My midwife was arrested! Please read...

[kalanamak]

 

VBAC is an individual decision agreed upon between patient and doctor.

 

"Whose bread you eat, his song you sing", so the insurance people are involved, too. If a doctor takes an unreasonable risk, the "informed consent" the mother signs will not protect the doc or hospital. After a bad outcome, people begin to think they were duped, and an attorney can help them move it to the courts.

[Sara R]

Changing topics now. . . . I was astonished to read in this thread that there are hospitals which prohibit VBAC. How absurd ! ! ! ! ! !

 

VBAC is an individual decision agreed upon between patient and doctor.

 

Dr. Amy wrote a blog post on this topic this week: The Legal Constraints of VBAC. The problem is that uterine rupture happens about 1% of the time with VBACs (slightly lower rate for VBA1C; higher after multiple c-sections and women who have had many children). 1% sounds rare unless you are the 1%. Uterine rupture happens scary fast and can endanger the life of the mom and baby unless a c-section is "immediately available." So about 10 years ago ACOG changed the VBAC recommendations, and hospitals without OBs and anesthesiologists on staff quit doing VBACs.

 

I attempted a home VBAC with my second child. First c-section was for breech, so they figured my chances were good. But I had obstructed labor-->"true CPD"-->hospital transfer-->second c-section and healthy baby (who probably would not have been healthy if we waited too much longer). During the pregnancy, I read and believed all of the natural childbirth information about there being no such thing as CPD. After my labor and birth, I realized they were wrong, and that was hard to accept. I appreciate reading a blog written by an OB that addresses and refutes those kinds of claims, and lets me see the other side so I can better evaluate what to believe.

[ktgrok]

Please do not angrily pounce on me for asking this question. (It would not be fair, especially since I support the profession of midwifery.)

 

When a lawyer, randomly to select a profession, is not licensed to practice law in State Q, he follows the procedure to obtain the necessary qualifications. Otherwise, he refrains from practicing law while living in State Q.

 

If a person wishes to practice the profession of midwifery, and his/her state does not allow legal exercise of same, why would not the midwife move to one of the states in the U.S. which does permit the legal exercise of this profession?

 

I do not understand a willingness to jeopardize the future freedom to aid mothers by practicing outside of the laws -- other than during an emergency situation.

 

Again, I beg of you all not to respond hostilely.

 

This isn't a perfect analogy, but I've had little caffiene today. But during the time of the underground railroad there were those helping slaves. It was illegal to do so in some states. They could have moved to a state where it was legal, but they didn't because they felt someone needed to help the slaves in the south, that it was a moral imperative.

 

There are midwives that operate in illegal states because they feel that it is morally wrong to force women to birth in hospitals. They feel these women deserve competent birth attendants at home, just like the women in states where it is legal. I for one am VERY grateful there are women that take this risk. I have a friend in NC who will avail herself of an illegal midwife when the time comes.

[wapiti]

In this case, the midwife did/does live in a state where she could practice. She crossed state lines. She had a decision...either help a mama deliver or let the mama deliver unattended at home. Which was the lesser wrong morally and ethically? She chose to put herself and her practice at risk to assist a birth where the parents appeared to be likely to choose to go unassisted if there was no midwife (this is what I've gathered from the story...Sue can correct me if I'm wrong). Has anyone considered that a portion of the blame should be on the parents???

 

Exactly. The parents absolutely should have some blame. But by agreeng to the hb she condoned it as sound medical judgment in this case. If she is a professional then she ought to have professional responsibility. There is such responsibility when harm follows a violation of the standard of care. Whether the standard of care is incorrect is irrelevant - by choosing to violate it she tooc a risc and bears responsibility if harm follows.

 

(please forgive me - i'd have more to say but my ceyboard is driving me nuts - some letters are brocen including commas and i have to copy and paste i's from other text)

 

There is no way to cnow with a high degree of certainty whether the parents would have gone thru with the hb if she had refused them but by agreeing to it she made it much much easier for them to choose hb. Maybe the moral choice would have been to help them understand that the hb was not in their baby's best interest in this case.

[Orthodox6]

I guess, then, I'll brave the egg-throwers and shift some possible blame to the mother under discussion. I will not attempt to read the mindset of this mother. I don't know her. For myself, however, I would set aside my philosophical beliefs about birth methods if I need to do so in order to have a greater possibility of a successful birth, for the sake of the baby. If there were no midwife where I was living, I would elect, as second choice, a "conventional" method of delivery. I would not ask someone (a midwife) to risk her livelihood by crossing state lines.

 

I was surprised about the VBAC constraint because of my own experience -- outdated though it be. DC#1 was born via C-section because he was jammed stuck in a strange position, and could not be turned, not even enough to permit the use of forceps. (I had gone through a long active labour before the decision was made.) DC#2 was born via C-section for the same reason, after I went through an active labour almost as long as that for his elder brother. For DC#3, the doctors told me that it probably was best to plan for a C-section. They told me just to call and meet them at the hospital when time came. . . . Fast forward to a different city for DC#4. The doctors reacted as if I were certifiably insane when I assumed that I would just meet them at the hospital for a C-section. I have much for which I never have forgiven this foursome of doctors, and it includes being forced to schedule the birth at their convenience.

 

OT, but related to births. . . Have there been any cases in the United States of a doctor sterilizing a mother without her consent ? I know this gets bandied about by people who believe, for example, that women on welfare should be forcibly sterilized, or same for other scenarios. What haunts me, however, is the case of my Mexican friend who was sterilized without the consent of herself, or of her husband, when she gave birth to their third child. This occurred at a large, well-equipped hospital in Mexico City.

[Sara R]

In the end, the reason there are midwives willing to practice without licensure, etc, is that there are parents out there that REFUSE to have a birth with an OB or a CNM.

 

Don't you think that can go too far, though? For example, look at this birth story and tell me what you think. Twins with a first time mom, presenting twin breech (footling breech at 38 weeks), water broken for 3 days (!) before the birth, and 33 hours between the birth of the 2 twins. I thought that midwife was tooootally mad to not insist that they transport to the hospital after the water had been broken for 24 hours (speaking as someone who did transport to the hospital after water was broken for 10 hours), let alone all of the other risks involved.

 

Maybe there are some women who would choose unassisted rather than hospital birth or hospital transfer. But I think there are many more who, if encouraged by people they trust (midwives and doulas) and the hospital was a friendly, respectful place, would choose to give birth in the hospital.

[unsinkable]

Exactly. The parents absolutely should have some blame. But by agreeng to the hb she condoned it as sound medical judgment in this case. If she is a professional then she ought to have professional responsibility. There is such responsibility when harm follows a violation of the standard of care. Whether the standard of care is incorrect is irrelevant - by choosing to violate it she tooc a risc and bears responsibility if harm follows.

 

(please forgive me - i'd have more to say but my ceyboard is driving me nuts - some letters are brocen including commas and i have to copy and paste i's from other text)

 

There is no way to cnow with a high degree of certainty whether the parents would have gone thru with the hb if she had refused them but by agreeing to it she made it much much easier for them to choose hb. Maybe the moral choice would have been to help them understand that the hb was not in their baby's best interest in this case.

 

Yes. Let's assume the MW provided assistance, comfort, support all thru the labor. What would have happened if the MW wasn't there at all? Would a first time pregnant mom been able to get to the point of delivering the baby (all but the baby's head) w/only her DH? I'd say no.

[Sara R]

Someone on the Skeptical OB blog said that the midwife named in this thread is charging $8000 per home birth. I have no idea if that is actually true.

[wapiti]

I know that in some places, a few midwives will believe that women deserve an out-of-hospital option no matter what, and will practice "underground" to serve that population. I have heard of that in several states. In our state, once they legalized homebirth the "underground" moved into the completely legal and open position immediately. I'm not giving opinion either way on this, just what I've seen.

 

i thinc this maces sense (again please forgive the ceyboard issues including no commas) to allow hb (my own OB was in favor and attended at least one). That might lead to clearer guidelines on who are appropriate candidates for hb.

 

But there is also great inconsistency amongst hospital births. i've never experienced any of the hospital birth "horrors" that i've heard about (mostly from reading on places such as the mothering website) (i had a section for breech with my first and then 4 hospital vbacs including twins). with hospital births hugely outnumbering homebirths; focusing on improvements there could have a greater impact.

[mommaduck]

Don't you think that can go too far, though? For example, look at this birth story and tell me what you think. Twins with a first time mom, presenting twin breech (footling breech at 38 weeks), water broken for 3 days (!) before the birth, and 33 hours between the birth of the 2 twins. I thought that midwife was tooootally mad to not insist that they transport to the hospital after the water had been broken for 24 hours (speaking as someone who did transport to the hospital after water was broken for 10 hours), let alone all of the other risks involved.

 

Maybe there are some women who would choose unassisted rather than hospital birth or hospital transfer. But I think there are many more who, if encouraged by people they trust (midwives and doulas) and the hospital was a friendly, respectful place, would choose to give birth in the hospital.

Yes, it can go too far. The Karen made a decision based on previous experience of both the type of situation, her abilities and past success rate, etc.

 

btw, my midwife and I were a good fit, because I knew she was not one that did whatever simply because she hadn't had failures in the past. I knew what her background was and her sensibilities lined up with mine. I was the only "Englisher" she was willing to take on because I #1 was not one to sue #2 she knew I had the sensibility that if she told me to get to a dr or hospital, I would immediately do so, not putting myself, my baby, nor my midwife at risk. This last baby, I knew there were issues and did not even bother calling the midwife, but rather got set up at a local practice, delivered in hospital, and it was a CNM that was on call. (my previous midwife is a CPM, but had been also certified in another country under an international program that is recognised).

Edited July 23, 2011 by mommaduck

[unsinkable]

Someone on the Skeptical OB blog said that the midwife named in this thread is charging $8000 per home birth. I have no idea if that is actually true.

 

The Wash. Post article linked says she charges from $2400 to $3600 per birth, had 135 births last year and is barely covering her expenses.

 

2400 x 135 = $324,000. I'd like to see her expenses.

[Orthodox6]

The Wash. Post article linked says she charges from $2400 to $3600 per birth, had 135 births last year and is barely covering her expenses.

 

2400 x 135 = $324,000. I'd like to see her expenses.

 

I absolutely am not being sarcastic when I wonder whether she has ongoing legal fees from other births.

[Slartibartfast]

Dr Amy (skeptical OB) is NOT a reliable source for homebirth or natural birth information. She is a shill for the ACOG.

Edited July 23, 2011 by Sis

[mommaduck]

I absolutely am not being sarcastic when I wonder whether she has ongoing legal fees from other births.

 

Regular, every person bills.

Taxes, social security, etc.

Supplies, gas, etc.

And currently, her attorney and court costs.

[unsinkable]

Regular, every person bills.

Taxes, social security, etc.

Supplies, gas, etc.

And currently, her attorney and court costs.

 

I mean real numbers that apply specifically to her midwifery business.

[Sara R]

Of course not. She attacks homebirth, certified professional midwives, and other natural childbirth stuff. (Let's abbreviate that NCB, shall we?) But she directly addresses the NCB ideas that OBs previously ignored, and most of the time she backs up her assertions with numbers (something that is sorely lacking from much of NCB. Speaking as a person who read the entire Gentle Birth Midwife Archives in 2000.) Of course don't take everything she says at face value, but I find it helpful to read the other side of the story before deciding what to believe.

[Orthodox6]

You're right. For all that I could know, she is married with a two-income household. If she is single, then of course she is living on the financial edge. That being acknowledged, an income of over $324,000 is a dreamland income, even after self-employment taxes.

 

At this stage, I encourage everyone to read the Washington Post article someone cited earlier. I just read it, and a great deal of helpful background/explanatory information is there.

 

http://www.washingtonpost.com/local/midwife-karen-carr-convicted-in-alexandria-babys-death-is-under-investigation-in-md/2011/05/11/AFlrp22G_story.html

 

One reads, for example, that she often reduces, or even waives, her fees. (lower annual income, accordingly) That speaks well of the woman.

 

One also reads, however, that her 1997 CPM certification is not accepted in her home state of Maryland.

In Maryland and the District, there is no license for CPMs, only for nurse midwives. In Virginia, CPMs can practice if they get a license; according to state records, the state has 55 licensed CPMs.

Carr did not want a license. And she didn’t want to become a certified nurse midwife, who are greater in number and often link their practices to a physician or a hospital. [end quote from article]

 

I admit that, after reading the article, I did not emerge with a favorable viewpoint of Mrs./Miss Carr and her style of practice. This from reflecting on the entire article, not just snippets.

 

 

Regular, every person bills.

Taxes, social security, etc.

Supplies, gas, etc.

And currently, her attorney and court costs.

Edited July 23, 2011 by Orthodox6

[unsinkable]

I absolutely am not being sarcastic when I wonder whether she has ongoing legal fees from other births.

 

That article said there was another baby that died (after birth) in Nov.

 

"In November, Carr attended to a mother pregnant with twins in rural Maryland. One was having trouble breathing after delivery, so paramedics were called, but by the time they got there, the baby was doing better, and the ambulance was sent away.

 

“Some hours later, the baby started going down again, so I brought the baby to the hospital. And it didn’t make it,” Carr said. “I’m not sure what happened to that baby, why it wasn’t breathing.”

 

Hospitals lose babies, too, she said.

 

“When you work with birth, you’re going to run into death,” she said. “It’s just inevitable.” "

 

ETA: Maybe it is a way to protect the identity of the baby but it is really creepy that she called the baby "it."

Edited July 23, 2011 by unsinkable

[Slartibartfast]

Of course not. She attacks homebirth, certified professional midwives, and other natural childbirth stuff. (Let's abbreviate that NCB, shall we?) But she directly addresses the NCB ideas that OBs previously ignored, and most of the time she backs up her assertions with numbers (something that is sorely lacking from much of NCB. Speaking as a person who read the entire Gentle Birth Midwife Archives in 2000.) Of course don't take everything she says at face value, but I find it helpful to read the other side of the story before deciding what to believe.

 

You forgot mothers. She attacks mothers.

 

She is pretty nasty.

 

 

NCB is not definitive because it includes natural birth in a hospital. I do agree there isn't a lot of information from the homebirth community but there is a lot of confusion due to different state laws, licensing, restricted homebirth, homebirth without a midwife present, homebirth with an untrained midwife...all sorts of things. If there was some consistency it would help.

 

She uses the numbers that help her case.

[Aelwydd]

Hospitals lose babies, too, she said.

 

“When you work with birth, you’re going to run into death,†she said. “It’s just inevitable.†"

 

ETA: Maybe it is a way to protect the identity of the baby but it is really creepy that she called the baby "it."

 

You are confusing the antecedent for "it." The "it" refers to inevitable occurrence of death when practicing obstetrics/midwifery.

 

Also, $2400-3600 is a low figure for home birth midwifery. I'm literally laughing at the idea that midwives are living it up. You need to research the lives of hb midwives much more closely.

 

First of all, midwives don't usually get paid the full amount of whatever they charge. Usually, because they give discounts for paying by a certain date, or because, in those states where midwifery is regulated, insurance only pays a percentage of the total amount.

 

Secondly, midwives don't work alone. They usually have at least one assistant, and she has to pay that person as well.

 

Thirdly, she didn't deliver all 135 births. No hb midwife ever delivers every single booking, due to complications that develop during pregnancy and delivery. When a woman develops pre-eclampsia, for example, in her 20th week, that means she is most likely going to transfer to an OB's care. That also means that the midwife is not collecting on that client, at least not the full amount, and the lion's share is always the birth, itself.

 

Fourthly, those fees include all supplies and screenings, appointments and the birth, itself. Find me one OB that will spend an average of an hour at prenatals, and actually sits with the mother during the entirety of the labor and birth, to personally monitor and attend her, and only charges around $3000 for it. That might pay for 1/3 of an average hospital birth, given that you have the OB's bill, the hospital's bill, and any specialists are tacked on as additional charges.

 

A midwife's supplies usually include such things chux pads, gloves, oxygen tank, fetoscope, emergency medications such as pitocin, etc. Also, her fees include cleaning up any mess from the birth, laundering sheets and other items, and generally putting the place back to rights before she leaves. It includes the follow up visits and calls and questions regarding bf'ing and so forth.

 

Finally, her fees must be enough to cover gas and time. She is traveling back and forth to the client's house, rather than having the client come to her. And, when she takes on a client, she is also assuming responsibility to be there for her client, no matter what. So, if her daughter gets sick, and needs someone to stay home, and she gets a call? Guess what? She has to arrange someone to watch her daughter, because she is always on call. When a midwife takes a client for a date, it's not just that date she blocks out--she has to block out the weeks before and after, because she is not able to simply induce on a pre-selected day and go to her golf game like an OB. No, she has to cancel vacations (Christmas, and so forth are game) and make sure that her calendar is free for that time period. She can't make any plans that might conflict with a due date.

 

Midwives offer some of the best value out there for birth, but they are typically undervalued, even though they are doing a very difficult job, with crazy hours and the fear of a witch hunt from physician labor groups that like to use the law to try to outlaw the competition's livelihood.

 

If you have any more questions on this, I am friends with a licensed hb midwife, and she can give you all the low down on what it means to do this job. It's hard, difficult, stressful work, and if you are assuming the responsibility for two lives, I hardly think that $3600 for hundreds of long hours at all hours of day or night, and the rearranging of your personal life, is "living it up."

[LittleIzumi]

You are confusing the antecedent for "it." The "it" refers to inevitable occurrence of death when practicing obstetrics/midwifery.

 

 

I think she was referring to:

 

That article said there was another baby that died (after birth) in Nov.

 

"In November, Carr attended to a mother pregnant with twins in rural Maryland. One was having trouble breathing after delivery, so paramedics were called, but by the time they got there, the baby was doing better, and the ambulance was sent away.

 

“Some hours later, the baby started going down again, so I brought the baby to the hospital. And it didn’t make it,†Carr said. “I’m not sure what happened to that baby, why it wasn’t breathing.â€

 

Hospitals lose babies, too, she said.

 

“When you work with birth, you’re going to run into death,†she said. “It’s just inevitable.†"

 

ETA: Maybe it is a way to protect the identity of the baby but it is really creepy that she called the baby "it."

 

I agree with the rest about midwifery expenses. Equipment & time & on-call babysitters & tons of gas, etc.

[WishboneDawn]

That article said there was another baby that died (after birth) in Nov.

 

"In November, Carr attended to a mother pregnant with twins in rural Maryland. One was having trouble breathing after delivery, so paramedics were called, but by the time they got there, the baby was doing better, and the ambulance was sent away.

 

“Some hours later, the baby started going down again, so I brought the baby to the hospital. And it didn’t make it,†Carr said. “I’m not sure what happened to that baby, why it wasn’t breathing.â€

 

Hospitals lose babies, too, she said.

 

“When you work with birth, you’re going to run into death,†she said. “It’s just inevitable.†"

 

ETA: Maybe it is a way to protect the identity of the baby but it is really creepy that she called the baby "it."

 

I've been following this but not commenting. My feelings about midwives in general are pretty favourable despite the fact that I haven't and don't tend to use one. I've just been very happy with my hospital births so it's not an issue for me.

 

But for the particular midwife that's quoted above I don't have good feelings. The attitude almost seems to be a shrug of the shoulders. No curiousity as to what happened so that she might improve her practice. A seeming blind spot where an issue breathing only indicates immediate trouble (sending the ambulance away when the baby could breath again) and not a real concern that needed immediate follow up and that idea that, you know, when you've involved in births, death happens. That's probably true but every death happens for a reason and none merits that casual attitude.

[kalanamak]

ISorry, but they, and their insurance companies, are more concerned about THEIR rear ends than your child's birth.

 

For the individual doctor who can no longer get admitting privileges, their rear ends mean the occupation they committed 11+ years of education to, often 200K debt for education and start-up, their families support, their self-respect. Plus, the training is specialized and there aren't a plethora of jobs for defrocked docs.

 

Why not work on changing the law instead of expecting thousands of OBs to take this on individually, and implying they are selfish if they don't? (I speak sincerely and frankly, but not sternly.)

[unsinkable]

You are confusing the antecedent for "it." The "it" refers to inevitable occurrence of death when practicing obstetrics/midwifery. No I am not. You edited my quote to leave out the part where the midwife called the baby it.

 

Also, $2400-3600 is a low figure for home birth midwifery. I'm literally laughing at the idea that midwives are living it up. You need to research the lives of hb midwives much more closely. You are inferring that I am saying I think she is living it up by asking to see her expenses. Nothing could be further from the truth. I am asking to see her expenses b/c I'd like to see them...if not hers then an equivalent midwife, monetarily (sp?)

 

First of all, midwives don't usually get paid the full amount of whatever they charge. Usually, because they give discounts for paying by a certain date, or because, in those states where midwifery is regulated, insurance only pays a percentage of the total amount.

 

Secondly, midwives don't work alone. They usually have at least one assistant, and she has to pay that person as well.

 

Thirdly, she didn't deliver all 135 births. No hb midwife ever delivers every single booking, due to complications that develop during pregnancy and delivery. When a woman develops pre-eclampsia, for example, in her 20th week, that means she is most likely going to transfer to an OB's care. That also means that the midwife is not collecting on that client, at least not the full amount, and the lion's share is always the birth, itself. This is what I read in the WP article: Carr said she delivered 135 babies last year and that she charges about $2,400 to $3,200 per delivery.

 

Fourthly, those fees include all supplies and screenings, appointments and the birth, itself. Find me one OB that will spend an average of an hour at prenatals, and actually sits with the mother during the entirety of the labor and birth, to personally monitor and attend her, and only charges around $3000 for it. That might pay for 1/3 of an average hospital birth, given that you have the OB's bill, the hospital's bill, and any specialists are tacked on as additional charges. Great! Just want to see some prices!

 

A midwife's supplies usually include such things chux pads, gloves, oxygen tank, fetoscope, emergency medications such as pitocin, etc. Also, her fees include cleaning up any mess from the birth, laundering sheets and other items, and generally putting the place back to rights before she leaves. It includes the follow up visits and calls and questions regarding bf'ing and so forth.

 

Finally, her fees must be enough to cover gas and time. She is traveling back and forth to the client's house, rather than having the client come to her. And, when she takes on a client, she is also assuming responsibility to be there for her client, no matter what. So, if her daughter gets sick, and needs someone to stay home, and she gets a call? Guess what? She has to arrange someone to watch her daughter, because she is always on call. When a midwife takes a client for a date, it's not just that date she blocks out--she has to block out the weeks before and after, because she is not able to simply induce on a pre-selected day and go to her golf game like an OB. No, she has to cancel vacations (Christmas, and so forth are game) and make sure that her calendar is free for that time period. She can't make any plans that might conflict with a due date. Thanks again!

 

Midwives offer some of the best value out there for birth, but they are typically undervalued, even though they are doing a very difficult job, with crazy hours and the fear of a witch hunt from physician labor groups that like to use the law to try to outlaw the competition's livelihood.

 

If you have any more questions on this, I am friends with a licensed hb midwife, and she can give you all the low down on what it means to do this job. It's hard, difficult, stressful work, and if you are assuming the responsibility for two lives, I hardly think that $3600 for hundreds of long hours at all hours of day or night, and the rearranging of your personal life, is "living it up."

I am not sure where you got the impression that I think MW live it up or any of the other things you wrote in this reply. I was simply stating that I'd like to see her expenses.

 

I was a postpartum doula years and years ago. I do know a bit about birthin' babies.

 

(I also had 66% of my kids with midwifes. In a hospital, tho')

Thanks for the reply.

Edited July 23, 2011 by unsinkable

[kalanamak]

She is a shill for the ACOG.

 

Do you mean to say you believe she is paid by ACOG? (Sincere question.)

[Sara R]

Sorry, but they, and their insurance companies, are more concerned about THEIR rear ends than your child's birth.

 

Their rear end translates to SOME child's birth. Their rear end would not be in trouble unless some child dies or is permanently damaged.

[kchara]

Do you mean to say you believe she is paid by ACOG? (Sincere question.)

 

I don't think Dr. Amy is paid by the ACOG, but she is quite possibly one of the most educated idiots you'll come across while researching obstetrics, midwifery, or homebirth. She has quite a reputation, and I don't know anyone on either side of the issue who considers it a good one. I've read recently she doesn't even promote ACOG guidelines, because they're, frankly, not invasive enough for her.

[kalanamak]

I don't think Dr. Amy is paid by the ACOG, but she is quite possibly one of the most educated idiots you'll come across while researching obstetrics, midwifery, or homebirth.

 

I ask, because I see shill thrown around as an insult when some other word like sycophant would be more correct.

 

I don't know Amy from a sprouted potato. I suspect I will keep it that way.

[Aelwydd]

I am not sure where you got the impression that I think MW live it up or any of the other things you wrote in this reply. I was simply stating that I'd like to see her expenses.

 

I was a postpartum doula years and years ago. I do know a bit about birthin' babies.

 

(I also had 66% of my kids with midwifes. In a hospital, tho')

Thanks for the reply.

 

Sorry for the misunderstanding. I was not just replying to your thread, but to several other posts in general. I should have been more clear in who I was addressing!

[Aelwydd]

I ask, because I see shill thrown around as an insult when some other word like sycophant would be more correct.

 

I don't know Amy from a sprouted potato. I suspect I will keep it that way.

 

Yeah, "shrill" is actually an understatement. She's like the Rush Limbaugh of anti-home birth crusaders.

[kalanamak]

Yeah, "shrill" is actually an understatement. She's like the Rush Limbaugh of anti-home birth crusaders.

 

But a shill has a profit relationship. They are either a paid "covert advertiser" or somehow getting a gain from the person they promote. After I read that, I went to the dictionary to confirm my suspicion, and my question was if the PP I quoted actually thought she was being paid to do this. Heck, she may be, but I somehow doubt it. But I am curious if people believe she is paid.

[WishboneDawn]

Of course not. She attacks homebirth, certified professional midwives, and other natural childbirth stuff. (Let's abbreviate that NCB, shall we?) But she directly addresses the NCB ideas that OBs previously ignored, and most of the time she backs up her assertions with numbers (something that is sorely lacking from much of NCB. Speaking as a person who read the entire Gentle Birth Midwife Archives in 2000.) Of course don't take everything she says at face value, but I find it helpful to read the other side of the story before deciding what to believe.

 

:iagree: I'd never read her blog before today and found some interesting info there. She's not exactly a diplomat but then I've read some pretty unkind stuff from the other side of the fence on many of the issues she addresses.

[Aelwydd]

But a shill has a profit relationship. They are either a paid "covert advertiser" or somehow getting a gain from the person they promote. After I read that, I went to the dictionary to confirm my suspicion, and my question was if the PP I quoted actually thought she was being paid to do this. Heck, she may be, but I somehow doubt it. But I am curious if people believe she is paid.

 

 

She might be paid. Frankly, I think she actually turns off a lot of other doctors. She was once a member blogger of an online scientific community. She wasn't on there very long before she and the administrators decided "mutually" that she wasn't a great fit. The reason being that she makes very emotionally charged accusations and her interpretation of data is, shall we say, creative. It didn't mesh well with the overall slant of the board towards an objective, measured approach to all evidence.

 

So, I don't know that she'd be paid by ACOG. I think they'd find her to be an embarrassment. However, her antics definitely draw a LOT of attention, and that means her advertisers probably adore her. I suspect that she thrives on being controversial because, frankly, it brings her more money.

[mommaduck]

For the individual doctor who can no longer get admitting privileges, their rear ends mean the occupation they committed 11+ years of education to, often 200K debt for education and start-up, their families support, their self-respect. Plus, the training is specialized and there aren't a plethora of jobs for defrocked docs.

 

Why not work on changing the law instead of expecting thousands of OBs to take this on individually, and implying they are selfish if they don't? (I speak sincerely and frankly, but not sternly.)

 

Their rear end translates to SOME child's birth. Their rear end would not be in trouble unless some child dies or is permanently damaged.

 

I think you both misread the intent of my statement. :) It was meant very matter of fact. That's the insurance company's job. That is their concern. It affect their profit/loss margin. I didn't mean to imply they had ill will towards anyone.

 

And it was in reference to the issue of dr's/hospitals not allowing VBACs as a broadbrushed rule, even though VBAC have a good rate of success in good candidates for it.

Edited July 23, 2011 by mommaduck

[TracyR]

I'm assuming this was done in PA, and to be honest I wouldn't want to be her right now. PA is a state with very HIGH malpractice insurance. Not sure why it is, but I've seen many doctors leave our area due to it.

With that said I know that in home midwifery is illegal in PA. So by doing that she took a HUGE chance. If something goes wrong people will jump at the chance to sue, and go for the highest amount possible.

 

I do appreciate midwifery, and three out of my four girls were delievered by a midwife ( even my last one who was born C-section my midwife attended) . But if you go in willingly doing something illegal you get put on the radar and chances are something is bound to happen. I hope that things really work out for her though. I don't like to see anything that gives midwifery a bad wrap because a midwife really is the way to go.

[mommaduck]

I'm assuming this was done in PA, and to be honest I wouldn't want to be her right now. PA is a state with very HIGH malpractice insurance. Not sure why it is, but I've seen many doctors leave our area due to it.

With that said I know that in home midwifery is illegal in PA. So by doing that she took a HUGE chance. If something goes wrong people will jump at the chance to sue, and go for the highest amount possible.

 

I do appreciate midwifery, and three out of my four girls were delievered by a midwife ( even my last one who was born C-section my midwife attended) . But if you go in willingly doing something illegal you get put on the radar and chances are something is bound to happen. I hope that things really work out for her though. I don't like to see anything that gives midwifery a bad wrap because a midwife really is the way to go.

 

She did practice here in PA (one of the ladies here had her as a midwife and I'm sure my midwife knew her). The situation occurred in VA, I believe. VA laws are different and she did not qualify under their laws. That was the big clincher.

 

In home midwifery is not illegal in PA. It's not legal either. Actually, it's legal for CNM's. But there is no law ruling out CPM's or DE's. However, there is no law for them either, so they are prosecutable if something goes wrong. This is my understanding of it all. I also live in Lancaster County and we have a high rate of homebirths here. In fact, many OB practices don't blink an eye about it if they hear you've had any or many. The CNM's at the practice I went to knew my CPM in a very positive manner.

Edited July 24, 2011 by mommaduck

[Dirtroad]

 

Many of the problems we're seeing today is a sue happy public. Only by producing a list of interventions can a doctor say they "tried everything" to ensure the mom/baby lived. If the lack of intervention truly was the safest route and a doctor took the intervention-less route, we'd sue him for not trying everything. Doctor's are in a no-win situation sometimes. I just wish I could go to a doctor and tell them, "Please help me make the best decision for me and my beliefs without worry of a malpractice lawsuit. I'm not going to sue you even if something bad happens."

 

:iagree:

[Spy Car]

:iagree: Here's the case from another point of view: here and here.

 

I have been on record in this thread as questioning the judgement (or lack of judgement to be more precise) of the mid-wife in this case. That said, I think this Dr Amy is unkind in her remarks and some of them cross the line into utter untruthfulness.

 

It is a shame that so much modern discourse has to take place outside the bounds of reasonability.

 

We ought to reject shrill commentators like this Dr Amy who clearly strive to create more heat than light, without suspending our rational minds as to what is (and what is not) a reasonable risk.

 

Bill

[Jean in Newcastle]

We ought to reject shrill commentators like this Dr Amy who clearly strive to create more heat than light, without suspending our rational minds as to what is (and what is not) a reasonable risk.

 

 

There. Bill used the correct word "shrill" instead of the incorrect "shill";)

[unsinkable]

I say, "Reject the shrill shills!"

[kchara]

But a shill has a profit relationship. They are either a paid "covert advertiser" or somehow getting a gain from the person they promote. After I read that, I went to the dictionary to confirm my suspicion, and my question was if the PP I quoted actually thought she was being paid to do this. Heck, she may be, but I somehow doubt it. But I am curious if people believe she is paid.

 

I think it's a very good possibility that she's being paid. Not by ACOG, but possibly by pharmaceutical companies, as much as she loves pushing for intervention. But... there's no proof, as far as I can tell.