How the Emergency Medical Treatment and Labor Act (EMTALA) Can Protect Your Rights in Labor
The Emergency Medical Treatment and Labor Act (EMTALA) enshrines the right of birthing people to receive stabilizing medical treatment—defined as the birth of the baby and the placenta—regardless of hospital policy. Yet hospitals routinely violate this law to deny care or coerce medical interventions. Here’s what you need to know to protect your rights.
How the EMTALA Protects Your Right to Medical Care
The Emergency Medical Treatment and Labor Act (EMTALA) was originally designed to prevent hospitals from declining care to patients who couldn’t afford treatment. It prevents hospitals from requiring that patients meet certain litmus tests before receiving emergency care. And it requires hospitals to provide stabilizing treatment in emergencies, including labor. This means that a hospital cannot refuse to treat you because you decline medically recommended treatments. This is especially important for birthing people whose doctors have recommended c-sections. If you show up in labor, the hospital has to treat you. They can’t make treatment contingent on accepting a c-section. They also can’t force you to have a c-section once they’ve admitted you. To learn more about why, click here.
No right to prenatal care
Although the EMTALA protects the right to receive emergency stabilizing care in labor, it does not guarantee the right to prenatal care. A doctor can generally terminate the doctor-patient relationship with reasonable notice. To learn more about when and whether a doctor can decline to give you prenatal care, read our blog post on whether your doctor can fire you.
If your doctor does stop providing you care, it is critically important to find another provider from whom to get prenatal care. Inadequate prenatal care greatly increases the risk of complications. It can also create conflict with the hospital when you show up in labor.
Denying Hospital Admission: A Coercive Care Strategy
Doctors sometimes violate the EMTALA in an attempt to coerce women into c-sections or other interventions they don’t want. The most common scenario goes something like this: A doctor recommends a c-section, or hospital policy “requires” a c-section in certain circumstances, such as if a woman has had a prior c-section. Many women mistakenly believe that hospital policy trumps their right to make decisions about their own care. Or they think that violating hospital policy means the hospital doesn’t have to treat them.
Even when birthing people know better, some hospitals and doctors decline care in an attempt to coerce families into medical interventions. They might refuse to admit a laboring person until she consents to a specific intervention. Or they might tell a pregnant person in advance that, if she shows up in labor, they will not admit her.
This is illegal. That hasn’t stopped doctors and hospitals from breaking the law. One recent report found that Georgia is one of the worst states in the nation for denying people emergency medical care. Over 10 years, there were more than 4,000 violations. Hospitals have not upheld their ethical and legal duty to their patients. As a result, some patients have died.
What to Do if a Hospital or Provider Violates the EMTALA
So if it’s illegal to not admit someone in labor, why do hospitals do it? And how do they get away with it?
The answer is simple: the law really only exists if we work to enforce it. When people don’t know their rights, they have no way to fight back. And even when they do know their rights, if they don’t make a record of violations, it’s difficult to do anything at all. Fighting back against obstetric violence is notoriously difficult, even when a hospital breaks the law. But it’s not impossible. There are a few simple things birthing people can do to protect themselves from EMTALA violations:
If a doctor threatens to refuse treatment if you show up in labor, remind them of their obligations under the EMTALA. Let them know that you will document it if they violate the EMTALA, and that you will pursue a complaint.
If you are in labor and a hospital is refusing to admit you, talk about the EMTALA. Sometimes it can be helpful to ask to speak to a patient advocate or administrator.
Record all interactions with doctors, hospitals, and hospital administrators. This is the best way to prove that a hospital has broken the law. Learn more about recording your birth here.
Seek legal advice if a hospital or doctor is threatening to refuse treatment. If you wait until you are in labor, it may be too late. But a lawyer who specializes in medical advocacy may be able to help you. Learn more about hiring a lawyer here.