Thank goodness I chose homebirth for the shoulder dystocia that nearly killed my baby

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I’ve always believed that there is no limit to which a homebirth advocate will not go to rationalize her decision to have a homebirth. Now I’ve had that belief confirmed.

A woman whose son suffered a severe shoulder dystocia, was born lifeless, waited 25 minutes for an ambulance and had to endure cooling therapy to preserve his brain function and may have sustained developmental impairment is actually crowing that it was the decision to give birth at home that saved his life.

When I first got examined by a midwife at home when my contractions started I was just 1cm dilated. I was in alot of pain but as this was my first baby obviously we all thought I would have hours and hours to go until things moved along.

… [O]ur homebirth midwife went off to do her Christmas shopping while we waited for things to progress.

So much for one on one midwifery care.

… just 10 minutes after rose had left my waters broke. Daniel had noticed mec in the waters which meant I would need to go to hospital to give birth. He rushed downstairs to call the midwives. I had started to get the urge to push and couldn’t stop. Ten minutes later a midwife arrived to examine me and saw that I was pushing Freddy’s head out. Rose arrived and they both realized that this baby was coming and coming fast! They told Daniel to call an ambulance.

Then disaster struck:

… Freddy’s head was out, he was stuck and he was lifeless. An ambulance from Sandhurst was dispatched and on their way. Sandhurst was over 30 minutes away.We were on our own.

The midwives struggled to deliver the baby for 5 minutes and finally he was born.

All of a sudden I felt release. The pain had gone and I felt a them place a lifeless 9lb 2 Freddy on my tummy just 28 minutes from when I got out of the bath. one of them shouted. The cord is snapped clamp it clamp it.!!!!!

Then for 15 minutes …..silence. I had my eyes closed. I felt the panic but I truly can’t remember alot.

In those 15 minutes Karen had scooped the mec out of Freddy’s mouth with Daniel’s T-shirt… Rose and Karen began to perform CPR on Freddy. …….Nothing. He was gone. They kept going and going and going. ….Nothing. I was laying on the bed crying, bleeding and in shock while they pressed on my precious baby’s chest and blew air into his tiny mouth.

The EMTs managed to resuscitate the baby. At the hospital he was subjected to hypothermia (cooling) therapy to preserve as much brain function as possible.

In a spasm of blithering idiocy, Freddy’s mother believes that the homebirth saved his life.

If we had opted for a hospital birth-

I would of got out of the bath, gone upstairs and my waters would have broken.

Daniel would of tried to move me as he knew I would have needed to got to hospital but I was in so much pain pushing I could not be moved. He would have called the ambulance……..No ambulance.

It would have been up to Daniel to try and deliver Freddy. There would have been no midwives to perform the McRoberts maneuver, to clamp Freddy’s cord, to perform CPR on him for 20 minutes.

Daniel would of tried to get him out. He would have told me to keep pushing. He wouldnt of known his shoulder was stuck. He wouldn’t know how to release it. Freddy would have still been inside me apart from his head when the ambulance arrived. He would have died and I would have probably died too.

It’s as if someone who was ejected from a car while driving drunk and unbelted shortly before the car burst into flames were crowing that it was the fact that he was drunk and unbelted that saved his life. Yes, that he was ejected and was not in the car when it exploded may have saved his life, but it was the decision to get into the car in the first place that nearly ended it. The assumption that the crash would have occurred in the absence of being drunk is completely unwarranted.

Similarly, it was the decision to choose homebirth in the first place that led to the events that nearly killed the baby. If Freddy’s nother had opted for a hospital birth she would have headed to the hospital when she began experiencing severe pain. Since her labor progressed so quickly, she would have been far along in labor by the time she arrived at the hospital. Had the mother been under the care of a remotely competent provider in a hospital setting, it is quite possible that the shoulder dystocia would have been resolved more easily, the resuscitation started sooner, the need for cooling therapy averted, and the as yet unknown long term damage to this child’s brain would never have happened.

Once again a mother who chose homebirth for no better reason than her “experience,” risked her baby’s life, nearly killed him, subjected him to prolonged oxygen deprivation and may have sentenced him to a lifetime of developmental disability is now trying to justify that choice. Pretending that it would have been worse if she had chosen hospital birth is like pretending that it would have been worse to drive sober and belted. In both cases, there is every reason to believe that the disaster would have not happened in the first place had a different choice been made. It defies comprehension that anyone could pretend otherwise.

  • Evie_L

    I’m curious how you would have resolved the shoulder dystocia in less than 5 minutes, or what you do when a woman shows up at the hospital only 1 cm dilated.

    • Montserrat Blanco

      I can not paste the link here because it is not possible with my mobile, but if you read the paper by Locatelly et al. At J Mater fetal Neonatal Medicine 2011 june you will find that most shoulder dystocias at a hospital are resolved within 80 seconds, much less than 5 min. Another paper by Lerner et al. At Obstet Gynecol aug 2011 demostrates that a time over 5 min between head and shoulders delivery increases significantly the risk of a permanent injury for the baby.

      It was a five min pubmed search. And I am not an OB.

    • Medwife

      5 min is an eternity for shoulder dystocia.

  • Rob C

    Absolutely disgusting! I cannot believe what I’ve just read!!!
    I’ve read many other articles here and I’m shocked you are still allowed to call yourself a professional.

    Amy you should be very ashamed of yourself. You are totally devoid of compassion and have a very biased view which you put across in the most unprofessional and vile way. I dare say lots of women are glad you no longer practice. You do not come across as any kind of advocate for women. The whole tone of this site, your attitude and that of some other commentators here depict people who have home-births as baby murders along with their midwives. You thrive on scaremongering and twisting facts to suit your own aims with no thought for others or even women’s rights.

    Many people will be glad that I will not grace your website ever again, but none more so than me. Reader beware…. this website is pure poison

    • Dr Kitty

      Rob..

      Have you read ANY of the Lisa Barrett posts?

      The posts about Gavin Michael, Shazad, Aquila?

      The other beautiful children who died or were damaged because of homebirth?

      There is an unlicensed homebirth midwife in the USA who has lost 9 babies during or shortly after labours she attended. NINE BABIES. Charles Manson is serving life in prison for his part in the deaths of nine people. She’s not.

      Nine full term, perfectly healthy, wanted and loved babies who would have survived in hospital.

      I have no compunction about describing her as a dangerous woman who has killed babies and lied to their parents both about the safety of homebirth and her competence to manage complications in order to bolster her ego and her bank balance.

      I’d rather Dr Amy’s tough love and “spite” than the false reassurance and platitudes of NCB.

      Either engage with us and explain your comments where you feel your views have been misrepresented, or STICK THE FLOUNCE- leave and don’t come back. It’s not like your comments have added much.

      • Evie_L

        Comparing an unlicensed midwife to a CNM is like comparing some dude who collects knives to a surgeon. Having a homebirth doesn’t necessarily mean using an unlicensed midwife.

  • Cody

    You need a prescription for T3s as we call them.

  • Lora Tree Hugginghippie Tomlin

    You Amy are a total idiot! Scare no getting women into a conveyor belt of interventions that are proven to have negative outcomes! Shame on you!

    • Bombshellrisa

      Birth with CPMs is the real conveyor belt-there is only one kind of care and birth that they can provide, OBs and CNMs can offer care to women from teen years to past menopause and treat a variety of conditions as well as care for women during pregnancy.

      • yugaya

        Does nine times higher death rate of breech babies in homebirth according to MANA stats than the death rate of breech births in hospitals count as a proven negative outcome or not?

        • Karma Kidney Stone

          Depends. Was the baby born vaginally with no pain meds?

          • Bombshellrisa

            Speaking of conveyor belt interventions, what about castor oil and blue cohosh? Aren’t those interventions? And aren’t birth affirmations interventions too? Seems to me that the only interventions we hear about in NCB world are the ones that have negative outcomes

          • Evie_L

            “Seems to me that the only interventions we hear about in NCB world are the ones that have negative outcomes”

            Well, those would be the only ones worth worrying about, wouldn’t they?
            And it seems like you’re agreeing that those are the ones you’re more likely to get in a hospital.

          • Bombshellrisa

            Read the comment again and take a second. There are plenty of interventions that are used by homebirth midwives. They just aren’t called interventions. They are associated with bad outcomes but no doula, homebirth midwife or NCB type will admit it. They choose to talk about interventions that OBs use and insist THOSE are the only interventions that have negative effects.

    • Karma Kidney Stone

      Proven? Do tell.

  • Regina

    This woman is a right cunt.
    To specify, I mean Ms. Tuteur.
    Cunt.
    She’d rather terrify women and harass them than do any research beyond her own narrow view.
    Cunt.

    • Kq

      Wow. Well, you’ve certainly posted a logical, well supported, fact based argument here.

      • yugaya

        That’s because she ‘did research’ beyond her narrow view and is ‘educated’. Once you attain such wisdom, any disagreement with how you view the world is always the result of people being ‘right cunts’. 🙂

        • Karma Kidney Stone

          If Dr Amy is a “right cunt” I don’t want to be wrong.

          [I know, bad pun, just one more]

          As opposed to a left cunt? How many cunts does a woman have, Regina?

          • Bombshellrisa

            If Regina was so well researched and feminist, she would have read Inga Muscio’s manifesto entitled Cunt, which gives the history of and evolution of the word cunt. It didn’t start as an insult.

          • Roadstergal

            Oooh, I am going to get that eBook. Thank you for the recommendation!

          • Bombshellrisa

            I enjoyed it. I hope you do too!

    • LibrarianSarah

      Nothing says “I support women” like liberal use of the word “cunt.” Keep on keeping on keyboard warrior.

  • EmmaJ

    I gave birth in the UK last year under private consultant care and I agree with the previous comment that the article is half right. I was also attended by two midwives during delivery in an NHS hospital, they were good, but by no means perfect, for example between two of them they couldn’t manage to get an IV line in me, my husband, an emergency doctor, had to do it for them. It was also the consultant who made the call to move to theatre for forceps delivery when my daughter was stuck. She was 100% healthy and I wouldn’t have it any other way. Before she was born I felt a lot of pressure for a natural delivery, no drugs, midwife led units, the latter are heavily pushed, constantly having puff pieces in my area in the local newspapers. I am glad I ignored it and would happily have another hospital delivery.

  • BCMom

    You cannot obtain Tylenol 3 OTC in Canada – only by rx. You can buy a “Tylenol 1” OTC here which is 325 mg acetaminophen/15 mg caffeine/8 mg codeine.

    • LibrarianSarah

      Seeing that I can’t buy white-out OTC here that still seems pretty awesome.

  • fiftyfifty1

    We used to use more codeine here in the US than we do now, especially postpartum. But now it has been removed from postpartum completely, at least in the city I work in. Codeine gets its pain relieving qualities not from the codeine itself but rather because the codeine is metabolized to morphine. Unfortunately, codeine metabolism varies considerably between individuals. Slow metabolizers will get very little pain relief from it. But worse are the ultra-rapid metabolizers–their blood morphine levels shoot up immediately. This variant is rare in European, Asian, Hispanic, and West African genetics but is found in up to 25% of individuals from East and Northeast Africa. Our city has a big Ethiopian and Somali population and there were some near misses in postpartum and breastfeeding babies.

  • fiftyfifty1

    If UK midwives are so well trained why did they bungle this delivery so badly?

    Mistake #1: They incorrectly assessed the cervix calling it 1-2 cm. But the cervix was stretching to 4cm with a buldging bag with contractions. The correct medical measurement is the largest diameter that the cervix measures, not the smallest. It showed real inexperience and bad judgement to leave a woman who was fully effaced and 4cm with a buldging bag alone without staying longer to determine cervical change.If this woman had gone to the hospital, they would not have sent her home. They might not have admitted her immediately, but they at a minimum would have asked her to walk for a period of time and done a recheck, and then she would have been admitted.

    Mistake #2: Inability to correctly resuscitate. What sort of clowns show up unprepared like these midwives did? What mother wants her baby resuscitated with a rag rather than proper equiptment?
    m

  • advocate for woman’s choice

    what a ridiculous article.

    shoulder Dystocias can occur to any baby and to take comments out of context to prove a theory is unfair to those people who are not as knowledgeable about birth.

    A woman who arrives at a hospital 1cm dilated will be told to go home until they are in ‘established’ labour and so this woman would still have been home when the birth happened. The community midwife who attended the woman and found her to be 1cm acted as all women opting for homebirths are aware of. that is if on VE the woman is not considered to be in established labour the midwife will leave the woman if the woman is happy for her to go, until the labour progresses.

    When choosing a hospital birth factors such as travel to hospital, childcare for other children, infection, increased intervention – such as constant observations leading to Drs saying the labour isn’t progressing as fast as wanted etc. when choosing a homebirth the women muct consider the possibility of emergency and need of ambulance.

    No matter what anyone thinks – a midwife will ensure the woman is aware of all risks for both hospital and home births and so the woman’s can make an informed decision.

    However, comments like this belittle the woman’s decision, put a spin on homebirths in general and shows just how biased opinions affect others.

    • The documentation that was available (but has since been removed) showed that:
      The woman had been laboring for at least ten hours before being assessed.
      The inexperienced midwife incorrectly assessed her at 1 cm, instead of 4 cm (stretching to 4 cm during contractions).
      Both midwives responding to the second call left their equipment in their vehicles, assuming incorrectly that they would be be only supporting the woman prior to a transfer.

      You can’t place the responsibility for the midwives’ mistakes on the hospital. The mother’s narrative of “home birth saved my baby” is largely in error due to both the mistakes made by the midwives that made the situation worse, not better – and because the intensive cooling therapy that saved Freddy’s life and brain had nothing at all to do with midwives, and everything to do with hospital care.

    • fiftyfifty1

      “shoulder Dystocias can occur to any baby”

      Absolutely! That’s why you want to give birth in a location with *immediate* access to an OB trained in resolving shoulder dystocia and a team of nurses trained in neonatal resuscitation in case it happens to your baby.
      You don’t want to get your care from some unprofessional idiots who leave you to labor on your own with 1 cm dilation *that stretches to 4cm with a buldging bag* with contractions (the mom edited this fact out of her current story, but forgot to delete it from her originally published story).
      Left a mom who was 4cm with a buldging bag to go X-mas shopping?! Couldn’t resolve a shoulder dystocia? Used a rag to try to suction mec from the baby?? Who are these clowns who call themselves healthcare providers?

      • Evie_L

        “unprofessional idiots who leave you to labor on your own with 1 cm dilation”
        That is what OB’s normally do. They will send you home.

        Oh, and according to what I’m reading above they apparently did resolve the shoulder dystocia in 5 minutes. What are you reading?

        • fiftyfifty1

          “stretches to 4cm” is 4cm, not 1 cm. OBs don’t send women home at 4cm with a buldging bag.
          You think that resolving the shoulder dystocia in 5 minutes is a good outcome? 5 minutes!!!??? You think that a baby stuck for 5 minutes and needing mec suctioning and resuscitation is a good outcome?!

        • toni

          good grief you are so ignorant. just stop.
          think about what you’re saying for ten seconds.. ask yourself how you think you would fare after not breathing for five minutes??

  • christine

    I’m currently pregnant, have no relation to Freddy’s mom,
    living in Europe in a country where they have a similar midwifery system to the
    UK’s, and researching birthing options. I’ve recently started leaning towards a
    hospital birth attended by a doula; however, I’m still undecided and as such,
    eager to learn more and more. You would think that a site managed by a medically trained professional like Dr Amy Tuteur would be very much welcomed by me; however, … it’s not. And I can’t imagine that I’m alone in being completely turned off by the doctor’s lack of compassion or humanity, not only for the poor mom featured in Dr Amy’s original post, with her childishly bullying rant against her, but for the lack of respect for moms in my situation. I do not need to be bullied out of my birthing options. I need to be respectfully informed of the facts, of potential consequences and outcomes, and how the alternatives could be better, etc, etc.

    I have found several studies that I’m sure you’re all aware of that indicates that homebirth is just as safe if not safer for moms and babies. What is it about homebirth that supports these conclusions? Isn’t it worth exploring this question? And yes, I’m also now very much aware of what can go wrong in a
    homebirth and how being in a hospital could mean saving one’s baby. Again,
    couldn’t we simply explore this to learn how homebirths could be safer for
    those moms who have been previously scarred by hospitals (including losing an older child in a hospital birth – yes, it happens) or for those who for
    whatever reason choose to birth at home?

    I’m always skeptical and immediately turned off by extremists. And this site (and maybe the US in general, I think it’s safe to say) is a home for extreme extremists. You can work towards your very noble goal of preventing future traumatic births without your ridiculing, bullying,and spewing hatred towards other moms. The homebirth movement is not going to die. There is simply too many horrific hospital birth fatalities, too many beautiful homebirth stories, and too many studies that support homebirth for the movement to die. However, much work can be done in the US and in other countries to make HB even safer for moms and babies. You could perhaps direct your energy, your education, and your humanity (I’m sure you’re not simply operating out of pure ego) towards this nobler goal, no? Perhaps then you would actually start making a positive change.

    Best wishes to all for a safe birth and healthy child.

    • Home births can be made safer – by strictly following scope of practice (low risk only, TYVM) and standards of care.

      This story transgresses on the standards of care. The midwife incorrectly assessed the patient as at 1 cm when she was further along. The midwife left. [Monitor the entire labor? Only in theory.] The patient had difficulty contacting the midwife when she was needed. The midwife arrived unprepared and inexperienced.

      How would you prevent these problems?

    • yugaya

      “I have found several studies that I’m sure you’re all aware of that
      indicates that homebirth is just as safe if not safer for moms and
      babies”

      Nope, they all show it is never as safe as hospital, but people still claim otherwise. I suggest you look up a thorough debunking og what MANA posted are studies that “prove” safety of homebirth on Honest Midwife’s blog – she is a former CPM who analyzed these studies and claims about them as part of her research paper.

  • I didn’t have to go through this – because I delivered in a hospital with the full complement of equipment and skilled personnel, not at home with midwives who hadn’t bothered to bring their kits up with them.

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