I just read this post on the Academic OB/GYN blog: Micro Tort-Reform: A potential solution to the VBAC liability issue. This was written after the NIH panel came out and recommended we decrease the number of cesareans and increase the number of VBACs (or at least make it more of an available option to mothers) and cited a huge problem for repeat cesareans being the issue of litigation.
The author of this post suggests a potential solution: a nationally accepted consent form for VBACs and repeat cesarean delivery. It would point out the risks and benefits of both procedures so the parents can make an informed decision, it would discuss what is needed at the hospital in case of emergency and if that hospital meets those standards, and- most importantly, I think- it would say something about how you’re aware of the risks and that by signing the consent, you release the hospital/OBs from any liability.
At first I thought–awesome idea, if it helps make VBACs more available. But then I thought… what if the OB does do something wrong (beyond “normal risks”) and you signed away your life saying you wouldn’t sue? I am not the type of person that would sue–it was my choice and I know what I’m getting myself into. But to have that option completely taken away?
So here are my questions….
Is that even legally binding? Can signing something like that really stop you from suing–can it really release the hospital from litigation?
Don’t hospitals already have something like this? Do you already have to sign a consent form for a VBAC? OR for a c-section? (Which actually makes me wonder… I never signed anything before my c-section. Is that normal?)
Would you sign it? Do you think this is a good idea?
How does it work when you have a VBAC at home? Don’t midwives have the same insurance issues as OBs???
That is a hard question, does one need to sign anything to have a baby!!!
Having a c-section Doctor have to ask a consent from the patient) That should include that the patient was not under the influence of any drugs (pain killer of sorts) and that she revived all the information prior to give her consent (which is not always the case during labor!!!)
I do not know! I had a VBAC here in Canada and during my OB visit I had a Gyn come to explain to me all the pros and con and that I should not get induced etc… and we talk and made the decision that VBAC was the better choice for us.
During our Vbac I had to go trough certain routine live (having a IV just in case, being on the monitor all the time, so I was pretty much in bed all the time)
But for this second VBAC I’ll try to have no IV and No all the time monitor so I could be mobile (or stay home the longest time possible) Last time it was not possible cause it was a 6 weeks early baby with premature rupture of mambrane!! But the VBAC when really good and no med were took 🙂
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If I understand a waiver like this, and it is possible that I don’t, when you sign one, you’re saying if any of the standard complications arise from my choice, then I won’t sue my doctor or the hospital.
I don’t think this ends your rights to sue of the doctor commits malpractice. But, that may also depend on the design of the form and it stands to reason that if the doctors are the ones designing the form, they’ll want to build in as many loopholes as they can.
I’ve adovcated for something like this to make VBACs more available, but I’m wary of having the folks who would be governed by it, write it.
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My pre-law answer is that no, a person cannot sign away their rights in this situation. However there have been loopholes, the complexities of which I am not fully acquainted with, so I forwarded your blog to some smart lawyer friends and hopefully they can come answer your question for you.
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I should also mention, they tried to force me to sign one of these when I was in the hospital and I flatly refused. I would not put my signature on anything. No one can force anyone to sign anything. EVER. Of course, if they’re trying to make you (prior to being in active labor and being basically incapacitated) then run run run run away!
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I did sign a “permission to operate” form before my c-section. I do not remember it saying that I signed away my rights to sue, but it outlined the risks of the c-section and said that I was giving consent for the surgery to take place. It’s routine for any surgery I’ve had.
I imagine that since your c-section was “emergency” (their definition, not yours) that that’s why you didn’t sign one. My c-section was scheduled and therefore “elective” (their definition, not mine). In “emergency” situations doctors assume consent; that you wouldn’t be at the hospital if you didn’t want the interventions.
Gina (or another law student/lawyer) please correct me if I’m wrong on that.
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To support Maya’s point, I signed consent for surgery on the second one, plus a tubal ligation agreement. What was funny to me is that I signed that danged tubal form at least four times, and then had to verbally consent twice more before anyone even picked up a scalpel.
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Actually, whether emergency or not, the mother (or someone responsible for her – meaning her husband or other family member, not the doctor) has to sign the cesarean consent form. A surgeon cannot perform any operation without one, to my knowledge. There is a “blanket” consent form that one signs when entering the hospital, which is what makes it possible for them to add intervention after intervention without really asking permission. I would never sign a blanket consent form – I’d edit mine to request permission before each new procedure or drug was administered. They must allow that, but of course, they rarely (never) offer that option. However, even if a blanket consent form is signed, if a mother says no to any procedure, her wishes must be followed. Even signing that form doesn’t necessarily sign away her right to refuse treatment. If you say no to an episiotomy, and they do it anyway, that’s technically assault.
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I actually signed a form like this before my VBAC. Well, a few weeks before–my OB reviewed it with me at my 36 week appointment. I believe i have read that a form like this would not hold up in court, but I don’t know anything about the legality of it. From a perspective of making more people aware of the risks of ERCS, unfortunately I don’t think it would make a difference. There is a consent form for that, too, but most doctors gloss over those risks while vastly exaggerating the risk of VBAC.
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