In re Madyun

On July 25, 1986, Ayesha Madyun (defendant) was admitted into D.C. General Hospital (hospital) (plaintiff) to deliver a baby. Madyun’s water broke 48 hours prior, and she remained at seven centimeters dilated throughout the day. Madyun and her husband were informed by the delivery physician that she would need a cesarean delivery because prolonged labor increases the risk of fetal sepsis, which can lead to brain damage or death to the baby. Madyun and her husband refused to consent to the procedure, citing Madyun’s religious beliefs as a Muslim and explaining that they did not feel it was necessary. The hospital filed a petition for a court order authorizing the cesarean section. A hearing took place at the hospital. During the hearing, Madyun testified that she understood that prolonged labor could lead to health risks for the baby but that she preferred to have a natural birth and reiterated her beliefs that a cesarean section was not necessary. She stated that she had a right to decline the cesarean section because it was her choice to decide whether she wanted to risk her own health for an undelivered fetus. Her husband testified that he also believed a cesarean section was not necessary because the hospital had not given Madyun an opportunity to deliver naturally and that it was Madyun’s choice whether to undergo the procedure. The physician testified that with each hour Madyun did not deliver, the risk of fetal sepsis increased. The physician also explained that fetal sepsis is often detected too late to save the baby and that, given Madyun had been in labor for about 60 to 70 hours, the risk of fetal sepsis was 50 to 75 percent but the risk of Madyun experiencing adverse effects from the cesarean section was 0.25 percent. The court granted the hospital’s order and denied Madyun’s motion to stay. Madyun and her husband appealed.