In this case,5 Laura Pemberton scoured Tallahassee and the surrounding areas for an obstetrician
who would attend her in a vaginal birth for her fourth child after a prior caesarean delivery. She
was rebuffed by every doctor she contacted; the risk of catastrophic uterine rupture was too high,
they told her. Believing in her body’s ability to give birth vaginally, Mrs. Pemberton decided to
deliver at home rather than agree to what she viewed as unnecessary surgery. More than a day
into her labor with no sign of complications, she nevertheless worried that she was becoming
dehydrated. She reasoned that the best way to safely manage her labor would be to go to a
hospital for intravenous fluids, and then return home. Mrs. Pemberton entered the hospital ex-
pecting to receive care and assuming that she, like other patients, had a right to informed medical
decision-making, including the right to consent to or to decline recommended medical proce-
dures. When she arrived, she was placed on a fetal monitor that showed that her baby’s heartbeat
was strong, and that her labor was progressing, albeit slowly. However, when the obstetrician on
call realized that she was attempting a VBAC, she refused to give the IV that Mrs. Pemberton
needed—unless she consented to a caesarean. Mrs. Pemberton was alerted by a nurse that
obstetricians were about to seek a court-ordered caesarean section. Without receiving the fluids
and while still in active labor, she fled the hospital out of the back steps in her bare feet.
Mrs. Pemberton made it home to continue her labor, her confidence bolstered by the baby’s
strong heart tones. Her progressing labor was interrupted by a knock at the door: it was a sheriff
and the State Attorney. They entered her home and even her bedroom, following her throughout
her house to make sure she did not flee again. They told her that she had to return to the hospital,
because a court order forcing her to undergo a caesarean section had been granted. Neighbors
looked on as she was removed from her home, still in active labor, with her legs strapped to-
gether on a stretcher. Once at the hospital, she was allowed a “hearing” in her hospital room,
with an armed sheriff, the State Attorney, and obstetricians crowding her room. Although a law-
yer was appointed to represent the fetus, no lawyer was appointed for her. She spoke between
contractions, without the benefit of counsel, telling the judge about the extensive research that
she had done to support her decisions. Despite the fact that she could already feel her baby’s
head in the birth canal and neither she nor the baby showed any signs of danger, the obstetricians
were convinced that she exposed her fetus to too much risk by continuing to deliver vaginally:
the judge agreed. Laura Pemberton was sedated, and her baby removed via caesarean section.
Mrs. Pemberton left the state and went on to deliver four more children, including a set of twins,
vaginally.
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