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Refusing a c-section = abuse and neglect?

A woman had her parental rights terminated after refusing to deliver by cesarean -- but that's not the whole story

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In 2006, a woman known only as V.M. in court documents gave birth to a baby girl, J.M.G., at a New Jersey hospital. During labor, V.M. “behaved erratically” and at some point refused to consent to a cesarean section, despite her doctor’s concerns about fetal distress. The obstetrician ordered an emergency psychiatric evaluation, which found that “V.M. was not psychotic and had the capacity for informed consent with regard to the c-section.” The staff then asked for a second opinion, but before the next psychiatrist could complete his evaluation, the baby was born vaginally. And healthy. Oops. 

Nevertheless, a social worker at the hospital contacted the Department of Youth and Family Services, and J.M.G. was removed from her parents. Eventually, a judge agreed with DYFS that V.M. and B.G.’s parental rights should be terminated. Documents recently released by the apellate court say flat out that at that point: “the trial judge found that J.M.G. was an abused and neglected child due in part to her parents’ failure to cooperate with medical personnel at the time of her birth. V.M.’s refusal to consent to a c-section factored heavily into this decision.” And still, V.M. lost the appeal.

Unbelievably outrageous, right? Louise Marie Roth at the Huffington Post lays out the case for exactly why terminating a woman’s parental rights for refusing a c-section is a heinous assault on her civil rights. Unfortunately, that’s not why the appellate court agreed that V.M. was guilty of abuse and neglect, no matter how large a role it played in the first trial. The new documents go on to say, “irrespective of whether or not V.M. consented to the c-section, there was sufficient credible evidence to support a finding of abuse and neglect as to V.M. The majority therefore eschews any discussion of the issue of c-section.”

It still sounds (and might actually be) pretty damned outrageous. What credible evidence could prove that a mother who wasn’t allowed to take her baby home from the hospital is guilty of abuse and neglect? Well, apparently, neither parent showed up to the first court hearing, days after J.M.G. was born, and when a caseworker called to ask where they were, B.G. answered, claimed he was not B.G., and claimed not to know who the caseworker was or anything about a hearing. Thus J.M.G. was placed in foster care. After the next hearing, where V.M.’s history of psychiatric illness and refusal to take prescribed medication came up, two psychologists who attempted to evaluate V.M. and B.G. ended up getting restraining orders against them; the second “was assaulted in the parents’ home.” Additionally, “The group contracted to provide parenting classes stated that it could not provide V.M. with services absent a psychological evaluation due to her disruptive and uncontrollable behavior.” Oh, and somewhere in there, V.M. claimed she had consented to a c-section, despite all evidence to the contrary.

In the pro column, the baby’s foster mother later testified that, based on her visits with V.M. and B.G., she thought they would make wonderful parents. But back in the con column, another psychiatrist who eventually did evaluate the couple diagnosed V.M. as a paranoid schizophrenic and B.G. as suffering from “‘folie á deux,’ a rare condition in which one person subscribes to the psychoses and paranoid delusions of another,” and “stated that it would be dangerous and reckless to return the child to them, because “[t]hese are parents who live in a world that has nothing to do with the world that we live in. And anything could happen there at any time and there’s no way to predict it.” A defense psychiatrist then countered that yes, they would make good parents, actually — and the flummoxed judge ordered a third opinion, after which he entered an order that said “adoption was an appropriate plan because of V.M.’s psychiatric condition and non-compliance with treatment and B.G.’s lack of acceptance.”

You get the picture. I won’t offer a guess as to whether this couple is as dangerously mentally ill as some of the psychiatrists claimed, or if they were the victims of a witch hunt, or somewhere in between. But it seems plenty clear that V.M.’s refusal to have a c-section was not the main issue in the appellate court’s decision, or even necessarily the first court’s.

The document does refer to several other legal decisions that weighed a fetus’s rights against the mother’s right to refuse a c-section, not all of which favored the mother. It’s well worth reading through those, for all the reasons Roth lays out. And she has a strong point when she says that “While the court opinion also focuses on the parents’ psychiatric diagnoses (which are fallible medical judgments) and their history of care in determining their fitness as parents and abrogating their parental rights, their psychiatric state would never have been questioned if the mother had not refused invasive abdominal surgery — which was entirely within her rights.” Probably true. The obstetrician is quoted as saying, “in the end with the mother’s life and baby’s life in balance, I think it was negligent . . . not to accede to what the doctors requested,” which is the kind of statement that makes me want to go give birth in the woods by myself if I ever do; refusal of an invasive and, as it turned out, unnecessary medical procedure should not call your skills as a mother into question before you even are one. But in the case we’re discussing, the appeals court actually agreed with that premise. To wit:

I would adopt the reasoning in L.V. as applied to the facts here. The decision to undergo an invasive procedure such as a c-section belongs uniquely to the prospective mother after consultation with her physicians. To allow such a decision to factor into potential charges of abuse or neglect requires a prospective mother to subjugate her personal decision to a governmental agency’s statutory interpretation creating a scenario that was neither contemplated nor incorporated within the four corners of the relevant statutory language. Her decision on matters as critical as this invasive procedure must be made without interference or threat. V.M.’s decision to forego a c-section had no place in these proceedings.

That’s exactly the kind of language women should want to see in legal rulings. And yet, Roth and other bloggers are holding this up as an example of, as far as I can tell, the exact opposite of what the latest judges actually said.

There’s no doubt that the doctors and staff at St. Barnabas were both paternalistic and ridiculously egotistical in their assessment that refusing a c-section equals neglect. There’s no doubt that the original trial judge should never have factored that into his decision — just as the appellate court unequivocally said. But given that that is what the appellate court unequivocally said, why are we now talking about this in terms of a legal system gone mad? That decision is actually evidence that the system worked, albeit far too slowly, to defend V.M.’s right to make medical decisions about her own body. It just didn’t defend her right to be a mother, based on the preponderance of the incredibly complex, conflicting evidence against her.

It’s possible that V.M. got completely screwed here; I’m glad it’s not my job to interpret the evidence. And it is terrifying that in too many cases, the state has successfully argued that a fetus’s rights outweigh its mother’s. But making V.M. out to be a poster girl for reproductive rights, based on a document that takes great pains to explain why she was declared an unfit mother regardless of her decision to deliver vaginally, seems like an awful stretch.

 

Kate Harding is the co-author of "Lessons From the Fatosphere: Quit Dieting and Declare a Truce With Your Body" and has been a regular contributor to Salon's Broadsheet.

What happened to Broadsheet?

A farewell (of sorts) to Salon's feminist blog

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Read about it here.

Did the recession prevent teen motherhood?

Some thank the economy for a decline in teenagers giving birth, but contraception is the likelier savior

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Did the recession prevent teen motherhood?

Teen births hit a record low last year, according to a CDC report released Tuesday, and the narrative quickly taking hold in the media is that we have the recession to thank. It’s a surprising idea, that teenagers are keeping it in their pants because a baby isn’t a prudent choice in the current economic environment. Foresight isn’t what we expect from those creatures of impulse — and, indeed, when is a baby a practical economic choice for a teen? It also struck me that the teen birth rate isn’t the same as the teen pregnancy rate, if you catch my drift (my drift being … abortion). I took my questions to a couple of experts in hopes of some clarity.

“The recession is everyone’s favorite causal explanation for things happening right now,” said Rachel Jones of the Guttmacher Institute. “Other than people conjecturing, there is no evidence that the recession has had a direct impact on teen sexual behaviors.” What we do know, however, is that contraceptive use increased among teens between 2007 and 2009. “We don’t know the reason for that increase,” she explains, and, in fact, it could be the recession — but, again, the truth is we just don’t know. Her no-nonsense take: “It seems if we want to look for reasons for patterns in teen birth rates, [birth control use] is the one indicator that offers us practical insights.”

Bill Albert of the National Campaign to Prevent Teen Pregnancy shared my initial skepticism about the economic explanation: “I just simply do not know many 16-year-olds who are thinking about bank statements when they hop in the sack.” But he pointed out that while roughly eight out of 10 teen pregnancies are unplanned, “there is a mushy middle ground [of teens who] say, ‘Well, yeah, I wouldn’t want to get pregnant, but it wouldn’t be the worst thing that happened.’” Call it the “mush” factor: Perhaps those ambivalent teens were swayed by firsthand experience of the economic meltdown: “Their parents might be struggling to make house payments,” he said. “They might know neighbors who have lost jobs and can’t find jobs.”

As for the question of whether a decrease in teen births might be linked to an increase in teen abortions, there is a bummer of a data lag: Guttmacher isn’t releasing 2008 stats on pregnancy terminations until early next year. However, says Albert, “if the past is prologue, the answer is probably no. What we have seen over the past two decades is that teen birth rates have gone down because the underlying pregnancy rate has gone down. Put another way, all three — pregnancy, abortion, birth — all tended to be going down at the same time.” Jones agrees: “Teen births and abortions seem to follow the same trajectory,” she said. “We haven’t seen any indicators that abortions have gone a different direction than births.”

You might recall that there was a troubling and unexplained rise in the teen birth rate in 2006 and 2007. Albert says the 2009 finding — which followed a 2008 decrease — suggests the uptick was “an abnormal blip” and that we’re now “resuming a nearly two decade trend toward fewer teen pregnancies and fewer births.” Inexplicably, some abstinence advocates think this report has “exonerated their approach,” reports the Washington Post. Valerie Huber of the National Abstinence Education Association told the paper, “This latest evidence shows that teen behaviors increasingly mirror the skills they are taught in a successful abstinence education program.” Except that … it doesn’t. Says Guttmacher’s Rachel Jones, “The levels of teen sexual activity haven’t changed, which would suggest that there isn’t more abstinence out there — but there was a change in contraceptive use.”

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Tracy Clark-Flory

Tracy Clark-Flory is a staff writer at Salon. Follow @tracyclarkflory on Twitter.

Olbermann still doesn’t get it

The MSNBC host is back on Twitter with a response to his critics -- but he ignores their key complaint

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Olbermann still doesn't get it

Update: Olbermann has responded on Twitter by blocking me and tweeting, “Your article embarrasses you and your site.”

Back from his self-imposed Twitter timeout, Keith Olbermann is lashing out at his feminist critics. As Sady Doyle explained last week in Salon, the online protest was started in response to Michael Moore’s mischaracterization of the allegations against Julian Assange. Olbermann became a target after retweeting a link from Bianca Jagger that incorrectly claimed “the term ‘rape’ in Sweden includes consensual sex without a condom,” and that named Assange’s accuser (which is generally a journalistic no-no). Overwhelmed by the Twitter campaign, which was waged with the hashtag “mooreandme,” Olbermann quit the microblogging site in a huff. This afternoon, after a few days of calm reflection, he tweeted a link to his thoughts on the matter:

I endorse, sympathize with, and empathize with, the rape consciousness goals of #mooreandme, and have already apologized accordingly. But I cannot defend and will not accept their tactics which mirror so many of the attitudes and threats they fight. I do not know of what Julian Assange is guilty, if anything, and neither does anybody else. But given the extraordinary efforts by Sweden to extradite him, to say he is benefiting from some form of rape apologism is not fact-based. It is also unfair to condemn as anti-feminist those who merely address the juxtaposition of this prosecution to the fact that Assange threatens the secret and nefarious activities of dozens of governments.

But, of course, his antagonists are not condemning him for “merely address[ing] the juxtaposition” (a point Kate Harding made clear in her Salon piece about “the rush to smear Assange’s accuser”). They allege that he spread misinformation about the accusations against Assange. As Doyle wrote, “People trust journalists: If a journalist says something, like ‘the term “rape” in Sweden includes consensual sex without a condom’ (Olbermann’s own, demonstrably false, as-yet-unredacted words), most people will believe that what he has said is true, and act as if it is true, without doing further research.” The protest has consisted of frequent calls for Olbermann to issue a simple correction, to set the record straight for his many followers.

Instead of doing that, though, Olbermann continues: “And I will not engage those who suggest that those who do not prioritize one issue to the exclusion of all others should succumb to forced financial contributions, or should ‘kill themselves.’” He followed up by retweeting one of the messages in question, which read in part, “Seriously, kill yourself.” Then he retweeted a call for him to donate $20,000 to the anti-rape organization RAINN as atonement. His antagonists have been quick to point out that he cherry-picked the “kill yourself” tweet, which is an exception in the thread, and that the call for “financial contributions” is simply in the interest of rape victims. One user wrote, “we WILL NOT be satisfied UNTIL you retract the false information you publicized re: Assange allegations.” Olbermann responded, “you’ll have to accept a block instead.”

It seems Olbermann’s Twitter vacation didn’t help him to raise the level of discourse or realize that, as Doyle put it, his “style of old-media authority doesn’t hold up” online.

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Tracy Clark-Flory

Tracy Clark-Flory is a staff writer at Salon. Follow @tracyclarkflory on Twitter.

Save the children from Hooters?

NOW calls on the breast-obsessed chain to stop serving kids

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Save the children from Hooters?

The National Organization for Women is protesting Hooters. I know: Yawn. Next I’ll be interrupting major sporting events with breaking news that Gloria Steinem isn’t a fan of the “Girls Gone Wild” franchise. But, seriously, the argument at play here is more interesting than it at first seems. It isn’t the breast-obsessed chain’s existence that is being challenged, but rather the fact that Hooters serves children. Clearly, there is abundant evidence that Hooters is guilty of poor taste (see: restaurant name) — but should the chain be forced to card customers at the door and turn away anyone younger than 18? Several California chapters of NOW have filed official complaints alleging just that.

Hooters is described in official business filings as a provider of “vicarious sexual entertainment.” NOW points out that the chain has “used this designation as a way to avoid compliance with regulations against sexual discrimination in the workplace.” The official employment manual warns that a waitress is, as NOW paraphrases, “employed as a sexual entertainer and as part of her employment can expect to be subjected to various sexual jokes by customers and such potential contacts as buttocks slaps.” At the same time, however, Hooters is marketed as a family-friendly restaurant. It offers a kid’s menu, high chairs, booster seats and all sorts of merchandise for little tykes — like a “Life begins at Hooters” T-shirt, an “I’m a boob man” onesie and a “Your crib or mine?” bib.

We could argue over whether Hooters has a healthy impact on a kid’s developing view of women and sex, but I tend to think entertainment and dining decisions should be left up to individual parents. More important, that isn’t the issue at hand. In this case, NOW (which hasn’t always been a model of moderate thinking) has taken the exceedingly reasonable position that Hooters shouldn’t be allowed to have the best of both worlds: Either it functions exclusively as an adult venue, and continues to protect itself (somewhat) from sexual discrimination claims, or it’s held to the same standards as any ol’ family restaurant and gets to keep on serving the kiddies tater tots and creepy onesies.

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Tracy Clark-Flory

Tracy Clark-Flory is a staff writer at Salon. Follow @tracyclarkflory on Twitter.

Why do serial killers target sex workers?

The question is raised after four female bodies are found on a Long Island beach

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Why do serial killers target sex workers?Authorities search in the brush by the side of the road at Cedar Beach, near Babylon, N.Y., Tuesday, Dec. 14, 2010. Police looking for a missing prostitute on Long Island's Fire Island have discovered three bodies and a set of skeletal remains near Oak Beach since Saturday. Investigators are considering the possibility that a serial killer may have dumped four bodies along the same quarter-mile stretch of beachside road, a police chief said Tuesday. (AP Photo/Seth Wenig)(Credit: AP)

As New York confronts the possibility that there’s a serial killer on the loose, many have taken note that this case looks a lot like what we see in the movies: The victims are all women, and at least one is suspected to be a sex worker. When it comes to serial murder, it turns out fiction really does reflect reality. A report was released last month finding that 70 percent of known victims of serial killers are women (consider that only 22 percent of homicide victims in general are female); and it turns out sex workers are 18 times more likely than “normal” women to be murdered. Why might this be? Well, in the words of the Green River Killer, who targeted prostitutes:

I picked prostitutes as victims because they were easy to pick up without being noticed. I knew they would not be reported missing right away and might never be reported missing. I picked prostitutes because I thought I could kill as many of them as I wanted without getting caught.

Since they’re doing illegal work, sex workers have to be secretive and discreet. They often work in isolated and industrial areas. They get in cars with strangers. There are rarely detailed records of transactions. Many are drug addicts and estranged from their families, so they are less likely to be reported missing. Anyone who knows anything about a girl’s whereabouts is likely involved in the trade themselves, so they aren’t super eager to speak with police. What’s more, as we saw with the Robert Pickton case in Vancouver, police sometimes discount tips from working girls (all the more reason to not risk talking to them in the first place).

It just so happens that Friday is International Day to End Violence Against Sex Workers, which was created in memory of the victims of Gary Ridgeway, a.k.a the Green River Killer. Similar to the Pickton case, local sex workers knew Ridgeway’s identity, but, as prostitute-turned-performance artist Annie Sprinkle puts it, they “were afraid to come forward for fear of getting arrested, or the police didn’t believe those that did come forward, or the police didn’t seem to care.”

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Tracy Clark-Flory

Tracy Clark-Flory is a staff writer at Salon. Follow @tracyclarkflory on Twitter.

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