Category Archives: informed consent

No, OBs are not accountable

I was reading this post from the skeptical OB today

as you may or may not know, I was banned from the skeptical OB for calling Dr Amy out on being a fence sitter on the issue of date rape. Remember that any time she complains about being “silenced” by home birth bloggers for asking uncomfortable questions. She does the same thing to people who think there isn’t a neutral zone when it comes to rape.

IN this specific post Dr Amy says a survivor of sexual abuse who had several cuts to her perineum done to her body against her will during labor, by an OBGYN isn’t experiencing violence. She doesn’t even condemn the behavior of the OB at any point. She laments a series of home birth deaths in australia, one of the summaries she quotes points out that the mom chose home birth because she had been treated so poorly in the hospital. The only violence in birth is when the baby is injured? Here is as close as she gets to saying anything condemning that horrible physician:

Don’t get me wrong. I’m not claiming that hospital care is perfect. Although there is rarely any violence, there is a great deal of poor and disrespectful treatment.

Beforehand she literally says that the baby being inside the woman fundamentally changes the interaction. She talks as though women are simply vessels for children, and that being such a vessel fundamentally changes the way that a woman would experience having her gentials repeatedly cut against her will. The lack of empathy is very telling. The woman who was cut against her will, over and over, well before crowning, should be comfortable going back to the hospital because Dr Amy is apparently the ultimate authority on what constitutes violence or not. Its laughable, especially from a woman who insists that one must be an expert on a topic in order to have an opinion. Dr Amy goes on and on about the inability of midwives to call out their fellow midwives for negligence and damage done to patients, but here Dr Amy does the same thing and ignores deplorable conduct on the part of a gynecologist.  She goes on to say:

However, the chief victims aren’t Western, white, well off women; the chief victims are the elderly, people of color and those of lower socio-economic status.

For a skeptic she sure has an aversion to actually linking to evidence. Being white and college educated are one axis of privilege, but it doesn’t erase being female. It doesn’t erase the fact that women, regardless of any of their other characteristics, are targets for sexual abuse and violence by virtue of being female. Why anyone would believe that this problem vanishes in the hospital is beyond me. One kind of oppression does not erase the other. Dr Amy’s total ignorance of contemporary feminism and social justice movements is showing once again.

ANYWAY, I wish i could comment so I could let everyone know that NO, you don’t have many avenues for redress if your OBGYN decides to do all kinds of shit to you without your consent. You need a ton of money (enough to pay a lawyer for a lengthy and probably fruitless lawsuit). Medical boards don’t give a damn about this, and the doctor and hospitals have better lawyers than 99% of the population.

Women have many legit reasons for choosing home birth, and this is one of them. A lot of the people in the comments section of the Skeptical OB, who claim there are Very Serious Consequences for physicians who do things against your will, are living in a dream world. In the real world, your word doesn’t matter at all. I know from first hand experience. The issue at hand here is that midwives and home birth do not solve the problem. Horrible attitudes from other people about abuses of women during hospital childbirth (including disbelieving the women, rebranding their experiences as “disrespect” instead of abuse or violence, insisting that they will be compensated despite all evidence, etc) makes a vulnerable population easy pickings for midwives. I know that seeing unauthorized procedures done to patients during my time working in hospitals was instrumental in my decision to have an out of hospital birth. I knew that these doctors were not accountable because they did it all the time. There isn’t anything that holds them accountable for these issues. A suit for battery is unlikely to succeed and is hard to pull off. Ignoring the problems won’t make them go away, and will in fact drive more women to seek care from midwives, who at least pay lip service to how damaging abuse during childbirth can be to patients.


name changes for negligent midwives

The skeptical OB has an article up about negligent midwives changing their names as to deceive their customers.

It happened to me, too. Ester Werbach now goes by “Nueve Lunas Maternity” on the internet. The Utah Midwive’s Association is well aware of it, and my complaints of sexual misconduct, and continue to support my abuser. They don’t care.

These types of actions also make it impossible for women to research their care provider. If you have a health care provider that has killed negligently, had their license suspended, or otherwise been reprimanded their patients have a right to know. Midwives rob women of the opportunity to know what they are getting into.

my perspective on informed consent or refusal

I worked clinical labs, and patient care, for many years. I did phlebotomy (venous blood draws), specimen processing, some testing, and some problem resolution with Doctors and Nurses. I worked in both clinics and hospitals. You can pick up a lot of information from these experiences if you make a point to do so (and I did). I also took an ethics course that was instrumental in my approach to patient care.

There were times that I had to draw blood on a patient that refused, either because it was a trauma/code, or because the person had a condition that made them unable to make their own care decisions. Some of these patients would protest during the blood draw.

I cannot express the level of guilt that went along with these draws. I was always very cautious to only draw patients on their own terms, whenever possible. It felt so incredibly wrong to be drawing blood from someone who was asking for it to end. I don’t even hug people without asking first. I had no paternal leanings that caused me to make decisions on behalf the patient “for their own good”. To do so would be dehumanizing.

Sometimes patients, who were competent to decide their own care, would ask for the draw to end before all the tubes were filled. I asked if they were sure, and if they were sure then the draw would end. They are human beings, after all. What right do I have to tell them that I should keep drawing their blood when they do not want me to? 

This is how I was trained, and how all phlebotomists are trained to limit liability. There are different kinds of consent depending on procedure, but people can easily revoke their consent if it was implied or verbal. It works a lot like sexual consent in that sense. Lawsuits can, and do, result from blood draws being done without patient consent. Its considered a civil case of battery if a phlebotomist, for instance, decided to draw blood from someone who was asleep. Here is a synopsis from findlaw:

Medical battery is the intentional violation of a patient’s right to direct their own medical treatments. Doctors must obtain a patient’s informed consent when rendering non-emergency treatment. If medical treatment is performed without the patient’s consent or against their will, the patient may have a claim for medical battery, even if the doctor did not intend to cause any harm.

In a medical battery claim, there is generally no need to prove injury or negligence. However, as in all battery cases, it is necessary to prove that the medical personnel engaged in unauthorized touching, contact or handling of the victim.   

It is hard to retain an attorney for these cases because the damages are often lower than their fees, but some wealthy people make a point of suing because of how disgusted they are with the violation of their person. I wish this option was open to everyone, because I have a feeling that these violations are more commonly enacted on marginalized people to begin with. Many people aren’t even aware that they are allowed to refuse if they want to.

I sincerely wish that it were easier to sue or reprimand health care workers who violate their patients rights, but it is very hard. I am convinced that the hospital whose attorney approved a forced c-section did so because the cost of a battery suit was likely less than the cost of a malpractice suit if the newborn was injured by refusal of a c-section. Something needs to be done to remedy this flaw in the system. 

I am continually in awe of midwives who seem to think that sticking your hand in someones vagina should require less etiquette and respect than I gave to patients during a blood draw. I cannot imagine continuing a pelvic exam on someone begging for it to stop. I would feel like a rapist. I think most decent people would. No one is entitled to another persons body, ever. 

What is wrong with these women, that allows them to think its acceptable to do this to people? I’ve written before that midwives who advocate natural child birth often seem to become hardened to seeing women in unbearable pain. Perhaps the midwifery attitude of “I know best” goes with the same territory. That was certainly the opinion of a woman who lost her baby to valerie el halta’s methods:

But rather than the “natural” childbirth she expected, Rose said El Halta subjected her to unwanted interventions. Without warning, she “stripped the membranes” — a procedure to separate the amniotic sac from the wall of the uterus and stimulate labor, Rose said.

“It was rough and painful, and she brings her bloody glove back out. ‘I figured I’d just help you along,’ she said. That was her attitude: Auntie Val knows best.”


“It was the single most painful thing Val did during my birth,” Rose said. “She had both of her hands inside me. I was yelling at her to get them out, but she refused because she was helping. If someone has two hands in you, and you’re telling them no, and they don’t stop — that’s why I call it a rape.”

This will continue to happen as long as other midwives accept it and do nothing to keep it from happening.