Is a mother in labor a child abuser?

i-9dc84d4d9156dccb30d5f62466b4219a-swblocks.jpgIf she lives in New Jersey, she might be. Because apparently, refusing a C-section (and then successfully vaginally delivering a healthy baby) and acting "combative" "erratic" and "noncompliant" during labor is considered child abuse and neglect and is grounds for the New Jersey Division of Youth and Family Services (NJ DYFS) to immediately take away your newborn child and permanently terminate your parental rights.

Sounds unbelievable, right? But I am so not making this up.

In the case of New Jersey Division of Youth and Family Services v. V.M. and B.G., In the Matter of J.M.G., new mother V.M. was never allowed contact with her daughter and has had her parental rights terminated. And now the decision has been held up on appeal (link to the decision). Father B.G. initially had his rights terminated too, but on appeal that decision has been reversed. No word on whether either parent has ever been allowed to see their daughter, who is now 2 years old.

I haven't been able to get back to original court decision contesting the DYFS decision, but from everything I've read, the whole argument against the mother is based on her behavior in the hospital - in labor - with a doctor trying to force a C-section on her. (I had a relatively uneventful childbirth experience, but I'm sure some of the same adjectives could be used to describe my behavior at times during the labor.)

As Louise Marie Roth of the Huffington Post writes:

The decision cites hospital records that describe the mother, V.M., as "combative," "uncooperative," "erratic," "noncompliant," "irrational" and "inappropriate." Also, her husband indicated that the way she was acting was not her "normal manner and that she is not as 'tranquil.'" Why would anyone expect a woman in labor to be compliant, tranquil, or rational? What kinds of expectations does our society have for women undergoing a powerful physiological process, often with an absurd amount of poking, prodding and general interference?

Furthermore, as Roth points out:

First, from a legal perspective, individuals have a right to informed consent and bodily integrity. ... In this specific case, one obstetrician who tried to convince the mother to consent to a c-section concluded that she was not psychotic and had the capacity for informed consent with regard to the c-section. It is clear within the law there is no informed consent without informed refusal, so this obstetrician's conclusion should have made V.M.'s refusal to consent to the c-section her decision alone. If this mother is not legally permitted to refuse major abdominal surgery, then she is clearly stripped of her civil rights to informed consent.

I'll note that in the appeal, the judges specifically refused to rule on whether the refusal of a C-section was grounds for child abuse, instead working around it and continuing to deny V.M. her child based on her behavior. Unless she was abusing other children or drugs, I can't imagine how her history could allow DYFS to go to such draconian measures immediately after birth. (I have seen no reports that she was abusing drugs/children/animals/cotton candy/the internets etc.) And even if she had other troubles, the investigation was prompted by her refusal of the c-section, not any other complaint.

To top it off, it's not like the NJ DYFS has such a stellar track record of protecting children under its care. (Though I am sure that 99+% of the time they do a good job of taking children out of terrible situations and finding better places for them. But there have been some real tragedies.)

I'll change my mind if new facts come to light, but from everything I've seen this is an outrageous violation of a woman's right to choose whether to have invasive surgery, her ability to express the emotions and frustrations that are a part of the childbirth experience, and the best interests of the newborn child to be with her mother. In my mind, the NJ DYFS decision is the real instance of child abuse here. I wish V.M. the best of luck getting her child back.

I first learned about this story 2 days ago (h/t Kate), but it's taken me this long to write about it because I have been too busy pondering my own good fortune in having a smooth childbirth without unnecessary interference from pushy doctors or child welfare officials. And I've been giving my 2 year old daughter lots of extra cuddles. I'm also sending a donation to the National Advocates for Pregnant Women, and I encourage you to do the same. This doctor's orders: Count your blessings, cuddle your children, and help those less fortunate around you.

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Horrifying and incomprehensible.

Wow. How can it be child abuse when the child was born naturally and healthy? I could maybe understand an argument made if the child suffered severly from the birth but this is ridiculous!

Normal legal proceedings in the US have to follow certain guidelines. If you obtain evidence illegally, it can't be used; and everything that follows from it is tainted. Child custody proceedings aren't bound by this. It's good that the court said they couldn't use the C-section decision in the battle, but it sounds like everything else they got followed from that report. If civil liberties and setting good legal precedent are the top priorities, it wouldn't matter if she was abusing other children or drugs or anything else unless they can prove it with a new investigation with legitimate probable cause.
If the child's welfare is the top priority, I'm sure the people at NJYFS think they are doing the right thing. But I've gotta say, if you didn't have other problems before a doctor got pissed at you during labor for not wanting to be slit like a fish and had your child stolen, you sure would afterward. Aside from the 'bad legal precedent' angle of tainted evidence, we have no way of knowing what kind of person the mother would have been if she hadn't had to go through this nightmare.

Living in NJ I can say I'd rather have the mafia put out a contract on me than get on the wrong side of some pen-pusher at DYFS.

By NoAstronomer (not verified) on 30 Jul 2009 #permalink

I think you are promulgating a seriously questionable and disingenuous meme on this one SciWo. It is absolutely relevant whether this woman is in fact suffering from serious mental disability because it puts into context the descriptors of

"combative," "uncooperative," "erratic," "noncompliant," "irrational" and "inappropriate."

We have a practice of violating the liberties of the mentally disabled when their behavior and mental condition is such that it poses a threat to the health and well being of themselves or others. Do we not?

So it comes down to the details of whether she was in fact in this threat-posing condition at the time. Not as to whether this would be an inappropriate move under any conceivable conditions which is what you appear to be saying here.

By DrugMonkey (not verified) on 30 Jul 2009 #permalink

I was horrified at first as well. Then I went digging for the appeal decision, since the embedded link did not work for me. I found this in the google cache... http://tinyurl.com/mf5mmv
Although the original denial of custody seems based on the shady reasons outlined in your article, the appeal presents a different picture. One that includes a history of psychotic episodes, refusals of psychological treatment and dueling psychiatric evaluations of the parents. Also two of the state psychologists got restraining orders against the parents after evaulating them.

DrugMonkey,

I have no idea where you've gotten the idea that she is seriously mentally disabled, but I'd appreciate the link if you have it. As quoted above, her behavior during labor was not her normal behavior, according to the child's father. And the NYT piece linked above says:

In investigating the referral from the hospital, the NJDYF learned that âV.M. had been under psychiatric care for 12 years prior to V.M.Gâs birth.â But the motherâs mental health was not the reason given for placing the child in foster care in the first place.

I can easily imagine someone with chronic depression treated with medication being under a psychiatrist's care for 12 years without being an unfit mother by virture of her mental illness. If we are to argue that pyschiatric care and mental illness make one de facto an unfit mother, then its only a short step to forced sterilization of people with mental illness or disability. And I'm not sure you want to go there again.

Further, I'd argue that even if V.M. is suffering from "serious mental disability" observations of her behavior during labor, even aside from the added insult of coercion into major surgery, have absolutely no relationship to her normal range of behaviors. Women do all sorts of "crazy" things during labor. We moan, we shit ourselves, we scream, we grunt, we swear like sailors... But when we don't have a fetus trying to make her way out of us, we act much more "sanely." Are you saying that someone with a mental disability does not deserve the right to be observed under less stressful circumstances to gage her fitness as a parent? DYFS did not watch her interact with her newborn in the hours after birth, it didn't visit her house in the days and weeks following the birth. No, it took the baby away before mother and child ever met. DYFS made the decision based on her behavior during labor, probably the single most physiologically and emotionally traumatic time of a woman's life.

Maybe here finally is where we disagree. As a woman who has gone through labor, I cannot imagine any conceivable conditions under which a mother's parental rights should be permanently severed based on her behavior during labor alone.

Perhaps the facts of the case will reveal themselves in a way more favorable to NJ DYFS, but until they do, I don't think anything I've said is questionable or disingenuous.

This is a very scary story. And unless, as SW says, there are other factors such as drug abuse, I find it appalling. I can't believe a country which enshrines its citizens holy right to carry weapons whose sole purpose is to shoot each other, denies a woman the right to decide whether she'll be cut into as she delivers her child, and punishes her by removing the child.

SciWo, the link provided by #6 is a start. My point is not to judge whether in fact this woman had other factors which taken together as a package resulted in the baby being removed from her custody. My point is to clarify that the refusal of c-section was only one of many factors which went into this decision making*.

The way this is being presented by you and by other bloggers portrays this as a single factor scenario by which the c-section refusal was the only factor. The additional evidence that is emerging seems not to bear this out. There seems to be a legitimate concern about the woman's mental health and capability to care for a child outside of the issue of c-section refusal.

__
*of course, we can never know the heart and mind of anyone sitting in judgment of a set of facts and which are most salient to that person.

By DrugMonkey (not verified) on 30 Jul 2009 #permalink

SW I think this is a wonderful post, and you make a very important point about women and labor: going through labor is not like, I don't know, watching TV and eating Cheetos. There is no way to evaluate or compare normal behavior with laboring behavior because labor is scary and painful, even as, for many women, it is also sacred and powerful and beautiful. If I hadn't had a birth plan going into my labor I wouldn't have been able to have the wonderful natural experience I had, because during the labor I was screaming and moaning (and all the other things you said) and was largely unable to form a coherent sentence. Does that mean I was unfit? No, I was just in what felt like wave after wave of interminable pain.

And DrugMonkey, you said @9 "The way this is being presented by you and by other bloggers portrays this as a single factor scenario by which the c-section refusal was the only factor" but wasn't SW's quote that indicated this from an NYT article? Even if other factors come out -- psychiatric care, etc -- does this appropriately explain what happened to this woman? At least I don't think so. I've been in a few L&D units, given birth myself, and assisted others, and I can say that the default medical view is that the doctor is right, the woman isn't in her right mind, and the partner of the pregnant lady can be cajoled/shamed/scared into whatever the doctor wants.

As for comment @5, these words ""combative," "uncooperative," "erratic," "noncompliant," "irrational" and "inappropriate"" are regularly used to describe pregnant women, women in labor, and menstruating women. The work of Davis-Floyd, Martin, Arms, and Vertinsky are all instructive. This is why I can't trust this whole mental health explanation. It's how women have been described for centuries, as a way to control them and their decisions.

Clearly the woman is the victim here, it's outrageous that the infant hasn't yet been charged with assault & battery.

Um, the description above does not match that given in the decision. You should read the entire decision, with all of the witness descriptions instead of selectively quoting from the first two pages.

By read the decision (not verified) on 30 Jul 2009 #permalink

I can see two possible interpretations of this story, and it's difficult to know without all the details (or perhaps even meeting the protagonists in person) what the correct outcome should be. Yes, C-sections are overused, done to protect the doctors & hospitals from lawsuits, women are not always treated with respect during labor and childbirth (been there, done that). On the other hand, there have been too many stories in the news lately of psychotic parents doing unthinkable things to their children (schizophrenic mother in Texas murdering her 3 week old infant, just this week; the Banita Jacks case in DC). If only someone had intervened for those children. The court documents suggest this woman may be schizophrenic or have serious bipolar disorder (and also said the parents had visition with the child). Yes, having a mental illness can make you an unfit parent, if you pose a danger to your child and don't have the capacity to care for her.

By neurowoman (not verified) on 30 Jul 2009 #permalink

Comment #6, posted while I wrote comment #7, does add some detail to the story. It's a messy story, because there are conflicting psychiatric reports and we will never see the original documents, etc., but there is reason for the court to believe that V.M. may be psychotic at times, and therefore a danger to her child. So one could argue that the end result (less danger to the child in foster care) justify the means (immediate removal from parents), but it strikes me that there must have been other, more just means of determining V.M.'s fitness as a parent than a snap decision within hours of childbirth.

And while DrugMonkey may continue to disagree with me on this, the messy facts of this case do nothing to dissuade me of my central argument (and that of Roth, Feministe, NAPW, and others): Behavior during labor, and medical decisions made by the mother regarding her labor, should never be grounds for charges of child abuse or neglect. While the court majority dodged this issue in the appeal, I applaud the single concurring judge who wrote that V.M.'s refusal of a c-section was within her rights and should never have entered into the decision making.

I'll draw an analogy and leave it out there for you all to debate (and then I promise my next post will be more fun).
Using a woman's behavior during labor and childbirth against her in a court of law is analogous to accepting confessions extracted under torture. Neither erratic behavior by a laboring woman nor a confession under torture should be taken to be representative of what that person might say or do when not under such extreme conditions. Erratic behavior during labor or confessing under torture is not irrational or insane, it's just a reaction to pain, sleep deprivation, and/or loss of control of one's body.

This is very disturbing. I've read the majority of the decision. Seems to be a bit of NJ DYFS covering their asses going on. The initial investigation and removal of the child was clearly due to her c-section refusal and behavior during labor, but because they took her baby away they got to delve into her entire life and say, "Well actually our decision is based on this other information". Yes, she has a history of mental illness but where is the evidence that she has caused harm to herself or anyone else during that time? Where are her prenatal records? How was her prenatal care?? Did she take care of herself and the baby?? That's a time that needs to be looked at. Both parents seem to be involved in some lying, but considering the situation of having their baby taken away, I'm not sure I blame them. From the decision, it is very difficult to determine what kind of parents they would be. There doesn't seem to have been any observation of the parents interacting with their baby while visiting her every two weeks and bringing lots of supplies for their child (as they were reported to have done in the decision).

There are some things very wrong with this case.

Also, seems to be a bit of the courts covering their asses too.

I'm going to go clutch my baby to my chest and feel sorry for this poor woman. Both of my children spent several weeks in the NICU after birth and that was sheer torture, even knowing that I'd have them home soon. The thought of someone taking one of them away before I'd had a chance to get to know them...

I don't even have words for the horror of that.

Oh, and as someone who had to make a snap decision whether or not to have a c-section, she has my sympathies there too. You're in pain, you're exhausted, you can barely think straight, and you need to make an incredibly difficult decision.

Sciencewoman wrote: Behavior during labor, and medical decisions made by the mother regarding her labor, should never be grounds for charges of child abuse or neglect.

Exactly. Unless, of course, you believe that a woman gives up all rights to make medical decisions about her body once an embryo is implanted in her uterus.

EVEN IF a C-section is the absolute best thing to be done for the sake of the yet-unborn-child, I do not think that anyone has the right to coerce a woman into accepting that procedure. I do not believe that the rights of the to-be child supersede the rights of the already-existing mother and it makes me shudder when things like this happen, threatening to continue to set and extend messy precedents that would argue otherwise.

Gah. After reading all that I'm really convinced it's a case of egregious abuse of power with the courts trying to make it seem like they were right all along.

The very fact they listed the husband as a defendant in the abuse case is disturbing- he was supposed to force his partner to have a c-section? There was no abuse.

DM- you're full of stinky, stinky bullshit on this one.
1) I'll grant that the refusal of the c-section was one factor among many. The court document makes it obvious that the c-section decision should not have been a factor at all. That is, the other evidence has to stand on it's own.
2)If, after reading the court documents, you think that even if we allowed the c-section refusal to be part of the decision, the evidence is anything like satisfactory to terminate parental rights... what are you smoking? Have you ever been in, or known anyone who has been in, a child custody hearing of this nature?

Monty Python starts to look more and more like reality TV doesn't it?

DrugMonkey: Words like "combative," "uncooperative," "erratic," "noncompliant," "irrational" and "inappropriate" are all subjective. How 'uncooperative' was she? How 'erratic?' Too much to make a rational decision? Besides, we have conflicting opinions regarding this woman's behavior from different care providers. The delivery team asked for a second psych opinion when the first didn't suit them. How many more opinions would they have sought until they got the 'right' one?

As to whether or not this woman suffers a mental disability which negatively impacts her ability to safely parent, we also have conflicting opinions -- two for and two agains. In any case, as another poster has pointed out, I too would be a bit pissed if someone stole my child from me -- I might even act a bit irrationally. The fact that two state appointed shrinks asked for restraining orders doesn't surprise me in the least. Wouldn't you be a mite hostile with a person who keeps telling you and the courts you are unfit to parent?

The default position in ANY situation regarding parental rights should be the child belongs with the parents until incontrovertible evidence shows a danger to the child. Does that mean some children might get hurt? Unfortunately, yes, just as some guilty people must go free to protect the rights of the accused. At any rate, we are far from proving the child will suffer with her natural parents in this case.

We have reached the point in this country where individual rights and liberty take a back seat to bureaucracy. These people made a bad initial decision based on biased opinions of a woman's behavior during an incredibly traumatic and emotional event. The bureaucracy chose to cover it's ass and trample this woman's rights in the name of 'protecting' a child -- the fall-back battle cry of every bureaucrat (and politician) seeking to justify bad laws and stupidity since the dawn of civilization. Every action these people have taken since that initial bad decision has been to meet one goal: to justify that initial bad decision. This case is a travesty and a testament to the danger of too much government involvement in personal affairs.

By Mark Sletten (not verified) on 31 Jul 2009 #permalink

Completely with SW, especially as articulated at #15. Look, school boards are willing to give vaccine exemptions to the school-going children of parents who claim a religious incompatibility with vaccines, yes? So (whether or not you agree the government should respect that particular opt-out), we've generally agreed as a society that people have the right to make some decisions--even decisions with possible life/death consequences--about their children, under much less trying circumstances than labor for pete's sake.

I'm astonished at people's reaction to this. If the baby had died in childbirth, we would be screaming because the hospital DIDN'T force her to have a C section.

Um, too bad DYFS wasn't around to help these poor kids:

http://www.foxnews.com/story/0,2933,535914,00.html?test=latestnews

They may well have saved this baby's life. Since the mother's medical records and history aren't available to us, and since we have no idea what specific behaviors triggered her being reported to DYFS, well, I'm not sure why everybody's so willing to jump to conclusions.

Really, do any of you know obstetricians and labor/delivery nurses who are anxious to call in child protection services for no reason? It's not like DYFS regularly prowls delivery rooms in NJ just looking for kids to grab.

By military wife (not verified) on 31 Jul 2009 #permalink

military wife: There are bad parents everywhere. The people in the story you quoted -- based on the information in the story -- have some serious quesions to answer. The point is in THIS story, based on the information we have, it doesn't seem right the state should have taken the child. You yourself acknowledge that by implying that even though it doesn't seem right, we should just trust the authorities because they aren't "...[prowling} delivery rooms in NJ looking for kids to grab." My question is why should we automatically assume the police and the authorities are 'right' in this case? As I've already said, absent incontrovertable proof of incompetence, a child belongs with her parents. The concept of "innocent until proven guilt" is forgotten when there's even the remotest chance a child might be in danger; this case highlights one of the many innocent people who suffer because of it.

By Mark Sletten (not verified) on 01 Aug 2009 #permalink

I usually don't add to comments on articles about controversial topics. Rhetoric usually makes the hairs on the back of my neck stand up. But, my anger issues aside..

I've read some more details on this case, and I have to disagree with the implications made here.

Here's the two possible scenarios-

1.The doctors and police are heartless monsters who would conspire to take a baby away from its mother as a means of punishment for her extreme behavior.

2.The doctors and police are(unethically)using this as an excuse(I'm guessing because they see it as their only option)to remove a child from what they believe is a dangerous and ill fit parent.

It's interesting to consider this as an example of following the intent of the law vs the letter of the law. And if so, why the former is the one that people get more upset about? (I said interesting to consider)

My hair stood on end when I read this, thinking much as said at #18, while the fetus remains inside her body, she can be as capricious as she chooses and it's a moot point.

Women do all manner of crazy things in labour, and I get sworn at more often than I would care to mention when I am delivering babies.

I'd go so far as to make the argument that a fetus putting a non-consenting mother in labour could better be constituted as assault.

However, reading through the court documents (in particular the fact that both a psychiatrist and a psychologist separately needed to get restraining orders against this couple even though they were trying to facilitate a reunion) makes me wonder how much of this is false hype. This level of paranoia and a diagnosis of folie-a-deux along with violent outbursts do not exactly make for happy families, and do generally lead to the apprehension of children.

Does anyone have an official link to the rate of C-sections at this hospital? Because I read one source that stated the rate was 48.9%!!! Which is ridiculously high, AND dangerous. But it wouldn't surprise me that there are hospitals with that rate, and one that did would be more likely to show this attitude to a mother.

Furthermore, I have read a case where the hospital and doctors got a court order giving them CUSTODY of the not-born fetus which gave them the right to perform a C-section against the consent of the mother. At least this woman was allowed to refuse, even if it cost her child, it's even worse when they legally subject you to major abdominal surgery and then take your child away because you disagreed with a doctor.