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My midwife was arrested! Please read...


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The state is pressing charges. That is what makes this so blasted frustrating. It's NOT the couple...it's the state! Thy are just going after Karen as a "scapegoat" for ALL midwives who do homebirths. Make sense? The birth itself was in September...6 months before her arrest! I tried calling her this morning to see if she was okay but got her voicemail.

 

:( That is so sad. :( It is interesting what a PP said about our country legalizing and legitimizing pro-choice. It doesn't seem to apply in this case. :(

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I'm truly sorry to hear about that. My midwife was a licensed home birth midwife in my state but she lost her license to practice after one baby died during the birth. I wish they treated doctors and midwives equally; either give midwives equal respect or pull OB's license to deliver babies when they lose one too.

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Karen was supposed to deliver my 5th child but I wound up having her at the hospital at 29 weeks due to a placental abruption. Karen is a wonderful caring midwife and I've just been sick over what is happening to her.

 

There are almost no options for homebirth in MD and Karen was one of the few willing to do them. I realize that she is breaking the law here but there are so few options here it makes me sick I'm glad there are people like Karen. When we first moved here the hospital by me had a VBAC ban in place (they have since reversed it but I still refuse to give birth there- we drove an hour to a hospital to deliver my son). There are also no close birth centers and they generally don't allow VBACs anyway. Homebirth is illegal. It leaves a lot of women with no options at all. I've had one cesarean for twins and even with two prior vaginal births I really had to fight to have VBACs for my two youngest.

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I'm truly sorry to hear about that. My midwife was a licensed home birth midwife in my state but she lost her license to practice after one baby died during the birth. I wish they treated doctors and midwives equally; either give midwives equal respect or pull OB's license to deliver babies when they lose one too.

 

:iagree: Also, if OBs are going to cry foul over "safety," as a group they should start practicing evidence-based care. So long elective inductions, routine episiotomies, continuous fetal monitoring for normal births, "time's up" cesareans, denying food/drink, standard IVs, and all the other practices that are not proven to improve outcomes (and instead add risk).

 

Ugh, I'm having flashbacks to when I helped to fight to get non-CNM midwifery legalized in my state. We eventually won, but it took a lot of trying. Only my last two home births were legally attended by a licensed midwife.

 

:grouphug: I hope this ends well.

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I had both my babies drug-free in the hospital with a Certified Nurse Midwife. My son even had a waterbirth. I am hugely in favor of midwives and woman-centered, family-centered care.

 

I am also in favor of midwife-attended homebirth for low-risk women, understanding that the vast majority of births are low risk and can happen in perfect safety at home with an experienced and competent attendant.

 

That said, a 43-year-old primapara with a breech baby is not low risk. When she was risked out of her first homebirth practice, she should have paid attention to that and looked for a hospital environment where she could maximize her choices. (Yes, they exist.) It sounds like she privileged having her ideal birth experience over listening to the facts about her level of risk, and this midwife went along with it. It's tragic. Serious errors in judgement were made all around.

 

And I agree that there's no excuse for practicing in a state that licenses DEMs without getting licensed.

 

:iagree::iagree:

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Karen is my midwife as well and I am so torn up over this! As far as the licensing issue-- VA does license CPMs but the law does not allow the midwife to carry oxygen and pitocin. Karen carried both-- perhaps that played into her decision to not get the license.

 

That could very well be. Karen did carry oxygen and pitocin. Carrying oxygen saved my ds9's life. He was purple-faced at birth and barely breathing (quick birth, cord wrapped around neck, would have happened that way in a hospital, too) and b/c she carried oxygen, ds was saved. Whatever the reason, I'm sure it was a good one. And this has nothing to do with the license anyway, I'm sure. It is a witchhunt, pure and simple. When I chose to be transported to York Hospital, Karen accompanied us there. Even though she is legal here, they treated her like DIRT. I was appalled. The transport was MY CHOICE (b/c I was exhausted) and my baby was perfectly fine and healthy. Makes me sick whenever I think about it. :glare:

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Karen consulted with my midwife on my planned home birth during labor after BirthCare also turned me away because I was having multiples. I don't know her personally, but I know several women who used her for their births. I understand that people here disagree with the risk of home birth when a midwife is not a CNM, but I want to point out that even in cases with slightly higher risk (and I can't speak specifically to the case in question because I'm only a layperson on these issues), less invasive birth care is still usually still better for the woman and the child, but that's care you are extremely unlikely to get in a hospital situation and CNMs almost always turn those cases way, leaving women who are VBAC, carrying multiples, etc. with fewer options when they deserve more. It makes me furious. And this case just makes me sad - for the mother, the baby, for Karen, and for any woman who wants to make her own decisions about her birth, because cases like these are rare but are used to intimidate women who aren't in risky pregnancies into thinking that a home birth is too dangerous an option.

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I had both my babies drug-free in the hospital with a Certified Nurse Midwife. My son even had a waterbirth. I am hugely in favor of midwives and woman-centered, family-centered care.

 

I am also in favor of midwife-attended homebirth for low-risk women, understanding that the vast majority of births are low risk and can happen in perfect safety at home with an experienced and competent attendant.

 

That said, a 43-year-old primapara with a breech baby is not low risk. When she was risked out of her first homebirth practice, she should have paid attention to that and looked for a hospital environment where she could maximize her choices. (Yes, they exist.) It sounds like she privileged having her ideal birth experience over listening to the facts about her level of risk, and this midwife went along with it. It's tragic. Serious errors in judgement were made all around.

 

And I agree that there's no excuse for practicing in a state that licenses DEMs without getting licensed.

 

:iagree:

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I'm not sure I understand the uproar over someone delivering babies without the proper license? Even hairdressers need a license. Nearly every profession regulates through state licensing.

 

If the uproar is because it's illegal, well that's a case for lobbying. The state, IMO, has an obligation to prosecute the illegal practice of medicine. And the illegal practice of law, etc.

 

Do I understand that she was practicing in several states without a license in any of them (MD, VA, PA)?

 

Is this about choices for delivery or obtaining an appropriate professional license?

 

Lisa

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There are also no close birth centers and they generally don't allow VBACs anyway. Homebirth is illegal. It leaves a lot of women with no options at all.

 

You do mean that homebirths are illegal for VBACs in MD, right? And I don't think that's quite true -- it may be illegal for a DEM or CPM to practice in MD, and it may be illegal for a CNM to attend a VBAC in MD, but I don't think there is a law that prohibits you from having an unassisted VBAC in MD. (Whether it's wise or not is a different question.) Homebirth with a licensed CNM in MD for a single baby, non-VBAC is perfectly legal (unless things have changed in the several years since I had a homebirth in MD attended by a CNM from BirthCare).

 

Not particularly applicable to the original thread, but I just wanted to clear up any confusion.

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VBACs in MD are not illegal. However, many OBs and CNMs will not do VBACs at home. I was scheduled to have my VBAC at a birth center in MD before I decided I wanted a home birth. The only CNM in my area refused to do a VBAC at home unless I was across the street from a hospital. Then I found Karen...she was a gift from God. Anyway, I just spoke to Karen and while she cannot speak about the specifics, it was wonderful to hear her voice. She is in good spirits and she was heartbroken over this birth. Karen isn't a robot. She always got "attached" to her mothers and the babies. Every one was special. The hospital in VA or DC (wherever they took the baby after the birth) is the entity who filed charges...6 mos. after the birth happened! It is a witchhunt. What interest does the hospital have in this? None. Absolutely none. I am furious. Whatever any of you think of this case, or Karen's reasons for taking on this birth or whatever...please remember that Karen is a human being with a family...just like the mother who lost her child. Losing that baby was tragic and devastating for the mother. And this is just as tragic and devastating for Karen. Nobody needs to be "blamed" for this.

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I am sorry this happened but your last statement regarding blame is erroneous. The mother is to blame for having idealized and ignored the risk to herself and her baby. Her actions are contributory negligence and assumption of risk. Legally speaking the hospital cannot bring criminal charges only the prosecutor in the county where the death occurred. This was avoidable with an ounce of prevention and some common sense on all the part of all involved. An entirely avoidable outcome that ends in tragedy for all.

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I am also in favor of midwife-attended homebirth for low-risk women, understanding that the vast majority of births are low risk and can happen in perfect safety at home with an experienced and competent attendant.

 

That said, a 43-year-old primapara with a breech baby is not low risk. When she was risked out of her first homebirth practice, she should have paid attention to that and looked for a hospital environment where she could maximize her choices. (Yes, they exist.) It sounds like she privileged having her ideal birth experience over listening to the facts about her level of risk, and this midwife went along with it.

 

:iagree: Like it or not, the state does pay more attention to the protection of voiceless members. When my GM chose to die at home without any medical care over something rather treatable, my mother respected her wishes (which were consistent with her life long avoidance of doctors -- she was a naturopath, of the Lindlar school, class of 1923). However, she was a grown, sensible woman, and although an autopsy was required because she died "out of care" and was not ancient, my mother was in no danger of being prosecuted. A baby has no voice in this. Hence the extra scrutiny.

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I am sorry that your friend is in a legal bind, I really am; yet, a baby is dead, needlessly. The midwife made a very bad judgment call given the circumstances of this birth. I realize that she is a woman with a family, and I do not question the love and dedication that she displays towards her job and feels for those families that she works with. I am sure she is heartbroken, as are the parents of the little one who was tragically lost; even so, I feel that she must be held legally responsible for her actions.

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I am sorry that your friend is in a legal bind, I really am; yet, a baby is dead, needlessly. The midwife made a very bad judgment call given the circumstances of this birth. I realize that she is a woman with a family, and I do not question the love and dedication that she displays towards her job and feels for those families that she works with. I am sure she is heartbroken, as are the parents of the little one who was tragically lost; even so, I feel that she must be held legally responsible for her actions.

 

I respect your opinion. I also must say that the mother in this case was WELL informed of the risk to herself and her baby. According to my midwife, the mother "desperately wanted this homebirth". But I hesitate to "blame" the mother or my midwife b/c this birth could have had a tragic outcome in a hospital as well. C-sections are not w/out risk to mother or baby either. Bad judgement? I don't know about that since Karen has delivered well over 50 breeches safely. There is risk in childbirth...no matter who attends or where it is. Blame will not bring this baby back, help the mother heal, etc. And if Karen is convicted, the community will lose one incredibly skilled and caring midwife. So many "what ifs" but all are hindsight...and hindsight is always 20/20.

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I am sorry this happened but your last statement regarding blame is erroneous. The mother is to blame for having idealized and ignored the risk to herself and her baby. Her actions are contributory negligence and assumption of risk. Legally speaking the hospital cannot bring criminal charges only the prosecutor in the county where the death occurred. This was avoidable with an ounce of prevention and some common sense on all the part of all involved. An entirely avoidable outcome that ends in tragedy for all.

 

I am sorry that your friend is in a legal bind, I really am; yet, a baby is dead, needlessly. The midwife made a very bad judgment call given the circumstances of this birth. I realize that she is a woman with a family, and I do not question the love and dedication that she displays towards her job and feels for those families that she works with. I am sure she is heartbroken, as are the parents of the little one who was tragically lost; even so, I feel that she must be held legally responsible for her actions.

 

How crazy-risky is it to attempt to deliver a breech baby in a home environment with a 43 year old woman?

 

I am no expert here, but this sounds like a case of exceptionally bad judgement that lead to the needless death of a newborn.

 

Bill

 

I've got to agree here. This is such a sad situation, but what makes it even more heartbreaking is that it could've been avoided had the midwife refused to deliver such a high risk case at home or if the mother had decided to deliver in the hospital where quick intervention could've occurred if/when it was needed.

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Slightly unrelated question (but it's been mentioned, soĂ¢â‚¬Â¦) -- some of you have said that your hospital "refuses" to do a VBAC.. which made me wonder.. what exactly will the hospital do if you show up in labour and refuse to agree to a c-section? They kinda have to deliver the babyĂ¢â‚¬Â¦. they can't force the c-section on you without your consent.. (can they?)

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Slightly unrelated question (but it's been mentioned, soĂ¢â‚¬Â¦) -- some of you have said that your hospital "refuses" to do a VBAC.. which made me wonder.. what exactly will the hospital do if you show up in labour and refuse to agree to a c-section? They kinda have to deliver the babyĂ¢â‚¬Â¦. they can't force the c-section on you without your consent.. (can they?)

 

From anecdotal stories, it appears that they may be able to get away with exactly that.

 

After everything I've read about the state of maternity care in the US I'm not sure I ever want another child.

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Slightly unrelated question (but it's been mentioned, soĂ¢â‚¬Â¦) -- some of you have said that your hospital "refuses" to do a VBAC.. which made me wonder.. what exactly will the hospital do if you show up in labour and refuse to agree to a c-section? They kinda have to deliver the babyĂ¢â‚¬Â¦. they can't force the c-section on you without your consent.. (can they?)

 

They can't force you to (that would be battery, I believe). They can, however, refuse to treat you. They'll let you stay at the hospital, but they're not going to give you pain medication or anything.

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How crazy-risky is it to attempt to deliver a breech baby in a home environment with a 43 year old woman?

 

I am no expert here, but this sounds like a case of exceptionally bad judgement that lead to the needless death of a newborn.

 

Bill

 

I know I'm jumping in late here, but some women chose homebirth because they can't afford hospital birth. It may be risky, but sometimes it is the best option available.

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I don't know what's right in this situation because I don't know enough about the specific risk factors involved. It does seem like a 43 yo woman with a breech baby and other risk factors maybe should not have been at home, but I honestly don't know. I chose to labor at home with what is generally considered a "high risk" pregnancy so I find it especially hard to judge just from a personal standpoint. I ended up a transport to the hospital for various reasons (though with a lawyer as my doula to fight for me, I was able to give birth to my breech little one vaginally) but if anyone had tried to stop me from trying to have the birth I wanted, I probably would have packed dh in the car and driven to the Farm. Seriously.

 

One of the trends I see in our society that increasingly upsets me is an inability to accept and live with risk without blaming people or trying to eliminate all possible danger. It may be that the risk Karen and the family took by allowing her to labor at home *was* too big a risk. However, there are risks with a hospital birth too (and I'm not saying they're equal, just that they exist). And I would suspect that the hospitals' desire to control risk by forcing all women who aren't in their 20's with 100% uncomplicated pregnancies to have a c-section helped lead the mother to make such a decision in the first place. Because when we try to make things entirely safe, we usually end up creating new risks and losing benefits that are important as well.

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I had both my babies drug-free in the hospital with a Certified Nurse Midwife. My son even had a waterbirth. I am hugely in favor of midwives and woman-centered, family-centered care.

 

I am also in favor of midwife-attended homebirth for low-risk women, understanding that the vast majority of births are low risk and can happen in perfect safety at home with an experienced and competent attendant.

 

That said, a 43-year-old primapara with a breech baby is not low risk. When she was risked out of her first homebirth practice, she should have paid attention to that and looked for a hospital environment where she could maximize her choices. (Yes, they exist.) It sounds like she privileged having her ideal birth experience over listening to the facts about her level of risk, and this midwife went along with it. It's tragic. Serious errors in judgement were made all around.

 

 

And I agree that there's no excuse for practicing in a state that licenses DEMs without getting licensed.

 

 

I doubt she could find anyone to allow her to birth vaginally in a hospital. And the safety of vaginal breech birth is comparable to surgical breech birth according to the most recent studies, particularly if the attendant is trained in breech birth. So the choice was probably between homebirth or c-section, which carries it's own risks. My anger is at the hospital system that puts women in the position of having to make that choice. Why on earth there aren't more doctors trained in breech I will never understand. Thankfully at least Canada is going back to advising vaginal breech.

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I know very little about home births. Would most midwives chose to deliver a breech birth at home? While I realize her lack of license in Virginia is an issue here, is it also an issue of allowing a risky birth to take place at home?

 

Mine does breech birth, but she is trained and experienced in it. It depends on the midwife. Mine also recently delivered twins.

 

Katie

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I am confused now. The mother decided to have a home birth. The (certified) midwife assists. The baby died. Who can say with absolute certainty that this poor child would not have died in a hospital? Is there proof of negligence on part of the midwife?

Tragic things happen, people die young. It is heart breaking and gut wrenching but horrible things happen without someone at fault. Sometimes there is nothing any human can do. We have to remember that (unless there is definite proof of negligence or lapse in judgment) we humans are not the arbiter of life or death.

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:iagree: I guess I need to further investigate why one wouldn't get a license or why a pregnant mother would want to use a direct-entry midwife vs a certified one. FWIW, I am in PA and used a CM for all four of my babies at a freestanding birth center.

 

I wish all families the best. It is always tragic.

 

Direct entry midwives ARE certified, they are Certified Professional Midwives, which are CPM's. They have passed national certification. However, about half of the states in the country refuse to acknowledge them. So you don't have a choice, as a mother, to hire one, despite their proven record of providing excellent health care. Certified Nurse Midwives, CNM's, are a totally different thing, with a different background and different protocols. CNM's can only practice under a doctor, and ultimately the doctor has all the control. CPM's consult with doctors, but don't work for a doctor.

 

In many states CNM's do not do homebirths, and in the state mentioned there are only 4 CNM's doing homebirths in the whole state. Not nearly enough for the women that need them. That is why women turn to CPM's.

 

I live in Florida and we do recognize CPM's, and license them. They have a strict standard they have to follow, and provide excellent care. They even can be paid by medicaid. But if my Licensed by the State of Florida midwife delivered a baby in one of the states that doesn't acknowledge CPM's she'd be arrested possibly.

 

It's like if half the states decided not to recognize chiropracters, or allergists, or something.

 

Katie

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They can't force you to (that would be battery, I believe). They can, however, refuse to treat you. They'll let you stay at the hospital, but they're not going to give you pain medication or anything.

 

You are kidding, right? :glare:

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Surely, you're not surprised. If it's practically illegal to give your neighbor a zucchini, it's sure as shootin illegal for adults to make their own decisions! If parents in Chicago can't be trusted to pack their dc's lunch, you can't be expected to be able to make big medical decisions! Silly patient! Only certain, specially trained professionals know what's good for you! Please do as you're told or we'll have to increase the amount of drugs we put in your food and water....That would be unfortunate, they're expensive and you haven't been paying enough taxes recently.

 

semi-sarcastic

 

Well put! Had not heard the bit about kids' lunches in Chicago?

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I am confused now. The mother decided to have a home birth. The (certified) midwife assists. The baby died. Who can say with absolute certainty that this poor child would not have died in a hospital? Is there proof of negligence on part of the midwife?

Tragic things happen, people die young. It is heart breaking and gut wrenching but horrible things happen without someone at fault. Sometimes there is nothing any human can do. We have to remember that (unless there is definite proof of negligence or lapse in judgment) we humans are not the arbiter of life or death.

 

I think that is the point that the OP was making. She is saying this is a witch hunt on the part of the hospital because the baby died on the midwife's watch.

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I'm not sure I understand the uproar over someone delivering babies without the proper license? Even hairdressers need a license. Nearly every profession regulates through state licensing.

 

If the uproar is because it's illegal, well that's a case for lobbying. The state, IMO, has an obligation to prosecute the illegal practice of medicine. And the illegal practice of law, etc.

 

Do I understand that she was practicing in several states without a license in any of them (MD, VA, PA)?

 

Is this about choices for delivery or obtaining an appropriate professional license?

 

Lisa

 

the problem is that in half the states in the country you CAN'T get a license, they do not license them. Which is the case in MD and PA. And in VA, which recently allowed licensing, the only way to get a license is to agree not the carry the medications that midwives need to carry in order to safely treat patients...so again, not really a viable option.

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the problem is that in half the states in the country you CAN'T get a license, they do not license them. Which is the case in MD and PA. And in VA, which recently allowed licensing, the only way to get a license is to agree not the carry the medications that midwives need to carry in order to safely treat patients...so again, not really a viable option.

 

That is so sad! Again I refer back to a previous poster who mentioned how in a country that is legally pro-choice, that these kinds of actions can take place. All the time you hear politicians saying that a woman has the right to choose what she does with her own body and yet they won't allow her to birth at home?? Where is the choice in that?? If she has the right to her body enough to abort her baby shouldn't she under that same right be able to choose to birth at home and the midwives to assist without fear of prosecution??

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I am sorry this happened but your last statement regarding blame is erroneous. The mother is to blame for having idealized and ignored the risk to herself and her baby. Her actions are contributory negligence and assumption of risk. Legally speaking the hospital cannot bring criminal charges only the prosecutor in the county where the death occurred. This was avoidable with an ounce of prevention and some common sense on all the part of all involved. An entirely avoidable outcome that ends in tragedy for all.

 

I think that is so easy to say in hindsight. Had she had a c-section in the hospital, and developed a blood clot from the surgery and died, would people be saying "oh, well, she could have avoided that with an ounce of prevention and some common sense?" And yet that does happen. There was no choice without risk. I had a home VBAC because the chance of something bad happening to the baby in a VBAC has to be weighed against the chances of something bad happening to me in a c-section at the hospital, and I had another child to care for, that I couldn't leave motherless. I chose the risks I could live with. I'm assuming the mother here did as well.

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:iagree:

I respect your opinion. I also must say that the mother in this case was WELL informed of the risk to herself and her baby. According to my midwife, the mother "desperately wanted this homebirth". But I hesitate to "blame" the mother or my midwife b/c this birth could have had a tragic outcome in a hospital as well. C-sections are not w/out risk to mother or baby either. Bad judgement? I don't know about that since Karen has delivered well over 50 breeches safely. There is risk in childbirth...no matter who attends or where it is. Blame will not bring this baby back, help the mother heal, etc. And if Karen is convicted, the community will lose one incredibly skilled and caring midwife. So many "what ifs" but all are hindsight...and hindsight is always 20/20.

 

There is no way to know what would have happened at a hospital....babies died there too unfortunately. A tragedy no matter where it occurs.

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Slightly unrelated question (but it's been mentioned, soĂ¢â‚¬Â¦) -- some of you have said that your hospital "refuses" to do a VBAC.. which made me wonder.. what exactly will the hospital do if you show up in labour and refuse to agree to a c-section? They kinda have to deliver the babyĂ¢â‚¬Â¦. they can't force the c-section on you without your consent.. (can they?)

 

They can get a court order if there is time. Hospitals have done it before. And just in the past month a local OB told a friend of mine that he wouldn't hesitate to get one to force her to deliver by c-section, if she gained even a pound more than his guidelines for healthy pregnancy.

 

She is now planning a birth with a midwife.

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ISometimes there is nothing any human can do. We have to remember that (unless there is definite proof of negligence or lapse in judgment) we humans are not the arbiter of life or death.

 

I had a "crash" C section for a stuck head. Apgars were 8 and 9. From the moment my OB stood bolt upright in the delivery room everything went so fast the lights in the hall I was being run down were a blur. I remember a lovely floating sense of calm because I was surrounded by a ring of nurses's faces as we whisked along, and I wasn't even doped, yet. I just love nurses.

 

So, no, there is no proof this baby would not have died, and yes, she would have ended up with a C section. However, the details of the case, probably carefully considered if it took them 6 months to press charges, are not open to us at this time.

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Slightly unrelated question (but it's been mentioned, so…) -- some of you have said that your hospital "refuses" to do a VBAC.. which made me wonder.. what exactly will the hospital do if you show up in labour and refuse to agree to a c-section? They kinda have to deliver the baby…. they can't force the c-section on you without your consent.. (can they?)

 

Actually, there have been judges give emergency orders to force women to undergo c/sections who attempted to usurp a hospitals "no vbac" rule.

 

I worked as a maternity nurse for four years. I have had one natural hospital birth, one birthing center birth with a CNM, and one unassisted birth. This is a topic that I am passionate about and have been personally affected by.

 

A few thoughts on this...

 

My understanding is that primip women over forty have close to an 80% section rate. Please quash this perception of mine if you can find statistics to refute it.

 

I also don't know that I believe that being older than thirty five necessarily makes labor and delivery more risky. It does increase risk of genetic disorders, but I'm not sure that it makes labor more risky if the baby is normal. Here is one study I have looked at previously. http://www.ncbi.nlm.nih.gov/pubmed/1804079

 

Breech is it's own animal with evidence on either side. However, most doctors will not deliver a breech. So, to be at a hospital just in case, is simply not an option.

 

So, if you are 43 with a breech baby and want to attempt a vag birth, can you just walk into a hospital and refuse a section?

 

Not necessarily.

 

I have seen women screaming "don't cut me" in labor and doctors give massive episiotimies despite their refusal. When I complained up the chain I was told that "a laboring woman can't really refuse an episiotomy because she'll just tear anyways, so we don't really *let* women refuse them". I have seen nurses call anesthesiologists to give women epidurals (who wanted to go natural) and then seen anesthesiologists ream women out and tell them they wouldn't give them an epidural if they changed their mind later and pressure them as hard as they could to get the epidural.

 

Hospitals make a lot of money off of managed childbirth. Women's desires... specifically laboring women's desires... seem to be worth as much as the opinion of a four year old from what I've seen. I am sure other ob nurses have seen differently, but I have worked in some areas that are very unfriendly to natural birth.

 

My insurance requires us to use a specific hospital, that is completely managed childbirth. My OB informed me he would probably use forceps to "give me something to push against" and he would have them put in a bladder catheter even if I didn't have an epidural. I was told the baby would be taken to a nursery immediately following delivery whether I approved or not. We eventually made the decision to go unassisted because of what we were up against. Could we have walked in and refused? Possibly. But I've seen laboring women ignored before. And, what is your capacity to argue treatment when you are in labor?

 

Unfortunately, because of hospital rules such as no vbac, no breech, etc, women are often pushed between a rock and a hard place when trying to get the birth they feel is the right decision.

 

Did this midwife take unnecessary risks? Possibly. Is the other poster right in stating that it's a witch hunt? I would think so.

 

Edited to add: Although I have been told before that the two do not compare, I am still surprised by a system that argues women's choice to abort a possibly viable infant, but will not allow a woman to make a birth decision that possibly adds risk according to which studies you look at. Where is women's choice in birthing? Oh, that's right... it's in the anesthesiologists and obs pocketbooks.

Edited by staceyobu
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:iagree:

Actually, there have been judges give emergency orders to force women to undergo c/sections who attempted to usurp a hospitals "no vbac" rule.

 

I worked as a maternity nurse for four years. I have had one natural hospital birth, one birthing center birth with a CNM, and one unassisted birth. This is a topic that I am passionate about and have been personally affected by.

 

A few thoughts on this...

 

My understanding is that primip women over forty have close to an 80% section rate. Please quash this perception of mine if you can find statistics to refute it.

 

I also don't know that I believe that being older than thirty five necessarily makes labor and delivery more risky. It does increase risk of genetic disorders, but I'm not sure that it makes labor more risky if the baby is normal. Here is one study I have looked at previously. http://www.ncbi.nlm.nih.gov/pubmed/1804079

 

Breech is it's own animal with evidence on either side. However, most doctors will not deliver a breech. So, to be at a hospital just in case, is simply not an option.

 

So, if you are 43 with a breech baby and want to attempt a vag birth, can you just walk into a hospital and refuse a section?

 

Not necessarily.

 

I have seen women screaming "don't cut me" in labor and doctors give massive episiotimies despite their refusal. When I complained up the chain I was told that "a laboring woman can't really refuse an episiotomy because she'll just tear anyways, so we don't really *let* women refuse them". I have seen nurses call anesthesiologists to give women epidurals (who wanted to go natural) and then seen anesthesiologists ream women out and tell them they wouldn't give them an epidural if they changed their mind later and pressure them as hard as they could to get the epidural.

 

Hospitals make a lot of money off of managed childbirth. Women's desires... specifically laboring women's desires... seem to be worth as much as the opinion of a four year old from what I've seen. I am sure other ob nurses have seen differently, but I have worked in some areas that are very unfriendly to natural birth.

 

My insurance requires us to use a specific hospital, that is completely managed childbirth. My OB informed me he would probably use forceps to "give me something to push against" and he would have them put in a bladder catheter even if I didn't have an epidural. I was told the baby would be taken to a nursery immediately following delivery whether I approved or not. We eventually made the decision to go unassisted because of what we were up against. Could we have walked in and refused? Possibly. But I've seen laboring women ignored before. And, what is your capacity to argue treatment when you are in labor?

 

Unfortunately, because of hospital rules such as no vbac, no breech, etc, women are often pushed between a rock and a hard place when trying to get the birth they feel is the right decision.

 

Did this midwife take unnecessary risks? Possibly. Is the other poster right in stating that it's a witch hunt? I would think so.

 

Edited to add: Although I have been told before that the two do not compare, I am still surprised by a system that argues women's choice to abort a possibly viable infant, but will not allow a woman to make a birth decision that possibly adds risk according to which studies you look at. Where is women's choice in birthing? Oh, that's right... it's in the anesthesiologists and obs pocketbooks.

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I think that is the point that the OP was making. She is saying this is a witch hunt on the part of the hospital because the baby died on the midwife's watch.

 

The hospital is not "pressing charges". The hospital has to report deaths. We have no evidence "the hospital" (actually, the CEO or the patient care committee, or something that is human) is dialing around trying to get county prosecutors riled up. Unless there is a track record of the county attorney digging and dedicating disproportionate resources to track midwives (and at least out here, they are up to the ears in drug cases), this may just be a straightforward case of an unlicensed person who bucked standards of care in the midwifery world and didn't clear the hurdle of a normal birth. Regardless of her personal dedication, worth, charm and general goodness, the legal gears of society aren't automatically a witchhunt just because we support the accused person.

 

Wow, I'm showing my age: dialed.

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I guess I am touchy because direct entry midwives (even CPM's) are illegal here in IL and actively prosecuted. Most of the counties in our state do not have a homebirth provider within a 2 hours drive. And most of those counties do not have options for VBAC (or natural birth, really.) (I deleted what was to become a soap-box speech!)

 

That's disappointing. I guess I was fortunate then - I had twins by VBAC in a hospital in Illinois (including turning the second one in utero during); my prior c-section was for breech of my first singleton (same doc). I went on to have three more hospital VBACs after moving to another state.

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The hospital is not "pressing charges". The hospital has to report deaths. We have no evidence "the hospital" (actually, the CEO or the patient care committee, or something that is human) is dialing around trying to get county prosecutors riled up. Unless there is a track record of the county attorney digging and dedicating disproportionate resources to track midwives (and at least out here, they are up to the ears in drug cases), this may just be a straightforward case of an unlicensed person who bucked standards of care in the midwifery world and didn't clear the hurdle of a normal birth. Regardless of her personal dedication, worth, charm and general goodness, the legal gears of society aren't automatically a witchhunt just because we support the accused person.

 

Oooops! I meant the state! I'm sorry. I think I'm overtired. lol I was referring to Sue's post here...

The state is pressing charges. That is what makes this so blasted frustrating. It's NOT the couple...it's the state! Thy are just going after Karen as a "scapegoat" for ALL midwives who do homebirths. Make sense? The birth itself was in September...6 months before her arrest! I tried calling her this morning to see if she was okay but got her voicemail.

 

Thank you for correcting me. :)

 

 

Wow, I'm showing my age: dialed.

 

:lol::lol: I remember rotary phones. lol

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This is tragic for everyone involved. There are always risks with any birth. There are no guarantees. But, it's not always someone's "fault" when the baby dies. Who is to say that this baby wouldn't have died in a hospital birth? We'll never know, but that doesn't necessarily mean it is the midwife's fault for doing the delivery or the mom's fault for choosing a homebirth.

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http://washingtonexaminer.com/news/2011/04/baltimore-midwife-charged-va-manslaughter

 

Grand Jury, no witch hunt here ,sorry for the failed conspiracy theory. This means that the following facts are true : 16 to 23 citizens reviewed the prosecutorial evidence and deemed the case to be worthy of a full trial on the evidence. That is not a witch hunt by the hospital or an over zealous prosecutor. As for the facts of the case only time will tell as to whether any charges whould have been brought or not.

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:iagree:

 

There is no way to know what would have happened at a hospital....babies died there too unfortunately. A tragedy no matter where it occurs.

 

Well then the midwife will have to suffer the repercussions for choosing not to have a license. Perhaps this will encourage others who choose to knowingly break the law to not participate in high risk births that would better served by someone else.

Frankly, I hope she receives a harsh sentence.

I only wish there was a way to charge the mother for valuing her birth experience over the life of her child.

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Well then the midwife will have to suffer the repercussions for choosing not to have a license. Perhaps this will encourage others who choose to knowingly break the law to not participate in high risk births that would better served by someone else.

Frankly, I hope she receives a harsh sentence.

I only wish there was a way to charge the mother for valuing her birth experience over the life of her child.

 

How exactly do you determine when someone is valuing a birth experience over the life of their child? Would you recommend a section for anyone over the age of 40? Exactly what risk factors are acceptable for a vaginal birth attempt?

 

I have heard more than one doctor say that birth would be safest if we sectioned everyone at 38 weeks. According to them, only women who agree to that are valuing the life of their child over their birth experience.

 

It's a harsh judgement to say someone valued a natural birth over the life of their child. Many women believe that attempting a natural birth is acting in their child's best interest.

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This is tragic for everyone involved. There are always risks with any birth. There are no guarantees. But, it's not always someone's "fault" when the baby dies. Who is to say that this baby wouldn't have died in a hospital birth? We'll never know, but that doesn't necessarily mean it is the midwife's fault for doing the delivery or the mom's fault for choosing a homebirth.

My mother was a NICU nurse before she retired. She is haunted, to this day, by a case where an OB, who was scheduled to go on vacation in a few short hours, made decisions to hasten the delivery of an infant that ended up dying. Completely preventable. Entirely caused by medical interventions. Not prosecuted.

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