Archives of Gynecology and Obstetrics

, Volume 285, Issue 5, pp 1195–1203 | Cite as

Court-visited obstetrical and fertility procedures

Maternal-Fetal Medicine



To study proposals and benefits of the court-visited obstetrical and fertility interventions.


A total of 72 articles including 25 published decisions of the trial, circuit, appellate, and supreme courts are identified through the ACOG, RCOG, SOCG, and keyword search. The grounds of the hearings and their outcomes are modeled as measurable outcomes. The hearing counts are used as index units.


Of the total adjudications reviewed, 28% are for criminal complaints and 72% for civil lawsuits. A substantial number of hearings (40%) concern mentally ill or impaired individuals. Among the hearings based on maternal–fetal conflicts, women’s autonomy is preserved in 25%, fetal rights are favored in 75%, and the rights of both are addressed in 6.25% of cases. Orders in favor of fetus are executed by coerced C-sections (20%), fetal custody (20%), and termination of parental rights (16%). The burden versus benefit ratio is 0.67 in the reviewed sample of coerced C-sections; 83.4% of the orders for involuntary sterilizations of mentally impaired are dismissed in favor of the constitutional rights (Amendments 1, 9, 14) and state mental health laws.


Court-ordered obstetrical procedures present an unsettled legal forum in terms of their complex interplay. The awareness of legal precedent can alert providers to possibility of an exception to the general presumption that the mother is competent, where it might trigger a legal or ethical council. Screening inventories (covering maternal–fetal attachment, judgmental fitness, prior obstetrical history, perinatal risk, formal/informal social support) jointly developed by the health providers and lawyers would assist involved parties in resolving complex situations without resorting to legal conflicts.


Court-ordered interventions Maternal–fetal conflicts Fetal rights Fetal custody Surrogacy Parental rights Involuntary sterilization 


  1. 1.
    American College of Obstetricians and Gynecologists (2005) Maternal decision making, ethics, and the law. ACOG Committee Opinion Number 32Google Scholar
  2. 2.
    American Medical Association (1990) Legal interventions during pregnancy: court-ordered medical treatments and penalties for potentially harmful behavior by pregnant women. JAMA Report 0098–7484Google Scholar
  3. 3.
    Anikwue M (2003) Breast still best: an argument in favor of one HIV positive mother’s right to breastfeed. 9 William and Mary J Women Law 479Google Scholar
  4. 4.
    Annas GJ (1987) The impact of medical technology on the pregnant woman’s right to privacy. Am J Law Med 13:213–232PubMedGoogle Scholar
  5. 5.
    Annas GJ (1987) Protecting the liberty of pregnant patients. N Engl J Med 316(19):1213–1214PubMedCrossRefGoogle Scholar
  6. 6.
    Bornstein BH (2003) Pregnancy, drug testing, and the fourth amendment: legal and behavioral implications. J Family Psychol 17(2):220–228CrossRefGoogle Scholar
  7. 7.
    Brenner B, Burnet P (1995) Court ordered obstetric intervention: a commentary. N Z Med J 108(1010):431–432PubMedGoogle Scholar
  8. 8.
    Cahill H (1999) An Orwellian scenario: court ordered cesarean section and women’s autonomy. Nursing Ethics 6(6):494–505PubMedGoogle Scholar
  9. 9.
    Cave E (2004) The mother of all crimes: human rights, criminalization, and the child born alive. MPG Books LtdGoogle Scholar
  10. 10.
    Chervenak FA, McCullough LB (1990) An ethically justified, clinically comprehensive management strategy for third-trimester pregnancies complicated by fetal anomalies. Obstet Gynecol 75(3 Pt 1):311–316PubMedGoogle Scholar
  11. 11.
    Chervenak FA, McCullough LB, Levene MI (2007) An ethically justified, clinically comprehensive approach to peri-viability: gynecological, obstetric, perinatal and neonatal dimensions. J Obstet Gynecol 27(1):3–7CrossRefGoogle Scholar
  12. 12.
    Cook RJ, Dickens BM (1999) Human rights and abortion laws. Int J Gynecol Obstet 65:81–87CrossRefGoogle Scholar
  13. 13.
    Coverdale JH, Chervenak FA, McCullough LB et al (1996) Ethically justified clinically comprehensive guidelines for the management of the depressed pregnant patient. Am J Obstet Gynecol 174 (1Pt 1):169–173PubMedCrossRefGoogle Scholar
  14. 14.
    Curran WJ (1990) Court-ordered cesarean sections receive judicial defeat. N Engl J Med 323:489–492PubMedCrossRefGoogle Scholar
  15. 15.
    Dalton KJ (2005) Refusal of interventions to protect the life of the viable fetus: a case-based transatlantic overview. University of Cambridge, ReportGoogle Scholar
  16. 16.
    Derouin J (1982) In re Guardianship of Eberhardy: the sterilization of the mentally retarded. Wisconsin Law Rev 6:1199–1227Google Scholar
  17. 17.
    Diekema DC (2003) Involuntary sterilization of persons with mental retardation: an ethical analysis. MRDD Res Rev 9:21–26Google Scholar
  18. 18.
    Fish J (2010) Fetal advocacy and the wisdom of judicial intervention. Health Law and Policy Institute, University of Houston Law CenterGoogle Scholar
  19. 19.
    Fleischman AR, Rhoden NK (1988) Perinatal law and ethics rounds. Obstet Gynecol 71(5):790–795PubMedGoogle Scholar
  20. 20.
    Gallagher J (1987) Prenatal invasions and interventions: what’s wrong with fetal rights? Harvard Women’s Law J 9:58Google Scholar
  21. 21.
    Hagell EI (1993) Reproductive technologies and court-ordered obstetrical interventions: the need for a feminist voice in nursing. Health Care Women Int 14(1):77–86PubMedCrossRefGoogle Scholar
  22. 22.
    Ibid (1982) Unborn; Part 1:16Google Scholar
  23. 23.
    In Re AC (1987) 533 A 2d 611 (DC)Google Scholar
  24. 24.
    In Re AC (1990) 573 A 2d 1235 (DC)Google Scholar
  25. 25.
    In Re “A” (2000) 1 FLR 549, 1 FCR 193 (UK)Google Scholar
  26. 26.
    In Re A. (in utero) (1990) 28 R.FL. (3d) 288,72 D.L.R. (4th) 722 (Canada)Google Scholar
  27. 27.
    In Re Baby Jeffries (1982) C.R.-C.L. L. Rev. 523 (MI)Google Scholar
  28. 28.
    In Re Baby M (1988) 537 A.2d 1227, 109 N.J. 396 (NJ)Google Scholar
  29. 29.
    In Re C.A.S., Belleville v. T(L) (1990) 59 O.R. (2d) 204,7 R.F.L. (3d) 191 (Canada)Google Scholar
  30. 30.
    In Re Children’s Aid Society for the District of Kenora (1982) 28 R.EL. (2d) 278 (Canada)Google Scholar
  31. 31.
    In Re Dunn v. Roseway (1983) 333 N.W. 2nd 830 (IA)Google Scholar
  32. 32.
    In Re F (1988) 2 All ER 193 (U.K)Google Scholar
  33. 33.
    In Re Grady (1981) 85 NJ 235, 426 A.2d 467 (NJ)Google Scholar
  34. 34.
    In Re Johnson v. Calvert (1993) 5 Cal.4th 84 (CA)Google Scholar
  35. 35.
    In Re Li, Yu (2003) 356 F.3d 1153 (CA)Google Scholar
  36. 36.
    In Re Maxon v. Superior Court (1982) 35 Cal.App.3d 628 (CA)Google Scholar
  37. 37.
    In Re MB (1997) 2 FCR 541(CA)Google Scholar
  38. 38.
    In Re Moore (1976) 221 S.E.2d 307 (NC) Google Scholar
  39. 39.
    In Re Nikolas E (1998) 22 M.S.R.A. § 4071 (ME)Google Scholar
  40. 40.
    In RE Stem Cell Patent Claims (2007) 35 U.S.C. §102, and § 103(WI)Google Scholar
  41. 41.
    In Re Taft v.Taft (1983) 388 Mass 331, 446 N.E. 2D 395 (MA)Google Scholar
  42. 42.
    In Re Termination of Paternal Rights (2009) Supp. 59-2136(h)(1)(D)(KS)Google Scholar
  43. 43.
    In Re Whitner v. State (1995) 492 S.E.2d 777, 778 (SC)Google Scholar
  44. 44.
    Irwin S, Jordan B (2009) Knowledge, practice, and power: court-ordered cesarean sections. Med Anthropol Q 1(3):319–334CrossRefGoogle Scholar
  45. 45.
    Judicial waiver of parental notice of termination of pregnancy (2006) V-06-N-1 (FL)Google Scholar
  46. 46.
    Keyserlingk EW (1982) The unborn child’s right to prenatal care (Part 1). Health Law Can 3(10):18Google Scholar
  47. 47.
    Kolder VE, Gallagher JD, Parsons MT (1987) Court-ordered obstetrical intervention. New Engl J Med 316:1192–1196PubMedCrossRefGoogle Scholar
  48. 48.
    Krauss DJ (1991) Regulating women’s bodies: the adverse effect of fetal rights theory on childbirth decisions and women of color. Hein’s Law JGoogle Scholar
  49. 49.
    Lachance D (1981) In re Grady: the mentally retarded individual’s right to choose sterilization. Am J Law Med 6(4):559–590PubMedGoogle Scholar
  50. 50.
    Levine J, Nolan K, Rhoden NK et al (1988) When refusing treatment jeopardizes another life. Nursing 18(5):145–147PubMedGoogle Scholar
  51. 51.
    Martin S, Coleman M (1995) Judicial intervention in pregnancy. 40 McGill Law J; 947Google Scholar
  52. 52.
    Matevosyan NR (2010) Pregnancy and postpartum specifics in women with schizophrenia. Arch Gynecol Obstet; 1–7Google Scholar
  53. 53.
    Matevosyan NR (2009) Reproductive health in women with serious mental illnesses. Sex Disabil 27(2):109–118CrossRefGoogle Scholar
  54. 54.
    Murray TH (1990) Moral obligations to the not-yet born: the fetus as patient. In: Richard T. Hull (eds) Ethical Issues in the New Reproductive Technologies. Wadsworth, Belmont, pp 210–223Google Scholar
  55. 55.
    Neale H (1990) Mother’s rights prevail: in re A.C. and the status of forced obstetrical intervention in the district of Columbia. J Health Hospital Law 23(7):208–213Google Scholar
  56. 56.
    Newkirk KL (1998) State-compelled fetal surgery: the viability test is not viable. William Mary J Women Law; 467Google Scholar
  57. 57.
    North Carolina Eugenics Board. Records of Eugenical sterilization in North Carolina (1935);
  58. 58.
    Ouellette AR (1994) New medical technology: a chance to reexamine court-ordered medical procedures during pregnancy. 57 Albany Law Review; 927Google Scholar
  59. 59.
    Rhoden NK (1991) A compromise on abortion? The Hastings Centre Report 19(4):32–37CrossRefGoogle Scholar
  60. 60.
    Rhoden NK (1986) The judge in the delivery room: the emergence of court-ordered cesareans. Hain Law JGoogle Scholar
  61. 61.
    Richmond FC (1934) Sterilization in Wisconsin. J Crim Law Criminol; 586–590Google Scholar
  62. 62.
    Robinson FC, Robinson SW, Williams LJ (1979) Eugenic sterilization: medico-legal and sociological aspects. J Natl Med Assoc 71:6Google Scholar
  63. 63.
    Rodgers S (1986) Fetal rights and maternal rights: is there a conflict? Can J Women Law 1:456–469Google Scholar
  64. 64.
    Royal College of Obstetricians and Gynecologists (2006) Law and ethics in relation to court-authorized obstetric intervention. Ethics committee Guideline Number 1Google Scholar
  65. 65.
    Pinkerton TM, Esq. (1988) Surrogacy and egg donation law in California. The American Surrogacy Center, Inc. (TASC) KennesawGoogle Scholar
  66. 66.
    Samuels T-A, Minkoff H, Feldman J et al (2007) Obstetricians, health attorneys, and court-ordered cesarean sections. Women’s Health Issues 17(2):107–114PubMedCrossRefGoogle Scholar
  67. 67.
    Sheena M (2005) Policing pregnancy: the law and ethics of obstetric conflict. Med Law Rev 15(1):148–151Google Scholar
  68. 68.
    Simon GR, Wilkins CJ, Smith I (2002) Sevoflurane induction for emergency cesarean section: two case reports in women with needle phobia. Int J Obstet Anesth 11(4):296–3000PubMedCrossRefGoogle Scholar
  69. 69.
    Smith KA (2002) Conceivable sterilization: a constitutional analysis of a Norplant/Depo-Provera welfare condition. Indiana Law J 77:389PubMedGoogle Scholar
  70. 70.
    Taylor E (1981) Constitutional limitations on state intervention in prenatal Care. 67 Va L Rev 1051Google Scholar
  71. 71.
    Thampapillai D (2005) Court-ordered obstetrical intervention and the rights of a pregnant woman. J Law Med 12(4):455–461PubMedGoogle Scholar
  72. 72.

Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  1. 1.Open Medical InstituteAtlantaUSA

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