account of Kelly’s story here. In short, however, Kelly, a young woman, was a rape victim who had asked her healthcare providers to be gentle with her as she gave birth to her first baby. (For victims of rape and sexual abuse, giving birth can be particularly traumatic, often reigniting memories of the assault.)

Kelly, who had had an epidural and was giving lying birth on her back, had not succeeded in pushing the baby out. The doctor said he was going to perform an episiotomy. She asked him not to. He went ahead and did it anyway.

He seems to have made a particularly bad job of it, using scissors to make 12 cuts before pulling the baby out.

We know all this because the baby’s grandmother was videoing the birth. (I strongly recommend that you don’t view the video if you suffer from birth trauma.)

A doctor describing the scene in the video writes:

“The physician here applied a medio-lateral episiotomy unnecessarily early through thick tissue, but rather than making a single definitive cut, he makes a series of short cuts that cause unnecessary bleeding and will interfere with healing. The episiotomy was done so early that the perineal tissues did not have time to stretch, so that the tissues were thick and bloody, a situation that would not have pertained if the professionals had waited…Having decided in advance to do an episiotomy, the doctor apparently does not even know how to do one – how to time it to minimize trauma. This behavior makes it more likely that severe trauma will occur.”

So far, so shocking.

But it gets worse. Kelly will represent herself in court because she has been unable to find legal representation. This is because, in the US – as in the UK – litigation for malpractice during labour or birth generally takes place when either the mother or the baby has died or has been left severely physically damaged as a result of poor medical decisions. Improving Birth, the organisation supporting Kelly, writes that lawyers she approached “were unable to see the value in a case where there were no permanent damages or deaths.”

At the heart of it all is the issue of consent. In California, a health professional needs the patient’s consent to carry out a medical procedure (except in cases of emergency). A similar law applies in the UK.

Yet there is plenty of anecdotal evidence of, for example, women having their waters broken during labour, to show that the issue of consent is often ignored, both in the UK and the US.

It seems extraordinary that this breach of a fundamental principle has not hitherto been tested in court. The outcome will be of interest to any woman whose wishes have been ignored during labour.

If you want to contribute towards Kelly’s expenses, you can do so here.

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