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Doctors okay liquids in labor; woman imprisioned for disobeying doctor's orders
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Last week The American College of Obstetricians and Gynecologists(ACOG) magnanimously decided to "allow" laboring women to take clear liquids during labor, instead of limiting them to ice chips and IV fluids. Women are still, of course, not "allowed" to have anything solid, because of the risk of aspiration if the labor ends in an emergency C-section with general anesthesia. Left unexplained is why every woman has to suffer to address a situation that few women end up in (an alarming number of labors end in C-sections, well over half in many hospitals, but most of them are done under spinal anesthetics) -- after all, most people don't avoid eating for twelve hours before they drive somewhere just in case they are in an accident and need emergency surgery. Also not explained is why denying sustenance to women engaged in long and grueling labors is better than addressing the issue of aspiration when it actually becomes a problem, i.e., when a crash C-section is about to happen. After all, people undergo emergency surgery all the time with food in their stomachs (see the snark above), so there has to be some sort of protocol.
Still, in spite of how much it gets my back up when people start talking about what grown women are and are not allowed to do, this is good news. Obstetrics is slowly evolving into a practice that works with pregnant women, instead of working on them, and that treats childbirth as something less than a life-and-death emergency, like a heart attack. Of course, the internet (and exam rooms, I'm sure) are filled to the brim with doctors protesting vigorously that denying food is an absolute necessity, but those same doctors were making that case for routine episiotomies only a handful of years ago, and for enemas and pubic-shaving only a handful of years before that. I really do see progress being made in the cause of non-medicalized childbirth.
However, there is a long way to go in recognizing pregnant women as people with rights independent of their pregnancy, as this distressing story from earlier this month shows. In March, Samantha Barton entered a hospital because she was having contractions (her 25 week pregnancy had apparently been complicated from the start). Her doctor ordered immediate bed rest, but Barton said that she would be unable to do that because she had two small children to take care of. Now, this might have been a good time for the doctor to engage in a little creative problem solving -- maybe networking with the hospital social worker to figure out what was possible, like temporary disability, subsidized child care, a home-visit nurse to allow at-home bed rest? Surely there something could have been done, but instead, the doctor got a court order that forcefully confined Barton to a hospital bed. She requested a transfer to another hospital to seek a second opinion (and perhaps a doctor who would be willing to work with her) but the court declined on the grounds that it wasn't in the best interest of the fetus. (And never mind the "needs" of all that inconvenient flesh containing the fetus, or the needs of the two already born children.) Barton's pregnancy ended in a still-birth three days later (perhaps the court should have considered that stressing a woman with involuntary confinement might also not have been in the best interest of her fetus), no doubt leaving her with crushing medical bills, and no baby to soothe the horror of imprisonment. Here's hoping her lawsuit is successful.
So roses and thorns, as my daughter's class says, for pregnancy-related news: Go ahead and sip some green tea between contractions, but don't get too mouthy with your doctor about nibbling on some chocolate, lest you find yourself shackled to your bed.
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