PHILADELPHIA -- Amber Marlowe was a seasoned pro at delivering big babies: Her first six each weighed close to 12 pounds. When she went into labor with her seventh last winter, she brushed off doctors who told her the 11-pound, 9-ounce girl could be delivered only by caesarean section.
But the staff at Wilkes-Barre General Hospital wouldn't budge. "All my others, I've done naturally," Marlowe recalled telling her physicians. "I know I can do it."
But when Marlowe checked herself out and went looking for a new doctor, Wilkes-Barre General's lawyers rushed to court to get legal guardianship of her unborn child, giving the hospital the ability to force Marlowe into surgery if she returned.
The case is one of several in recent months that have revived a debate about whether mothers have an absolute right to choose when, where, and how they give birth, if the health of their baby is at stake.
A spokesman for the American Hospital Association was unable to say immediately whether the organization has taken a position on the issue.
Some groups representing doctors, including the American College of Obstetrics and Gynecology, have said that physicians should refrain from doing procedures unwanted by pregnant women and that use of the courts to resolve conflicts is almost never warranted.
Marlowe ended up at another hospital, where she had a quick, natural birth she described as "a piece of cake." She didn't know about the first hospital's action until her husband was told by a reporter.
"They don't know me from anything, and they're making decisions about my body?" she said. "It was terrifying."
Officials with Wilkes-Barre General did not return calls seeking comment.
In Salt Lake City, an acknowledged cocaine addict with a history of mental problems resisted having a caesarean for about two weeks before acquiescing. One of the twins she was carrying died during the delay. The mother was charged with capital murder, but she ultimately pleaded guilty to a lesser charge of child endangerment and was sentenced to probation.
Last month, prosecutors in Pittsburgh charged an unlicensed midwife with involuntary manslaughter after she failed to take a woman to the hospital when her baby began to be delivered feet first. The child died two days later. The midwife said she had been trying to honor the mother's wishes to have the baby at home.
Some women's advocates said the cases show a newfound willingness by some legal officials to interfere with women's choices about pregnancies. "My impression is that we have a political culture right now that falsely pits fetal rights against women's rights and that you are seeing a kind of snowballing effect," said Lynn Paltrow of the New York-based National Advocates for Pregnant Women.
Legal specialists and medical ethicists said that attempts to force women to undergo certain procedures for the benefit of their children may be on shaky ground.
"There are 50 years of case law and bioethical writings that say that competent people can refuse care, and that includes pregnant women, as well," said Art Caplan, chairman of medical ethics at the University of Pennsylvania.