Another devastated homebirth loss mother

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I’m grieved to point out a new and growing genre of mommy blogs: blogs set up specifically to recount the death or serious injury of babies at homebirth and the aftermath for their devastated mothers and families.

I came across a new one yesterday, Dreams That You Dare To Dream.

As the mother explains:

I once dared to dream that I could have a family of my own. I, who was told I could not get pregnant, astoundingly did. My dream was shattered on October 2, 2012 when my daughter died at birth. I now write about how life, love and who I am has changed to my very core.

Every one of the blogs in this new genre are deeply moving. Some are deeply infuriating. This one is particularly eloquent. The author has a gift with words such that her story has a raw immediacy and her pain is almost palpable.

I will remember the way it felt when I delivered my child’s head. The sense of relief knowing that just another push or two and I would to hear my baby cry, hold my baby in my arms, and watch my baby suckle at my breast… I will remember the moments of anguish that followed as my body betrayed both myself and my child. The moments when I was forced to pivot onto my hands and knees in hopes that my body would release and my beautiful child would be born into this world pink and bewildered. I will remember the intense yet defeasible [sic] pushing, my midwife’s profanities, the impenetrable words NINE-ONE-ONE. I will remember the sirens, the voices of the rescue team…

You feel as if you were there with her in the hospital ER:

I will remember the entry to trauma room, the extreme abandon I felt for my own safety, and my focus on my daughter’s wellbeing. I will remember having to deliver my placenta and attempt to be stitched without proper anesthesia all while a curtain was drawn between myself and my daughter…

And you shudder as the mother recalls hearing the words that she (hopefully) was not supposed to hear:

I know the first words I remember after coming out of … anesthesia were from the lips of [my husband’s] mother “She robbed everyone of this baby,” she accused.

Finally, you read how she was forever changed. The person that she was before her daughter died no longer exists.

Looking at the picture of her beautiful daughter you can see how easy it is to imagine that the baby is sleeping, soon to wake crying for her mother’s breast. Instead she will never awaken, a deeply wanted child inadvertently sacrificed to a strange cult-like philosophy that denies that childbirth is inherently dangerous and thereby denies babies the emergency assistance they need when things do go wrong.

Another homebirth, another shoulder dystocia, another dead baby and another homebirth midwife who will never be held accountable for presiding over the preventable death of a beautiful baby girl.

Ricki Lake, Ina May Gaskin, Melissa Cheyney, the Midwives Alliance of North America, the Big Push for Midwifery and other homebirth advocates and organizations have blood on their hands. With the possible exception of Ricki Lake, they know that homebirth increases the risk of perinatal death and they are doing everything in their power to hide that information from women considering homebirth.

When will it stop?

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  • Minerva

    Dr Amy,
    I saw a post on a website of a mother asking about HBing.

    I responded about how my daughter was born with an apgar of only 2 because of a nuchal cord that was so tight it compressed her oxygen during delivery and it was a team of neonatologists who were able to run the code seconds after birth that saved her life. I was told how HER midwife is a specialist in “baby recesesutation” and she doesn’t have to worry about it because in 17 years she’s only had “1 emergency” and she saved the baby herself. Also, “birth emergencies are rare, and the cord around the neck is never a problem.. People think that because doctors take the baby and give them oxygen they saved their lives but really they didn’t need it”.

    Those are actual quotes. It makes me want to bang my head against a wall because that seems like its the only way their reasoning would make any sense.

    • Amy Tuteur, MD

      I saw that. You tried to warn them, but they refuse to listen to anyone who tells them anything other than they want to hear.

  • Alicia

    I have a medical question for those here who are qualified: With SD, can oxygen be given to the infant while medical personnel are trying to get the shoulder out? Or would it not work because the chest is too compressed in the birth canal?

  • Alicia

    From what little has been written, it appears the father wasn’t really involved. The mom was planning being a single mom, and the father isn’t even mentioned in the story of the birth, only his mom. So I would say that in this case, yes, no one wanted the baby more than her.

  • Alicia

    Not all women who chose to homebirth that ends up in tragedy are willfully ignorant and more concerned with themselves than their baby. If you actually read what this mom has written, you would see that she was more concerned with her baby, and it’s clear she already blames herself. There’s a big difference between moms who think they’re doing the best they can because they’re lied to by the people they trust, and the moms who are only self-centered twits who think their uneducated, unqualified CPMs/DEMs can do no wrong and don’t care about their baby’s health. This particular mom is the former, and is in extreme pain. Have a little compassion for the ones who were duped because no one’s perfect.

  • Laura

    Andy, if you have had experience with competent midwives and conscientious obstetricians then I am very glad. If you have a pediatrician who has been supportive and helpful as well then that is good, too. Unfortunately, that is not always the case. Many people here are reporting things they’ve witnessed, experienced firsthand, or read about that defies logic and sound reasoning with birthing practices. There are several “loss moms” who post here at times, too, who have had very traumatic experiences. I do believe you when you say that the home birth exposure you have had has not included any of these negative experiences. And again, I am very glad for your good experiences. .

  • Ashley

    I had a homebirth. Our Midwife was a labor and delivery RN before she went on to become a CPM. She was NOT willing to deliver a baby before 37 weeks or if the mother had gest. diabetes, an ultrasound was set up for an anatomy scan and to check my placenta position. I was also tested for GBstrep and if it came back positive I would have been given antibiotics during labor (at home), she also would not offer a water birth if there was any sign of meconium once my waters broke. I just want you to know that we are not ALL quacks. Some of us chose to do so because the local hospitals push very risky unnessesary interventions and we felt in a healthy situation this was our best choice. (I had delivered before at a hospital and we do not have birthing centers where I live)

    • Captain Obvious

      Did she carry pitocin, cytotec, methergine, hemabate, a Bakri ballon, and blood products if you bled? Did she have oxygen and a bag and mask set up? When was her last NRP recertification? Can she intubate? does she have a ventilator? Did she have back up help if a shoulder dystocia occurred? Extra hands to help with SD manuevers? Can she repair a cervical laceration, or a fourth degree laceration? Can she open and repair an expanding vulvar hematoma? If you had a velamentous insertion of the cord to the placenta, could she perform a manual extraction of the placenta? Would you tolerate a manual extraction of the placenta? If you needed an urgent or emergent D&C how could she do that? Can she perform a vacuum or forceps if the FHR dropped while pushing and you needed an expedidated delivery? Could she perform an emergent cesarean? Then you really took a risk with your baby, because these things are not that uncommonly needed with low risk deliveries.

    • fiftyfifty1

      “she also would not offer a water birth if there was any sign of meconium once my waters broke”
      Just as a point of comparison, in England you would be transfered to the hospital if the fluid showed meconium, not just risked out of the waterbirth part. So yes your CPM sounds less risky than the average CMP, but that isn’t saying much.

    • MikoT

      Our Midwife was a labor and delivery RN before she went on to become a CPM.

      A labor and delivery nurse is not the same as a CNM, and does not have anywhere near the same level of training.

      push very risky unnessesary (sic) interventions

      Oh here we go again.

      Firstly, the interventions themselves are very low risk despite what the crystal gazing crowd will tell you.

      Secondly, they are done in response to known risk factors to reduce risk. There is no way of knowing after the event which interventions were necessary and which ones weren’t, only that fewer babies die overall.

      we felt in a healthy situation this was our best choice

      The truth is not a matter of opinion, and all the handwaving in the world is no substitute for rigorous empirical analysis.

      I suppose this is the part where you tell me that all mothers are different and that we should put aside a hundred years of obstetrical knowledge in favour of a midwife’s intuition.

  • fiftyfifty1

    Great! So a mom on her 5th baby with a BMI of 39.5, a hematocrit of 31%, and a blood pressure of 139/89, who went off her antidepressants just so she wouldn’t risk out would be an acceptable candidate! Yikes!

    • Bombshellrisa

      You have a point there-I would also like to add that just because they *say* on the website that they won’t accept women with certain conditions, it doesn’t mean that they won’t. Seriously, the midwives that delivered my husband knew that my mother in law had Hodgkins lymphoma-it didn’t stop them from taking her money and helping her plan a home birth. The midwife was the first CPM in WA state, what an example of practice she left for the other midwives to follow.

  • fiftyfifty1

    ” A monster episiotomy and a vaccum would’ve most likely saved this baby”

    No, not at all. Shoulder dystocia is a bony problem not a soft tissue problem so an episiotomy in itself doesn’t help. It’s true that an episiotomy is often cut with a S.D., but that’s just so you have enough room if you have to resort to the internal Shoulder Dystocia Maneuvers (e.g. reaching in and pulling out the posterior arm, intentionally breaking the clavicle, wood’s screw etc.). A vaccum is not useful when a baby’s head is already out. Vaccums can be useful if the baby is not coming down due to maternal exhaustion, but they should not be used in cases of anticipated bony obstruction.

    What would have saved this baby is a provider who knew the Shoulder Dystocia Maneuvers, and an immediately available team to do the resusitation.

    I do find it interesting that the EMTs were able to unstick the shoulder dystocia but the midwife wasn’t. This speaks very poorly for the training of this midwife. Probably no experience beyond McRoberts and the “infallible” Ina May position.
    I feel awful for this mother, this father and those poor EMTs.

    • I don’t have a creative name

      Really? Interesting. Just going by what she told me. 🙂

      Man, am I glad I am done having kids. So much can happen.

      • fiftyfifty1

        A vaccum and an episiotomy can save a baby for sure if the baby is in the birth canal and not getting enough oxygen and you can’t safely wait for spontaneous delivery. Then yeah, cut an episiotomy and use the vaccum (or forceps) and get the baby out. This is likely what happened to your friend. But that’s totally different than a shoulder dystocia. A shoulder dystocia is a bony impaction of the baby’s shoulder against the mom’s pubic bone. The head is already out. Yanking on the head of a baby impacted bone-on-bone is a very bad idea….

  • CitrusMom

    I am 36 weeks pregnant so I *really* don’t want to read this story if I could find it, but am curious, did they have indications of heightened risk for SD? I am a proponent of hospital birth (this will hopefully by my 3rd) so don’t misunderstand my question. I’m just wondering if this particular danger was heightened here and ignored, or they didn’t test for size, or if it was just bad luck to have an SD. BTW this was the thing I was most scared of with DB1 because it seemed like even in a hospital it was not a 100% guaranty that they could resolve it.

    • Alicia

      From has been shared of the birth story (the birth was only a few months ago so the mom is still very fresh in her grief – not a lot of medical details are written about), there seems to have been no indication that there would be a problem with SD or anything. The baby’s head was delivered and the next thing the mom knew, there was a problem. Delivery was attempted at home with the help of EMTs, then (from what I understood) the baby was born in the ambulance. But since not a lot of details of the pregnancy hasn’t been shared, there’s no mention of any risks.

  • I have four children, all of whom were born in the hospital. However, the first and third (with my ex-wife and current wife, respectively) were attempted homebirths that were transported (not, however, in a pell-mell emergency fashion). I have even had Ina May Gaskin stay at my house for a couple nights when she and Stephen visited our town and needed lodging.

    My interest all along has been in following the most prudent evidence-based approach; I am not the type to go after something because it is flowery “woo”. From the time my oldest was born in the year 2000 to my youngest in 2012, I have seen a sea change in the approach used in hospitals: rooming in, encouragement of breast-feeding, etc. have replaced the old retrograde approach that was still in place here in the Midwest a decade ago. It said something, I thought, that so many of the approaches favored by midwives were being adopted by hospitals, doctors, and nurses.

    But I am always willing to change my mind if the evidence points me there. In that respect, the statistics I have seen on this blog relating to perinatal mortality are very interesting food for thought. However, when the mortality risks we are trying to prevent are described as being rarer than one in 600, I wonder if the use of hospitals is overkill based on a sentimentality around babies. Is it not perhaps true that rare conditions could be prevented from killing anyone if we all lived in hospitals all our lives? Particularly in the case of older or higher risk people with health conditions, this must be true; yet, we as a society understand that we cannot afford to do this, nor do we want to subject everyone to this extreme a precaution to save a relative few.

    So even if choosing homebirth creates additional risk, is that additional risk commensurate with the level of additional risk we allow in other ways, like taking our children with us on car rides? Even car seats and seatbelts are not foolproof, after all. And we allow them to ride bikes, skateboards, swim at the lake, eventually drive cars themselves…see my point?

    My youngest child was born last year by scheduled C-section. A controversial choice for the crunchy members of our social circle to be sure; but after experiencing three children with head circumference beyond the 99th percentile, my wife and I did not feel any other option was reasonable at that point in our situation–and sure enough, his head was the largest of all four, and in fact he was the largest baby ever born at that hospital in its decades-long history. But my wife chafed at being required to submit to continuous fetal monitoring while waiting for the C-section to be prepared. The nurses and administrator insisted on it, chalking it up essentially to “better safe than sorry”. But remember: this was a scheduled C-section. Whatever might have happened during that hour or two of waiting would have been statistically much more likely to happen in the many hours and days that preceded our arrival at the hospital.

    Follow this to its logical end, and the only way to really be safe would be to have pregnant women spend their entire pregnancies, or at least the last trimester, in the hospital with continuous fetal monitoring. Of course, this will never happen: it is too expensive, and women would not put up with it. So we have to tolerate some level of risk beyond what we could conceivably achieve with modern medicine; the difficult trick is deciding where to draw the line. If a family draws that line somewhere a little higher than you would, but still within a level lower than a one in 600 mortality risk, are they really being so monstrous?

    • Dr Kitty

      Alan…some of what you have written comes off as a little…eugenicist, or “don’t worry, you can try again”.
      Not helpful, respectful or even true for many people.
      It is not sentimental to want all of your children to survive and thrive.

      If a family knows they have a one in 200 chance of UR and still choose HBAC, personally I think they’re crazy, but entitled to their choice. The problem is that without MANA releasing their statistics NO ONE has any idea what the risk of HB in the USA, as currently practised, is. With almost 30,000 HBs on the books we should have some idea, the fact that we don’t….I’m guessing the risk is higher than you think.

    • KarenJJ

      “If a family draws that line somewhere a little higher than you would, but still within a level lower than a one in 600 mortality risk, are they really being so monstrous?”

      If that’s all it was then it’s really not such a problem. People make different choices and choose different risks for themselves and their families. Such is life.

      Instead, there are people calling themselves ‘midwives’ when they really aren’t trained in anything much recognisable as midwifery any where else in the developed world, websites egging on women in to ‘stunt’ birthing their VBAC breech twins and enormous amounts of misinformation along the lines of sucking on a cinnamon candy and blowing on a hemorrhaging woman to stop