The hospital has threatened to perform cesarean surgery on Jennifer Goodall "with or without [her] consent." (Hospital via Shutterstock) 
 
 In an action that appears to be increasingly commonplace, a Florida hospital has threatened to force a pregnant patient to undergo cesarean surgery against her will, or to report her to child welfare authorities for attempting to exercise her right to make the medical decisions she deems best for herself and her family. 
 
 Jennifer Goodall of Coral Gables was informed in a July 10 letter from the chief financial officer of Bayfront Health Port Charlotte that because she decided to attempt vaginal delivery before agreeing to cesarean surgery in her fourth pregnancy, her prenatal care providers intended to report her to the Department of Children and Family Services, seek a court order to perform surgery, and perform cesarean surgery on her “with or without [her] consent” if she came to the hospital. 
 
 A complaint on behalf of Goodall was filed in federal court last week by National Advocates for Pregnant Women (NAPW) and Florida attorney Patricia E. Kahn, seeking a temporary restraining order to prevent the hospital from carrying out its threats. Federal District Judge John E. Steele denied the request, stating in part that Goodall has no “right to compel a physician or medical facility to perform a medical procedure in the manner she wishes against their best medical judgment.” 
 
 Goodall is now 41 weeks pregnant and has told her lawyers she is terrified to enter a hospital. Given this and the weight of medical evidence in Goodall’s favor regarding the safety of the delivery she wanted to have, it is unclear whether the hospital or the courts are considering “best medical judgment” and in whose interest they are acting. 
 
 Goodall delivered her three other children via c-section and now desires to undergo what is commonly known as vaginal birth after cesarean (VBAC). In decades past, VBAC was a common choice for women who had previously had c-sections, rising from roughly 5 percent of all deliveries after a cesarean in 1985 to roughly 28 percent by 1996. The rate of VBAC deliveries started to fall in the late ’90s, according to the American Congress of Obstetricians and Gynecologists, reaching 8.5 percent in 2006 due in part to “restrictions that some hospitals and insurers placed” on the procedure. In tandem with what some have noted as pressure on women to undergo cesareans, the rate of cesarean delivery overall in the United States simultaneously increased dramatically over the past four decades, from 5 percent to over 31 percent in 2007. 
 
 Medical and public health bodies have long criticized the high rate of cesarean sections in the United States. The World Health Organization points out that at the current rate of 30 percent of all deliveries, cesarean sections in the United States far exceed what should normally be between 5 to 10 percent of all deliveries. ACOG agrees. “The current cesarean rate is undeniably high and absolutely concerns us as ob-gyns,” ACOG President Richard N. Waldman said in a statement. “[ACOG’s] VBAC guidelines emphasize the need for thorough counseling of benefits and risks, shared patient-doctor decision making, and the importance of patient autonomy. Moving forward, we need to work collaboratively with our patients and our colleagues, hospitals, and insurers to swing the pendulum back to fewer cesareans and a more reasonable VBAC rate.” 
 
 “The risks associated with a vaginal delivery are lower than the risks associated with a C-section overall, as long as you can deliver the baby at a facility equipped to handle a C-section in case of emergency,” Roger W. Harms, an obstetrician at the Mayo Clinic in Rochester, Minnesota, and medical editor-in-chief of MayoClinic.com, said in a statement. And the recovery time is faster. Undergoing a cesarean surgery for the fourth time carries a 1 in 8 chance of major complications. In short, VBAC deliveries are safer for both the pregnant person and the fetus and lead to fewer complications. 
 
 These facts did not escape Goodall, who said in a statement released by NAPW: 
 
 My decision to allow labor to proceed before consenting to a surgical intervention is based on years of research, careful consideration of the risks to me and my baby, and my family’s needs. All I want is to be able to go to the hospital when I’m in labor and have my medical decisions respected – and my decision is to proceed with a trial of labor and not have cesarean surgery unless some medical complication arises that makes cesarean surgery necessary for my or my baby’s health. Instead of respecting my wishes like they would for any other patient, my health care providers have made me fear for my safety and custody of my children. The people who are supposed to be caring for me and my baby have put me into an even more dangerous situation. I know I’m not the only one to go through this; I’m speaking out because pregnant women deserve better. 
 
 “I would definitely consent to surgery if there were any indication during labor that it is necessary,” Goodall added. “I am trying to make the decision that will be safest for both me and my baby, and give me the greatest chance at being able to heal quickly after my child is born so I can care for my newborn and my three other children.” 
 
 NAPW staff attorney Farah Diaz-Tello expressed disappointment in Judge Steele’s ruling. “The process of labor and delivery isn’t a procedure; our client is the one trying to avoid a compelled medical procedure. Deciding whether and when to consent to surgery is a constitutionally protected right,” she said in a statement. Diaz-Tello explained that every appellate court to rule on this issue on a full record has held that pregnant women retain their constitutional rights, including rights to medical decision-making and bodily integrity. “No woman should fear that because she’s pregnant, she can be threatened, coerced, or deprived of her constitutional rights,” she said. 
 
 But this is exactly what happened to Rinat Dray in Staten Island and to at least six other women in Florida, according to NAPW. “Florida is particularly bad for people giving birth,” Diaz-Tello told RH Reality Check in an email. “We know of at least a half dozen other women who have had court orders or threats of legal action this against them, but the certainty with which hospitals have made these threats makes us think there are more we don’t know of.” 
 
 According to declarations of medical experts filed with the lawsuit, the hospital’s actions violate medical ethics. In a statement to NAPW, Mary Faith Marshall, director of the Center for Biomedical Ethics & Humanities at the University of Virginia School of Medicine, called the hospital’s actions “troubling.” 
 
 “Given the clear statements from ACOG’s Committee on Ethics and other professional groups that coerced or court-ordered medical procedures are not ethically justified, it is stunning that a hospital would threaten such an action,” she said. 
 
 Diaz-Tello acknowledged the hospital’s concerns about malpractice liability, but noted that there is no legal or ethical authority that supports managing liability concerns by forcibly performing unwanted surgery. “The Florida Supreme Court has said health care providers are protected from liability when they respect and follow the decisions of a competent and informed patient to delay or refuse a proposed treatment, even when there are risks involved,” she said in the NAPW statement. “Ms. Goodall has explicitly and carefully documented her informed decision to proceed with a trial of labor; there is no justification for forcing her, or any person, to have unwanted surgery to protect a hospital’s bottom line.” ||||| Answering a Facebook campaign to show support, dozens swarmed the sidewalks in front of a Port Charlotte Hospital Sunday picketing against the hospital's insistence for a Cape Coral's mother to have a birth by C-section. 
 
 "Jennifer is not alone, she's not the only one," said one of the supporters. 
 
 We first told you about Jennifer Goodall's family when the hospital threatened legal action against her if she didn't comply with birth by cesarean. Goodall gave birth Friday and did have C-section birth. 
 
 Shouts of "Enough is enough" and "Honk if you hate forced surgery" came from the protesters toward anyone who drove by the Bayfront Health Port Charlotte Hospital. 
 
 Joining the moms were many youngsters standing along side their peers. 
 
 "Vaginal birth is not a procedure it's a normal outcome of pregnancy," said a protester. 
 
 They argue the decision of which way to go isn't left up to them. 
 
 "Every woman deserves the right to make choices about their birth and every woman deserves the right to say no if she doesn't want to consent to surgery," said Shannon Mitchell who is a mother of four. "I know what it feels like to just be in that position." 
 
 Mitchell claims she faced the same threats the Goodalls did with her own pregnancies. 
 
 "Florida's patient bill of right says we can refuse any procedure we want. And refusing cesarean is a procedure," argued Mitchell. 
 
 The National Advocates for Pregnant Women admit there is a higher risk of complication during a natural birth if the mother has had a prior C-section. 
 
 Goodall had three C-sections before this latest birth. 
 
 "Forced surgery is not an appropriate response to physicians fears about liability," said a protester. "We're tired of forced surgeries." 
 
 "Women are just asking for the chance to try and do what their bodies are designed to do," said Megan Nickel-Martin with ICAN. 
 
 Despite their presence Sunday, Bayfront Health refused to respond to the protesters but instead preferred to stand by their statement issued Saturday: 
 
 "Patient privacy laws prevent us from discussing any individualâ€™s care and treatment, but weâ€™d like to share some insight into our general practices. Every year, women and families throughout Charlotte County and surrounding areas trust our hospital care team to welcome their new babies into the world. We provided care for more than 1200 new babies and their mothers last year. We are honored to play a role in the lives of these families and take our responsibility to new and expectant mothers very, very seriously. We have equal responsibility for the health and well being of the babies born at our hospital. Our hospital is very respectful of a patientâ€™s right to informed consent and we eagerly encourage patient involvement in decisions regarding their care, particularly in respect to a motherâ€™s birth plan. We also rely on physicians to use their clinical judgment based on their training and experience to deliver the standard of medical care that preserves human life and results in the best possible outcomes."
– Two weeks before she gave birth to her fourth child, a Florida hospital threatened to force a C-section on 29-year-old mom Jennifer Goodall "with or without [her] consent," Jezebel reports. Goodall wanted to try delivering vaginally before agreeing to what would be her fourth cesarean—if it was necessary. But Bayfront Health Port Charlotte also threatened to call the state Department of Children and Families because, the hospital said in a letter to Goodall, a VBAC (vaginal birth after cesarean) could lead to “death or serious injury” to the baby, reports the News Press. "My health care providers have made me fear for my safety and custody of my children. I know I'm not the only one to go through this; I'm speaking out because pregnant women deserve better," Goodall says in a statement. She delivered Friday … by C-section, NBC News reports. The courts didn’t back her up. A federal judge earlier this month sided with the hospital, saying the mom-to-be had no "right to compel a physician or medical facility to perform a medical procedure in the manner she wishes against their best medical judgment.” Though VBACs carry some risk, as many as 80% of women go through them safely; the World Health Organization has criticized the US for its high rate of C-sections. And like any other surgery, opting in or out is a "constitutionally protected right" held up by other courts, a National Advocates for Pregnant Women attorney tells RH Reality Check. “No woman should fear that because she’s pregnant, she can be threatened, coerced, or deprived of her constitutional rights,” she says. (A happier pregnancy story: A woman missing part of her heart managed to defy the odds.)