Changing the Practice of Maternity Care in Canada - The Legal Avenue

I've been struggling with what happend to me - struggling with the very disturbing idea that a lot of the things that I hold dear, that I thought were inviolable were indeed violated. I find when I don't have something to concentrate on - my mind automatically goes there - as such I've spent a lot of time thinking about what happend to me, thinking about whether or not it will/could happen again. It's not like everything else that "I'm over" - things that I generally don't dwell on, things that don't consume my thoughts when I have nothing else to think about.

I'm moving past the stage where it's a crappy situation that is overwhelming. I'm trying to figure out what I can do to put it behind me - to put it with the rest of everything else that has been crappy in my life - in the past. I need closure and to get closure I need to regain the sense that I am indeed able to have control, that I can prevent the same shitty thing from happening again, either to myself or to someone I love. I need validation that the rights I thought I had, I indeed had, and that they were wrongly violated, and that there is some consideration of that. I also need to know exactly who/what I should be angry with - angry with my doctors, angry with the hospital, angry with a system or a maternity care culture that is insensitive to the needs of women who have no desire to achieve a vaginal birth. Right now I'm just angry - and at it all, and most of the time.

I've been doing a lot of research - Can-lii (a resource to look up Canadian judgements) has become my hobby. And in the course of my research, I have discovered that never before in Canada has a woman who did not want a vaginal birth, who asked for a csection but was subjected to a vaginal birth and wound up with a healthy child and the 'normal' physical sequalae of vaginal birth sued, and had the case go to trial.

There are scant few cases where women have sued for a bad birth experience that resulted in a healthy child, more cases where women (or more specifically their children) have sued as result of being left with life-long disability as a result of birth. In the few cases I have found that do not involve life-long disability - the amount of damages is typically less than $25,000. There's one case where negligence resulted in the still birth of a child, where damages of $60,000 were awarded. The nearest I can come to a similar case was involving a woman named Lesli Ann Szabo who gave birth to twin boys in Hamilton, Ontario in 1992 and then sued for $2.4 million (the twins were healthy) for excessive pain during childbirth - the case settled out of court for an undisclosed amount.

That's not to say that the case is without merit, or that no damage has resulted from the experience. Research on the legal aspects of patient autonomy, medical battery, informed consent, and the right to security of person has revealed a large body of applicable case law that is quite favourable to the proposition that a woman has a right to choose an elective cesarean at term, and that unreasonably denying her access is a violation of her charter rights.

However, there is no precedent (and if there is, please let me know) for this exact situation in Canada. Perhaps that is why it persists - quite simply because nobody has stood up and said, "this is wrong and it needs to change" and pursued legal action and set legal precedence. If all the women before me have been unwilling or unable - and I myself were to be unwilling despite being able - could I ever expect things to change?

Perhaps this is my fight to pick, and perhaps by pursuing it in this way I can put it in the past.

A Note to Little Bean

Dear Little Bean:

I am sorry, I have not been able to greet news of your pending arrival with the unfettered joy that accompanied news of your sister's pending arrival. I did not pee on three pregnancy tests, as I did with your sister, just to make sure it is real...I peed on one. I peed on one - and greeted the news with a combination of happiness, but also a great deal of anxiety. I did not call every one who needed to know within mere moments of seeing the news - I've told a few people, first your daddy - we drove by daddy's office and had your sister hand him the pregnancy test. And a couple of days later your Grandma J and Grandpa G, your aunts T and W and uncle M and a few close friends - your Grandmas P and B still don't know. I did not immediately call my doctor to get a referral to a maternity care provider - rather I only just placed that call today, a week after 'seeing' the news. Since seeing the news, my sleep has been less than stellar - in part because of your big sister, but also in part because of my own worries and anxieties. My worry that my trust and confidence will be betrayed again. My worry that despite having a plan (albeit a rather pricey one) - that something will happen to frustrate that plan. My utter terror of being again in the worst pain of my life, out of control, and without choices that I thought I had...knowing that this is possible, is very frightening to me.

I am sorry, that I am unable to confidently welcome the news of your pending arrival, I wish that was different - but little bean, please know - that you are very wanted and your mother's anxiety and fears have nothing to do with you, and everything to do with the context in which you are coming to be. You are loved and wanted, and I will deal with it as best I can.

Forgive me little bean - my response to your pending arrival, is just another unfortunate consequence of what happend when your sister came into this world. It's not your fault, it's not hers - but it sucks. It sucks that I can't greet this news with the unfettered joy that it deserves to be greeted with. You are wanted and loved, and I will do everything to ensure your safe arrival into this world.

Love,
Mommy