Mother bleeds to death at homebirth, but at least she had a “really lovely spontaneous birth”

No mother should ever die at homebirth.

Maternal deaths in the hospital are unusual; perinatal deaths are 100 times more common. There are so few maternal deaths in the developed world that they are measured per 100,000 and most of the women who die have serious medical complications like cardiac disease or pre-existing medical conditions. Death from a routine childbirth complication like bleeding is almost unheard of in an age of blood transfusions and surgical repair.

That’s why it’s horrifying to consider the latest report of a maternal death at homebirth. This marks the 4th publicly reported maternal death at homebirth in the past 4 years. All 4 women were in excellent health prior to childbirth and at least 3 (possibly 4) out of 4 simply bled to death.

Joanne Whale bled to death in 2008 as a result of a uterine eversion. Her midwife did not even know how to start an IV.

Sara Hedgepeth Osceola, mother of 6 small children, bled to death while attempting a VBAC at home.

Caroline Lovell, a homebirth activist, died shortly after she gave birth to her daughter.

Now comes word that Claire Teague bled to death due to retained placenta while the midwife went home.

According to the Mail Online:

A mother died within hours of giving birth at home after a private midwife committed a horrifying catalogue of errors, an inquest heard.

Claire Teague, 29, was left bleeding in bed after Rosie Kacary allegedly pulled out her placenta following the delivery.

The midwife is also accused of failing to realise a large section of the placenta had not come out and not stitching a tear.

In addition:

Mrs Teague complained to her husband, Simon, about feeling weak and in pain after the birth but Kacary left and only returned after ‘repeated contact’.

When she came back to the couple’s home in Woodley, near Reading, Berkshire, she discovered Mrs Teague had stopped breathing.

Instead of performing CPR on a firm area such as the floor, Kacary is said to have done it on the bed, where it was less effective…

The midwife left at 10am. Mr Teague claimed that when she eventually returned and attempted to resuscitate his wife, she ‘didn’t seem to know what she was doing’.

The inquest heard from a paramedic who described the ambulance that took Mrs Teague to the Royal Berkshire Hospital as ‘swimming in blood’.

Doctors established around a third of the placenta – measuring 8in by 3in – had not been delivered.

Kacary believes that she did nothing wrong and (the classic excuse of the homebirth midwife)  the patient would not have accepted advice to transfer.

She believed the placenta had been complete and said, if she thought otherwise, she would have advised an immediate hospital transfer.

But she said: “As Claire felt completely well at the time, I’m very sure they would have declined my suggestion to transfer.”

Why did Claire Teague die?

A post mortem found that Mrs Teague died due to a lack of oxygen caused by the severe haemorrhage due to a recent vaginal birth with a retained placenta.

But, according to Kacary, at least she had a great birth!

“Claire had a great pregnancy, she had a really lovely spontaneous birth at home and I hope Simon in time will remember that.”

Because when it is all said and done, for a homebirth midwife, it’s all about the process, and death is a small price to pay for a great birth experience.

  • Irene midwife

    What a completely biased article!
    There are bad professionals in every profession! Homebirth is as safe as hospital birth if accompanied by a good professional. You are mixing apples with umbrellas

    • LauraN.

      Irene, what do you consider a “good professional?” One who meets the requirements for his trade? Homebirth midwives responsible for tragedies largely do meet all the licensing/training requirements for the CPM credential. So what makes them “good”?

      Do you have evidence that HB is safe with a “good professional”? And if this evidence excludes whatever your definition of a “bad” midwife is, does it also exclude “bad” in-hospital providers? It wouldn’t matter much if it takes comparing the cream-of-the-crop HB midwives against the schmuckiest OB/GYN to find home birth safe.

    • Young CC Prof

      “There are bad professionals in every profession!”

      By that logic, there should be some bad apples in hospitals as well. Certainly hospitals have made mistakes. However, taken all together, home birth comes out worst in almost every important risk category.

      • toni

        Jeekers CC, get some kip! lol

  • Hannah

    Every other mammal gives birth outside of a hospital. Humans wouldn’t even be here and would have been extinct if it wasn’t “natural” to give birth somewhere other than a hospital. To me, it’s completely unnatural to give birth in a hospital setting and studies show hospital births are the ones that have increased complications. Here’s clinical studies from home births from 1990 to 2009 showing the risks are lower than hospital births. http://www.cdc.gov/nchs/data/databriefs/db84.htm So where’s your data???

    • Box of Salt

      Hannah, read more of the posts on this site. Dr Amy can’t put all the stats into every single post – that would take up too much print, and dilute the point of posts like this one.

    • Box of Salt

      Hannah,
      where are the mortality rates listed in your link? This data brief just summarizes who’s having the home births, and where.

      The only discussion of “risk” is tallying up preterm births, low birthweight, and multiples.

      So, Hannah, where’s your data?

      It’s not in your link. If it’s in the references, why don’t you highlight which ones and summarize what you think the results show for us.

    • MLE

      Right, and even today if there were no hospitals, there would be plenty of women giving birth successfully. Enough to keep the Human race going. You’d just be missing a lot of moms and babies who didn’t make the evolutionary cut. But who cares about them, because it wouldn’t be “natural” for them to survive.

    • Amy Tuteur, MD

      No other mammal wears clothes, lives in houses with central heating or uses the internet. Does that mean you are going to stop doing those things?

    • Bombshellrisa

      “To me, it’s completely unnatural to give birth in a hospital setting”
      It IS unnatural-in nature, complications occur and mother, offspring or both die unless someone intervenes.

      • The Bofa on the Sofa

        Exactly. So what if it is “un-natural”? Death is completely natural, doesn’t make it all that desirable.

    • suchende

      Lots of animals that aren’t extinct have tragic perinatal and neonatal death rates. We selfish humans want better perinatal death rates than nature provides.

      • The Bofa on the Sofa

        “natural” for humans is something like 8 children, with 5 of them surviving.

        Yep, damn us for not wanting 40% of our children to die. Thankfully, we are smart enough to prevent it.

        Why anyone would want to go back to that “natural” outcome is beyond me…

    • suchende

      Don’t you know even midwives and their assorted organizations now admit that home birth is riskier than hospital birth?

    • Certified Hamster Midwife

      Turtles aren’t mammals, but like all creatures they have tremendous wastage in their reproduction. I was listening to something about sea turtles on the radio the other day: 1 in 1,000 of them survive to sexual maturity, and then those offspring have 99 extra hatchlings.

  • Meredith Hedgepeth

    I am Meredith Hedgepeth, the sister and best friend of Sara Hedgepeth Osceola…. With that being said I truly hope that you, Amy Tether read this comment! This is not my opinion but the facts!! My sister did not die of a home birth, but in a medical facility under the care of medical doctors!! People please do not listen to anything this woman says as she is ignorant and a liar!!

    • Captain Obvious

      No woman should die at childbirth, so sorry for your loss. But are you trying to say its the hospitals fault? So if a person gets injured in a car wreck and is brought to the hospital and dies, would you argue that, that person died as a result of being in the hospital under the supervision of doctors? You need to start a VBAC in a hospital with immediate access OR and staff. That is the protocol. To start a HBAC and die as a result of that, some accountibility has to happen. Once the body goes into hypovolemic shock, organ systems start shutting down. The doctors only have a short timeframe to reverse the damage. If it takes too long to get to the hospital once it starts, then the blame goes with that decision to have a HBAC.

      • Meredith Hedgepeth

        Obviously I am saying that the medical staff that gave her the misdiagnosis is at fault!!

    • suchende

      Why was she in the hospital if her choice to home birth hadn’t already put her in moral peril?

      • Karen in SC

        I think you meant “mortal peril”. And I agree, while little info is available, clearly something went wrong at home first.

    • Meredith Hedgepeth

      What Amazes me about your comments is that you have no idea what the situation was or the original plan …….was to have a home birth…. Later in the pregnancy she was diagnosed with a condition that would prevent a homebirth from happening….. A few months later she was also misdiagnosed And given clearance to have a home birth… The day she went to the hospital there was no midwife nor doula at her home…..after some bleeding then she went to the hospital with her husband

    • Amazed

      While I am very sorry about your loss, I cannot help but remember how fast any mentioning of your sister’s story was erased from the net. Why was that and why were you and her other family or friends (I assume) were so quick to hide facts? Your coming here about a year after the post, rambling how we shouldn’t listen to anything “this woman” says because she’s “ignorant” after doing your best to make sure that we cannot learn the facts is not filling me with trust.

      Dr Amy is known to own her mistakes. Sara’s family and/or friends are known to hide information. I won’t listen to your plea.

      By the way, I seem to remember that Sara was a grand multipara who already had a C-section. I am shocked that she needed a diagnosis at all to know that she was not a good candidate for homebirth.

  • I’m a midwife

    Following on, arrogant practitioners, lay midwives, doulas & obstetricians cause unnecessary maternal & neonatal deaths. Not the choice or birth place, choice or birth attendant does that for us.

  • I’m a midwife

    PEOPLE!!!! Please, please can we stop this home birth versus hospital birth savagery?
    Might I suggest the first port of call at a birth is the MIDWIFE. Not the doula, not the obstetrician, it is the midwife. Where ever a woman is labouring, however she as commenced labour, it is our DUTY, let me repeat this word, DUTY, to be listening in the that baby’s or those babies heart rates, from the beginning of one contraction to the beginning of another, every 15-30 minutes thought out first stage, then after EVERY SINGLE contraction thought out second . this is not because we are trying to intervene or cause aggravation to that champion of a woman at such an intense period of her birthing, it is to detect any serious variations in the foeal heart rate. Once detected it is a matter of contacting emergency services or getting to a hospital ASAP. A dead baby is due to prolonged distress, or, of course ruptured uterus or placental abruption- even a cord prolapse may not be a catastrophe.
    A bleeding woman needs immediate transfer, to theatre where ever she be.
    I put it to all of you, the midwife has her knowledge & training by which to make decisions, the fault lies with their failure to act when they KNOW what is normal, what is SAFE & chose to disregard this knowledge. It is not guessage, it is not maybe, we know why mothers & babies die unnecessarily during & after birth, regardless of where they are,

  • my midwife Forced that stuff on me (breastfeed) I went home and gave him a bottle..stupid witch..

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