Oregon homebirth midwives sued for $50 million

Meet Abel, a gorgeous toddler who cannot walk, talk or sit unaided as a result of oxygen deprivation sustained at a birth supervised by homebirth midwives.

Abel’s parents believe that the midwives and the birth center at which they worked should be held accountable.

According to the Bend Bulletin

… Kristine and Greg Andrews — on behalf of their son — are suing the state of Oregon, Motherwise Community Birth Center, midwife Nicole Tucker, CPM and midwife Christyn King, CPM for the medical problems they say the baby faces as a result of oxygen starvation during birth.

The lawsuit asks for $25 million in noneconomic damages as well as $22.5 million in economic damages in the form of ongoing medical and therapeutic care and lost wages. It also asks for $3 million in noneconomic damages to Kristine Andrews for the experience she had with her son’s birth…

The lawsuit states no monitoring equipment was used to check the fetal heart rate. Nevertheless, “the fetal heart rate was noted to indicate periodic bradycardia (slow heart rate) and nonreassuring decelerations of the fetal heart rate.”

When born, the infant did not respond to stimulation and did not breathe on his own. He was taken to St. Charles Bend, and 10 days later was discharged with signs of brain damage caused by oxygen starvation from birth.

The baby suffered, among other things, significant brain damage and cerebral palsy.

Abel’s parents have not stopped there:

Finally, the lawsuit alleges the state was negligent.

The Oregon Administrative Rules have a list of “absolute risk factors” for birthing centers. When a risk factor is present, the regulations state a pregnant mother should be transferred to a higher level of care, like a hospital. One of the risk factors is hypertension. The state listed the threshold at a blood pressure of 150/100.

According to the lawsuit, that threshold was “inappropriate and not evidence based.”

The Andrewses allege the state was negligent for several reasons, most notably because of the blood pressure level it lists as a risk factor. The lawsuit also alleges the state didn’t require a mandatory disclosure form … and that it didn’t implement “evidence based standards for the protection of Oregon citizens.”

In my view, this lawsuit, and a similar suit filed in Michigan are just the first shots across the bow. I suspect that, ironically, the ongoing attempt to popularize homebirth and license homebirth midwives is going to end in the abolition of the homebirth midwifery credential, the CPM (certified professional midwife) and reverse the trend to license homebirth midwives.

Before Ricki Lake and The Business of Being Born, and before the Big Push, the national effort to license homebirth midwives, homebirth was a practice restricted to true believers. Sure homebirth dramatically increased the risk of perinatal death, but lawsuits rarely followed in the wake of those deaths. For the true believers, process is more important than outcome, and a few dead babies here or there did not weaken their commitment to privileging the process.

But homebirth midwives got greedy. They wanted access to insurance reimbursement and to more customers. The resulting effort to popularize homebirth has led to women choosing homebirth because they believed the propaganda. They thought homebirth was safe because that’s what homebirth advocacy organization claim, despite their own data that shows that homebirth increases the risk of neonatal death. Indeed, the Midwives Alliance of North America (MANA), the organization that represents homebirth midwives, refuses to release their own death rates.

Parents learned in the hardest way possible about the dangers of homebirth and that homebirth midwives are not honest about the real risks of childbirth, about the fact that the CPM is not accepted by any other country in the first world due to lack of education and training, and that being near a hospital is meaningless in the face of a life threatening emergency.

This new group of homebirth parents were never true believers and they see no reason to protect incompetent midwives and deceitful homebirth advocacy organizations. They intend to hold them accountable.

And that will hopefully mark the beginning of the end for the licensing of homebirth midwives.

Learn more about Abel and the foundation his family set up to support children with cerebral palsy and birth trauma at We Are Abel.

  • Ibrahim Hublou

    A sad outcome of what is most of the time a very wonderful life event for everyone.

    I graduated as a Nurse-Midwife in Flanders (Belgium) and spent some time in a midwifery practice in Rotterdam (The Netherlands) where the midwives where involved in the whole spectrum of giving birth: pre, post, home birthing as well as midwife assisted hospital or birth center births.

    In 1995 I was blessed to be invited by my colleague Mrs Sharon Evans (CPM) who ran then MOMS, Mid-Oregon Midwifery Services, in Bend, Oregon. The care the midwives there provided was in any aspect ways above what I had encountered up to then and since then.

    In the margin of MANA – in which Mrs Evans was much involved in – finalizing the CPM certification process at the time I sat a final draft version of the CPM exam. Twice. Twice I failed.

    — My English writing wasn’t so good in those days and the first time my pencil was more scratching the paper than writing. Otherwise I surely would have gotten the marks of a GP. Right?

    Stating that no other country has adopted or recognized CPM-credentials and using it as an argument to try to torpedo a whole profession that provides overall an excellent service to local communities ignores that such process is always a matter of highly sensitive diplomacy over many many years; decades even. Actually, many jobs that need vetted skills need recertification if the person moves a bit ‘too far’ from the geographical region where the training happened. Pilots trained in the US need to re-sit exams when willing to fly in the EU. My brother-in-law needed to re-sit exams and write a new thesis after having trained and worked for many years as a dental surgeon in the UK on his return to his native Iran. Just a few examples.

    The midwifery training as it was before in Flanders (the Dutch speaking part of Belgium) was only recognized by The Netherlands as equal after the Dutch received part of the EU quota assigned to Flemish herring fishing fleet. Double Dutch as they limit the number of midwives that can get into their training, reducing costs, and accept midwives graduated in Flanders; trained in facilities paid for by the Flemish taxpayers.

    No, GPs are rarely honest when talking midwifery politics. In this case there is no doubt to me that this particular law case is used not to safeguard choice to prospective parents or even to improve the care framework in which legal midwifery care is provided but to frantically protect the old socio-economic status of the old medical establishment. Too bad. GPs can play an important role, next to midwives, doulas and the intra-mural care available (hopefully) to women; couples; pregnant, birth-giving and during the post post-partum.

    I think it is best to leave Court matter to lawyers and judges and to focus on how things can be improved; to learn from a situation with the intend not to slide to over-regulation or drive people into having to avoid to practise openly, but in a way midwifery care can overall (pregnancy has its risks) be practiced with the best possible training options available, in the most free legal framework and with the best tools available if needed.

    “Verloskunding Vademecum” (2003) DUTCH
    http://fliphtml5.com/dyfu/gxul
    Document describing the relations, based on the occurrence or absence of risk factors in pregnancy, between midwives, GPs and intra-mural caregivers as used in The Netherlands. The Dutch organisation of midwives (http://www.knov.nl/ ) used to have a version in English.

    —–
    I am not subscribed to this forum.
    You can send a copy of your reply to: handy@riseup.net

  • Insider

    The link in Dr. Amy’s post above (and in another post) to the Bend Bulletin article no longer works, but you can read this very sad story of a botched home birth in Oregon here:

    http://www.bendbulletin.com/health/1897490-151/the-risk-of-being-born-at-home

    Today there’s a follow-up to the story here:

    http://www.bendbulletin.com/health/3024219-151/former-bend-midwives-face-discipline

    The Oregon board that governs midwives wants to revoke the licenses of and issue thousands of dollars in fines against two former Bend midwives it says failed to properly assess risk factors in a birth that resulted in the child’s cerebral palsy.

    The Board of Direct Entry Midwifery says Christyn King and Nicole Tucker violated six current and former Oregon statutes in an April 2010 birth. The board says they failed to assess and take action on the risk the mother’s high blood pressure posed to the birth and failed to plan the hospital birth the law requires for patients with such a risk factor.

    The board says the women broke the law by also failing to disclose their lack of malpractice insurance to the client….

    Kristine Andrews [the mother], now 35, filed a lawsuit against the midwives and the state in 2012. The case against the state was dismissed, but Andrews said she’s still in arbitration with the midwives. Andrews said neither King nor Tucker told her high blood pressure put her birth at risk. To bring it down, they told her to eat cucumbers, drink water and go for walks.

    Toward the end of her pregnancy, Andrews she said grew concerned and asked the midwives if she should consult an OB-GYN she had seen previously.

    “They were like, ‘Oh, no, no, no,’” she said. “‘You just need to eat your cucumbers and this is fine, and we’ll let you know way in advance of any kind of emergency.’ So it was all very downplayed, and I don’t think they were concerned.”…

    In addition to revoking their licenses, the board is proposing civil penalties of $5,000 against both King and Tucker in addition to up to $5,000 toward the cost of the disciplinary proceedings against them.

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  • Jamie

    This doctor is an idiot. How many babies die or leave the hospital with a disability? She writes this as if these things only happen during a homebirth. How many women get a CS from the hospitals ignorant policies and Epidurals. Homebirths have been proven in studies to be safer. Safe “er”. There is always going to be some level of risk no matter where you deliver your baby. This is another case of the high ego-ed, ignorant, bias doctor who knows nothing but to write a prescription.

    • Amy Tuteur, MD

      I’m an idiot? You’re the one who can’t seem to grasp 4th grade math:

      http://www.skepticalob.com/2012/02/basic-arithmetic-lesson-for-homebirth.html

      • Jamie

        your kidding right? the birth rates are uncomparable, with just a single death from homebirth out of 750, and then trying to compare the ratios as if it’s apples to apples… the rates are completely unbalanced and cannot be compared to eachother. In a true risk scenario it would be better to have the birth in the hospital, but for most births any emergency issues are almost always created by the doctors and hospital, by giving drugs and doing other practices that create most of the complications in the first place that would never exist with homebirths. Again, these ratios cannot be compared. Fact is, homebirths are safer and you provide a bs link with a bs “comparison”. Why don’t you compare rates from America?

        • Amy Tuteur, MD

          Still can’t grasp 4th grade math.

          • Anj Fabian

            I’m thinking “still can’t grasp 4th grade composition”.

    • Squillo

      She may be bias, but at least she’s educate.

      • Jamie

        Educated? in what? prescription drugs, which are poison and only mitigate symptoms while creating other side effects? She was taught one thing and one thing only. Everything she was taught in medical school is completely controlled by the pharma industry with what THEY want her to know, including their own falsified studies, etc etc. She knows nothing of real medicine (natural medicine, herbs, healing and super foods), nor does know how to actually heal or cure anything.

        So in reality she has been brain washed with false knowledge that can’t help anybody. The only good doctors are trauma / surgical doctors. She was taught to have an ego and think she’s smarter than everyone else when really she’s dumber when it comes to health because she went to mainstream “medical” school. And then society brainwashes everyone else to believe doctors are “educated” and are superior. I’ve never met a bigger idiot when it comes to health than MD’s. Spread the word, MD’s are idiots when it comes to actual health, disease prevention, nutrition, curing and healing.

        • Amy Tuteur, MD

          So you’ve been to medical school? That’s how you know what is taught?

          Wait, what? You’ve never been to medical school and just made up stuff about it? Oh, that explains the crazy.

        • Squillo

          Sigh. It’s so hard to know when someone is laughing at you on the Internet, isn’t it?

          • Amazed

            Hush. She might flounce off and I’d rather keep her around. She’s too funny for us to lose.

            Jamie, would you mind commenting under more recent posts, so we can better enjoy the myriads of pearls of wisdom you’re presenting us with?

  • kristine

    First of all his name is Abel, not Able. I too went to MCBC and I hate every single one of those midwives. My pregnancy was normal, so l never got to see all of their “education” in action. They let me labor for 32 hours without being able to urinate. They said I could not urinate because “my body was using it all up”, by which they meant the water I was continuously drinking at their encouragement. They even gave me 2 different IV’s of fluid. All the while my bladder was distending and prevention my son from descending down. He could not come out due to my bladder becoming 3 times it’s size. These women did not know what they were doing. I had to experience pain( and still due) due to their negligence. When I tried to ask questions about what happened they told me “I don’t know” and ” I am not sure”. Then they walked away. You can read about my OHLA complaint, which by the way, does not even contain everything they did wrong. They changed financial agreements on me midway, never went over a informed consent with me. They were caught lying to OHLA during the investigation. If nothing goes wrong with your birth, you would have no reason to doubt them. How does a midwife prove their knowledge if they usually take low risk patients? They learn to call 911 when shit hits the fan and that’s about it. They showed me no compassion or care. They did nothing but stare blankly at me during labor and left the hospital as soon as I got into my hospital room. My son and I would have died if we did not transfer to the hospital. These midwifes did not give a crap about me or my son’s safety. They just wanted the almost $7000.00 paycheck without even delivering my son. Shame on you and those midwives that think every woman who doesn’t get their fantasy home birth is just seeking revenge. They screwed up and wont take responsibility.

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