A Tampa Bay doctor may be in trouble for emailing his patient and threatening to send police to her home to force her to come to the hospital and have a c-section birth. It’s a bizarre and shocking story that involves VBAC controversy, the National Advocates for Pregnant Women, and an extremely accomplished doctor who possibly crossed an important line.
Lisa Epsteen is a stay-at-home, homeschooling mother of four. She’d had four previous c-sections, but really wanted to try a VBAC (Vaginal Birth After Cesarean) for her fifth birth. After some online research, Epsteen started working with Dr. Jerry Yankowitz, who had been recommended in a VBAC support room chat. Yankowitz is the chair of University of South Florida’s obstetrics and gynecology. He is one of the few doctors in the nation who is doubly certified in genetics and maternal fetal medicine and his areas of expertise include ultrasound diagnostics.
Late in her pregnancy, Dr. Yankowitz began to suggest that Lisa have another Cesarean, instead of the vaginal birth she wanted. Not only were the prior c-sections an issue, but the baby wasn’t in a good position for vaginal birth and Lisa had developed gestational diabetes during her pregnancy. These signs, coupled with Lisa’s medical history, meant that she wasn’t a good candidate for VBAC.
The controversy thickened when Epsteen went for an ultrasound on Tuesday. At this point, she was a week past her due date. During the ultrasound, doctors at the University of South Florida saw signs of fetal distress. They asked Epsteen to go to the hospital immediately for surgery. She declined, explaining that her husband was at work and she couldn’t leave her 2-year-old child with strangers. Instead, she scheduled a c-section for Friday.
When Dr. Yankowitz learned of the situation, he fired off an email demanding that Epsteen come in for surgery. His threatening communication said:
“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. 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.”
Epsteen didn’t heed the doctor’s warning. She took to the internet to complain about the threats. She got the National Advocates for Pregnant Women involved and had lawyers reply to Dr. Yankowitz. She spoke to reporters, saying that she wanted to help other pregnant women who felt bullied by their physicians. ”Honestly, I feel abandoned. There has to be a level of trust between provider and patient, and that has been betrayed. It’s circumstances like this that make women feel like they have no options but to birth their babies on their own — and put themselves in more dangerous circumstances — because they feel bullied.”
Personally, I have to admit that while I hope the doctor was wrong in his prediction, I feel more sympathy for Dr. Yankowitz than Lisa Epsteen. While threatening police intervention is wrong, he seems genuinely concerned about Epsteen’s health and the health of her child. I cannot imagine being told that my child was experiencing fetal distress and deciding to go home and wait a couple days before addressing the problem.
I completely agree that pregnant women have the right to make their own decisions about their bodies and that within reason, a woman’s birthing choices should be respected. But Lisa Epsteen was not acting reasonably. She was putting herself and the child in her stomach in harm’s way. Dr. Yankowitz’s response was extreme, but I think he was probably trying to scare her into action, not really considering delivering her baby by force.
At this point, Lisa Epsteen still hasn’t given birth. She told reporters that she is afraid to return to the University of South Florida for the procedure. I hope that she finds a hospital soon and that she and her baby are okay. But no matter the outcome, I don’t think anyone can blame Dr. Yankowitz for his desperation to make sure that his patient and her child come through childbirth healthy.