Prominent midwife retires after homebirth death

Back in April Brynne Potter, CPM, in her role as a board member of NARM (North American Registry of Midwives) appeared on the Kojo Nnmadi radio show to defend Karen Carr, the midwife who pled guilty to felony charges in connection with the homebirth death of a breech baby. What Potter neglected to mention is that she was on leave from her practice for recently presiding over — you guessed it — the homebirth death of a breech baby.

In the wake of that death, Potter is giving up the practice of midwifery. A supportive article in a Charlottesville newspaper bemoaned the fact that her practice Mountain View Midwives was breaking up, while entirely neglecting to mention why, implying that Potter wanted to spend more time on her NARM duties.

Oh the one hand, I applaud Potter for her mature approach to the homebirth tragedy. It is devastating for any practitioner to lose a patient, even more so, if the practitioner questions her own culpability in that death. The patient was a primip who was wrongly thought to be vertex. She purportedly “declined” vaginal exams in labor. The breech was not discovered until it began to emerge during delivery in the bathtub. The head was trapped. By the time Potter cut an episiotomy and delivered the head, the baby was dead.

A period of reflection is quite appropriate in the wake of such a tragedy. Potter ultimately decided that she could no longer attend women at homebirths. That, too, is a mature decision, considering that she, like all certified professional midwives, is grossly unqualified to provide care to pregnant women. What is far less admirable, is her determination to continue defending the indefensible by hiding any information that would alert women to the dangers of homebirth.

In addition to hiding her role in a preventable homebirth death, Potter continues to defend MANA for hiding the death rates of the 23,000 planned homebirths in ther databse. I called into the Kojo show specifically to ask Potter why MANA (the Midwives Alliance of North America) the organization that represents homebirth midwives, and the sister organization of NARM, is hiding their death rates..

Potter tried to dodge and weave:

… So I can’t really speak to a specific about some assumption of hiding. What I would say is that MANA’s — I know MANA stands ready to meet the needs of any reporting mandate. It is a private data set in which isolated cases of death would only be isolated cases similar to this case that we’re talking about today. We wouldn’t be able to make any extrapolation of a trend to homebirth. The only place we can do that is from the CPM2000, which was a cohort study that mandated all CPMs to report in prospectively all of their data for one year. And that study was published in the British Medical Journal, and it is absolutely in line with outcomes of all other published studies around homebirth, which is…

Potter almost surely knows the MANA dataset is not private, that the cases of death are not isolated and that it is simply a lie to say that we could not use the data to make a determination of the safety of homebirth with a CPM. MANA knows that homebirth substantially increases the risk of neonatal death and they are doing everything in their power to make sure American women do not find out. Potter, by acting as a spokesperson for homebirth midwifery is complicit in hiding this important information.

Potter’s comments about the Johnson and Daviss CPM2000 (Johnson and Davis, BMJ 2005) study are also untrue, but she may not have known that at the time. Since then, I have gone to her blog and explained that the “outcomes of all other published studies” as well as state and national data show that homebirth with an American homebirth midwife dramatically increases the risk of neonatal death. Did Potter address my extensive explanation. No, of course not, she — you guess it — hid it by deleting it. Not only was she unable to defend the studies that she publicly cites as supporting homebirth safety, she found the information so compelling that she removed it so no other women could learn the truth.

Ms. Potter, if you are reading this, I have a question for you:

Presiding over as completely preventable homebirth death, you appear to be shaken to your core. You reasonably concluded that you could not continue to provide a model of care that lets babies die unnecessary deaths. You KNOW that “trusting birth” kills babies who didn’t have to die. You know that MANA is hiding the death rates of CPMs because they are afraid to tell American women the truth. You know that the published data and state and local statistics confirm that homebirth kills babies.

Don’t you feel any obligation to tell American women the truth?

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