New Yorker Rinat Dray recently filed suit against Staten Island University Hospital because doctors allegedly forced her to have a C-section without her consent 3 years ago.

During the birth of her third son, Yosef, in 2011, doctors reportedly pressured Dray to have a C-section despite her explicit wishes for a vaginal birth following hours of labor, according to the New York Times.

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Attending physician reportedly told Dray her uterus would rupture and by not consenting to the surgery she would be committing child abuse and her child would be taken into custody of welfare services.

Though the University Hospital denies all claims, Dray's hospital record shows a handwritten note signed by the director of maternal and fetal medicine overriding Dray's refusal. The hospital lawyer had also added his written agreement.

This runs in direct opposition to statements made by the ethics committee of The American Congress of Obstetricians and Gynecologists, stating that under no currently imaginable situation should any pregnant woman be coerced to have unwanted surgery.

In spite of any doctor's recommendations, even if it would be in the best interest of the child, the mother is to have the final word if any surgery is to take place.

According to Dray, she had been switching doctors for each of her children with the explicit desire to perform vaginal birth on each. Following two caesareans, she found Staten Island University Hospital through the Internet and positive word of mouth.

After hours of labor, Dr. Gorelik offered Dray an epidural for the pain and time to reconsider. Dray was adamant and pleading for additional hours of attempted vaginal birth. Dr. Gorelik then insisted on the caesarean and refused to "bargain", witnesses say.

Even on the operating table, Dray kept pleading for the operation to be cancelled and for her normal delivery to continue. Dr. Gorelik's reported answer was "Don't speak" as he continued the surgery against her wishes.

The discrepancy between the hospital's alleged practices and the ethics committee's statements and judicial precedents may be a combination of a hospital lawyer's incompetence and a doctor's hubris, according to Dr. Mary Marshall, bioethicist and professor at the University Of Virginia School Of Medicine.

Barring a court order, no surgical procedure can legally be done by force, even if inaction would endanger the fetus, says Dr. Arthur Caplan, bioethicist and professor at NYU. The law is designed to be on the side of pregnant women, not the doctors'.

Over the past 40 years, only an estimated 30 pregnant women have been forced by court order to undergo a caesarean or other non-consensual medical procedures.

The lawsuit names Dr. James J. Ducey, the hospital director of maternal and fetal medicine who wrote the note, and Dr. Leonid Gorelik among the defendants.

Dr. Gorelik was the attendant who delivered the child, but denies having forced Dray to any procedure, claiming the C-section was entirely consensual.

Hospital spokesperson Christian Preston also defended the hospital's practices, stating that the C-section rate of the Staten Island University Hospital remains a considerable 12% lower than the state average. He declined to comment on the case itself for legal reasons.

Nevertheless, cases like these open up an ongoing debate of fetal rights laws that are currently underway across the US.

In 2004, a woman in Utah was initially charged with double murder following a delay in her C-section resulting in stillborn twins but plead down to the lesser charge of child endangerment.

The state of Alabama has had similar applications of a chemical-endangerment law against pregnant women who use drugs with ensuing arrests and forced interventions of their pregnancies.

C-sections have been steadily on the rise since the mid-90s, reports indicate, with 33% of all births in the US recorded as caesarean births in 2012.

In 2012 alone, that was 1.3 million births. The World Health Organization, however, advises a number of no more than 10-15% of all births be caesarean.

This increase has been attributed to more high-risk pregnancies as older women desire children, more mothers who wish to schedule their births and increased fears of malpractice lawsuits should a normal birth lead to complications for the child.

According to a WHO report published in 2010, over 6.2 million births worldwide were unnecessarily performed c-sections during 2009 at an estimated cost of $2.3 billion US. Numbers that are expected to have only increased since then.

The report went on to detail the countries with the highest rates of C-sections, with Brazil in the lead of many listed Latin American countries with 45%, followed by Iran at 41%, South Korea at 38%, Portugal at 34%, Australia at 30%, Germany at 27% and China at 25%.

Among the countries in the opposite side of the spectrum where underuse was suspected, Africa and the third world was heavily represented, with Burkina Faso scoring the lowest at 0.7%.

TagsHospital, Malpractice, Lawsuit, C-section, Caesarean, Pregnancy, Fetal rights, Staten Island University Hospital