It’s hard to put yourself in the shoes of Sherise Doyley, the pregnant mother of three who ended up facing a judge while giving birth at the University of Florida Health Hospital in downtown Jacksonville.
She arrived at the facility with plans to give birth. She knew she wanted to try a vaginal birth, but from her years of experience as a professional birth doula, she understood that things don’t always go as planned.
She arrived at the hospital in the evening after her water broke. Doctors said they were concerned about the risk of uterine rupture, a potentially fatal complication for her and her baby. She knew the risk was less than 2% and repeatedly told her doctor she would not agree to a C-section without first attempting a vaginal birth. The doctors seemed to relent, and she was left in labor for several more hours.
A nursing supervisor then carried the tablet to the bed and told him he was in court. reason? I cannot consent to a Caesarean section.
This is exactly the situation that advocates for pregnant women are talking about when they say that you shouldn’t lose your constitutional rights just because you’re pregnant.
I’m an Alabama-based reporter who has spent my career focusing on women facing the consequences of the state’s fetal sex policies. The idea is that a fetus should have the same legal status as a child. My research showed how similar theories played into the cases of Cherise Doyley and Brianna Bennett, two women in Florida who experienced eerily similar situations. In both cases, they found themselves fighting for the right to make medical decisions because they were pregnant.
I obtained a video recording of D’Oyley’s court hearing. I was shocked to see her make her case from her hospital bed. Courts have recognized many times that they cannot force someone to undergo treatment, even if it could save someone else’s life, but this video highlighted to me how pregnant women are a rare exception.
In several states, judges have ruled that pregnant patients can be forced to receive blood transfusions or remain on bed rest if it is in the best interests of the fetus. In Doyley’s case, the court will likely force her to undergo surgery.
ProPublica has already investigated how abortion restrictions lead to the denial of life-saving care to pregnant women. Experts worry that the opposite problem, forced treatment, could become more common in states such as Florida, which have fetal personhood policies.
Ms. Doyley signed a waiver allowing the hospital to discuss her case with ProPublica, but a spokeswoman for the University of Florida Health in Jacksonville declined to comment, citing patient privacy.
By sharing and discussing her case with Doyley’s consent, we aim to show what forced treatment looks like. And while we encourage you to read the full investigation, we also wanted to give you an inside look at the Zoom court hearing so you can see for yourself what happened.
a public hearing is convened
A nurse operates a tablet for a virtual hearing. Cherise Doyley finds herself facing a court hearing over her birth choices. Retrieved from ProPublica
You can see the confusion on Doyley’s face as he learns that his medical decisions will be taken to court. She asked for a lawyer or at least a patient advocate. Florida courts do not require a lawyer to hear a pregnant woman’s medical decisions, and the hospital did not provide one, so Doyley was left alone.
Judge Michael Kalil, wearing a black robe, answered the phone and explained how the hearing would be conducted. Doyley, a black woman, lay in a hospital bed, connected to an IV and a monitor and covered with a sheet. Doyley was surrounded on screen by more than a dozen doctors and lawyers, most of them white, who offered extensive testimony about what would happen to the baby if she continued to refuse a C-section.
judge explains court procedure
Judge Michael Kalil explained that the State Attorney’s Office requested that the emergency C-section be ordered at the request of the hospital. Retrieved from ProPublica
Dr. Erin Barnett said at the hearing that she did not believe Doyley would be able to successfully deliver the baby vaginally. Prolonged labor increases the risk of uterine rupture, which could kill Doyley and her baby, she said. Dr. John Davis, director of obstetrics and gynecology, said at the hearing that the hospital is recognized for having a low C-section rate and not performing unnecessary surgeries. Mr Doyley’s condition required intervention, he said.
“Everyone was very concerned about the welfare of the baby,” Jenny Van Ravestein, director of women’s services at the hospital, said at the hearing.
Mr. Barnett and Mr. Davis did not respond to requests for comment, and the hospital declined ProPublica’s requests for interviews with them and others involved in Mr. Doyley’s care.
Studies regarding the risk of uterine rupture after previous caesarean section are unknown. Studies have shown that 0.15% to 2.3% of these labors result in rupture, depending on many factors, including weight, history of successful vaginal births, and whether labor started spontaneously or needed induction. To Doyley, both numbers felt quite low.
But not included in the testimony are many of the downsides Doyley faced in undergoing another C-section, which can involve a long recovery period, infection and other complications, and the risk of death.
But she couldn’t explain her reasoning until the judge decided to unmute her.
Doyley testifies
Once Doyley was unmuted, she testified that a C-section could have put her life at risk. Retrieved from ProPublica
Doyley had a reason for wanting to avoid major abdominal surgery. She had a difficult time recovering from her previous C-section. Bleeding after a previous C-section sent her back to the hospital for almost a week.
She was worried that she would not be able to care for her children if she had a hard time recovering from the surgery itself and could even develop complications. And she worried that if she died, her children would end up in the foster care system. Ms Doyley said she did not believe surgery was a low-risk option. She wondered aloud during the hearing whether the lives of other children, and her own, mattered to the hospital and doctors.
Kimberly Mutcherson, a law professor at Rutgers University, said women who want to choose treatments that doctors see as risky often face accusations that they don’t care about their babies.
“You’re a bad mother, aren’t you?” Ms. Matcherson said. “That’s a big part of the thought process here. This is not what mothers do. Mothers make sacrifices, like allowing someone to cut you up.”
Obstetricians care for two interconnected patients: the mother and the fetus. Sometimes their needs conflict. In such cases, the American College of Obstetricians and Gynecologists’ ethical guidelines say doctors should prioritize the mother’s health. But Drexel University law professor Elizabeth Kukla said these cases show that doctors sometimes prioritize the welfare of the fetus over the mother.
“This reflects a deep understanding of women as childcare workers,” Kukla said. “Women in their role as childbearers.”
The hearing lasted more than two hours. At one point, Doyley asked to be transferred to another hospital because she didn’t want hearing officials to perform the procedure if she needed a C-section. Hospital officials said that was unlikely because another hospital would have to accept her as a patient first.
Doyley agreed to remain at Florida Health, but asked if the hospital could assign a black nurse or doctor to care for her. She wondered aloud during the hearing what would happen that morning, past the court-imposed 6 a.m. deadline. “Are they going to tie me up and perform a C-section against my will?”
A deadline has been set
Doyley says she doesn’t like how her care is decided by the nurses and doctors who attended the court hearing, most of whom are white. Retrieved from ProPublica
The judge did not order an immediate C-section, but said the hospital could perform one without her consent in an emergency.
Doyley later said he did his best to remain calm and composed. And at the end, she expressed her gratitude to the judge, emphasizing how absurd the whole thing felt to her.
“Thank you for spending two hours on Sunday researching my medical history and fighting for my vagina and my baby,” she said.
judge’s rules
Trying to remain calm, Doyley thanked the judge at the end of the hearing. Retrieved from ProPublica
Doctors said the baby’s heart rate slowed for several minutes overnight. They rushed Ms. Doyley into surgery, and she gave birth again by caesarean section.
At 8 a.m. the next morning, the nurses stood Doyley in front of the tablet again for a final hearing. Doyley said the baby was born at 2 a.m. but had not yet been taken to the neonatal intensive care unit to meet her daughter.
“Tell them you don’t want to participate,” she said. “You can all hold your own meeting. I would like to see the child.”
When Khalil hears that the baby has been born, he wishes Doyly well and ends the incident.
The incident has been resolved
Hours after giving birth via C-section, Doyley found herself back at another hearing before seeing her baby. Retrieved from ProPublica
In response to ProPublica’s questions, Khalil wrote in an email that the judicial code of conduct prohibits judges from commenting on cases. “These ethical standards exist to protect the integrity of the judicial process, ensure fairness to all parties, and preserve the neutrality of the courts,” he wrote.
For a year, Doyley and his family tried to forget about the incident and move on. But she couldn’t shake the feeling of being violated. If hospitals can force surgery, she said, it can happen to anyone.
“When we use the courts to basically coerce people and force them to undergo unnecessary medical procedures against their will, that is, in my eyes, tantamount to torture,” Doyley said.
