Does this list take into account hospital admission forms?

Excerpt from Born in the USA: How a Broken Maternity System Must Be Fixed to Put Women and Children First by Marsden Wagner, MD, MS:

There are a number of things women can do during pregnancy to make sure that their rights are not violated. One strategy is to customize a hospital’s boilerplate consent form. Most patients don’t know that they are not required by law to sign the hospital’s consent form and that they have the right to change it to reflect their wishes regarding specific treatments. Many physicians tell patients that their hospitals’ consent forms do not protect them from lawsuits, but this is not the whole story. If your wish to refuse treatment is documented, under U.S. law it’s very difficult, if not impossible, for a hospital or doctor to be held liable for not doing the procedure. On the other hand, if a patient’s wish to refuse a C-section is documented and the patient is given one anyway, the doctor and hospital are subject to criminal battery charges, regardless of whether the woman or baby were harmed by the C-section.
A pregnant woman who finds that her hospital is not willing to comply with her wishes for her labor and birth can also file a complaint with the chief compliance officer of the hospital. All hospitals that receive federal funding (approximately 80 percent of hospitals)must adhere to a set of rules called the Center for Medicare and Medicaid Service’s (CMS’s) conditions of participation (CoP). These rules require hospitals to honor patient rights as defined by the Patient Self-Determination Act, the Consumer Bill of Rights and Responsibilities, EMTALA, and the large number of actual cases that uphold a patient’s right to refuse treatment, to be fully informed of the risks, benefits, and alternatives of any proposed treatment, and to participate in all treatment decisions.
Hospitals that fail to adhere to the CoP are subject to heavy fines and risk losing their right to qualify for Medicare and Medicaid funding. In addition, the CoP require that hospitals institute an internal grieving process and give patients the information they need to know about how to file a complaint and where to appeal in the case of an unfavorable ruling.
Once a woman is in labor, she can often get doctors to comply with her wishes by telling them that she is aware of her rights under EMTALA. EMTALA was originally enacted to prevent “patient dumping” – hospitals refusing to admit a woman in labor for whatever reason, often because it appears that she will not be able to pay for maternity services. Before EMTALA, some hospitals would station guards in the hospital parking lots to intercept women in labor and turn them away. Now hospitals are required to admit women in active labor, explain the risks, benefits, and alternative of proposed treatments, and honor their treatment wishes, including the right to refuse treatment, regardless of their ability to pay.
Under the act, no patient who requires emergency care, which is defined to include laboring women, can be transferred to another hospital until after they’ve been “stabilized.” In the case of a woman in labor, stabilization is defined as the delivery of both the baby and the placenta. EMTALA begins to apply when a patient comes within 250 feet of the hospital building. So EMTALA can get the woman in labor into the hospital and, once inside, if her wishes are not honored, the CoP can make sure they are. There’s no question that it can be difficult to sue a doctor for malpractice and that most states do not adequately discipline physicians who commit malpractice, but it can still be worthwhile to sue an obstetrician, especially one who fails to obtain proper consent or who coerces a patient into consenting to a medically unnecessary procedure, such as a C-section, that results in physical or emotional harm. Any form of physical force to perform a medical procedure without a patient’s consent constitutes ground for battery (a criminal action) as well as for malpractice (a civil action). Lawsuits can cost a doctor or hospital a great deal of time and money, and until more women pursue this route, physicians will continue to see C-section as a no-fault course of treatment.
Short of filing a lawsuit, filing a complaint with the state medical board can be a very effective means of changing the birth climate in a given state. Though few complaints actually cause physicians to lose their licenses, they can lead to other disciplinary actions, such as the loss of hospital privileges or the loss of professional credentials. In addition, many states have searchable databases of complaints, malpractice suits, and disciplinary actions against physicians, so a complaint is public information and may deter patients, which can have financial repercussions for the physician. At the very least, filing a complaint with the medical board, the hospital, and the insurance company establishes a record (letters of complaint usually remain on file permanently), so that if other patients complain about the same physician, the organizations will see a condemning trend.

What does it take for a woman to be deemed “incompetent”? I hope it requires a lot more than a note from her doctor!

You said: “Remember, being educated is always key in having quality maternity care and the best outcome possible for yourself and your baby!”

I fail to see how your article is connecting the act of knowing your rights, to actually ensuring that they are enforced. Do you think that Catherine Skoll, a police officer, didn’t know her rights when she was assaulted while giving birth? Do you think VM didn’t know her rights when she refused to sign the hospitals pre-consent form and her baby was subsequently removed by CPS? Do you think the woman who refused bed rest and was forced to remain in the hospital did not know her rights? Do you think the countless women who are assaulted and traumatized each year by their care providers while giving birth simply do not know what their rights are?

If there is some way that knowing what our rights are will protect us from assault, please shed some light on this! Otherwise, your article seems like “blaming the victim”. To tell women that were assaulted in the course of their maternity care knowing their rights is the “key in having quality maternity care and the best outcome possible for yourself and your baby!” is not at all true. You are implying that these women simply didn’t know what their rights were which led to them being assaulted. It has even been suggested in the comments that women need to need to “fight” for their rights, and they are being chastised for not suing their providers after they are assaulted.

Do you think the women I mentioned above didn’t fight? And what was the result of them fighting? Did they have a safe and satisfying birth experience? If people want women to go in fighting for these rights, they should advise them that fighting can lead to the providers fighting back, which can lead to the woman being assaulted, which can lead to PTSD and a years long recovery. There are risks involved with fighting, and that recommendation should never be suggested lightly.

There are also risks involved in suing. And unless you are offering to call multiple lawyers and retell the woman’s story for her and be rejected multiple times in her place, and you are willing to pay for the extra therapy it will take to recover from that experience, please do not imply that these women should be suing. Many of them try, most of them will not find a lawyer willing to take the case. There is an emotional cost to this process and unless you are ready to help the woman with that please don’t tell her what she should be doing. What she should be doing is trying to recover by getting herself through each day.

Do you counsel other people who have been assaulted, maybe by a burglary, a mugging, a rape – that knowing their rights is the “key” to this not happening to them? To borrow a sentiment I read the other day: try telling your rapist that what he is doing is a violation of your rights and see if he stops.