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How far over due date is tooo far before a baby is in danger?


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Again, it depends on the state and how the midwife is practicing. Here, certified midwives cannot perform homebirths. My midwife attended my birth, but dh is on the birth certificate as the one who delivered, even though he just cut the cord. She could be non existent on paper as far as this birth goes. I hope that she is and would think that any mw that took someone on at the last minute would cover her behind by getting some signatures.

 

eta: that doesn't make much sense now that i've read it! non existent on paper, yet getting a siggy that she's not responsible. sheesh, i don't know!!

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Again, it depends on the state and how the midwife is practicing.

No, it doesn't.

 

Regardless of what the regulations are, this midwife has assumed the care of this woman. SHE is responsible for the woman's care (ETA: and the baby).

 

If she is practicing legally, if something happens to Mama or baby, it's her hide.

 

If she is practicing illegally, if something happens to Mama and baby, and it's found out she provided care, it's her hide.

 

Even a good mw who crosses every "t" and dots every "i', who has been practicing for YEARS, who follows the regulations for the state (if there are any), who follows her own protocol exactly, if caught in a situation where something goes sour, it's her hide.

 

Back-up doctor available or not, it doesn't matter.

 

Even if your dh caught your baby (whether in her presence or not), your mw did your prenatal care right? You sought her to be your primary care provider during your pregnancy/labor/birth/postpartum? If so, SHE was responsible regardless of who is listed as "attendant" on the birth certificate.

 

Sorry....as a homebirth midwife this is something I am pretty passionate about. ;)

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Sil just called....niece's water broke at 2:00 a.m. She's made it 5cm in 15 hours but now contractions have stopped. Hasn't had a single one in 30 minutes and isn't effacing very well. The Midwife is nervous but niece refuses to even consider going to the hospital. Apparently the midwife has done just about everything she knows to do to get this labor moving. At any rate, if the baby's heartrate stays strong I would imagine that the MW will stick with this until 24 hours has elapsed. At that point, if my niece is still not wanting transport, I am not certain what can be done or if the MW will call it quits or if she even can legally.

 

Sigh.....praying that those contractions resume and they get that baby out now.

 

Faith

 

Praying....

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Honestly, that sounds really scary to me.

 

I had homebirths with lay midwives and with CNM midwives. . . and all were strict that you had to have the baby by 14 days or you'd have to be induced in the hospital. . . And, of course, no OB/MD I've known would allow you to go past 14 days. Nowadays it seems even earlier, and lots are being indued at 3-7 days. . .

 

I think she is endangering her baby. But, I don't know how much can be done about it.

 

Frankly, I'd fully expect her to keep neglecting that baby after it is born, and have CPS in my speed dial. . . b/c you are gonna need it. And, maybe think about whether you'd be willing to take that baby in as a foster if it gets taken away. . .

 

I'd be really upset if I were you. I'm angry just thinking about that baby. It could already be dead. I'd be tempted to call CPS or the health dept, or whereever, and ask if there is anything that can be done. . . If you could get her into an ER for any reason, they could likely compel her to be treated and get that baby born, as it is obviously in immeditate danger. But, if she isn't seeing any doctor, I just don't know how you'd handle it.

 

UGH! You poor thing!

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Either way, this MW is on the hook. If she doesn't cover her hiney 90 different ways, she's hung out to dry. Documentation, documentation, documentation!

 

Oh I agree completely with both you and Heather, no arguments from me there. It's really not fair to MW/Drs.

 

My point was simply that it does not change the free will of the patient.

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At any rate, if the baby's heartrate stays strong I would imagine that the MW will stick with this until 24 hours has elapsed. At that point, if my niece is still not wanting transport, I am not certain what can be done or if the MW will call it quits or if she even can legally.

Sure, she can and should quit at this point. If your niece is refusing to follow her recommendations the MW has no responsibility to continue to care for her. She's going to be in worse trouble if she tries to deliver this baby at home and runs in to trouble.

 

This girl should be in the hospital. MW should call her an ambulance and document like crazy.

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No, it doesn't.

 

Even if your dh caught your baby (whether in her presence or not), your mw did your prenatal care right? You sought her to be your primary care provider during your pregnancy/labor/birth/postpartum? If so, SHE was responsible regardless of who is listed as "attendant" on the birth certificate.

 

Sorry....as a homebirth midwife this is something I am pretty passionate about. ;)

 

Actually no, I had to see a back up physician, at least twice, who would have been my primary care provider. Then also sign something up front saying we were in charge of our birth. However, I know the patient could say anything and choose to prosecute whomever she wants- which is where a strong, trusting relationship w/ your patient would come in handy.

 

I agree that this situation is no good for anyone involved and am praying for a positive outcome.

Edited by jentancalann
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Actually no, I had to see a back up physician, at least twice, who would have been my primary care provider. Then also sign something up front saying we were in charge of our birth. However, I know the patient could say anything and choose to prosecute whomever she wants- which is where a strong, trusting relationship w/ your patient would come in handy.

 

Your midwife did absolutely none of your prenatal care? And you had an unassisted birth? The midwife wasn't there at all in the capacity of midwife? If she was there, acting at any way as a midwife, she could be held responsible.

 

I would venture to guess that this form you signed twice was a CYA form for the doctor. He wasn't going to be there acting as the responsible care provider at the actual birth. Thus signing a form saying you were the one "in charge of your birth". Should you have transported and called him in, then at that point he would have been your PCP and would be responsible.

 

Does this make any sense??? I'm not trying to argue but simply point out that when you have an OOH birth, if you have an attendant there who has provided care for you during pregnancy and during labor, they can be held responsible. It doesn't matter what the regulations are or who is at that birth (even a doula simply present at a birth could be called to testify if a situation went to trial). When the sh*t hits the fan, someone is going to be called upon as the responsible party. Unfortunately in our society this is how it is with midwifery and OOH birth (and yes, birth in the hospital too but when things go wrong OOH, it is scrutinized so very much).

 

I agree, the relationship is important. For both you and your midwife. But it's not a guarantee that if something were to happen, it will keep things from getting nasty. I know of one situation where the family had a poor outcome and at first chatted with the mw and everything was cool, same great relationship that they had prior to the birth. A few months later their story changed (saying things happened at the birth that did not happen) and they were seeking to have her certification revoked.

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My response before the update:

I am normally a natural/homebirth advocate. I believe that the medicalization of birth in our culture is a travesty. However, I am a homebirth advocate when it's assisted, informed and intentional. I believe in trained midwives, and ongoing (though non invasive) prenatal care.

 

This situation, with the combination of under care and over-due, I feel it's neglect not informed decision making.

 

After the update:

 

Praying her her as a mom, human and young women. Also praying that your relationship with her eventually heals. And that she gets constistent treatment for her personality disorder.

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I agree that the mw should call an ambulance. Don't the ambulance workers have some leeway to take a patient who doesn't want to go under the theory that they are not in a position to make good decisions? (E.g. head injuries, etc.?) I'm all for mom making informed decisions for her child's care, but in this case "informed" doesn't seem to apply?

:grouphug:

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I agree that the mw should call an ambulance. Don't the ambulance workers have some leeway to take a patient who doesn't want to go under the theory that they are not in a position to make good decisions? (E.g. head injuries, etc.?) I'm all for mom making informed decisions for her child's care, but in this case "informed" doesn't seem to apply?

:grouphug:

 

This raises an interesting question: does anyone have the right to intervene on behalf of the infant? (Not looking to start an ethics debate, I am truly genuinely curious.) If someone were to call an ambulance, would paramedics have that right/responsibility, even if the mother declines treatment?

 

FaithManor, still praying for am update with good news.

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This raises an interesting question: does anyone have the right to intervene on behalf of the infant? (Not looking to start an ethics debate, I am truly genuinely curious.) If someone were to call an ambulance, would paramedics have that right/responsibility, even if the mother declines treatment?

 

FaithManor, still praying for am update with good news.

I've been thinking about this too. Here's an interesting perspective.

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I've been thinking about this too. Here's an interesting perspective.

 

Excellent article. It seems like, to an extent, that is what happened here: To avoid being treated against their will or to avoid being incarcerated, women with high-risk pregnancies and therefore the greatest need for prenatal care, will avoid doctors or will withhold important information from their doctors concerning their health. As a result, the health of the fetus will be placed in even greater jeopardy.

 

There was at least the feeling, to the mom, of being treated against her will in a manner she disagreed with, and her response was to drop off the grid almost entirely, and refusing traditional medical care at all.

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Thanks, Perry. Excellent article. Sobering and thought provoking.

 

I guess the angle I was considering was more like a Good Samaritan law in emergent situations. I didn't really think about all the points that article covers.

A couple others:

What are mothers' rights during childbirth?

 

Is a Woman in Labor a "Person"? New Assaults on Pregnant Women's Civil Rights in a NJ Case

ACLU's position

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This raises an interesting question: does anyone have the right to intervene on behalf of the infant? (Not looking to start an ethics debate, I am truly genuinely curious.) If someone were to call an ambulance, would paramedics have that right/responsibility, even if the mother declines treatment?

 

FaithManor, still praying for am update with good news.

 

I think, in order to do so you would have to reevaluate RvW &tc. If a 'wanted' fetus has rights, then don't the 'unwanted' ones as well?Perry, some of those articles were truly chilling. Losing custody of an unborn child?!? That's insane.

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Hi everyone,

 

There is an update thread "Niece.....we nearly lost her" and you can check in for the details.

 

As to the ongoing debate, except for the few states that have laws about causing miscarriage through physical violence or drunk driving or whatever and thus charging individuals, unborn children do not have rights. If they did, then all abortion situations would be illegal and a violation of the unborn's rights.

 

As for EMS, if the mother is conscious and under basic questioning, appears to be lucid, no...she can not be forced to be transported. Paramedics do not have a right to force this. Now if a parent refuses transportation of a born child and the child is not stable and desperately needs medical attention, they can call the police and CPS who can put a police officer on the step who "seizes" the child because he/she is in danger. It can take a few minutes although in most cities, it can be done some what quickly. Also, if a paramedic does call the police sometimes this alone before the arrival of an officer or social worker, will cause the parent to agree to transport. However, the paramedic can be sued for violation of the parent's rights if he/she is wrong about the dianosis and the child was not in imminent danger. So, paramedics are pretty careful and many times loathe to make the call unless the case is cut and dried....unconscious child with bleeding loss, child had to be resuscitated, etc. If the paramedic is sued and the review board finds in the parent's favor, the paramedic can just leave the medical profession.....no ambulance company will ever hire them again or so we have been told and so she has been cautioned in her classes.

 

Had the MW called for an ambulance and had niece refused transport, as long as she was not in a legally altered mental status (in and out of unconsciousness or unresponsive, no suspicion of drunkeness which is a legally altered mental state, and no sign of drug use or overdose, no significant blood loss which can lead to mental confusion, etc.) the paramedics could not just strap her to a board and carry her out against her will. By state law, she has a right to lay there and die and take the baby with her.

 

Thankfully, nothing came to that. After 15 hours of pretty hard labor and not progressing, niece was getting worn out and just wanted it to be over or so we have been told. Though she's made a lot of truly stupid decisions, when told that the baby's heart rate was dropping too low during contractions, she began crying and asked for help. The ambulance was there ASAP and off they went. SIL says she was pretty disappointed that it ended in c-section but relieved that the ordeal was over and the boyfriend seems to be attentive to both mamma and baby so that is a good thing...we'll see if that continues.

 

Mostly, I think because of the bi-polar and the fact that I am certain the doctor was gruff because he was fed up with her lifestyle and he's probably seen more than his fair share of tragedy because of stupid decisions, he probably criticized her and she said, that's it, I'm done. This niece does not take even a hint of constructive criticism without a major tantrum....has never been able to handle that emotionally. The midwife got sucked in by my sil telling a lot of lies to make things sound much better than they were. I am sure if she had known the whole truth, she never would have taken niece as a patient with only one week to go to her due date. But, I am ever so thankful that a qualified MW was there, knew what to do, and was able to get niece and sil to "see the light" and the outcome was good. Previous to meeting the MW, niece was determined that she was going to have the baby at home with just the immature 19 year old boyfriend attending the birth!!!!!!!!!!! She and Rosie probably would have died.

 

What's that saying, alls well that ends well, ....time for chocolate.

 

Faith

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Faith, would this be a good time for you guys to make a quick and quiet visit to the hospital to offer love and support? Just a "I know we've had our problems, but I wanted you to know I'll help you any way I can" kind of thing? Sometimes the "fuzzy aftermath" of a new baby can soften hardened hearts.

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In Florida, two weeks past due is due cause for induction, 42 weeks. Dangers include enlarged baby and compromised amniotic fluid, which may not be supplying nutrients anymore to baby. As a result, expect baby to be born enlarged, drier and wrinklier.

 

At the minimum, mom needs an ultrasound and need to do a kick count evaluation.

 

Keeping your niece in my thoughts.

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