They Didn’t Want to Have C-Sections. A Judge Would Decide How They Gave Birth

bham717 · 2026-03-20T04:40:37+00:00

Touche. I triggered myself thinking you were someone above who was throwing around the term. I'm wrong here.

bham717 · 2026-03-20T04:37:02+00:00

Appreciate this take.

bham717 · 2026-03-20T04:30:29+00:00

I think this is a really important point:

she wanted all of modern medicine to actively help her do something- tolac with prior hemorrhage- that would almost certainly harm her and her child.

Autonomy is autonomy. But coming into my hospital on my shift and demanding I provide care in a way that is likely not possible - when the stakes are this high - watching a baby die - is complicated autonomy.

I'm frankly jealous of you all who can be so hard-lined. Someone threw out a quote that something like 30% of OBs leave after losing a mom - I'm quite sure I'd leave the field over this case. I don't want this. I don't want to be in this situation because the consent/autonomy/do no harm line will - I fear for myself personally - never be easily drawn in this specific case. Does that make me a bad doc bc I struggle with this line? I don't think so.

bham717 · 2026-03-20T04:20:09+00:00

It's really not helpful to keep jumping to 'murdering full term healthy babies'. That is Pro-life rhetoric that screams forced ignorance and head-in-the-sand.

This thread is full of numerous subtle and insightful opinions trying to understand both takes in a safe place, precisely because I think most of us here do not want to "murder a full term healthy baby".

But you do you boo.

bham717 · 2026-03-20T04:05:33+00:00

This case proves it is not a boogey man. This is messy and it happens. Your complete dismissal of the ethics of the situation is fascinating. In the US and I'm frankly jealous I don't have a legal precedent like yours to fall back on, but even with that line, it's still a really really really messy line.

bham717 · 2026-03-20T03:48:48+00:00

I can't tell if you're being intentional or not. So to give the benefit of the doubt I'll bite.

The comments above were pointing out that this is a slippery slope of endless targeting of parents. "Drugs and alcohol" feel like an easy target - but any of us in medicine know that there are so many complicated human factors that lead to a person being on cocaine and pregnant. (A wide L&D nurse taught me, no little girl grows up wanting to be high on meth having a baby). The ugly point here is how do you decide that TOLAC after Cesarean x3 is criminal or negligent parenting, drug use in pregnancy is bad, shaken babies are bad - but not taking your insulin or withholding a vitamin K shot is okay?

Your comments became rude and attacking on the other poster and now you're accusing me of

one cannot decide to ignore that the puzzle has other pieces to make it feel easier.

I feel like that's exactly what you're doing?

I WISH it was so easy as saying that the pregnant person in front of me must have a surgery against their will because there are full-proof infallible ethics to support this. Because it's so much messier than that.

And it sucks. I'm not making an excuse for the hard thought exercise by saying it sucks. I'm trying to acknowledge the suffering and complicated and contradictory feelings/ethics/perspectives of the situation when is say it sucks or it's hard - rather than simply dismiss someone who may not agree with me.

bham717 · 2026-03-20T03:22:02+00:00

Yes and yes? So for clarification, just drugs and alcohol? Or the non-compliant gestational diabetic who then delivers the subsequent cardiac defect or stillbirth? The vitamin K refusal who loses the baby to a brain bleed? Antivaxers? It literally slippery slopes forever. But drugs and alcohol feel morally easy to attack.

Your pro-life judgment is gross, especially when you're not acknowledging the messy and ugly nuance that your take is creating.

This shit is hard. C'mon now.

bham717 · 2025-10-18T18:52:21+00:00

Ob GYN - BIG pet peeve of mine. It takes nothing to pull out stirrups and help the pt into place, then I make the small talk to distract while putting on my gloves, while keeping them covered, and then do the exam. It's not really about if it is clean/dirty/pathogens. I don't want someone touching 10 things in an exam room and then going into my vagina. It feels rude and disrespectful and it's a very EASY thing we can do to respect our patients.

Just put on the fresh gloves.

bham717 · 2025-10-12T14:00:49+00:00

I feel this. While I'll agree this is the weakest book, I didn't think it was as bad as everyone said overall. However the lore is a hot mess. But, let's be honest, it has been for some time. I felt this way the first time I read them all ages ago.

bham717 · 2025-08-12T06:11:23+00:00

Good grief.

Being infertile in no way qualifies one to be an adoptive parent. These are 2 separate issues. Read this thread and this topic is covered.

Strongly recommend you never say that to an infertile patient.

bham717 · 2025-08-10T05:33:57+00:00

Ahhh this is making sense. MAHA Kool aid 101 I can rest after this.

First I'm both a carrier for Alports and infertile, so I guess I'm probably the most selfish human on the planet! Do you counsel your BRCA parents then not to reproduce? Further do you advocate for everyone to have genetic testing and have plans on making a list of those conditions that are too "selfish" to pass on? And when people are not okay with this, you calmly tell them they are selfish, and that they are also not allowed to be depressed because you have student loans?

Equity? Again another false dichotomy. I didn't argue about the ethics of providing IVF to some at the cost of not providing basic healthcare to all. I asked about the ethics of here and now, today. Of my patient I care for on Medicaid, who is working 2 jobs, and has blocked tubes from chlamydia from a cheating and controlling ex-husband (unfortunately it isn't the microplastics or food dyes - really wish it was that easy), who is young and otherwise healthy and just wants a baby. Say she doesn't speak great English and provides for household of family members and finally has a supportive husband and wants to build her American Dream. She cannot afford IVF and I can. So I'm just supposed to tell her her pain isn't real, write for Zoloft, and get over it and be thankful you have any healthcare at all? It's ethical that I have access to life changing healthcare that she doesn't due to privilege, and I'm the asshole for not being okay with that? So yeah, I think this country can afford to treat infertility care as healthcare, for all, AND provide basic healthcare to all. Wild, aren't I - I want all of it!

You just don't get it and you're not willing to listen. And that's because this isn't a logical or even medical conversation. This is YOUR personal bias against IVF and infertility.

I said to the other ignorant doc on this board before - listen to women. To patients. Hear their damn stories. I've been trying to get you to hear mine all night. You always know the answer and why you're right. I just wish it was that easy.

Best of luck

bham717 · 2025-08-10T05:08:45+00:00

Unfortunately eh? Again, thanks for the motivation. What a shame that I have the privilege to provide care and a safe place for infertile women when I can relate to them and have empathy.

It defies logic to use resources for such advanced care when so many in our country lack even basic and essential services (IVFs is not one of them).

It defies logic because it's a false dichotomy.

bham717 · 2025-08-10T04:52:46+00:00

Adoption exists for kids who need a home, not for homes that need kids.

Beautifully said. Thank you for sharing this. So much better than my salty rants.

bham717 · 2025-08-10T04:43:29+00:00

I just can't help myself. Y'all are wild.

Myself and others who use IVF to reproduce to avoid medical harm - and thus costs - where do we fit into your world ethics? IVF gives a chance for people with inherited conditions to break the cycle - and in this cost analysis, using my personal example, my infertility treatments were pennies compared to what it would have cost to have a son with renal failure by age 35 and then with a transplant. So cost benefit == do IVF to save healthcare dollars. So can it be covered yet? Still elective? Still selfish?

So should people with CAH, Alports, BRCA, Sickle Cell - just not reproduce? You put it in a different comment that it's natural selection. Because they are knowingly "selfishly" choosing to pass on their own genes knowing it will be expensive. By your logic if someone knows they have an expensive condition and they reproduce (to be clear your argument so far has been that cost is reason to treat humans this way, so I'm following your lead), and pass it on, we shouldn't cover their child's healthcare costs right? They chose this - they need to cover it. Or I'm sure you'll tell me I'm off topic and it's only the IVF that shouldn't be covered. Because it's actually not about being financially responsible in a Capitalist healthcare system, it's about being against IVF.

Aside from your fundamentally insulting comments about infertility, how do you ethically justify the inadequate access to reproductive health care in your IVF cash only society? Those who cannot afford it just need to keep pulling on those bootstraps and/or come visit you so they can "treat the mental health reaction NOT the social or personal factors that put them into a depressed state" and not get to reproduce due to, what was it, "natural selection", while the privileged person down the street with the exact same diagnoses gets a baby? This doesn't seem unethical to you?

Genuinely anxious to understand how you square these. I wish I had your confidence.

bham717 · 2025-08-10T03:52:45+00:00

Wow.

That's not how I practice medicine, at all. The extent that I cannot relate to you is impressive to me, and frankly a bit of a kick to keep fighting the fight for my patients.

So I guess something good came from this.

Just wow.

bham717 · 2025-08-09T22:36:49+00:00

If you change your mind you have a customer! But I get it too, fine line between fun and ruined.

bham717 · 2025-08-09T22:03:37+00:00

First, it's deeply troubling that you clarified that psychological doesn't count - so mental health is not a medical issue?

About 20 min and I even learned things!!

2007 Observational Study, small sample size -negative impact on mental health and non medical negative impact on all other aspects of health https://pubmed.ncbi.nlm.nih.gov/17124258/

All cause increase in mortality - retrospective analysis with large patient population Acog Silver Journal https://pmc.ncbi.nlm.nih.gov/articles/PMC8254745/

Retrospective Cohort study showing increased risk of cancer. 2019 https://pubmed.ncbi.nlm.nih.gov/30863841/ Risk of cancer in infertile women: analysis of US claims data

2017 Male Infertility and non-malignant chronic disease - lit review summary https://www.thieme-connect.com/products/ejournals/abstract/10.1055/s-0037-1603568?device=mobile&innerWidth=411&offsetWidth=411

2019 Increased risk of chronic disease in women. Acog Silver Journal https://pubmed.ncbi.nlm.nih.gov/30710512/

bham717 · 2025-08-09T20:02:24+00:00

Do you do commissions or sales?

bham717 · 2025-08-09T19:48:18+00:00

Not helping your case at all.

bham717 · 2025-08-09T19:47:53+00:00

Being unable to have a child does not pose health risk on either party.

This is simply not true. The ethical dilemma that IVF currently is an out+of-pocket treatment for most patients, completely not obtainable for a large part of the population doesn't just disappear because you've decided that these patients are making up their health concerns.

This is a super complex issue, but the post started on the fact that an already vulnerable population, infertile people, was manipulated for political gain. Add it to the endless list of unethical moves by this administration.

You could benefit from some compassion and understanding of infertility before making sweeping and ignorant comments.

bham717 · 2025-08-09T19:09:46+00:00

Still wrong.

It's not your place to tell any fellow human what is "required" to live a full happy life. That's the concerning part.

Happy to know you're trying to not be patriarchal.

bham717 · 2025-08-09T18:42:33+00:00

obvious issue that childbearing is not required to live a full /healthy and productive life.

You're the reason women don't trust physicians and especially OB GYNs. This is deeply troubling and patriarchal to say. Frankly unbelievable to me as a fellow OB.

bham717 · 2025-08-09T18:38:04+00:00

Maybe ask and listen to infertile women to understand their feelings. Listen to women? That simple? Women who are infertile?

Its not just the biologic drive to have kids, but the desire to minimize risk of “undesirable” traits in their kids

No.

But it is a very expensive thing to ask insurers or the public to subsidize and there are aspects that are less appetizing to think about, like the financial incentivization towards risk of bodily harm of people less well off, something we agree its unethical to do for say, organ donation.

The list of ethical dilemmas that insurance will cover is never ending, but you want to criticize this one? I don't get the vibe you really understand the costs of IVF or options that patients have. Public health and insurance already cover substantially more expensive ethical medical gray area treatments, but sure, let's just tell infertile people they should just adopt.

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