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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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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.

 

I could tell similar stories to this. Of course, these women were told that everything possible was done and it happened anyways... instead of being told they put their birth experience ahead of their child's life.

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Once my state got licensure for DEMs, it also gained access to midwifery statistics and licensure review, enacted restrictions and regulations, and provided legal access to emergency medications. Twins and breeches are prohibited unless birth is imminent. VBAC is allowed under certain conditions.

 

Licensure brings midwifery out of the dark and makes it easier for women to get safe and appropriate care.

 

I'm uncomfortable with the extremes on both sides of the home birth/hospital birth debate. "Birth is always safe" is as wrong as "birth is always an emergency." Birth has risks no matter the location. Each woman must evaluate which risks are most acceptable to her. It's unfair to accuse a home birther of caring more about the experience when women have medically unnecessary inductions, c-sections, and epidurals. Pot meet kettle? :)

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I could tell similar stories to this. Of course, these women were told that everything possible was done and it happened anyways... instead of being told they put their birth experience ahead of their child's life.

So now you are placing the blame back on the parents? And you have no experiences to the contrary, where it is the medical practitioners that could reasonably carry the responsibility?

ETA maybe I am not understanding you correctly. Please explain what you mean.

Edited by Lawana
ETA clarification
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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.

 

Wow...why on earth would you say something like that??? Women don't choose home birth because they value their experience over safety...they choose it because they have looked at the various risks and felt that home birth was the safest overall choice. There are risks to c-sections too, especially when the baby is breech. Serious risks...the one that made me choose homebirth over repeat cesarean is that a woman is 400% more likely to die in a c-section than a vaginal birth.

 

just wow.

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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.

 

 

perhaps I'm cynical, but I believe that emotions probably played more of a role than logic...it is well known that when babies die people look to blame someone, anyone. Even when it isn't anyone's fault. Hence the ridiculously high rate of malpractice cases against doctors.

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You are kidding, right? :glare:

 

Nope. It happened to a friend of mine. (Doesn't prove it always happens that way, of course, just that it happens sometimes.)

 

I can understand it, logically, because in treating a patient a doctor takes on risk, and if the patient is unwilling to follow his recommendations, the doctor should be able to refuse the risk that patient represents.

 

On the other hand, it's really hard on the patient, who might not have another option for medical care.

 

I don't see a good solution on either side, honestly.

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So let me get this straight...she was not licensed when she could have been, she (I assume) charged money for a medical service, she performed certain "acts" which she knew she was not allowed to do, she carried medications (with full intent to use them) that she was not allowed to administer, and she allowed a high risk pregnant woman to "convince" her to take a risk with her and her baby's life. And she knew all this going in?

 

Yeah, sorry but she did just about everything wrong in this case and while I'm not against home birth at all, I think that if you want to take risks with other people's lives then you have to be willing to stand up and take the responsibility when it all goes to crap. I'm not sure she deserves jail time, but I'd definitely have to hear all the evidence before I could say that for sure.

 

I think if she was not charging money for her services she would not be prosecuted because then she'd just be someone helping out with a home birth. But when you label yourself an expert in something as serious as childbirth and then allow a woman who was told multiple times that she needed a more emergency ready setting to talk her into doing something she inherently knew could go very wrong, well...she should not have been be surprised when the worst case scenario happened.

 

And yes, childbirth is completely natural and has never been safer than it is today, but 100 years ago every 1 out of 100 women died in childbirth. People feel it's natural and safe because, well it is. But that's not because childbirth is naturally safe, it's because pregnancy care and medical care during childbirth have greatly improved.

 

And for the record I refused a C-section and no one berated me or refused to give me drugs or birth my baby.

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So now you are placing the blame back on the parents? And you have no experiences to the contrary, where it is the medical practitioners that could reasonably carry the responsibility?

ETA maybe I am not understanding you correctly. Please explain what you mean.

 

The blame for unnecessary medical procedures gone wrong lies completely on the medical personnel. I'm just saying that a mom who has a hospital delivery that goes wrong won't be blamed. Which she shouldn't... it's not her fault. However, if a woman delivers at home and something goes wrong, she was putting her birth experience ahead of her child's life. It's just a double standard.

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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.

 

WOW !

I am so glad I live in a country like Australia where hospitals and insurance companies don't have such a hold on women in labour!.

Here nobody forces you to have an epidural, or use forceps, or have a cesarean. Nobody forces drugs or painkillers on women in labour. When you book into the hospital to have your baby ( usually 4-5 months before the baby is born) you go through a birth plan with the midwives, and the plan is followed, ( unless of course there is an emergency).

 

When my sister had her baby last week, she was told because the risk of her hemorrhaging was so high, they wouldn't even think of doing a cesarean.

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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.

 

 

My husband has been a lawyer for 18 year, mainly as a prosecutor. He says grand juries tend to do whatever the district attorney wants them to do. :glare:

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http://www.courts.state.va.us/courts/circuit/handbook_grand_jurors.pdf

 

Here is the handbook from Virginia for grand jurors. It is an amazing amount of information and quite well written.

 

However, they receive all their information from the prosecution - the defense cannot present any evidence or argument. The DA tells you the prosecution's side and then tells you to vote.

 

from the document linked above

 

"The Grand Jury only determines whether there is probable cause that the accused committed the crime and should stand trial."

 

The only information whether or not the accused committed the crime is provided by one side - the prosecution.

 

Grand jury is a tool for the prosecution. If the prosecution has a case they want to drop, but victim's family is pressuring the DA, the prosecution indicates to the grand jury that it is not a strong case, and the case goes away without the victim's family being able to blame the DA. The idea that a grand jury prevents a "district attorney witch hunt" is not a given. Elected officials are under enormous pressure to satisfy not only justice, but people as well. Grand jury can be an effective tool.

Edited by Michele B
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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.

 

I hesitate to even say this...but had Karen NOT taken this birth the community would not have lost her as a midwife.

 

Hindsight is 20/20...but even if the poor baby hadn't died, I don't think it is wrong to say that a 43 yo first time mother w/ a breech baby is a poor candidate for homebirth.

 

It breaks my heart to read the mom was desperate for a homebirth.

Edited by unsinkable
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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.

 

Wow, I'm showing my age: dialed.

 

That's like when I make "roll down the window" motions when my kids are in the car and I am outside the car, trying to talk to them -- I put my hand in a fist and make a circular motion. They think it's hilarious.

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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.

 

My sister, then 22, was cut open navel to pubis because "the baby was in distress" (um, no, she wasn't) because the doctor was going to miss his flight. The baby (now in her twenties) is fine. My sister was literally scarred for life. She never got over it. Her next birth was a 22 hour labor at home with a midwife. Perfect apgar. Genius kid.

 

Oh, and she made sure I read A Good Birth a Safe Birth while I was pregnant. Talk about the "medicalization" of childbirth!

 

 

I don't understand why she didn't comply with licensing.

 

Just b/c someone *can* drive doesn't mean that they're legally entitled to. If an unlicensed driver was in an accident, they'd be charged accordingly...so I guess I just don't see a difference.

 

Is it ridiculous that some states are apparently against midwifery altogether? Absolutely! It sounds as though if she'd complied with the licensing issues, she'd be in a far better situation.

 

You know, this is a very slippery slope. I'm going to replace one word in your quote:

 

 

I don't understand why she didn't comply with licensing.

 

Just b/c someone *can* drive doesn't mean that they're legally entitled to. If an unlicensed driver was in an accident, they'd be charged accordingly...so I guess I just don't see a difference.

 

Is it ridiculous that some states are apparently against homeschooling altogether? Absolutely! It sounds as though if she'd complied with the licensing issues, she'd be in a far better situation.

 

Just saying.

 

 

asta

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I am a midwife.

It is outside of my guidelines to breeches for first time moms.

We have a wonderful backup here, and so when we have a situation like this, we send them to him. Even he does not do first time mom breeches, but works with us all to get those little babies to turn around....unless the birth is imminent :)

I hesitate to even say this...but had Karen NOT taken this birth the community would not have lost her as a midwife.

 

Hindsight is 20/20...but even if the poor baby hadn't died, I don't think it is wrong to say that a 43 yo first time mother w/ a breech baby is a poor candidate for homebirth.

 

It breaks my heart to read the mom was desperate for a homebirth.

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My sister, then 22, was cut open navel to pubis because "the baby was in distress" (um, no, she wasn't) because the doctor was going to miss his flight. The baby (now in her twenties) is fine. My sister was literally scarred for life. She never got over it. Her next birth was a 22 hour labor at home with a midwife. Perfect apgar. Genius kid.

 

Oh, and she made sure I read A Good Birth a Safe Birth while I was pregnant. Talk about the "medicalization" of childbirth!

 

 

 

 

You know, this is a very slippery slope. I'm going to replace one word in your quote:

 

 

 

 

Just saying.

 

 

asta

 

Just saying. Someone who chooses to disobey the law of the land is choosing to accept the consequences of doing so. There ARE times when a person may feel that they are justified in doing so -- and will do so despite the consequences because the issue is that important to them. But they are accepting that they could be arrested, spend time in jail, even lose their lives for the stand they are taking. So it is not a decision to be taken lightly.

Edited by vonfirmath
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WOW !

I am so glad I live in a country like Australia where hospitals and insurance companies don't have such a hold on women in labour!.

Here nobody forces you to have an epidural, or use forceps, or have a cesarean. Nobody forces drugs or painkillers on women in labour. When you book into the hospital to have your baby ( usually 4-5 months before the baby is born) you go through a birth plan with the midwives, and the plan is followed, ( unless of course there is an emergency).

 

When my sister had her baby last week, she was told because the risk of her hemorrhaging was so high, they wouldn't even think of doing a cesarean.

 

Don't base your entire impression of the U.S's birth policies on some of the anecdotes on this thread. I went through a birth plan and the plan was followed even though my Dr. told me that some of it was not her preference. (I realize that you can't base your impression just on my anecdote too but wanted to point out that it tends to be the extreme anecdotes that are shared on a thread like this.)

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Just saying. Someone who chooses to disobey the law of the land is choosing to accept the consequences of doing so. There ARE times when a person may feel that they are justified in doing so -- and will do so despite the consequences because the issue is that important to them. But they are accepting that they could be arrested, spend time in jail, even lose their lives for the stand they are taking. So it is not a decision to be taken lightly.

 

 

Agreed.

 

I think this is a horribly sad situation for everyone involved. I'm heartbroken for the mother who thought she was making the best choice for her birth with the information she had, and for the midwife who relied on her extensive experience and knowledge to make her call.

 

That said, just like the above states, when you CHOOSE to disobey the law you shouldn't be surprised or dismayed when you are subject to the spelled out consequences. Whether that be midwifing without a license or homeschooling without following the state regulations.

 

Do all you can to change the laws you don't agree with, and if they can't be changed then break them if you must - but take the consequences without complaint.

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Don't base your entire impression of the U.S's birth policies on some of the anecdotes on this thread. I went through a birth plan and the plan was followed even though my Dr. told me that some of it was not her preference. (I realize that you can't base your impression just on my anecdote too but wanted to point out that it tends to be the extreme anecdotes that are shared on a thread like this.)

 

:iagree: Though my son was born in a hospital, he was delivered by a midwife in the lovely maternity center of the hospital. No drugs, no episiotomy, no bottles/pacifiers given unless the mother okay'd it.

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Asta, homeschooling isn't endangering lives. Practicing medicine without a licence is, that's why its illegal. Same as operating a motor vehicle unlicensed.

 

But homeschooling *is* illegal in some countries. Because they believe you could screw up your child's life.

 

Don't base your entire impression of the U.S's birth policies on some of the anecdotes on this thread. I went through a birth plan and the plan was followed even though my Dr. told me that some of it was not her preference. (I realize that you can't base your impression just on my anecdote too but wanted to point out that it tends to be the extreme anecdotes that are shared on a thread like this.)

 

I have given birth once in the USA and twice in Germany (two different hospitals). My experiences in the German hospitals were superior in every way. They didn't force *anything* on me or even try to. When I said I didn't want any meds, they didn't even ask me a second time. When my son was sunny side up and causing terrible back labor the midwives twisted and turned me until he turned the right way. When I wanted a VBAC, they were completely fine with it, they didn't give me any hassle *at all*. When my second birth ended in an emergency c-section I was fine with it because I knew it was *actually* necessary. I can't even express how different the experiences were.

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I have given birth once in the USA and twice in Germany (two different hospitals). My experiences in the German hospitals were superior in every way. They didn't force *anything* on me or even try to. When I said I didn't want any meds, they didn't even ask me a second time. When my son was sunny side up and causing terrible back labor the midwives twisted and turned me until he turned the right way. When I wanted a VBAC, they were completely fine with it, they didn't give me any hassle *at all*. When my second birth ended in an emergency c-section I was fine with it because I knew it was *actually* necessary. I can't even express how different the experiences were.

 

But I've given birth twice in the US and nothing was forced on me nor did they even try to. That's why anecdotal evidence isn't enough. Also - the US is so much bigger than Germany. And each state has different laws.

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But I've given birth twice in the US and nothing was forced on me nor did they even try to. That's why anecdotal evidence isn't enough.

 

Absolutely true. I highly recommend the book "Birth as an American Rite of Passage" for statistics vs. anecdotal evidence. Unfortunately, the trend in American hospitals is away from natural birth. There are lots and lots of hospitals that will not do VBACs at all.

 

Also - the US is so much bigger than Germany. And each state has different laws.

 

In the case of what hospitals or doctors try to talk you into, insist is necessary and such, laws have little (if anything) to do with it.

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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.

 

based on what we're seeing in America when it comes to people who risk their lives to knowingly break the law, the "high risk" doesn't stop people from breaking the law, and many times dying.

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My husband has been a lawyer for 18 year, mainly as a prosecutor. He says grand juries tend to do whatever the district attorney wants them to do. :glare:

 

When I served on our local grand jury several years ago we heard an assault case. The DA tried to pressure us to make decision after only hearing from the victim and his wife, but their stories seemed rather fishy and didn't quite add up. The DA seemed rather ruffled when we insisted on speaking to the physician the victim saw after the assault. Then was all kinds of agitated, almost angry, when we decided the assault didnt meet the legal requirements for a felonious assault, because it didn't. Not saying your DH is like this, but my exp. Says grand juries often feel compelled or pressured to make decisions against their conscience.

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In the case of what hospitals or doctors try to talk you into, insist is necessary and such, laws have little (if anything) to do with it.

 

I'll concede that;) Perhaps it's better to say that different states have different cultures. Where I live on the West coast there is a culture that is much more amenable to midwives etc. (and more natural medicine in general).

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Absolutely true. I highly recommend the book "Birth as an American Rite of Passage" for statistics vs. anecdotal evidence. Unfortunately, the trend in American hospitals is away from natural birth. There are lots and lots of hospitals that will not do VBACs at all.

 

 

 

In the case of what hospitals or doctors try to talk you into, insist is necessary and such, laws have little (if anything) to do with it.

 

can you [or anyone] share any info about the legal/ malpractice issues overseas? The legal ramifications and tort involved seem to play a HUGE part in how doctors in America practice.

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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. [snipped for brevity]

 

Wow...why on earth would you say something like that??? Women don't choose home birth because they value their experience over safety...they choose it because they have looked at the various risks and felt that home birth was the safest overall choice. There are risks to c-sections too, especially when the baby is breech. Serious risks...the one that made me choose homebirth over repeat cesarean is that a woman is 400% more likely to die in a c-section than a vaginal birth.

 

just wow.

 

:iagree:

 

My first 2 children were born at a hospital. My last 2 at home. After DD2 and the treatment I and my DD received at the hospital, I would never girth birth in one again. Yes. Doctors (and hospitals) have their own agenda that can get in the way of the baby's health. My own CPM midwife is VERY experienced in all sorts of circumstances. Her agenda is a healthy safe birth of a baby.

 

My 1st doctor's agenda: hurry up so I can go golfing. No. Seriously. He said that to me and he wasn't joking.

 

With DD2, I had no say and no choices in my long, stalled labor. And they forced their agenda on me. My husband was there and they ignored him completely. My DD2 was in ICU unnecessarily for 4 hours before ANYONE even told me. (DD2 stayed in ICU for a total of 5 days. She did not need to be there but again I had no choice in the matter. I am not the first to have these experiences. Oh... and because my insurance dictates where I must go, I had no choice in choosing a different hospital either.)

 

I realize not everyone has these experiences. I'm ok with that. I don't think all OBs are bad or evil. But don't tell me that because I choose a CPM not recognized by my state that I value a birth experience over a healthy baby. That's offensive. It was because of these hospital experiences that I choose NOT to be in a hospital due to safety and health reasons.

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based on what we're seeing in America when it comes to people who risk their lives to knowingly break the law, the "high risk" doesn't stop people from breaking the law, and many times dying.

 

The problem is that when doctors want to categorize *all* births as inherently risky, then it becomes difficult for women to make good decisions.

 

I'll concede that;) Perhaps it's better to say that different states have different cultures. Where I live on the West coast there is a culture that is much more amenable to midwives etc. (and more natural medicine in general).

 

My first birth was in California. I know someone in Washington state who recently had a repeat c-section because she could not find a hospital who would do a vbac. I have another friend who recently had an unassisted childbirth in California because the hospital was unwilling to work with her on certain issues and she lived too far from a midwife.

 

Your statement may be true of pockets of the west coast, but it isn't universally true. Again, based upon what I see happening in the natural parenting community, the medical community in the US seems to be trending away from natural childbirth options.

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I'll concede that;) Perhaps it's better to say that different states have different cultures. Where I live on the West coast there is a culture that is much more amenable to midwives etc. (and more natural medicine in general).

 

Sadly, this is far, far, far from what many (most?) American women have access to. :( My state has the highest number of births per capita. In addition to knowing lots of pregnant and birthing women, I also taught natural childbirth classes for eight years. I received hundreds of birth stories from my students. If the woman had been very careful in her selection of birth attendant and hospital, she generally ended up with close to the type of birth she wanted. If the woman went along with what her (not carefully chosen) OB ordered and hospital policy, she almost always ended up with pitocin, an epidural, and/or a c-section. Thankfully, most of my students paid attention and switched care providers if needed.

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can you [or anyone] share any info about the legal/ malpractice issues overseas? The legal ramifications and tort involved seem to play a HUGE part in how doctors in America practice.

 

Germany has laws similar to the US. However, damages are much lower. BUT, that is mostly because the true fallout of damage is absorbed by the government through socialized medicine and the social security system.

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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. ....when we try to make things entirely safe, we usually end up creating new risks and losing benefits that are important as well.

:iagree:

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:iagree: Though my son was born in a hospital, he was delivered by a midwife in the lovely maternity center of the hospital. No drugs, no episiotomy, no bottles/pacifiers given unless the mother okay'd it.

 

This was my experience also. I had two with an OB and one with a CNM, but nothing was ever forced on me. With my oldest, delivered by OB, the nurse did try to pressure me into an epidural, but ultimately they needed a signature before they could do anything and DH refused to sign (I had already had stadol so it was DH's signature they needed).

Our hospital is very much into keeping baby with mommy as much as possible after birth and doesn't want to do anything that could interfere with breastfeeding. When DS was born they had remodeled the maternity ward so that a healthy baby never had to leave mom's room. He was bathed and everything right there in the room with me.

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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.

 

Not only do OBs do stuff like this, but they go along with parents doing this too. I was flabbergasted when one person I know chose to induce at 38 weeks, rather than at least waiting until 40 weeks, because her parents would be in town. She wanted them to be able to see the baby before they went back home. Is that really a good reason to risk prematurity issues? Really?

 

Don't base your entire impression of the U.S's birth policies on some of the anecdotes on this thread. I went through a birth plan and the plan was followed even though my Dr. told me that some of it was not her preference. (I realize that you can't base your impression just on my anecdote too but wanted to point out that it tends to be the extreme anecdotes that are shared on a thread like this.)

 

This is true. I'm pretty happy with two of my births. One of those was born at home. The last one was induced at the hospital, 9 days late, with an OB well-known for being ok with natural birth (one of the very very few who will deliver twins vaginally). I went in there with the intention of stubbornly fighting for what I wanted, and there were a few moments I had to be a little bit more stubborn with the nurses.

 

However, my first birth was a transfer. Had my midwife not come with me, I would have ended up with an unnecessary c-section. She then saved my baby from being bottle fed formula even though I clearly stated I was breastfeeding. Why? Because she decided that my daughter's blood sugar was too low without bothering to test her blood sugar. And when I wanted to go home 30 hours later, I was told, "Well, even if you are discharged, your baby must stay here," even though there was absolutely nothing wrong with her.

 

I'll concede that;) Perhaps it's better to say that different states have different cultures. Where I live on the West coast there is a culture that is much more amenable to midwives etc. (and more natural medicine in general).

 

And even here, midwives lose their license for when a death occurs. The midwife who oversaw my first two births lost hers when a baby died. I don't believe there were any obvious problems with the birth, and the parents didn't blame her. I wasn't all that happy with my second midwife. There are so few midwives that I ended up having to see one in another country for my last baby.

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She then saved my baby from being bottle fed formula even though I clearly stated I was breastfeeding. Why? Because she decided that my daughter's blood sugar was too low without bothering to test her blood sugar.

 

I did have trouble with this. My nurse was a British woman who had what I think of as a British nanny's "no nonsense" attitude. Fortunately I was a bit more stubborn and knew enough about how hospitals work to ask to speak to the charge nurse.

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When I served on our local grand jury several years ago we heard an assault case. The DA tried to pressure us to make decision after only hearing from the victim and his wife, but their stories seemed rather fishy and didn't quite add up. The DA seemed rather ruffled when we insisted on speaking to the physician the victim saw after the assault. Then was all kinds of agitated, almost angry, when we decided the assault didnt meet the legal requirements for a felonious assault, because it didn't. Not saying your DH is like this, but my exp. Says grand juries often feel compelled or pressured to make decisions against their conscience.

 

 

That's what I meant. And why I don't think Elizabeht's comment about this being a decision by a grand jury and NOT a district attorney witch hunt makes any sense. I think my husband used phrase "the prosecutor 'indicates' the outcome he wants." ;) I don't think grand jury does or means what many of us think/thought. It is a let down.:glare:

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In my experience, if you want an intervention free birth at a hospital you have to choose your OB and your hospital VERY carefully and then pray you get a LD nurse who is ok with intervention free births. Once you are actually at the hospital laboring there are few choices left to you. The Dr or nurse says "I am going to do X", "We are going to do Y" and unless you fight back and are willing to argue, it happens and happens fast, within seconds of the statment. Statisticly, interventions of almost all types lead to increases in risk for the mother and the child.

 

The USA is NOT a leader in preventing maternal deaths or infant deaths. I used to have statistics on both, but can currently only find WHOs statistics for maternal deaths http://www.who.int/making_pregnancy_safer/topics/maternal_mortality/en/index.html

I'd like to point out the blue listed countries all use midwives at a significantly higher level (about 50% vs 8%) than the US. There are obviously MANY factors involved in the US's lower statistics, but I think the type of care is extremely significant.

 

I'm sure that this is at least part of the reason this "high risk" mother chose to labor at home. It is heartbreaking that a women's child died under the care of a midwife. It is also sad that the midwife had to be illegal to give quality care to her patient. I hope for healing for all involved.

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In my experience, if you want an intervention free birth at a hospital you have to choose your OB and your hospital VERY carefully and then pray you get a LD nurse who is ok with intervention free births. Once you are actually at the hospital laboring there are few choices left to you. The Dr or nurse says "I am going to do X", "We are going to do Y" and unless you fight back and are willing to argue, it happens and happens fast, within seconds of the statment. Statisticly, interventions of almost all types lead to increases in risk for the mother and the child.

 

The USA is NOT a leader in preventing maternal deaths or infant deaths. I used to have statistics on both, but can currently only find WHOs statistics for maternal deaths http://www.who.int/making_pregnancy_safer/topics/maternal_mortality/en/index.html

I'd like to point out the blue listed countries all use midwives at a significantly higher level (about 50% vs 8%) than the US. There are obviously MANY factors involved in the US's lower statistics, but I think the type of care is extremely significant.

 

I'm sure that this is at least part of the reason this "high risk" mother chose to labor at home. It is heartbreaking that a women's child died under the care of a midwife. It is also sad that the midwife had to be illegal to give quality care to her patient. I hope for healing for all involved.

 

Choosing a midwife in this situation is simply ignorant. The mother placed her "desperate" desire for a homebirth over the life of her child.

 

The midwife CHOSE not to be licensed in VA. She then combined that with participating in a delivery that would have been better served in a hospital. Hopefully the criminal justice system doesn't let her off lightly. She should pay, and pay dearly, for her arrogance.

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Choosing a midwife in this situation is simply ignorant. The mother placed her "desperate" desire for a homebirth over the life of her child.

 

Statistics prove that homebirth is safer. Your average first-time-mom-to-be has little way of assessing her true risk when the medical profession wants to speed up nearly all deliveries. It's completely unfair to this mother to assume she was placing her desire for a homebirth of the safety of her baby. Unnecessary interventions (used *regularly* by most hospitals in the US) *also* have risk factors that sometimes end with a still-born baby.

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Choosing a midwife in this situation is simply ignorant. The mother placed her "desperate" desire for a homebirth over the life of her child.

 

The midwife CHOSE not to be licensed in VA. She then combined that with participating in a delivery that would have been better served in a hospital. Hopefully the criminal justice system doesn't let her off lightly. She should pay, and pay dearly, for her arrogance.

 

Had she complied with the laws she wouldn't be able to carry much needed oxygen and pitocin. That would put her clients and their babies at risk. That is the reality. The situation has no easy answers....if midwives stop practicing illegally than women will not have safe options for homebirth. Some of us, including this midwife, are not ok with limiting women's choices like that.

 

I suppose it is an act of civil disobedience.

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Choosing a midwife in this situation is simply ignorant. The mother placed her "desperate" desire for a homebirth over the life of her child.

 

The midwife CHOSE not to be licensed in VA. She then combined that with participating in a delivery that would have been better served in a hospital. Hopefully the criminal justice system doesn't let her off lightly. She should pay, and pay dearly, for her arrogance.

 

I find it hard to believe that you blame the mother in this case. Do you also blame mothers who have a "desperate" desire for a pain free birth or scheduled labor, and their child dies? It happens and more often than a child dying under a midwife's care if only because it is SO much more common. All of those things lead to a greater chance of maternal and infant mortality. That is not saying that those things CAUSED the death of a child, but neither has it been proven that a homebirth CAUSED the death of this child.

 

As I stated previously, the midwife could NOT be licensed in VA and provide the quality of care she needed to provide to the patient.

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I just want to address the people who are saying that the hospital or doctor can not force care upon you against your will; you don't know what you are talking about. Just because it didn't happen to you doesn't mean that it doesn't happen. My first hospital birth was horribly mismanaged and the doctor did eventually lose his license for falsifying records. During my second hospital birth I was strapped to a gurney and had barbaric things (things that would have been considered torture if done by anyone else anywhere else) done to me against my will. I lost a serious amount of blood after delivery and they didn't even know because I had been left alone (not even in a room) without any care at all.

 

Doctors and hospitals absolutely can and will violate patients rights and informed consent laws. Of course, this is antedotal but there are thousands more stories just like mine and where else are they going to come from other than the patients. Doctors certainly aren't going to be reporting this stuff themselves and it is almost impossible to report anything if the baby is born healthy because the excuse is always that whatever was done was in the best interest of the baby (even when that is not the case). Once a baby is viable, the medical system usually insists that the infant's rights override the mother's and they can pretty much do whatever they want using that as an excuse.

 

The truth of the matter is that most babies can be delivered safely in the back seat of a taxi. Most births are not emergencies and do not require western medical care. Now if women could trust doctors to believe that and act on it then we could trust then when they say that something different needs to be done. Unfortunately, that is not the case which leaves women in the horrible position of trying to figure it out themselves and then decide if they want to give up all autonomy at a hospital and possibly actually incure greater risks or take their chances at home and usually have a safer delivery.

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There are very good hospitals and doctors that won't force anything on the mother unless it *TRULY* is a life or death situation. And there are very bad hospitals and doctors where they do nothing but force their wishes on women who are vehemently not consenting. Apparently it would be VERY difficult for a woman to win an assault and battery case, or any other kind of case, against the bad hospital/doctor if the baby was okay, because people will say "oh, the baby was okay, what are you complaining about?" :( It drives me crazy that doctors can get away with completely disrespecting and even effectively assaulting/molesting women in labor.

 

And NO, NOT all doctors/hospitals are the bad ones!! (Any more than all CPMs are good care providers.) It's very hard, or perhaps impossible, to tell from anecdotal stories which is more prevalent. But I know that if I am ever in a situation of having a baby in a hospital, I will be doing so much questioning, I will have a doula and my husband there, they will be instructed in what should not be done to me under any circumstances except in a true life or death situation, and I *WILL* go running from any hospital where they don't leave room for normal progression of labor. If I have to pay for a midwife out of pocket to avoid a hospital like that, I'll do it.

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The truth of the matter is that most babies can be delivered safely in the back seat of a taxi. Most births are not emergencies and do not require western medical care. Now if women could trust doctors to believe that and act on it then we could trust then when they say that something different needs to be done. Unfortunately, that is not the case which leaves women in the horrible position of trying to figure it out themselves and then decide if they want to give up all autonomy at a hospital and possibly actually incure greater risks or take their chances at home and usually have a safer delivery.

 

I agree 100%, this is what I was trying to get across.

 

eta: Nobody has said all doctors and hospitals are like this. But it can be very, very difficult to figure out which ones are the good ones.

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