Thursday, October 2, 2008

Jury Duty and Maternity Care

Well, those of you who know me won't be surprised to know that I can often easily find parallels between birth and life. Here goes my description of that latest parallel. This week, for the first time, I was chosen to sit on a jury.

On Monday night, something I said jogged Andy's memory that I was supposed to call to see if I was expected to attend for jury duty. So, in a panic, worrying that I had been expected to be there on Monday, and having forgotten to call Sunday night, I dial the number. The recorded voice tells me that I was to report to the courthouse the next morning. I am both relieved (that there is no recorded voice telling me that I was in contempt of court for not going in Monday), and suddenly concerned about all the practical matters like arranging childcare for my 2 year old and 7 year old with whom I am homeschooling.

The next morning, I get up, convinced that if it is a criminal trial, I will not be chosen. As a social worker/therapist with an abuse history, it's a big stretch to find a case for which I can be truly impartial. Or so I think.

I can't get into the details of the alleged crime, but I think the process is decidedly more relevant. They revealed very few details of the case, just enough to ask the questions they needed to ask to pick a jury of his peers. I was not in the first group of jurors to go up and get questioned. In fact, with my crystal ball at lunch that day, I had calculated to my family that I had a less than 1% chance of getting on the jury, given that I had only calculated a handful of people that they would eliminate based on their responses to the questioning, and there were still greater than 30 of us sitting in the second group, each with only a 1/30 chance of being called to replace any eliminated jurors. I learned how inexact a science it is to calculate the actual likelihood of an occurrence. And no, it isn't lost on me that in the field of obstetrics, events with a 1% likelihood, or even less are often purported to have a much greater risk.

Upon returning from lunch, I learned that only 7 of the original 20 were chosen for the jury. So, another group of 20 was called up. As I often do :-D, while waiting during breaks in the process, I struck up a conversation with the woman sitting next to me. Being more brazen in my activism, and noting that she was a 20 something, I decided to take the opportunity to discuss ICAN's mission.

As it turns out, the young woman sitting next to me, though not pregnant and with no children, was very interested in hearing more. Her sister is pregnant, and having had a cesarean with her first child, is hoping to avoid one with this child. Yet, she's not feeling supported in that goal by her care providers, a tale all too familiar to those of us in the birth world. I shared with her some suggestions for how her sister might determine how supportive her doctors were of VBAC. I was able to suggest that there were other practices a bit further out of the area that might be more supportive of her wishes.

By the time she was excused from jury duty, I think there is a decent chance that either she or her sister will contact me for more information and/or come to a meeting.

Okay, back to jury duty. As I sat there listening to the process throughout the day, hearing the careful questions posed to potential jury members about their ability to be impartial and follow the mandates of the legal system; each time the question was posed to another potential juror, I considered it carefully. And despite my own history of family violence (this case does involve a level of violence), each time I mentally answered yes to the question of whether I felt I would be a suitable juror. One of the questions the judge posed to us to help us determine that was something to the effect of "if you were the defendant (and subsequently we were asked if we were the prosecutors), would you want a person in your current state of mind to sit on the jury?"

By the time I was called up and questioned, I had given it a great deal of thought. The answer was uneqivocally yes; and I answered to that effect. I admitted to a family history of violence and that I am a social worker by profession. By the time the jury questioning was over, I had been asked many times whether I felt I could fulfill the duties of juror. And each time, the answer was yes. So, in the end, I guess I shouldn't have been surprised to have been selected.

Today, having heard most, if not all of the testimony, my fellow jurors and I will be charged with the awesome responsibility of quite literally deciding a man's fate. And I've wondered if I am being dramatic when I say that. To be truthful, I don't have any way of knowing what the penalty might be if he is found guilty as charged. But, nonetheless, given that it seems a fair assumption that the crimes with which he is charged will carry the risk of substantial jail time, I find myself feeling the weight of the responsibility.

How do I tie this into birth you ask? Well, as I sit there, I can't help but wonder if obstetricians, who in many ways carry a similar burden of awesome responsibility, truly appreciate the depth of that responsibility. Or are they too jaded to truly understand the impact of their actions or inactions?

In respect to obstetricians, I've heard far too many credible (yes, one of our jobs as jurors as charged by the attorneys is to assess the credibility of witnesses) accounts of OBs who, citing dubious scientific rationale, induce women, immobilize women, and yes violate women, to believe that as a profession, they carefully consider the "evidence" as well as the impact of their recommended interventions on the lives of women and their families. Do they, as a whole, engage in the kind of deliberate weighing of the risks of the proposed intervention as well as not using it. Nor do I see much, if any credence given to the fact that there are emotional considerations of interventions for women as well as concrete physical considerations.

For Obstetricians, has medicine become primarily defensive; an effort to avoid perceived potential consequences of inaction, in the form of malpractice suits? Are they more concerned with their own convenience than with the well-being of women and their families (and by the way, I specify families and not babies, because I feel confident that obstetrical decisions and events effect more than the mother-baby dyad)?

The truth is, I don't know the answer for certain, or as we've been cautioned throughout this jury experience, even beyond a reasonable doubt. But I do believe with certainty that these professionals should be asking themselves these questions on a constant basis.


Stassja said...

I realize this post may be old, but I've just stumbled across your blog and I've found it very interesting!

This line in particular really hit me: "Are they more concerned with their own convenience than with the well-being of women and their families (and by the way, I specify families and not babies, because I feel confident that obstetrical decisions and events effect more than the mother-baby dyad)?"

It really got me thinking that perhaps it's also the known vs the unknown. If they give the woman with a slow labor pitocin, or induce a woman who isn't really past dates, they know for the most part what complications will likely arise. It's what might happen in the unpredictability of nature that they fear, I think. Is it right? No, but I can understand that line of thinking.

Thank you for your wonderful posts! I'll definitely be subscribing. :)

Christie CC said...


I agree that attempting to have control and fear of the unknown are definite factors that come into play in maternity care.

But what has been forgotten (by both providers and women) is that birth cannot be controlled. As a control-freak myself, I had to really grapple with this. And, ironically, it may have been the fact that both a repeat c/s and a VBAC carried risks for my baby and myself that helped me to let go of control.

I believe that the more women inform and empower themselves, the more collaborative the relationship between a woman and her care provider, the less either will feel the need to control what cannot be controlled. I'm not sure that makes sense.

I'm thinking of research that I'm aware of which highlights that veterinarians are less likely to be sued by their clients' "owners". Why is that? I believe it is because, as a profession, they don't make promises and they communicate with their clients.

I think in turn, doing so would help to alleviate the need to predict or control.

Thanks so much for your comments!