Articles by Month: February 2008

Birth in India - legal case mounted

I have received an email from Ruth Malik, my contact in India, who is setting up a new childbirth education service for Indian women. She has mounted a legal case to challenge the management of the birth of her second child, which she considers was an unnecessary caesarean birth. She has asked that I circulate the following petition that she has submitted to the Indian authorities, to provide information, support and encouragement for other women in India who may also feel their births were mismanaged. It is an interesting story, and one that will resonate with women in many countries, not just India.

MAY IT PLEASE THIS HON'BLE FORUM TO ACCEPT MY PLAINT AS UNDER:

This Complaint is against the Medical negligence/ Malpractice of the Respondent Doctor and the Hospital as a result of lack of due care, abrupt decision making in carrying out childbirth leading to Emergency Cesarean Section of the Complainant on 24th March 2006.

FACTS OF THE CASE

1. I am a foreign national married to an Indian. I have a 5 years old male child born by caesarean section.
2. . I consulted Respondent No 1 for my second pregnancy and expressed my strong desire for a normal vaginal delivery. She gave me full support for the same.
3. . On my due date (17.03.06) she examined me cursorily per abdomen and declared that I had a lazy uterus and my previous scar was paper thin and thus I was unlikely to be a suitable candidate for normal delivery. I was not satisfied by her statements so I approached another doctor at ...... Healthcare Centre for second opinion ( Annexure A) regarding my chances of having normal child birth. They carried out Ultrasonography (Annexure B) and NST ( Non Stress Test) and assured me that all is well so I stayed home waiting for Labour.
4. . On 24.03.06, Respondent No 2 carried out CTG (cardiotopography) for which I had to lie on my back. A belt was tied around my abdomen to check baby’s heart rate. I felt uneasiness and incredible heat, they said after a few seconds that I would be taken up for surgery.
5. . Though I signed the informed consent for emergency Cesarean section, I was not convinced with the indication verbally given by the attending staff at Respondent No 2. They admitted me at 2.54pm and at 3.05 (Annexure C) I was in the operation theater for a surgery by Respondent No 1.
6. . In the operation theater, Respondent No 1 told me of being misinformed and the doctors who gave me second opinion as QUACK. This further added to my doubt regarding her decision for Cesarean section , but I was helpless for myself by that time.
7. . I had a baby girl, who was pink and healthy when shown to me in the operation theater. I could not relate her to the emergency scene I was shown to be suffering from.
8. . I was discharged from the hospital on 27.03.06, feeling confused and cheated.
9. . I went back to Respondent No 1 after ten months to clear my confusion and to find out what really had happened. She told me that I had rupture of membranes and fluid was leaking out. I pulled my discharge card (Annexure D) and asked her why it was not mentioned there. She grabbed it from me and quickly scribbled scar dehiscence in the mid portion of scar with herniation of membranes.
10. . Respondent No1 again tried to satisfy me by stating that I was lucky that I came in as soon as labour started. I was stunned and told her that I have never had been in labour. She was silent on this. By this time, the mental strain and agony was unbearable.
11. . I applied for and got my indoor case papers and discovered questionable discrepancies, evident of deficiencies of services suffered from both the Respondents as a consumer / an Expectant Mother and at last a Deceived Mother.
12. . What I inferred from my research was that I was wrongly stamped as an emergency cesarean section, what I really needed was careful support and monitoring for a few more days, which (duty of due care) was denied to me by both the Respondents.
13. . An evaluation of Respondent 1’s series of actions demonstrates that she intended the birth to consist of an emergency Caesarean section before I was given to chance to commence natural labour. I must conclude that the surgery was pre-planned by Respondent No 1.
14. . Childbirth is the Reproductive right of a woman. Normal childbirth has a more positive impact on the body, in establishing breast feeding and thus providing good growth parameters for the baby. Researches have further laid down the safety criteria of reproductive organs after normal deliveries. The humane bond between child and mother is being weakened by these increasing rates of intervention i. e. cesarean section. The modern medical technology aims at providing qualitative health care but what I experienced as a woman as well as a mother at Respondent No 2’s care, of being violated, deliberately abused by the doctors on whom I trusted for seeking help of experiencing a normal childbirth which was deserved in my case.
15. .I made a complete inquiry of my case and decided to raise my voice because it concerns the reproductive rights of so many women who have suffered from this deliberate negligence and left confused or misinformed by their gynecologists. When I compared this fact with other countries, I found that it is easy to see the standards for practice of major hospital abroad on the internet but impossible to get an ideal of practice of Gynaec/ Obstetrics in India. I wondered what human care and which standard of medical services is provided to a dependant consumer called “Patient” in these corporate hospitals.

THE MAIN DEFICIENCIES OF SERVICE I SUFFERED:

During my pre-delivery care.

1. . My doctor and I never had time to talk to each other which is highly unethical, and extremely dangerous for the patient. I felt I was a burden to my doctor rather than a woman paying a huge amount as a consumer for availing her medical services.
2. . My mother had all three children delivered normally ten days overdue. As a literate woman I assume that my post maturity may be because of this genetic factor. I mentioned this every time to my doctor during my regular ( Ante Natal Care) checkup in expecting a rational and scientific explanation from a qualified Medical professional What I got was as answer was, her silence.
3. . She was under professional obligation of satisfying my queries. But I was left confused. It was my right to know my status as an expectant mother and then only I would have been in a position to exercise my options about my baby’s birth. Respondent No 1 has totally neglected her duties as a medical professional.
4. . Because of this deliberate negligence of Respondent No 1, I had to seek second opinions from other professionals expending more time and money in my last few stressful days of pregnancy.

   During my stay at Hospital

5. . Respondent No 2 had supported Respondent No 1 in carrying out an unethical surgery, in interest of revenue generation.
6. . When I was admitted on 24.03.06 at 2.54pm at Respondent No 2, I was not having any pain, fluid leaking from vagina or decreased foetal movements etc. As a routine practice, a detailed history and complete checkup ( external and internal) has to carried out, but the attending doctor ( Registrar Gynecology) at Respondent No 2 did not examined me internally ( that is per vaginally). In her notes (Examination per Abdomen in Annexure C) my uterus was found to be relaxed (that means not in Labour) but in the consent form for surgery, I was stated to be in labour (that is Rhythmic contractions of uterus). Can this be possible or acceptable to man of rational thinking?
7. . It was a pre planned surgery on part of Respondent No 1. Respondent No 2 ( also being a healthcare professional) did not bother to inquire and justify the consultant’s decision and thus supported her in this deliberately planned act of negligence and money generating Malpractice.
8. . At the time of taking consent for the surgery, the reason given to me was postdated pregnancy overdue by 7 days. I was with 41 weeks gestational age on 24.03.07 I was not convinced this to be the reason for emergency cesarean but the hype was deliberately created by both the Respondent so as to avoid me in making decision about my surgery. They put me on the Operation table on 3.05pm. Is this brief time period with so many misinformation, can allow an expectant mother to understand the so called informed consent and assent to it?

   I was made to sign the consent under undue influence

9. . In the operation theater, when Respondent No2 labeled the second opinion giver professional as QUACK, I was surprised to see the dirty politics of medical fraternity, (in which ultimately innocent patients are being victimized.)
10. . Because of her abrupt decision about my cesarean section, I was prevented from experiencing the natural bliss of being a mother, left with an unnecessary scar on my abdomen and a feeling of guilt. I suffered a lot of mental agony and stress from this incident which is supposed to be a wonderful and blessed part of every woman’s life.
11. . Now I already have two unnecessary cesarean which had further reduced my chances of having normal delivery in future. My reproductive rights had been deliberately violated.
12. . I was denied by both Respondents the duty to care (careful monitoring of maternal and foetal well being) for at least few days, owed by me. So I would have equally exercised my choice in the process of decision making about child birth , signed the Informed consent with consensus, not with confusion . At last I may have achieved a normal vaginal birth and enjoyed the motherhood more healthier both physically and emotionally.
13. . Respondent No 1 failed in her obligation to reasonably pursue the option of a VBAC birth as we had previously discussed and agreed upon. By confusing me with unsound medical information she failed to serve my best interest as her patient and failed to provide appropriate services to me as a consumer of health care.

Posted by andrea at 02:39 PM