Originally Posted by Cynthetiq

I was looking for the New Scientist Indiana study and haven't been able to find anything on it. I did however stumble upon this Junkfood Science blog entry.

Originally Posted by Study Abstract

We investigated perinatal and maternal deaths occurring among women who were members of a religious group in Indiana; these women received no prenatal care and gave birth at home without trained attendants. Members of the religious group had a perinatal mortality rate three times higher and a maternal mortality rate about 100 times higher than the statewide rates. These findings suggest that, even in the United States, women who avoid obstetric care have a greatly increased risk of perinatal and maternal death.

PIP: All reported perinatal and maternal deaths from 1975 to 1982 among Faith Assembly members living in the state of Indiana were verified. Fetal death and the neonatal mortality rate were defined per 1000 live births; perinatal mortality was the combination of fetal deaths and neonatal deaths per 1000 births plus fetal deaths; and maternal mortality was calculated per 100.000 live births. 344 live births were identified in Elkhart and Kosciusko Counties among religious members during this period. 291 of these mothers (85%) did not have prenatal care, the prenatal care for the remaining 53 (15%) was unspecified. The mothers tended to be aged 20-34, white, married, and have minimum of high school education. 21 perinatal deaths were established among this population sample with 12 fetal deaths and 9 neonatal deaths. 11 fetal and 6 neonatal deaths occurred to members residing in the above 2 counties. Trauma or asphyxia at birth (often as a result of umbilical cord problems) and respiratory problems were responsible for most of the mortality. 6 maternal deaths occurred: 4 due to hemorrhage and 2 caused by infection. During this period there was a total of 61 maternal deaths in Indiana, and thus about 9% of maternal mortality occurred among Faith Assembly members (100% vs. 36% deaths caused by hemorrhage and infection). 3 of the 6 church members who died were 35 or older, and 2% of the births occurred to women 35 or older in these countries. The estimated perinatal mortality rate for this group was 45/1000 live births vs. 18/1000 for the whole state, almost 3 time higher. The fetal mortality rate was 32 vs. 9 for Indiana (significantly higher); and the neonatal mortality rate was 17 vs. 9, respectively. The maternal mortality rate was 872/100.000 live births for church members residing in the 2 counties vs. 9/100.000 for Indiana: an astounding ninety-twofold higher rate.The risk of perinatal and maternal death is greatly augmented even in the US when women do not utilize obstetric care.

Originally Posted by Laura L. PEMBERTON, et al., Plaintiffs, v. TALLAHASSEE MEMORIAL REGIONAL MEDICAL CENTER, INC., Defendant.

Order compelling mother, who was in
labor attempting vaginal delivery at home
without a physician present at conclusion
of a full-term pregnancy, to submit to a
caesarean section that physicians opined
was medically necessary in order to avoid
a substantial risk that her baby would die
during delivery did not violate mother's
substantive constitutional rights; whatever
the scope of mother's personal constitutional
rights, they did not outweigh the
interests of the State in preserving the life
of the unborn child. U.S.C.A. Const.
Amends. 1, 4, 14.

Originally Posted by Laura L. PEMBERTON, et al., Plaintiffs, v. TALLAHASSEE MEMORIAL REGIONAL MEDICAL CENTER, INC., Defendant.

Ms. Pemberton delivered a prior baby in
1995 by caesarean section. Most caesarian
sections are performed using a horizontal
incision. Ms. Pemberton's 1995 caesarian,
however, was performed using a vertical
incision. Moreover, the vertical incision
extended well beyond a traditional low vertical
incision up into the thickened myometrium.
The nature of this caesarean presented
a greater risk of uterine rupture
during any subsequent vaginal delivery
than would be the case with a more typical
caesarean section.
When she became pregnant again in
1996, Ms. Pemberton attempted to find a
physician who would allow her to deliver
vaginally. She was unable to find any
physician who would do so. Every physician
she contacted advised her that, because
of the type of caesarean section she
had undergone previously, vaginal delivery
was not an acceptable option.
Undeterred, Ms. Pemberton made arrangements
to deliver her baby at home,
attended by a midwife, without any physician
attending or standing by and without
any backup arrangement with a hospital.
On January 13, 1996, after more than a full
day of labor, Ms. Pemberton determined
she needed an intravenous infusion of
fluids; she had been unable to hold down
food or liquids and was becoming dehydrated.
She went with her husband, plaintiff
Kent Pemberton, to the emergency
room of defendant Tallahassee Memorial
Regional Medical Center (``the hospital''),
where she requested an IV.
Ms. Pemberton first saw a family practice
resident on call for obstetrics, who
brought the case to the attention of Dr.
Wendy Thompson, a board-certified family
practice physician whose practice included
obstetrics. Dr. Thompson advised Ms.
Pemberton that she needed a caesarean
section. Ms. Pemberton refused, saying
she wanted only an IV so she could return
home to deliver vaginally. Dr. Thompson
declined to assist in that plan by ordering
only an IV and instead notified hospital
officials of the situation. Hospital officials
set about securing additional opinions from
board certified obstetricians Dr. A.J.
Brickler and Dr. David R. O'Bryan, the
chairman of the hospital's obstetrics staff.
Dr. Brickler and Dr. O'Bryan each separately
concurred in the determination that
a caesarean was medically necessary.
Meanwhile, the Pembertons left the hospital
against medical advice, apparently surreptitiously.
The hospital set in motion a procedure
devised several years earlier (and used
once previously) to deal with patients who
refuse to consent to medically necessary
treatment. The hospital called its longtime
attorney, John D. Buchanan, Jr., who
in turn called William N. Meggs, the State
Attorney for Florida's Second Judicial Circuit,
where Tallahassee is located. Mr.
Meggs, who had the responsibility under
Florida law to institute any court proceeding
seeking to compel a medical procedure
without a patient's consent,1 deputized Mr.
Buchanan as a special assistant state attorney
for purposes of dealing with this
matter. Mr. Buchanan contacted Second
Circuit Chief Judge Phillip J. Padovano,
advised him of the situation and of Mr.
Buchanan's intent to file a petition on behalf
of the State of Florida seeking a court
order requiring Ms. Pemberton to submit
to a caesarean section, and requested a
hearing.
Judge Padovano went to the hospital
and convened a hearing in the office of
hospital Senior Vice President and Chief
Medical Officer Dr. Jack MacDonald. In
response to the judge's questions, Drs.
Thompson, Brickler and O'Bryan testified
unequivocally that vaginal birth would
pose a substantial risk of uterine rupture
and resulting death of the baby.
Judge Padovano ordered Ms. Pemberton
returned to the hospital. Mr. Meggs and
a law enforcement officer went to Ms.
Pemberton's home and advised her she
had been ordered to return to the hospital.
She returned to the hospital by ambulance
against her will.
Judge Padovano then continued the
hearing in Ms. Pemberton's room at the
hospital. Both she and Mr. Pemberton
were allowed to express their views. The
judge ordered that a caesarean section be
performed.
Dr. Brickler and Dr. Kenneth McAlpine
performed a caesarean section, resulting in
delivery of a healthy baby boy. Ms. Pemberton
suffered no complications.
In due course, Mr. Buchanan prepared a
written petition setting forth the claim for
relief previously submitted orally and a
proposed order. Judge Padovano entered
the order on February 2, 1996. Ms. Pemberton
did not appeal.2
Ms. Pemberton now seeks in this federal
court an award of damages against the
hospital. She has not named the physicians
as defendants because the hospital
has agreed, for purposes only of the claims
at issue in this lawsuit, that the physicians
acted as agents of the hospital, thus allowing
entry of a judgment against the hospital
for any claim established against any or
all of the physicians.
Ms. Pemberton claims that the forced
caesarean violated her substantive constitutional
rights and that the procedure that
led to entry of the order violated her right
to procedural due process. She seeks relief
under 42 U.S.C. § 1983 and, alleging
conspiracy, under 42 U.S.C. § 1985. Ms.
Pemberton also alleges common law negligence,
in effect, medical malpractice, as
well as false imprisonment arising from
her forced return to the hospital. Mr.
Pemberton joins as a plaintiff alleging loss
of consortium.3
The hospital has moved for summary
judgment. For the reasons that follow, I
grant the motion.4

Originally Posted by Laura L. PEMBERTON, et al., Plaintiffs, v. TALLAHASSEE MEMORIAL REGIONAL MEDICAL CENTER, INC., Defendant.

The record includes testimony of six
physicians on this subject. FiveÐthose
whose testimony has been offered by the
hospital 13Ðuniformly assert the risk of
uterine rupture from any vaginal delivery
in these circumstances is unacceptably
high and the standard of care therefore
requires a caesarian. Dr. O'Bryan, for
example, placed the risk at four to six
percent.14 When the consequence is almost
certain death, this is a very substantial
risk; as the physician convincingly
explained, if an airline told prospective
passengers there was a four to six percent
chance of a fatal crash, nobody
would board the plane.
In response, Ms. Pemberton offered the
affidavit of a sixth physician, Dr. Marsden
G. Wagner.15 Dr. Wagner placed the risk
of uterine rupture slightly lower, at between
two and 2.2 percent, and said the
risk the baby would die if there was a
rupture was 50 percent. If these are the
facts, it is hardly surprising that Ms. Pemberton
could find no physician willing to
attend an attempted vaginal delivery.
Presumably there would still be no passengers
on a plane if the risk of a crash was
only two percent and if, in any crash, only
half the passengers would die.
Moreover, Dr. Wagner's analysis assumes
a delivery in a hospital attended by
a physician. In fact, however, Ms. Pemberton
was in the process of attempting
vaginal delivery at home without a physician
either participating or standing by.
Prior to attempting to deliver vaginally at
home, Ms. Pemberton was unable to locate
a single physician willing to attend the
birth; this shows just how widely held was
the view that this could not be done safely.
Ms. Pemberton's request to the hospital
was not that she be allowed to deliver
vaginally at the hospital but instead that
the hospital provide an IV so that she
could return home to deliver there.16
Even Dr. Wagner does not suggest that
Ms. Pemberton could have delivered safely
at home without an attending or even a
standby physician.17