Hospital sought court order to force C Section

username123

meeeeh wrote: »

You were implying that it was only to save another person. I didn't object to anything else.

I never said you did

Im asking a straight question, feel free not to reply but I am simply curious to know - is a person allowed to refuse surgery when they are in grave danger - assuming they are conscious and not mad etc..?

Edit - question not directed at anyone in particular.

meeeeh

lazygal wrote: »

A private early dating scan provided my due dates. If I'd gone by the hospital's last menstrual period method I'd have been classed as overdue at eight months gestation as I don't ovulate on day 14 of a 28 day cycle like I'm 'supposed' to.

Who said that they wanted c section just because of due date. As far I know they did a scan that morning and it was not great but I'm not medical professional to know what you can see on those scans.

clairefontaine

username123 wrote: »

I never said you did

Im asking a straight question, feel free not to reply but I am simply curious to know - is a person allowed to refuse surgery when they are in grave danger - assuming they are conscious and not mad etc..?

Edit - question not directed at anyone in particular.

Yes they are. Unless the doctors get a psych diagnosis and they are deemed to be crazy.

lazygal

meeeeh wrote: »

Who said that they wanted c section just because of due date. As far I know they did a scan that morning and it was not great but I'm not medical professional to know what you can see on those scans.

The quote from RTE you posted referred to her due date. So did media reports, including the fact the woman disputed the hospital dates. I can easily see how date dispute can arise when hospitals don't bother with early scans.

meeeeh

username123 wrote: »

I never said you did

Im asking a straight question, feel free not to reply but I am simply curious to know - is a person allowed to refuse surgery when they are in grave danger - assuming they are conscious and not mad etc..?

Edit - question not directed at anyone in particular.

For me it depends if affects other people (contagious diseases).

username123

clairefontaine wrote: »

Yes they are. Unless the doctors get a psych diagnosis and they are deemed to be crazy.

I mean a not crazy person, and not a contagious disease. Just a random situation like a burst appendix say.

So if a woman is allowed to refuse surgery when it is only her affected, or if she is allowed to refuse surgery to save an older (say 12 year old) child (by refusing to donate her kidney to him say) - why is it different in the case of an unborn baby?

meeeeh

lazygal wrote: »

The quote from RTE you posted referred to her due date. So did media reports, including the fact the woman disputed the hospital dates. I can easily see how date dispute can arise when hospitals don't bother with early scans.

I was pointing out that they were both in danger. Rte is the first link I found but somewhere else it said that signs on the last scan were not good. What that means I don't know but I doubt everybody wanted to work during the weekend (court, doctors...) just because people didnt agree on due dates.

Das Kitty

wolfpawnat wrote: »

But they do. You get a minimum of two. One at your first appointment to date it, which they double check again at the anomaly scan.

1 scan is what you get in Galway, at "around" 20 weeks.

I know a couple of women who have had to wait til 35 weeks, one of whom,only to find out the baby had a condition that meant it wouldn't survive outside of the womb. I'd much prefer 20 weeks to come to terms with that than 5.

I agree that you're signing your body over to the HSE when you enter their system. I had a number of procedures performed on me and later my newborn without mine or my husband's consent. When my milk didn't come in quickly enough I was outright threatened that if I didn't provide a bottle that they'd take my child away to put him under UV lights. He was at that stage only mildly jaundiced. But I found the pressure to produce milk counter productive.

I had great care in general, but I did get a very bitter taste in my mouth over how I was treated by some. Another silly woman thinking she knows best. No one listened when I insisted my early labour pains were abnormally painful, and basically I had undiagnosed OP positioning, which in the end contributed to my baby's heart rate dropping in the 2nd stage of labour and an emergency section. It was the only time in my adult life I felt like my body was not my own.

iguana

I was only offered one scan in Holles St last year at 22 weeks and at that scan they brought me forward by 5 days. If an anomaly had shown up I'd have been in a very tough situation timewise. As well as that they don't actually offer a full anomaly scan in Ireland. I moved to Wales when I was 28 weeks pregnant and the midwives and doctors were quite surprised at some of the checks that weren't done. That's not to mention the fact that in the UK CVS tests, a blood test at 14 weeks which will show up numerous genetic conditions, such as trisomy problems, are routinely offered. Considering that the TFMR campaigns had been big news in Ireland earlier that year, seeing the difference in care offered felt quite devastating.

In fact the difference in care offered overall was astounding. In Wales midwife clinics are held in every GP surgery so most of your appointments are local and at an arranged time as opposed to spending a couple of hours shuffling along the benches at Holles St before each appointment. At your first appointment you are assigned a community midwife and apart from holidays/illness all your pre and postnatal care will be done by this midwife (as will your homebirth if you want one). You are immediately given her (or his) mobile number and encouraged to call them 24/7, if for some reason your midwife can't answer your call is transferred to on call team for your region. Many of your appointments, especially later in pregnancy, are done in your home. If you want, and they highly recommend it, the midwife will call to your home in the last trimester so you can write your birthplan together and talk about how you are feeling. Low risk women are encouraged to consider homebirthing if it appeals to them. All of the community midwives are trained in waterbirthing* and they are enthusiastic about the benefits. In the trust I was in (Abertawe bro Morgannwg/Swansea in Glamorgan) if you don't want a homebirth there is the option of a homely birthcentre, (where waterbirths are offered). There are also two midwife led hospital units, similar to the Irish Domino Scheme except that they too can offer waterbirths. And two hospital maternity units. Unless medically indicated, women can choose whichever option they want right up until the end of their pregnancy. Unlike in Ireland where you either go midwife led (if you're lucky enough to be in the few parts of the country where it's an option) or consultant led, and the most minor of medical conditions will ensure you can only go consultant led, it's possible to see an obstetrician during your pregnancy and still avail of a homebirth/midwife led birth. So while in Ireland my endometriosis meant I could only have consultant care, as soon as I got to Wales I was given an appointment with an obstetrician who was happy that my endo would not cause complications so I was cleared to continue as I wanted. And when a woman goes into labour (unless her waters break first) her initial examinations are done by her midwife, in her home as the longer a woman labours at home, the lower her risk of intervention.

While the Welsh system offers significantly more in the way of a personal, natural experience on the otherhand they also offer more options when it comes to medical intervention and pain relief. For example, in both maternity units patients can choose self-administered Remifentanil, a medical pain relief which has fewer side-effects and complication risks than an epidural or pethidine, and afaik is not available in Ireland. If you choose/need a hospital birth, while the accommodations are not as nice as the birth centre or even the MLU, once you are admitted you get your own room with a private bathroom, so you can bathe for pain relief. You are also guaranteed to have one to one midwife care with a midwife who sits at a desk at the end of your bed the whole time. You have a tv/dvd player in the room and adjustable lights, so you can labour in dimmer light as many women apparently prefer. (This is in the hospital that is referred to as a bit of a cattle market compared the other birth options in the region.) It's a wonderful service that is highly patient led while still providing the best medical care. While I'm not going to slate the Irish maternity service completely and may very well choose to use it in the future, it has such a long, long way to go before it even starts to compare to the service offered on the other side of a 2 hour ferry journey.

*Waterbirthing is supported by the British Royal College of Obstetricians and Gynaecologists when done in low risk pregnancies as long as the baby is monitored properly ( www.rcog.org.uk/files/rcog-corp/uploaded-files/JointStatmentBirthInWater2006.pdf ) so it would be nice if the scaremongering nonsense being scattered about on this thread could be dropped.

Neyite

IvyTheTerrible wrote: »

I thought the dating scans in Ireland were done too late to be fairly accurate. (ie to get a "reliable" date, the scan has to be done in the first twelve weeks, most women in Ireland don't get scans so early). Correct me if I'm wrong, that's just my understanding.

That is correct. The later in pregnancy you are, the more guesswork is involved as the images on screen are fuzzier- this was the sonographer that told me this.

In utero, the first twelve weeks are pretty uniform which is why the measurements correspond to dates so well. In later trimesters, the fetus has spurts of growth at different times, which is why there are variations in birth weights.

But, a lot of hospitals are phasing out the dating scan. In UHG (Galway) the first scan they offer is around 22-24 weeks -even if you register with your GP early. My gp wrote to the early pregnancy unit requesting that they see me asap when I was 9 weeks pregnant. (I had had 2 private scans from fertility treatment up to this.) I was given a first appointment and scan date for my 19th week, despite my GP telling them it was a twin pregnancy, of which I had a missed miscarriage of one of them, I had an existing endocrine issue which can be aggravated by pregnancy, and I was also 37, so technically a "geriatric" pregnancy.

I was told rather snottily on the phone that I was "lucky" to be given a scan at 19 weeks. Luckily when I was logged with the consultant for the endocrine issue they called me in at 11 weeks and scanned me then.

I have to say though, when I did get into the system, the care I received was excellent - I had an emergency C-section, but am satisfied that it was completely necessary to save my son, and probably myself.

meeeeh

First time when I was private I got scans whenever was my first appointment with consultant (around 12 weeks). The second time when I was public my first scan was at 9 weeks (two miscarriages in between) then at 16 and about at 25 irc and so on (Mullingar hospital).

Morag

If you have had two miscarriages they put you on the extra early monitoring list and you get more scans.

In france, germnay denmark, sweden and the usa you get a scan as a matter of course each visit.

Victor

krankykitty wrote: »

The fact of the matter is that unless you are in an immediate life threatening situation and cannot advocate for yourself, someone carrying out a procedure on you without your consent or without explaining it at the very least is assault.

We don't know the details of the case and there may have been difficulties in getting an informed decision from the mother. The life threatening factor seems to have been present.

username123 wrote: »

Having read the entire thread the most thought provoking post on it was iguanas regarding the thought experiment of a mother refusing to give bone marrow to her child and should she be forced. Of course not.

I personally do not believe that any person should be subjected to surgery without their consent, even if it is to save another person.

The situation for women and reproductive rights is bad enough in this country without surgeons deciding to cut women open without consent also.

There will be cases for patients who are already unconscious (whether under anaesthetic or not) and can't give consent for a procedure, for that consent to be sought from a next of kin or in the absence of a next of kin and in the heat of the moment for the medical team to make necessary decisions based on ethical standards.

Would you have a doctor stand by and not treat an unconscious person bleeding to death because they don't have the paperwork?

Note that under R v Brown* (persuasive, but not binding), you aren't allowed harm yourself or others.


* Obtuse, I know. Note that harm and pain are different things.

meeeeh

Morag wrote: »

If you have had two miscarriages they put you on the extra early monitoring list and you get jmore scans.

In france, germnay denmark, sweden and the usa you get a scan as a matter of course each visit.

So did I and everyone that was there at the same time as me. I I don't know when the others had their first scan at the hospital (i presume about 12 weeks) but they had them at every visit. it wasn't in Mullingar hospital but in one of the local clinics so I don't know if there are some differences in care. All in all I had about five or six scans and It never even occurred to me that others in Ireland don't get a scan whenever they are in the hospital.

username123

Victor wrote: »

Would you have a doctor stand by and not treat an unconscious person bleeding to death because they don't have the paperwork?

No but if that person had expressly given non consent before they became unconscious I wouldnt be happy for that to be disregarded. The unconscious person is a bit of a red herring that only came up while we were discussing things that happen with non consent.

I dont understand what you mean with the R Vs Brown - people cause pain and harm to themselves all the time and are not in any trouble for it, smokers, drinkers, bad diets, drug addicts, obesity etc... They also cause pain and harm to others, obese children, children having circumcision for religious reasons, getting childrens ears pierced, etc...

There is a difference between causing pain or harm to another person by your action and pain and harm happening to someone by your inaction. I think we can all agree that a mother should not be forced to give up a kidney to save the life of a 12 year old child for example? So why should she be forced to undergo surgery to save the life of a child that hasnt been born yet?

IvyTheTerrible

lazygal wrote: »

A private early dating scan provided my due dates. If I'd gone by the hospital's last menstrual period method I'd have been classed as overdue at eight months gestation as I don't ovulate on day 14 of a 28 day cycle like I'm 'supposed' to.

I really don't like the idea of just going by the last period method. I had been on the pill for years, and I gave it up because of migraines. I was only off it a few months when I got pregnant, and I had completely fallen out of the habit of noting my dates (which I used to do religiously before I went on the pill). Before I realised I was probably pregnant, I had an extremely busy couple of months, so I could not for the life of me remember when my last period was, it could have been anytime over the range of a whole month. So I was delighted that I got the dating scan, otherwise I don't know what sort of date I would have been given!

eviltwin

How many posters here have had personal experience of the maternity system in this country? I think a lot of people believe the hype that its the "best in the world". This story is a very extreme one so we have heard about it but every day there are little examples of lousy treatment of women in maternity pre and post natal.

lazygal

Having had many a chat with women who've given birth in Ireland none would say it was world class. Friends who had babies in California and London had far superior care to what anyone I know got here. I think we need to stop equating low levels of maternal deaths with amazing world class care in terms of how women experience maternity services in Ireland.

grarf

eviltwin wrote: »

How many posters here have had personal experience of the maternity system in this country? I think a lot of people believe the hype that its the "best in the world". This story is a very extreme one so we have heard about it but every day there are little examples of lousy treatment of women in maternity pre and post natal.

Best in the world? Hmm. I don't buy it. I got a scan at 13 weeks, and am getting my next hospital appointment at 30 weeks. NOTHING in between, just a GP visit or two. No anomaly scan at 20 weeks, nothing, by default of that particular hospital. Not hugely impressed, and getting the anomaly scan done anyway, privately.
To be honest, this being my first pregnancy, I'm feeling a bit 'left alone' by the system. Not lousily treated, the midwifes are lovely and all, but my GP didn't offer a huge amount of info at my last appointment, and neither did the hospital...

seamus

username123 wrote: »

So if a woman is allowed to refuse surgery when it is only her affected, or if she is allowed to refuse surgery to save an older (say 12 year old) child (by refusing to donate her kidney to him say) - why is it different in the case of an unborn baby?

Legally, because the constitution recognises the right to life of the unborn and so the courts can make rulings designed to save that life provided that the mother's right to life is not prejudiced.

Ethically/logically because 99.99% of people consider an unborn child at term to be a full human being, capable of surviving outside of the womb and therefore entitled to the same protections as any other child.

I completely understand both parties' points of view on the case in the OP. However the size of the baby would seem to indicate to me that the woman was in fact correct and her "due date" was nothing of the sort. Of course, I say that with exceptionally limited information about her history.
The hospital for their part can only go on the dates that they have and can't rely on what they would consider the woman's "gut instinct" as the basis for making medical decision.

In essence, I reckon both the woman and the hospital were correct and were making the correct decisions based on the information that was available to them. This just highlights the massive failings in the Irish health system that such uncertainties can occur because routine procedures like the 12 week scan are bypassed.

clairefontaine

Morag wrote: »

If you have had two miscarriages they put you on the extra early monitoring list and you get more scans.

In france, germnay denmark, sweden and the usa you get a scan as a matter of course each visit.

In the US you don't get one each visit. You get three in a normal pregnancy, a viability, a dating scan at 12 weeks, and the anomoly scan. You also get am ambio at 18 weeks if you are 35 or over at the time.

During scans in the US you also have three people looking at the later scans, so you have three sets of eyes interpreting them. They emphasize hugely the importance of the dating scan too.

However, the US still has a very high c section rate, so I don't know how much the dating scan affects this. My guess fear of litigation is what drives their high section rate.

IvyTheTerrible

Morag wrote: »

If you have had two miscarriages they put you on the extra early monitoring list and you get more scans.

In france, germnay denmark, sweden and the usa you get a scan as a matter of course each visit.

In France you don't get a scan at every visit, unless you go private. You get three scans (10/12 weeks, 20 weeks, 30 something weeks) paid for by the social security system. You also get a monthly visit to the gp/gynaecologist, and all medical visits paid for after the 6th month.

Interestingly, about doctors being "pushy" for caesarians, in France the hospital and gynae gets the same fee from the social security regardless of whether the birth is natural or by caesarian, this is apparently to prevent doctors pushing for unneccessary sections.

pwurple

lazygal wrote: »

I know women in Cork and Louth who got only one scan at 34 weeks. No dating or anomaly scans before then were offered.

My pregnancies were in Cork. First pregnancy scan on first pregnancy was at 8 weeks in the EPU, as I hadn't had a period in 6 months and had no idea how pregnant I was. Second scan was back into the normal system at 12 weeks. Had a scan at 21 weeks, 26 weeks, 30 weeks and 41 weeks.

Second pregnancy I did know my dates, my first scan was scheduled for 12 weeks in CUMH.

One scan at 34 weeks is not the norm in CUMH. I can only assume they weren't attending the hospital, but had requested the midwives clinic instead.

Neyite

eviltwin wrote: »

How many posters here have had personal experience of the maternity system in this country? I think a lot of people believe the hype that its the "best in the world". This story is a very extreme one so we have heard about it but every day there are little examples of lousy treatment of women in maternity pre and post natal.

My sister is pregnant in the UK, and like Iguana's experience, has a range of options, and the facilities are far superior than here - on the NHS. She said her birthing suite is like a hotel. Pregnant women also get free dental treatment there, which we dont have in Ireland.

grarf wrote: »

Best in the world? Hmm. I don't buy it. I got a scan at 13 weeks, and am getting my next hospital appointment at 30 weeks. NOTHING in between, just a GP visit or two. No anomaly scan at 20 weeks, nothing, by default of that particular hospital. Not hugely impressed, and getting the anomaly scan done anyway, privately.
To be honest, this being my first pregnancy, I'm feeling a bit 'left alone' by the system. Not lousily treated, the midwifes are lovely and all, but my GP didn't offer a huge amount of info at my last appointment, and neither did the hospital...

That's how I felt. I lost a twin at 8 weeks (discovered this in a private scan at 9 weeks) and was in tears in the GP's. All I wanted was to be checked by an obstetrician- to ensure that the remaining twin was ok, and that the miscarried one would not cause infection/loss of the pregnancy, and the hospital refused until I was 19 weeks. I got the distinct impression that the view was "if you manage to get the pregnancy to stick as far as 20 weeks and we will deign to look at you then" and I wonder how much of that is policy so that women do not ask doctors in this country for abortion in the event of things not working out in early pregnancy. As in Savita's case.

Morag wrote: »

If you have had two miscarriages they put you on the extra early monitoring list and you get more scans.

I'll be very interested to see if this is the case on my next pregnancy, since I've miscarried twice now. However, I'll still stay sceptical, considering 2 months ago, having miscarried, they told me that it was hospital policy not to scan after a negative test, as it "was likely" that I had passed all the tissue, and that I'd "probably" not have an infection and to "keep an eye on it" () I was not examined physically at any stage by either a midwife or doctor, the only test they ran was a urine sample. When I asked the doctor how I'd know I was infected, I was told that

a foul smelling discharge would alert me. (I'm guessing by that stage, I'd be pretty septic by then!)

And this is mere months after Savita Halappanavar miscarried and died from infection in that very hospital, in that very same early pregnancy unit. How helpful - now we self-diagnose septicemia at home to avoid pesky women asking for procedures in the hospital that "a catholic country" cannot offer. Nice to see they learned something from her death- which is as usual in Ireland, outsource the problem to someone else to deal with. :rolleyes:

I dont fault the staff - the midwife was lovely and compassionate, but she has to follow HSE policy, as did the doctor. First class service? From the beleaguered staff perhaps, but not from their employer. Not even close.

eviltwin

I had three miscarriages before my last pregnancy, despite that - and the fact I had a "high risk" pregnancy - I still was only given one scan at 22 weeks. Thankfully there were private scans I could get but they don't come cheap. I made a complaint to the hospital in question when my son was a few months old about that and my general care which left a lot to be desired and the response was pretty much " you're okay, you're baby is okay, be happy with that and don't be bothering us".

lazygal

As far as I'm aware three miscarriages cause the extra care to kick in, not two, and even then very early miscarriages might not 'count' if the woman never went to the GP for confirmation.

LittleBook

wolfpawnat wrote: »

You get a minimum of two. One at your first appointment to date it, which they double check again at the anomaly scan.

Morag wrote: »

Some women only get 1or 2 scans at 20/22 weeks due to the lateness of booking in with the maternity hospitals due to demand on services, we have been in a baby boom.

lazygal wrote: »

I know women in Cork and Louth who got only one scan at 34 weeks. No dating or anomaly scans before then were offered.

clairefontaine wrote: »

I was not able to get a dating scan at all, private or public,and unaware of private clinics at the time.

Das Kitty wrote: »

1 scan is what you get in Galway, at "around" 20 weeks.

I know a couple of women who have had to wait til 35 weeks, one of whom,only to find out the baby had a condition that meant it wouldn't survive outside of the womb. I'd much prefer 20 weeks to come to terms with that than 5.

iguana wrote: »

I was only offered one scan in Holles St last year at 22 weeks and at that scan they brought me forward by 5 days. If an anomaly had shown up I'd have been in a very tough situation timewise. As well as that they don't actually offer a full anomaly scan in Ireland.

Neyite wrote: »

In UHG (Galway) the first scan they offer is around 22-24 weeks -even if you register with your GP early. My gp wrote to the early pregnancy unit requesting that they see me asap when I was 9 weeks pregnant. I was given a first appointment and scan date for my 19th week ...
I was told rather snottily on the phone that I was "lucky" to be given a scan at 19 weeks.

meeeeh wrote: »

First time when I was private I got scans whenever was my first appointment with consultant (around 12 weeks). The second time when I was public my first scan was at 9 weeks (two miscarriages in between) then at 16 and about at 25 irc and so on (Mullingar hospital).

grarf wrote: »

I got a scan at 13 weeks, and am getting my next hospital appointment at 30 weeks. NOTHING in between, just a GP visit or two. No anomaly scan at 20 weeks, nothing

pwurple wrote: »

My pregnancies were in Cork. First pregnancy scan on first pregnancy was at 8 weeks in the EPU, as I hadn't had a period in 6 months and had no idea how pregnant I was. Second scan was back into the normal system at 12 weeks. Had a scan at 21 weeks, 26 weeks, 30 weeks and 41 weeks.

Second pregnancy I did know my dates, my first scan was scheduled for 12 weeks in CUMH.

eviltwin wrote: »

I had three miscarriages before my last pregnancy, despite that - and the fact I had a "high risk" pregnancy - I still was only given one scan at 22 weeks.

FFS, I know "every pregnancy is different" and we have a two-tier health system here, but how can there be such differences in such a basic and important health care requirement?! Mind ... boggled! :mad:

iguana

lazygal wrote: »

I think we need to stop equating low levels of maternal deaths with amazing world class care in terms of how women experience maternity services in Ireland.

Our maternal death rate isn't actually especially low, we just hadn't been calculating it to the same standard as other countries. When the same method of calculating maternal death that they use in Britain is used here, our maternal death rate is the same as theirs too. They have just been holding themselves to a higher standard, while we have been under reporting. http://www.independent.ie/irish-news/rate-of-maternal-deaths-here-is-double-official-figure-28939773.html

lazygal

LittleBook wrote: »

FFS, I know "every pregnancy is different" and we have a two-tier health system here, but how can there be such differences in such a basic and important health care requirement?! Mind ... boggled! :mad:

That's our 'world class system' in action.

seamus

We went semi-private in the Rotunda and my wife got an ultrasound at every single appointment, in addition to the big scan at 20 weeks. My sister in law went semi-private in the Coombe and only got one scan at 20 weeks, she had to pay for an early scan elsewhere herself.

So the level of care differs massively between hospitals, never mind between tiers or between pregnancies. Tbh, while I have no doubt that those providing maternity care in Ireland are very good at what they do, the "Best in the world" attitude started to surface around the late 90's/early 00's, when birth rates were in an historical lull.
Now that babies are booming, we're starting to see huge cracks in the service.