State Cesareans: Treating Natural Birth as Neglect in New Jersey Division of Youth & Family Services v. V.M. & B.G.
An estimated 1.5 million cesarean sections are performed in this country each year, making it the most common inpatient surgical procedure.[1] However, the procedure is not without controversy as the United States’ cesarean rate has consistently increased for the last eleven years to a present record-high of 31.8 percent[2] of births, more than double what the WHO recommends.[3] While many medical professionals have agreed the rate is too high, citing diminishing health gains and an increase in maternal and fetal health risks, the heated debate over strategies and policies to reduce the rate between OB/GYNS, midwives, childbirth educators and public health specialists continues.
A recent appellate case in New Jersey involving a woman who refused to undergo a cesarean section and the subsequent removal of her healthy child inflamed a new wave of discussion surrounding cesareans and their prevalence as part of the current medical and legal structure of American maternity care.[4] In New Jersey Division of Youth & Family Services v. V.M., the Superior Court of New Jersey affirmed the termination of parental rights and deferred to the lower court’s finding of abuse and neglect as to V.M, the mother of the child.[5] The majority abstained from ruling on the cesarean and tersely affirmed the decision while it was Judge Carchman’s lone concurrence that considered it inappropriate to consider the refusal to undergo the procedure, though he did not go far enough and reverse the trial court.[6] Thus, while the court officially did not comment on the cesarean, their improper consideration of an invasive medical procedure was a factual and legal error that will achieve the same purpose in altering birth and the culture of choice in the child welfare regime.
