A pioneer ruling fails that choosing between childbirth or caesarean section is the responsibility of the mother, not the doctor

A judge from Las Palmas de Gran Canaria has handed down a pioneering sentence in Spain that recognizes the “fundamental right” of a pregnant woman to choose between a natural birth or a caesarean section and condemns the Canarian health system to compensate a mother with one million euros for prolonging a twin birth for 17 hours, considering it an act of “obstetric violence”.

In a sentence to which Efe has had access, the city's Contentious Administrative Court number 5 rules that, by imposing a natural birth on the mother, the doctors at the Maternal and Child Hospital of Las Palmas de Gran Canaria did not respect the ” fundamental right” of the mother to decide if she wanted her twins to be born vaginally or by caesarean section, causing irreversible brain damage to one of the little ones.

Judge Ángel Teba García fully upholds the claim filed by the Acosta y Navarro law firm on behalf of the affected party against the Canary Islands Health Service, “in view of the flagrant violation by the intervening physicians of the right to information of which he was the exclusive holder the woman in labor and the inalienable right to opt for a cesarean section as a surgical alternative to give birth to her two babies”.

The sentence considers that the woman was not informed “of the circumstances in which her childbirth took place nor of the advantages or disadvantages, dangers and risks of natural childbirth compared to a cesarean section so that she, correctly informed, under her own responsibility , could opt for one or the other possibility”.

In this case, the judge reasons, “what is observed is the imposition 'contra legem' (against the law) of the medical criterion that the appellant give birth by natural childbirth, subjecting her and the two fetuses to a strenuous natural childbirth that lasted a whopping 17 hours and with a disastrous result that the mother and her son must grapple with, in addition to his twin sister, and that no amount will ever be able to compensate”.

The sentence understands that the behavior of the physicians of the Maternal and Child Hospital incurred in an “inadmissible usurpation of another's right” that has led to “a terrible result, caused by those who stole the possibility that (the mother) could opt for the caesarean section in due time avoiding any injury to your child.

The judge defends that the right of the pregnant woman “to be informed of the existing alternatives, with their pros and cons, to give birth” assists her “during the pregnancy, before giving birth, when the process began, throughout throughout it and until the last moment of giving birth”.

And he reproaches the Canary Islands Health Service for “a patriarchal conception of women, contemptuous of their capacity for self-determination even when it is enshrined in the Law, dismissive of their competence to decide once properly informed, which aborts any autonomy they may have and which can be classified unambiguously as obstetric violence”.

Circumstances of each case

The Canary Islands Health Service argued in the trial that the final decision between natural childbirth or caesarean section corresponds to the obstetrician and that it will be this medical professional who will have to assess the concurrent circumstances in each case to decide on the matter.

The judgment rejects this argument: “the final decision is not made by the physician but by the patient, under her responsibility, once she has been correctly informed of her situation and of the existing alternatives, in this case natural childbirth or caesarean section, and ensures that otherwise is to ignore the rights that the Law recognizes to patients, in this case to any woman who is going to give birth”.

The magistrate who issued the decision came to the conclusion that “what happened in the present case was the 'manu militari' imposition of the medical criteria of the doctors who attended the appellant, who, in their professional work, do not contemplate any alternative to natural childbirth and for this reason they dispensed with informing the mother, in writing, during the period of 17 hours, of the alternative that constituted the cesarean section and of the advantages and risks that it implied.

The resolution recalls that the Canary Islands Health Service has been sentenced to pay substantial compensation in similar cases, which it warns “should not be borne by the Canary Islands taxpayer but by those physicians who transgress the law in pursuit of the primacy of natural childbirth by above any circumstance”.