A Florida woman found herself in the unusual position earlier this week of receiving an email from her obstetrician in which the doctor threatened to send police to her home if she refused to come to the hospital for an immediate cesarean section to deliver her fifth child. Lisa Epsteen had delivered her four previous children by cesarean, but had enlisted the help of Dr. Jerry Yankowitz, chairman of the University of South Florida's department of obstetrics and gynecology, to attempt the high-risk process of vaginal-birth-after-cesarean (VBAC).
Epsteen was ultimately able to schedule her surgery for March 8, as she wanted, days after she received the email from Yankowitz stating, according to the Tampa Bay Times:
"I am deeply concerned that you are contributing to a very high probability that your fetus will die or your child will incur brain damage if born alive. At this time, you must come in for delivery," Yankowitz wrote.
"I would hate to move to the most extreme option, which is having law enforcement pick you up at your home and bring you in, but you are leaving the providers of USF/TGH no choice," he continued.
After contacting advocacy groups, Epsteen was able to delay the surgery and avoid police action. The Times reports:
Yankowitz was frank with Epsteen about the risks she faced after four caesareans, she said. They met multiple times during her pregnancy, and he stayed in touch by email.
In their last meeting on Friday, she said he urged her to think about his recommendation that she have a caesarean. Epsteen had developed gestational diabetes, another risk factor, plus the baby was not in a good position for a vaginal delivery.
When an ultrasound Tuesday showed the fetus in possible distress, other USF physicians sent her directly to Tampa General and wanted to deliver right then.
But she questioned their alarm. Besides, she couldn't leave her 2-year-old son with strangers. She was driving the family's only car, so her husband, a team leader at a call center, couldn't get to her.
"In Dr. Yankowitz's defense, and all of the other physicians there, I don't think they are trying to cover themselves. I think they really do have the best interests of my child and myself at heart," she added. "On the other hand, this is not the way to go about protecting my baby or me."
Yankowitz was named the USF chair of obstetrics and gynecology in late 2010. He is one of the few doctors in the nation who is doubly certified in genetics and maternal fetal medicine, according to the USF website. His areas of expertise include ultrasound diagnostics.
After the lawyer got involved, Yankowitz sent a subsequent email saying he wouldn't send law enforcement to Epsteen's home. "I personally recognize and respect your right to make the medical treatment decisions for both you and your unborn child. . . . In that regard, please understand my frustration as I truly believe you and your child are in jeopardy."