Empty arms, broken heart, another homebirth death


Another homebirth death …

From The Experience Project:

I lost my son … in Feb 2013 at 40 weeks 2 days during delivery, the last pushes killed him official cause was cord prolapse. The hospital staff tried everything possible to revive him for 26 minutes after his birth but he never came back to us. He was 8lb’s 6oz and absolutely perfectly beautiful. I miss him, my arms ache, my heart hurts, my breasts ache every time I am around a baby …

… with all the heartache, bewilderment and questioning that accompanies a homebirth loss:

I have gone through feelings of guilt I should have done something different … I do still blame the midwife as I do feel she was not monitoring him very well at all & was very against me going to the hospital & told my husband that all women say that they wanted to go & to ignore me until I insisted screaming for my husband to call 911 when she finally used the fetal doppler to check his heart rate & he was fading fast…

This was our first baby we had no way of knowing how things were supposed to be we were clueless thinking we were going to have this beautiful romantic home birth & instead we live in a nightmare…

The doctors and nurses struggled to save the baby:

His heart stopped almost as soon as I was transferred from the the stretcher to the hospital stretcher as they were trying to position him for an emergency C-section his heart stopped & the Dr said it was to late for a C-section he was wedged to far down in the birth canal. I pushed with everything I had & finally delivered him within minutes …

But it was too late:

He never took a breath I didn’t understand he was dead I didn’t believe them when they told me he was dead. I remember … thinking his little blue body was perfect & beautiful & thinking of course that is what he looked like. I petted his head as the Dr cut the cord & told him “Hello” then he was whisked away to a warming table set up in the room across from my bed & I watched as they were performing CPR the hospital staff did such a good job that he turned pink but his heart never beat on it’s own & he never took his first breath.

I kept saying they made a mistake as I cuddled his lil body I finally asked the Dr if there was a mistake & was he really dead & he told me with tears in his eyes that yes he was dead.

And the midwife?

She said her name was Sharon Kocher however we found out this was not her “real” name I think her “real” name is Victoria I don’t know her last name… I forgive her but I pray every night that God will block her from practicing again.

A bit of internet research revealed this:

Victoria Kocher helped bring tiny Ethan Criswell into the world in the home of his parents, William and Cheryl Criswell.

Despite Ethan’s diminutive size and physical ailments, Kocher said she saw no reason to call the hospital. “He looked tiny, but what’s my judgment of small?” she said. “He breathed good … I saw no risk.”

Ethan, who authorities said was delivered seven weeks premature, weighed less than 3 pounds and suffered from multiple birth defects, was born March 14. He died seven days later at an area hospital.

Ethan’s parents are charged with involuntary manslaughter. Kocher, who said she served as the family’s labor coach, is charged with child endangerment…

The Criswells, through their lawyer, tell a different story. “She represented herself as a licensed practicing midwife,” said attorney Lynn Johnson, who also accused Kocher of lying about her name. “The Criswells knew her as Sharon, not Victoria.” …

Kocher refused to comment on the allegation she used an alias. According to court documents, she has also used the names Sharon J. Kocher, Vicky J. Newman, Victoria J. King and Victoria J. Smith.

According to another news story:

Victoria Kocher later pleaded guilty to a charge of unauthorized practice of midwifery and was sentenced to five years probation.

The mother who posted her story on The Experience Project is left with empty arms and a broken heart:

I have felt that all this is a nightmare that I will wake up from since that day. I think about him everyday, I grieve everyday, I have returned to life in someways it does get easier to cope but I do not think I will ever stop grieving for him.

261 Responses to “Empty arms, broken heart, another homebirth death”

  1. monica james
    December 10, 2013 at 6:08 pm #

    My husband and I has been through so many trials with family deaths and his illness, that changed both of us. I became an unhappy and unappreciative wife. My husband left. My relationship with him was suffering. Him leaving was the worse thing that ever happened to me, that wake’s me up crying all nite. I started working with Dr Sango as a stander. But little did I realize that Dr Sango was going to reveal all the things in me that needed to change. helped me see the kind of man I’m supposed to be with. and i started seeking the hand of Dr Sango to change my heart and my husband’s. I had to accept that I could not change my husband, only Dr Sango can do that. I went to my husband and asked for his forgiveness for all my shortcomings as a wife. I asked him to give me another chance. He is now home.thank you father for job well done in my life you can also reach him via email address : sangospelltemple@gmail.com

  2. lovedmymidwife
    March 30, 2013 at 2:40 am #

    Clearly this woman, Kocher, is not educated enough to do what she says. People like this shouldn’t call themselves midwives. Midwives, real midwives, are wonderful care providers. My midwife is a CNM and not only did she do my pre and post -natal care, she gave me a pap smear, is certified in neonatal resuscitation, has a wonderful relationship with our hospital and the doctors there. My daughter was born in a birth center with a CNM, a CPM and 3 nurses present. The labor was perfect, the pain minimal and the birth flawless. My baby was born crying and perfectly healthy. No complications no issues. It is possible to have an out of hospital birth in which everything is completely fine. Midwifery is not the problem here. There are stupid doctors who screw things up too and they shouldn’t be allowed to call themselves doctors either. Personally I did copius amounts of research on the midwife I chose, I do the same when choosing a doctor. Be proactive about your care people.

    • March 30, 2013 at 8:29 am #

      The labor was perfect, the pain minimal and the birth flawless.

      So it wouldn’t have mattered if your midwives were idiots.

      Of course it is possible to have OOH birth without problems. That IS the problem – knowing whether yours will be one of them, and how well even the most wonderful, well trained midwife will do if it goes pear-shaped, and you need resources a midwife simply doesn’t have.

      Post hoc, ergo propter hoc.

    • Poogles
      March 30, 2013 at 9:42 am #

      “Midwifery is not the problem here.”

      You’re right…real midwifery is not the problem here. Lay midwifery, like CPMs/LMs/DEMs however, is the problem.

      “There are stupid doctors who screw things up too and they shouldn’t be allowed to call themselves doctors either.”

      There are ways to hold a doctor responsible if they commit malpractice, including revoking their license, if the malpractice was egregious enough. There is currently no real way to hold lay midwives responsible, even “licensed” CPM’s are usually let off with no more than a slap on the wrist, even in the worst cases of malpractice leading to death.

  3. wantsanswers
    March 25, 2013 at 11:01 pm #

    Please how did you track down all the information about Sharon &/or Victoria Kocher?

  4. Mac Sherbert
    March 25, 2013 at 1:48 pm #

    This is just wrong. I came to this site looking for information about VBACs that wasn’t all sunshine and flowers. Now I can’t keep stop reading, but I wish I could. Thankfully, CPMs are not legal in my state. They are trying to get legal status and stories like this will keep me writing the legislature to make sure they are never legal here!

  5. theadequatemother
    March 25, 2013 at 10:29 am #

    OT: Dr Amy I want to wish you and yours a happy Passover!

  6. Lisa from NY
    March 25, 2013 at 8:12 am #

    Enochs Mom posted a response to her own essay:

    “She didn’t share that some of the herbs or methods she used carried a great deal of risk & actually made my labor much more difficult than it should have been.”

    What herbs?

    • Susan
      March 25, 2013 at 10:37 am #

      My guess is Blue and Black Cohosh ( one may be worse than the other). Both have the side effect of decreasing uterine blood supply from what I understand. I am always stunned by all the posts of midwives that use this that decry medications we use in the hospital which are well researched and monitored.

      • The Bofa on the Sofa
        March 25, 2013 at 11:17 am #


        If midwives CAN give it or do it, it’s good
        If midwives aren’t allowed to give it or do it, it’s an evil intervention

  7. Lisa from NY
    March 25, 2013 at 7:54 am #

    Sharon Kocher is not a licensed midwife. It is wrong to lump her with midwives.

    • Gene
      March 25, 2013 at 10:10 am #

      Agreed. Any CNM should be offended that someone with little to no training (aka: DEM, CPM, or what-ever alphabet soup these frauds make up) is claiming to have as much training and experience as s/he does.

  8. Ontario Midwife
    March 24, 2013 at 6:55 pm #

    This woman is a criminal and is in no way representative of the profession of midwifery. Sometimes this site and Dr. Amy make good points and raise important issues. I wish that it was made clearer who is being criticized when you refer to midwives.

    • auntbea
      March 24, 2013 at 7:22 pm #

      This woman is a midwife. She calls herself a midwife and her client calls her a midwife. You’re apparently in the community: if you do not want this woman taking that title, do something about it. Lobby for regulation. Call the relevant ADA and ask her to be prosecuted. Gather all the midwives who feel the way you do and push for standards of care. Don’t just insist she’s a bad apple.

      • Certified Hamster Midwife
        March 24, 2013 at 7:51 pm #

        If an OB engaged in this kind of behavior, other doctors are in a position to stop her.

    • Bombshellrisa
      March 24, 2013 at 9:13 pm #

      Dr Amy has made it clear on many occasions that it’s the “traditional birth attendant”/DEM/CPM midwives that need to be stopped. There are midwives that work within a system that allow homebirths (Ontario is one of those places, right? As well as parts of Australia and the UK and the Netherlands) within a strick criteria and those midwives are well educated and trained-she does not speak out against midwives with real education.

    • The Bofa on the Sofa
      March 25, 2013 at 11:46 am #

      As auntbea says, instead of complaining about Dr Amy, why don’t you join with her in trying to getting rid of those supposed “bad apples” who are giving midwives a bad name?

      I’ve said it many times, if your defense of your professional consists of “we aren’t all quacks” then you have got a problem. Being a midwife yourself, you are among the best suited to help fix that problem. Dr Amy is not going to be able to do it, because she gets dismissed as being a meen OB.

      You may like to think that quacks like this are “in no way representative of the profession of midwifery,” but it is clear that they are far too much the face of it. Doesn’t that bother you? It would sure bother me.

  9. Felicitasz
    March 23, 2013 at 10:31 pm #

    (Why on the planet do I come here to read before bedtime?!)
    I am so outraged I am out of here before I say something truly unladylike.

  10. Lena
    March 23, 2013 at 1:46 pm #

    I’m not a crier, but this story just got to me. Every story of loss that I’ve read here has broken my heart, but for some reason I have tears running down my face this time. I can just feel the pain and the shock and the confusion in her words.

  11. Alicia
    March 23, 2013 at 1:45 pm #

    How many more babies have to die before this woman (the “midwife”) goes to prison?!

  12. Anon
    March 23, 2013 at 9:53 am #

    My son was born nine days after Enoch. It was a completely uneventful pregnancy, which was preceded by two healthy pregnancies and completely straightforward NSVDs. My labor was uneventful until I was complete, at which point he developed dramatic bradycardia, which my nurse immediately recognized thanks to continuous monitoring. It resolved, and then recurred while I was pushing, which signaled to my doctor that he needed to get out immediately, and he was, with his cord wrapped all around his little body. At a month old, he is thriving, smiling at us, getting squeezed by his sisters on an hourly basis. Enoch’s mom has empty arms and a permanently broken heart. Without the expert care I received, that could be me ( and my family.) my heart breaks for all of them, but especially Enoch, who never even had a chance.

  13. Olga Mecking
    March 23, 2013 at 8:30 am #

    This is so sad and heart-breaking. I can’t belive how irresponsible these midwives are! Especially that a week ago, I gave birth to a healthy baby boy. I planned to have him in a hospital-based birth centre. Only he had meconium in the waters and so the midwife sent me to the hostpial, where several great and very kind doctors and nurses monitored his heartbeat. I was given pain relief (no epidural, just a shot of pethidine, which made the contractions manageable, and allowed me to go through transition without even noticing it). My son was born somewhat blue, but soon pinked up and started breathing. The whole birth took all of 4 hours, 5 minutes of pushing. I required all of one stitch. Not only I now have a beautiful baby boy, who is alive and healthy, but a good experience in the hospital. A few days after birth I was as good as new, and am almost back back to normal. Somebody once commented that they should stop reading this blog because it’s too sad. I agree. And now excuse me, I am going to hug my son- and my two other girls. I am so so sorry for this mother’s loss. I hope the midwife will be punished.

    • Durango
      March 23, 2013 at 9:13 am #


    • Amazed
      March 23, 2013 at 11:21 am #

      Congratulations! So happy for your little guy.

  14. Amazed
    March 23, 2013 at 6:41 am #

    I am thinking of how eerily this story resembles the story of Birdie’s Mama, Erin Newman-Long. They were both fascinated with the ideal of a beautiful, romantic homebirth, a perfect homebirth, as nature intended all births to be. And they both ended up with a tragedy.

    Midwives like the ones who supported their illusions are freeloaders, pure and simple. They are having a free ride on the OBs’ success. Two hundred years ago, no one would have thought about a romantic birth – parents and midwives alike prayed for a live mother and child and considered themselves damn lucky if they got this because they were all too aware that Mother Gaea was a cruel deity. Now all midwives can sell is the ideal that they themselves created and cultivated. After all, what can they offer if the charm is broken, the illusion destroyed? And midwives themselves may not be realizing what they are selling – they are being taught that everything is a variation of normal, so they lie without actually lying. It’s a vicious circle.

    Poor baby Enoch and his family.

    Oh, and since I am sure that all midwife supporters and especially Sisters in Chains will start howling how the mother won’t “persecute” the midwife, so why is the nosy state poking its long nose in other people’s business: it is absolutely the state’s business. It shouldn’t be the parents’ job to demand justice. Justice should be delivered, no matter the parent’s wishes. Otherwise, we’re back again to the gool old time before there was no law. I suppose it’s the same time whern all cavemen were happy and all cavewomen delivered singing ’cause that’s what nature intends.

  15. Kate
    March 23, 2013 at 4:03 am #

    My full term baby was 5 pounds, and she was tiny. A 3 pound baby being described as “small”? Understatement of the year.

  16. Sue
    March 23, 2013 at 3:12 am #

    The site where the story was originally posted shows you comments of at least two more mothers who lost babies in HBs.

  17. Meagan
    March 23, 2013 at 12:15 am #

    The whole thing is chilling, but oddly enough, this is the part that made me stop in shock: “…told my husband that all women say that they wanted to go & to ignore me” I wonder how many midwives feel this way. I also wonder how many “warn” expecting mothers that they are likely to want to go to the hospital at some point but “won’t need to” and how many just promise uncomplicated beauty, then let the new parents forget that time of panic in the happiness of the birth that *usually* turns out ok?

    • fiftyfifty1
      March 23, 2013 at 9:11 am #

      ” I wonder how many midwives feel this way.”
      Every single one of them to some degree or another.

    • Lena
      March 23, 2013 at 1:43 pm #

      I’ve read so many home birth stories where women ask to be transferred for pain relief and are refused, but because the end result is a healthy baby they tell themselves they’re grateful for having their wishes ignore. Even Rixa Freeze once said that the reason she gives birth at home is because she knows that if she were at a hospital she’d ask for an epidural, because, you know, that the absolute worse thing that can happen.

      • BeatlesFan
        March 23, 2013 at 7:24 pm #

        Meanwhile, if they have their wishes ignored in a hospital, it’s tantamount to rape, even if the result is a healthy baby. The hypocrisy astounds me.

    • Bombshellrisa
      March 23, 2013 at 1:59 pm #

      I know that when transfers were mentioned during prenatal appointments, the CPMs I knew said that “oh, those are almost always for pain relief” and acted like if you absolutely HAD to have the evil epidural, then they would transfer you but really, since it’s only pain relief and you are a goddess birth warrior, you should be just fine at home or the birth center.

      • Aunti Po Dean
        March 24, 2013 at 3:44 pm #

        yes and on MDC there is the view that a trasfer for pain relief shouldn’t then go on intended place of birth OOH birth stats …like this is the worse thing tht could happen

        • fiftyfifty1
          March 24, 2013 at 4:57 pm #

          This makes me wonder how this works in Oregon. If a woman transfers from home for pain relief she still gets “home” listed as intended place of birth, correct?

          • Jessica
            March 25, 2013 at 11:08 am #

            Yes. The birth certificate doesn’t ask the reason for the transfer, just whether the mother went into labor planning to deliver outside of a hospital.

    • Sue
      March 24, 2013 at 3:35 am #

      So the reason you pay a lay MW is to stop you going to hospital to access pain relief or increased safety? I’ll say it again – save the money, start UCing at home, then transfer early.

  18. Sue
    March 23, 2013 at 12:09 am #

    Is there, anywhere, a body representing midwifery who looks at adverse outcomes like these and refines their practice guidelines accordingly?

    Most professional groups would warn their members with anecdotes like this, with advice about what errors were made and how to prevent recurrences. Is this done anywhere within midwifery?

    • fiftyfifty1
      March 23, 2013 at 9:11 am #

      ha ha ha ha

      • March 23, 2013 at 2:07 pm #

        Maybe we should consult a noted anthropologist?

        • Bombshellrisa
          March 23, 2013 at 4:46 pm #

          Or a public health scholar

          • Siri
            March 23, 2013 at 5:22 pm #

            Nooooooooooooooooo!! Anyone but the dreaded public health scholar. Take it back, quick! Or you’ll conjure her up, red hair and all.

          • Sarah
            March 25, 2013 at 8:15 am #

            Hahaha I’m a red head doing my masters in public health… So far away from TFB though!

          • Kalacirya
            March 25, 2013 at 10:06 am #

            So what you’re saying, is that your red hair comes from a bottle? You can’t be far away from Gina and have real red hair, that all the haterz are jealous of.

          • Sarah
            March 25, 2013 at 7:40 pm #

            I’m in Australia- natural red head but funnily enough don’t think the whole world revolves around ME ME ME. And I work in a maternity hospital in a clinical role but wouldn’t dare suggest I knew anything about birth or labour compared to the amazing obs I know!

        • Aunti Po Dean
          March 24, 2013 at 3:46 pm #

          or a birth advocate

    • Captain Obvious
      March 23, 2013 at 9:51 am #

      No, but there is a book circulating among the midwives I think called “from calling to courtroom” which helps them defend their incompetence.

    • Squillo
      March 23, 2013 at 11:29 am #

      The only American midwifery association that even has clinical practice guidelines I’m aware of is the ACNM.

      There’s absolutely no incentive for homebirth midwifery orgs to create guidelines because there’s virtually no penalty for bad outcomes. Why would they voluntarily establish standards of care?

  19. Sue
    March 22, 2013 at 10:14 pm #

    If Enoch’s mother ever ends up reading this, I would like her to know that the deceptive midwife should take responsibility for this tragedy. You and your husband wanted to go to hospital and she discouraged you. I hope your story will prevent other tragedies, which is the reason why it was posted here.

    • Amazed
      March 23, 2013 at 1:26 pm #

      I bet this midwife will take just as much responsibility as Rose Kacary who said it was ‘unfair’ of Simon Teague to not take some responsibility for his wife freaking DYING after Ms Compassionate Midwife left a part of the placenta inside.

      • Eddie
        March 23, 2013 at 1:36 pm #

        What I find astonishing about the people who defend these midwives is that they always seem to say, “She was so caring,” as if that is far and away the most important attribute of someone who medically attends a birth.

        • anon
          March 23, 2013 at 2:52 pm #

          But if you follow their logic, it’s not astonishing at all- these are people who truly believe that “there’s nothing safer than birth”. By that logic, your mailman could deliver your baby. There’s no expertise required, and therefore, the only time bad things happen is when the provider just doesn’t care about you- and since everyone knows that doctors are callous, horrid people, then it stands to reason that bad things happen in hospitals. A midwife, who has four hour long appointments and brings you cookies and sews you curtains or whatever the eff it is they do during those eternal appointments, cannot possibly have a bad outcome. THEY CARE SO MUCH.

          • Eddie
            March 23, 2013 at 4:29 pm #

            Good point! I just can’t get my head around that logic.

        • Amazed
          March 23, 2013 at 3:05 pm #

          Ah yes, the caring. I can’t see how caring is a substitute for competence, I simply don’t get it. I still can’t fathom what the Kerr family paid Lisa Barrett for. What does “holding the space” mean? I am really short of money right now. Can’t I hold the space for an expectant couple? If they pay me well enough, I’ll be your faithful, most caring Amazed! Can’t these people realize that they buy their midwives’ caring just like they buy their, no doubt, organic food?

          It’s ridiculous. It’s funny. It’s tragic.

          By the way, Sarah Kerr who claimed she knew the risks involved, still wailed that she was not informed about the specific risks of having twins. Guess who “didn’t inform her”? Not the caring, wonderful Ms Barrett. The big bad she-wolf, I mean, lady doctor.

        • Squillo
          March 23, 2013 at 3:25 pm #

          Right. She just didn’t care enough to get an adequate education to make her a competent healthcare provider.

        • Siri
          March 23, 2013 at 5:08 pm #

          Like normal birth, ‘caring’ needs to be a retrospective diagnosis.

      • Siri
        March 23, 2013 at 5:10 pm #

        Come, come – she said ‘a little bit unfair’ . And Claire did have a lovely spontaneous birth… Urrrggghhh. Evil woman.

  20. Lisa the Raptor
    March 22, 2013 at 10:12 pm #

    Oh, poor woman, poor father and poor baby. This midwitch woman needs to be in jail! This is the perfect example of the frauds that call themselves midwife. How can anyone not see that without keeping them regulated, anyone can be a “midwife”? This is all just such a freaking waste.

  21. Sue
    March 22, 2013 at 10:12 pm #

    This is the kind of story that makes me think that UC may be safer than an incompetent “MW”. Then there might be no obstruction to people calling an ambulance and going to hospital early.

  22. Charlotte
    March 22, 2013 at 7:35 pm #

    My heart goes out to this family. They and baby Enoch were the tragic victims of the criminally negligent fake midwives and deadly culture of NCB lies that this blog exists to fight against.

  23. CDNGuest
    March 22, 2013 at 6:19 pm #

    Somewhere in all of this there must be grounds for criminal prosecution, or at least a criminal investigation. Negligent homicide. No different than the charges they would lay if it was a drunk driving accident.

    I feel absolutely broken for this family. My deepest condolences.

  24. March 22, 2013 at 6:03 pm #

    How utterly tragic. My heart aches for baby Enoch’s parents and I’m filled with absolute rage and disgust at the midwife. To me it would seem that she was deliberately working under an alias to prevent clients finding out about her past. Sickening… I feel nauseated to think of the selfish evil involved in an act like that.

  25. March 22, 2013 at 3:50 pm #

    Nope. Nothing wrong with our home birth midwifery system here in the USA. Nothing wrong at all……

  26. Amy
    March 22, 2013 at 3:46 pm #

    It is obvious from these posts that homebirth with an incompetent midwife is not a problem exclusive to reasonably educated middle class white women. Clearly the poorly educated are falling victim as well.

  27. DiomedesV
    March 22, 2013 at 2:27 pm #

    How tragic. My deepest sympathies to the mother.

  28. quadrophenic
    March 22, 2013 at 2:25 pm #

    This is so heartbreaking. No family should have to endure this.

    Which leads me to question this: I am sure that many homebirth midwives are far more competent than this person, and would have transferred at the first sign if trouble. Why aren’t the trained, competent midwives speaking out against these charaltans? Where is the outrage from the homebirth community? Isn’t it in their best interest to keep homebirth as safe as possible under the circumstances and create standards for training and licensure? I can’t imagine any profession not wanting to weed out incompetence, especially when innocent people lose their life as a result.

    • The Bofa on the Sofa
      March 22, 2013 at 2:41 pm #

      It’s a curious thing. There are places that “license” midwives. However, that doesn’t stop anything, as the midwives either run around working unlicensed, which may or may not be illegal, or go to places where licensing is not required, which means that they are not beholden to any regulation at all.

      I agree that it makes no sense that the supposed “good” ones aren’t up in arms about these clowns. Yet, whenever they come to comment here, all we hear is “not all midwives are like that” and they get all defensive. I have said this many times, it seems to me that the “we aren’t like that” midwives should actually be agreeing with Dr Amy. I’ve come to believe that is because they are afraid to criticize what others are doing because they fear that they won’t stand up to scrutiny themselves (glass houses and all that). You start criticizing others, you will have to face the criticism yourself.

      I’ve said it many times recently, if your defense of your profession is “We aren’t all quacks, there are some good ones” you have got a problem. It means that the quacks are way too extensive in your profession, and/or they have way to much power that prevents the “good ones” from doing something about it.

      • quadrophenic
        March 22, 2013 at 2:59 pm #

        Coming from a profession that is strictly regulated and licensed (law) I guess it’s just hard for me to understand why you wouldn’t want standards in your industry. The value of your services go down if you don’t have minimum standards in your profession.

        You’re absolutely right about the “we aren’t all quacks” defense. It’s just embarrassing.

      • March 22, 2013 at 7:46 pm #

        From what I can tell – the Powers That Be in midwifery actively work against accountability and shelter incompetent midwives.

        The strongest evidence of this is that the only midwives that will speak out in public are no longer working as midwives. If it is so costly to speak out against even obviously negligent midwives, then the push back in the community and power structure must be significant. This push back rarely happens without the assent of the powerful, silent or otherwise.

        • Sue
          March 22, 2013 at 10:23 pm #

          I also don’t get why the professionally-trained midwives won’t call out the rogues. Don’t the unlicensed/lay providers make a mockery of the years of training and experience of the professional specialist-nurse MWs? Why subject yourself to standards and regulation but not speak out against those who flaunt the standards? We’ve talked about this before, but there hasn’t been a good explanation of the politics/dynamics.

          • March 23, 2013 at 8:14 am #

            Some people have confidential information. Sara Snyder has some. The Navel Gazing Midwife likely has more.

            There’s a fascinating sociology study that detailed the social networks of drug users. It should be easier to illustrate the social networks of midwives, if someone could gain entry.

          • Siri
            March 23, 2013 at 5:04 pm #

            A mole! We need a mole! An agent provocateur. An undercover op. Will you volunteer, Anj?

          • Siri
            March 23, 2013 at 5:06 pm #

            Agente provocateuse in your case. I think. My French is a bit rusty.

          • March 24, 2013 at 6:01 pm #

            I make a LOUSY spy. You need some who can play the game well. 😛

          • March 23, 2013 at 8:20 am #

            What it comes down to in the end is the advocacy of friends and family is enough to convince people that a care provider is trustworthy. That plus some irrational optimism keeps these midwives in business.

            They’ll stay in business unless their community calls them out or the law comes for them.

        • Something From Nothing
          March 23, 2013 at 12:12 pm #

          Hmmmm… Sorta reminds me of the Catholic Church, moving pedophile priests around and covering up a scandal to protect their own interests. Home birth midwifery is religion, and I despise religion in all its forms. It corrupts the human mind.

          • Captain Obvious
            March 24, 2013 at 4:50 pm #

            It is hard being raised Roman Catholic and finding out all these atrocities. Haven’t really gone back to church since my mom died from ovarian cancer. And with all the other issues coming to light, I practice do onto others as they would do onto you. Yet I sit here during a spring snowstorm watching The Bible.

          • March 24, 2013 at 6:09 pm #

            Eh, I made a religion analogy/joke about sports right before the Sandusky scandal broke. It’s not religion, it’s people and organizations protecting themselves by sheltering perpetrators.

            The bigger and more powerful the organization, the bigger and badder things they can hide. To give Penn State credit, they learned from the RCC disaster and dodged for a short while before they decided it was more pragmatic to come forward than to let the story get completely away from them.

      • March 24, 2013 at 6:21 am #

        As I mentioned upthread, the most ardent defender of midwifery that I know personally (well, Ina May did stay at my house, but that was the only time I met her so I mean someone I know on an ongoing basis) also regularly complains bitterly about the really shady, inexperienced “midwives” she hears about that give the whole “industry” a bad name. And I’m not talking about in a defensive type situation: she brings these women up unprompted.

        BTW, did anyone notice this section of the article Dr. Amy linked to? I thought there would be some reaction, from her or from someone:

        A 1998 study from the National Center for Health Statistics and the Centers for Disease Control and Prevention revealed lower mortality rates for infants delivered by certified nurse-midwives than for babies born in hospitals.

        “There are definitely segments of the population that like to take control of their own birth,” said Diane Barnes, a certified nurse-midwife and director of WomanCare Inc. in Reeds Spring. “For a normal, healthy woman, being outside of the hospital can be completely safe as long as they have a qualified provider to make sure they’re safe.”

        • March 24, 2013 at 7:17 am #

          “completely safe”
          Any time that is used to refer to birth, in or out of a hospital, it is a lie.

          Birth is not safe. There are dozens of things that can cause injury, permanent injury and death. We can prevent some them. The rest we can attempt to prevent, but never remove the risk altogether.

          CNM or not, she’s still lying.

          • March 24, 2013 at 8:33 am #

            The operative word in Alan’s quote is “CAN be completely safe…” Yes, she can, and probably will be. The central problem is no-one can guarantee it, no matter how normal, healthy, low risk.

            In an inconsequential conversation with one of my daughter’s young carers (about Mary Wolstencroft, and her death in childbirth, and its effects on her daughter Mary Shelley) she tossed into the conversation that a schoolfriend had died in childbirth, aged 18. Bled to death. Aged 18. How could that happen? It isn’t an illness, you know.

            In the 21st century, most of the terrors of childbirth can and have been forgotten. But the saying about those who ignore history being condemned to repeat it comes to mind. Pushing the safety of childbirth is, at one level, fair and accurate and life enhancing for women – but it is also a lie, and a betrayal of women, who need to know that its safety can not be taken as a given.

            Presumably, fewer people die of heart attacks than previously. No-one is selling the idea that heart attacks are natural and you can have one at home. This is a poor analogy, I know – but sometimes a healthy fear is protective and precautionary.

            Are women adults, capable of dealing with reality, or children to be petted and reassured? What is the problem with giving them real, hard information? Not just the reassuringly low numbers of disastrous things that happen – but a bit more hard, reliable information on why? I have no idea why an 18 year old had a fatal hemorrhage – but I doubt it was because she wasn’t normal or healthy. Placenta praevia? Some rare complication where the bleeding could just not be controlled? Or the assumption that it couldn’t/ wouldn’t happen? Women need to know that birth is safer, not safe; about what is avoidable and what isn’t, what is inevitable and what isn’t, and nobody seems very keen on providing it. Why not?

            The saddest part of this woman’s story was her disbelief. Babies of normal healthy women do not die. But they do, and sometimes when they shouldn’t and safe not safer is not just a lie but a trap.

          • March 24, 2013 at 9:09 am #

            Nice catch. She likely phrased that way deliberately, because caregivers who are conservative and risk averse will talk about what the risks are and how they can be minimized.

            People who ignore risks don’t need to talk about risks, don’t want to talk about risks. They’ll talk about how safe something is, how rewarding something is, even how superior something is.

            I’ve seen two rhetorical strategies regarding risk/safety in child birth. One is to minimize the risks, offer reassurance (The hospital is ten minutes away.) and then move briskly on to extolling the benefits of ______ (NCB, HB, HBAC).

            The other one is to acknowledge ‘some’ risk but immediately follow it up by insisting the alternative is even more risky and/or expensive and unpleasant.

        • Rebecca
          March 24, 2013 at 10:19 am #

          Alan, That study has little to no bearing on the safety of homebirth, since 95% of CNM-attended births in the study were in hospital (and another unspecified fraction in birth centers). It certainly has no bearing on the safety of births attended by a CPM or lay midwife. Also, since the evaluation is centered on infant mortality, not perinatal mortality, it is most likely measuring something other than the relative effectiveness of different L&D attendants. Full text of the study is here:

          • March 24, 2013 at 2:23 pm #

            Thanks for the info. I would still like to see more of the kind of CNM that was profiled on the NPR story.

        • Susan
          March 24, 2013 at 12:07 pm #

          Alan- Dr. Amy has consistently had nothing but positive things to say about the CNMs she worked with in the hospital. I thought highly of the CNMs I worked with too! ( well, there was an exception…but that’s real life)

          • March 24, 2013 at 2:26 pm #

            That’s cool.

        • An Actual Attorney
          March 24, 2013 at 3:02 pm #

          Wouldn’t that be the logical outcome, since an educated (really educated not “educated”) CNM would transfer care to the OB when faced with troubling signs? It’s my understanding both from this blog and from med mal litigation that it’s never fine fine fine fine fine dead. That only happens with CPMs who aren’t looking for real markers.

    • Siri
      March 23, 2013 at 4:58 pm #

      The home birth community seems to be inhabited by singularly callous people, who find that it is worth ostracising and ignoring loss parents, sacrificing other people’s (and sometimes even their own) babies, and protecting dangerous midwives, all for the sake of avoiding any kind of discussion whatsoever of the risks and benefits of home birth.

      • Siri
        March 23, 2013 at 5:01 pm #

        I mean, just look at Lisa Barrett’s many supporters and admirers – bizarre ain’t the half of it! Look at Janet Fraser.

  29. Siri
    March 22, 2013 at 1:26 pm #

    Aaaarrrgggghhh!!! Enough death and suffering already! When will this madness end?! If you have ever seen a primate mother trying to make her dead baby come back to life, you know how much she suffers; how much more a human mother. The thought of her asking the doctor if her baby was really dead is just unbearably sad.

  30. PrecipMom
    March 22, 2013 at 1:14 pm #

    That poor mother. I don’t think that anyone reading her words could feel anything other than the greatest compassion for her loss.

  31. I don't have a creative name
    March 22, 2013 at 1:11 pm #

    How heartbreakingly tragic. I want to cry for little Enoch, and his grieving mom and family. Not every hb’er is of the vagina-worshipping, my-experience-matters-more-than-my-baby ilk. Some of them have just been genuinely duped, like this poor woman. Nothing will ever make it okay that Enoch died needlessly, but maybe his story can be used to avert other deaths. Enoch’s mom, if you ever read this, you have my sympathy and my prayers.

  32. Renee Martin
    March 22, 2013 at 1:03 pm #

    I found this when looking up this “MW”:

    “Senator Loses Leadership Post After Sneaking Midwifery Into Bill”
    (Google this, I can’t CnP for some reason)

    Just shows how underhanded MW supporters are. This guy credits a HB MW in saving his fifth baby, but the baby wasn’t even delivered by a MW. This is old, but important.

    • road2vba2c
      March 22, 2013 at 2:19 pm #

      An educated midwife knows when to say, “This needs to be handled by a doctor.” Just like any educated alternative medicine specialist, they will transfer care to a medical doctor when needed. A chiropractor saved my mother’s life. She had back pain and went in to the chiropractor for an adjustment. The chiropractor had her do a urinalysis and diagnosed her with diabetes and sent her to a medical doctor for treatment. Twice she had been treated by other less competent medical doctors with what we now know was symptoms of diabetes and given wrong diagnoses. Just saying I think the competent provider in general (medical doctor, chiropractor, herbalist, midwife) knows when to say, “I don’t know what to do, you need to go to someone better equipped to handle this situation.”

      • I don't have a creative name
        March 22, 2013 at 2:58 pm #

        An educated midwife knows when to say, “This needs to be handled by a doctor.”

        Like a CNM. The problem is too many CPM’s and DEM’s who are convinced of their own infallibility with issues of labor, delivery, and neonatal assessment, despite little to no medical training. We have no problems with TRULY educated midwives. But CPM’s and DEM’s are out there spreading the nonsense that birth is “safe” and therefore, “hire me! My lack of medical training is fine since this process is inherently safe!”

        • quadrophenic
          March 22, 2013 at 3:09 pm #

          I want to like this 1000 times. A true professional must acknowledge limits. As a lawyer I tell my clients when something is beyond my scope. My dentist tells me when an oral surgeon needs to step in. My GP told me when he needed me to see an ENT because he didn’t know what else to do for my sinus infection. Only the ignorant refuse to admit when they’re in over their heads.

      • Sullivan ThePoop
        March 23, 2013 at 10:11 pm #

        Considering that once you turn about 35 urinalysis for diabetes is standard care this story is hard to believe.

        • Certified Hamster Midwife
          March 24, 2013 at 7:46 pm #

          Or if you’re overweight. I’ve been getting urinalysis pretty much every time I visited the doctor since I was in my teens.

          The difference in this story is that she wasn’t at the doctor for a physical.

      • PrecipMom
        March 24, 2013 at 4:11 pm #

        The provider whose care came close to costing my daughter’s brain and possibly her life was a CNM. Well respected and with a great resume. She transferred us late (not until there had been an actual episode of apnea) and we only narrowly avoided brain damage.

        • Certified Hamster Midwife
          March 24, 2013 at 7:49 pm #

          Some people have training and then reject it. There seem to be some CNMs who are fully trained and practice in hospitals, and then catch woo and never quite recover.

    • March 22, 2013 at 2:20 pm #

      Yup, this is what allowed us to use a CPM for my wife’s first pregnancy in ’08-’09 (we would not have felt comfortable covertly using a DEM as friends of ours did before ’07).

  33. Renee Martin
    March 22, 2013 at 12:56 pm #

    I had a 33w preemie too, who was breathing fine (mostly) because of the steroid treatment I got pre labor. I cannot IMAGINE looking at her and thinking “all is well!” and she was #4! Preemies just look, well, funny. There is no way any sane person could see one and mistake them for term, or normal.

    Is this “MW” a religious “MW”? Usually people that ignore preemies are “putting it in Gods hands” or “doing gods will”, and are either aligned with a faith healing church of a QF denomination. (Or, they are just ignorant.)

    • LukesCook
      March 23, 2013 at 3:26 pm #

      And did neither the mother nor the midwife realise that the mother was in labour preterm?

  34. Renee Martin
    March 22, 2013 at 12:33 pm #

    But, but, but, Dr Amy, the baby died in the hospital! (alas, it *will* be counted in hospital stats) This has nothing to do w HB! /snark

    I do wonder if this Mom had been listened to, and transferred when she asked, if it would have been soon enough to save the baby. It wouldn’t have hurt.

    This is a common refrain in HB losses:
    “…[the MW] was very against me going to the hospital & told my husband that all woman say that they wanted to go & to ignore me…”

    I also wonder why, if home is SO wonderful, why “every mom” wants to go to the hospital? I also wonder how many screaming women this MW has denied proper care to? The myth of the caring MW, who listens and is in tune w you, just won’t die! No matter how many times they are shown to ignore women, be nasty, and stone faced in the face of pain, and their own negligence.

    This poor mom (and Dad, sibs, etc), that must have been a nightmare- to be mid emergency transfer, during pushing? OMG. The poor baby, he will never have a life.

    • Allie P
      March 23, 2013 at 10:15 am #

      “myth of the caring midwife” — So true! It’s only in midwifery where pain is thought of as something to ignore and people in pain should be told to suck it up. My nurse kept asking when I wanted my epidural. I said I could wait. She asked me to chart my pain on the scale and said “yeah, you’re going to want that epidural by the time I can get the Anesthesiologist here.” Pain is pain, and if a woman doesn’t want to be in pain, she shouldn’t be. Sadly, even in hospitals with midwifery practices, I’ve seen too often the midwives making the decision that women should “tough it out”.

      • Ashley Wilson
        March 29, 2013 at 7:19 pm #

        I have a “friend” who is training to be a L&D nurse. She’s very crunchy, had her baby at a free standing birth center, is anti vac, thinking breast feeding will cure EVERYTHING (this is why she went from a friend to a “friend”). Honestly I’m not surprised she hasn’t just decided to be a midwife and is actually going the science route. But she made this huge rant about once she is practicing she will opening deny women pain meds and will just tell them to tough it out.

        She is going to get fired so quickly.

        That’s when I bet she will start looking at being a CPM, because she has already proven herself to be a birth junky, integrating herself into my- and my friends- lives whenever one of us is expecting. Even when it is the worst kept secret that she hates that person, and that person hates her in return. You get pregnant and she is suddenly your best friend.

    • Aunti Po Dean
      March 23, 2013 at 6:38 pm #

      This is one of the reasons why intended place of birth is important to collect and why the recent Oregon data is so important because it does collect this

  35. March 22, 2013 at 12:33 pm #

    “the Dr said it was to late for a C-section he was wedged to far down in the birth canal.”

    Is this a thing? My younger daughter was born via non-emergency C-section after my wife had been pushing awhile and the OB could see and touch the top of her head.

    • I don't have a creative name
      March 22, 2013 at 1:08 pm #

      I wondered about this. I have a friend who had an emergency caesarean after she was quite far into the process. The doctor, as she tells it, had to reach way in there and grab the baby out by his feet. She was on abx shots for a while because of this and the baby had major Marge Simpson head for quite a while.

      • Amy Tuteur, MD
        March 22, 2013 at 1:30 pm #

        With prolonged pushing, the baby can develop swelling on the top of the head. This is known as”caput.” The caput might be visible but the baby’s head may be stuck much high and a C-section can be done. If the head is visible and has no swelling, vacuum or forceps are indicated.

        • Bystander
          March 23, 2013 at 4:08 am #

          That’s a chilling term considering how close it is to kaput: finished, destroyed, terminally broken. In a HB situation, that’s scarily close to the truth. 🙁

          • Captain Obvious
            March 23, 2013 at 10:39 am #

            It’s Latin, like many medical terms. The Latin word caput, meaning literally “head” and by metonymy “top”,has been borrowed in a variety of English words, including capital, captain, and decapitate

          • Amazed
            March 23, 2013 at 3:54 pm #

            I don’t get it. Dr Amy and Captain Obvious know things in such detail, they know the terms and what should be done, yet they are teh evil OBs who never saw a normal birth and just want to slice us all open. The midwife clown on MDC can’t tell the difference between mono and di twins but she’s the caring expert?

    • theadequatemother
      March 22, 2013 at 1:19 pm #

      I would assume that the baby was pretty much crowning and the OB made a judgement call about what would be faster…CS or episiotomy +/- forceps/ vacuum and chose the latter.

      It can be extremely traumatic to the fetus to push it back up when it is at advanced station for an abdominal delivery. It can be done but I think it is a last resort kind of choice.

    • Guestll
      March 22, 2013 at 1:43 pm #

      My husband’s birth mother showed up at a hospital in advanced labour, having had no prenatal care, and no idea she was pregnant with twins. Twin #1 was almost crowning and was born vaginally. Surprise twin #2, my husband, was footling and his cord prolapsed. He was an emergency section. My mother, who was an L&D nurse for many years, said that the delivery would have been fraught regardless, given the circumstances. He is lucky to be alive.

      • fiftyfifty1
        March 22, 2013 at 9:18 pm #

        Being able to see and touch the scalp is not a good indicator of how far down you baby is. In an obstructed labor especially the scalp gets swollen and pooched forward and the baby can seem a lot father down than it really is.

  36. The Computer Ate My Nym
    March 22, 2013 at 11:48 am #

    told my husband that all women say that they wanted to go & to ignore me

    Um…about that “midwives respect women’s choices more than OBs” meme anyway…

    • Squillo
      March 22, 2013 at 11:55 am #

      Exactly. They respect women’s choices as long as those choices align perfectly with their own preferences.

    • Starling
      March 22, 2013 at 9:01 pm #

      The woman in question–the one whose choices are important–is the midwife. What, you thought it was the mother?

  37. The Computer Ate My Nym
    March 22, 2013 at 11:46 am #

    This was our first baby we had no way of knowing how things were
    supposed to be we were clueless thinking we were going to have this
    beautiful romantic home birth & instead we live in a nightmare…

    Periodically someone will say something like “it’s cruel to use the stories of women who have lost babies to make your point.” Well, maybe it is cruel. But if Enoch’s parents had seen this before their baby was born, maybe they would have reconsidered home birth. Maybe this big, beautiful baby would have been born alive and healthy. For the babies that still might be saved and in justice to the families who have lost children, it’s necessary to expose these unsafe practices and help eliminate them.

  38. Dr Kitty
    March 22, 2013 at 11:38 am #

    Enoch’s mother’s grief is so raw. I am so, so sorry for her loss.

    She was cruelly deceived by a birth junkie who thinks her desire to deliver babies trumps their parents’ desire to have a healthy, living child.

    5years probation doesn’t seem to have worked out. Prison seems unlikely given that this was a stillbirth, but I live in hope.

    There are no Misspuri entries on the Sisters in Chains page, either they don’t know about Kocher, or they don’t want to acknowledge her as one of theirs.

    Seriously, could we do a list of HB MWs with known adverse events, currently or previously under investigation or sanction? It would be a bloody long list, but it might help someone.

    • Amazed
      March 22, 2013 at 12:17 pm #

      Don’t want to acknowledge her as one of theirs? Have you recently taken a Make Me Good and Kind pill? You’re giving them too much credit, Dr Kitty. There isn’t anyone these clowns wouldn;t acknowledge as one of theirs. The more devastated families, the greater martyrs midwives are.

      OT; Mothercat on the MDC is a homebirth midwife. She seems unwilling to close her eyes to incompetence and bad stats. She might not be eager to take the midwife we’re discussing to her bosom.

      • March 22, 2013 at 12:37 pm #

        “You’re giving them too much credit, Dr Kitty. There isn’t anyone these clowns wouldn;t acknowledge as one of theirs.”

        Not true. My friend Lynn, who posted on here once, is an activist who lobbies the legislature for protection of the right to homebirth and for midwives to have the right to practice; but she also spends a great deal of time and energy fighting against unlicensed and incompetent midwives, and I have heard as many tragic HB horror stories from her as I do on this blog.

        • March 22, 2013 at 1:11 pm #

          How does she fight to hold those midwives accountable?

          Who does she report them to?

          • March 22, 2013 at 2:33 pm #

            I don’t know the exact details of what she does, but I have repeatedly heard her complain bitterly about fly-by-night types who “witness a few births and throw up a shingle” and has described the shoddy methods they use that kill babies.

            She is a high-powered, Type A lobbying type person who arranges local town halls with legislators and periodically travels to Jeff City as well as various midwifery and LLL type conferences, so I feel confident that she is not just idly complaining but is working to professionalise the discipline.

        • Dr Kitty
          March 22, 2013 at 1:42 pm #

          Yeah, but is she active on Sisters in Chains, Alan, because those “clowns” are…somewhat indiscriminate in their support of dangerous, negligent midwives.

          You know amazed and I were specifically talking about SIC, right?

          • March 22, 2013 at 2:26 pm #

            No, I did not. Sorry: thought you were talking about MW/HB supporters generally.

        • March 22, 2013 at 2:34 pm #

          The “right to homebirth”? What does that even mean? Homebirth isn’t illegal, it’s just misguided and dangerous. And your friend is foolish and likewise dangerous to hear/experience those horror stories and continue to advocate homebirth.

          • March 22, 2013 at 3:03 pm #

            It was illegal in Missouri, an abnormally strict state until that law passed, and last I checked it was the state with the lowest rate of homebirth in the nation.

            From Lynn’s perspective, to be against all homebirth because of the horror stories of the most inexperienced and negligent practitioners would be to throw the baby out with the bathwater. I have become convinced by the evidence cited here that homebirth even with highly skilled practitioners is more risky than I would tolerate if I had it to choose again; however I do still think there is a huge difference between different kinds of practitioners. And that does not only include midwives, btw. The birth attendant for my family’s first attempted homebirth was a board-certified physician with hospital privileges.

          • Guestll
            March 22, 2013 at 3:43 pm #

            I don’t think it’s about being against all homebirth. But the overwhelming majority of homebirths taking place in the US are with CPMs. The credential is a farce and it needs to be abolished.

            I don’t doubt that there are SOME good CPMs out there. Great — go and get an education along with proper training, same as you would do in the rest of the industrialized world, and get a credential with merit and standing.

            I think homebirth can be an okay choice for a small cohort of tightly screened women. Enoch’s mother, as a first-timer, should not have been delivering at home, regardless of whether it was with a CPM, CNM, or board-certified physician.

          • The Bofa on the Sofa
            March 22, 2013 at 4:03 pm #

            Here’s the problem with homebirth:

            The most qualified providers are not willing to do homebirths, because it they too risky, which makes the liability too high. Therefore, you do it with someone less qualified, because they are not liable for the outcomes.

            How does that make any sense at all?

            How in the world can midwives get away with that kind of lack of professional standards?

          • Sue
            March 23, 2013 at 3:08 am #

            I don’t see how it is possible to compel anyone to deliver in hospital, even if you wanted to, but it should be possible to regulate providers – licensed or not.

            The one good outcome of LB in South Australia is new legislation to regulate the behaviour of unregistered providers.

            If all providers had to be professionally trained and registered health care providers who were obliged to have a conjoint appointment and undertake education and audit through a hospital, and if patients were tightly risked-out (eg no first-timers) and liberally transferred, me might no longer need this discussion.

          • The Bofa on the Sofa
            March 23, 2013 at 9:15 am #

            Among the things you would need to require for providers is that they carry malpractice insurance, to ensure that patients have recourse in the case something goes wrong.

            And as I have indicated previously, as soon as you do that, then no one will be doing homebirths because the premiums will be through the roof. Any adverse outcome in a homebirth is going to subject to a malpractice suit, and it is going to lose because it is clearly NOT standard practice. So the malpractice suit is a slam-dunk case.

            And make no mistake, make homebirth providers worth suing, and they are going to be sued all over the place.

            The only way that midwives can be doing homebirths here in the US is by keeping themselves immune from malpractice suits. Of course, what that also means is that they are immune from any liability in the case of bad outcomes, almost no matter how badly they screw up.

            Short answer: responsible professionals are not really going to be able to do homebirths in the US. The only ones that will be able to do it are irresponsible hacks.

          • March 23, 2013 at 8:07 pm #

            Okay, so effectively it would be a backdoor ban on doing any kind of assisted homebirth, sort of like how those marijuana tax stamps were never actually issued to anyone.

          • Box of Salt
            March 23, 2013 at 8:29 pm #

            would you go on that dangerous mountain climbing expedition paying guides who carry no insurance of any kind?

            By the way – kudos to you for getting with the program here.

          • March 24, 2013 at 6:03 am #

            I climbed to the summit of Mount Kenya with a guide I’m really doubtful carried insurance. He did however rescue me when I slid off the trail partway down a glacier.

            But I’m just thinking someone could read a whole deal listing risks (another comparison that comes to mind is participating in medical research, testing a drug that might be dangerous) and sign something saying you understand homebirth is inherently dangerous and you aren’t going to sue (at least not for anything that could be boiled down to “this wasn’t as safe as being in the hospital”).

            Thanks for the kudos, but I’m curious: what specifically do you refer to in terms of “getting with the program”? (If you mean that I no longer feel like I’d be comfortable with the risk of homebirth, I crossed that rubicon fairly shortly after landing here.)

          • Box of Salt
            March 24, 2013 at 12:46 pm #

            Alan “I’m curious”
            Your posts now actually contribute to the discussion, rather than de-railing it into the “All About Alan Show.” Thanks!

          • The Bofa on the Sofa
            March 24, 2013 at 8:51 am #

            Okay, so effectively it would be a backdoor ban on doing any kind of assisted homebirth,

            Not really. The disappearance of homebirth would happen by itself due to the cost of insurance because of the high risk. And the ones that do it would have to be extremely careful.

            Look at bungee jumping companies. The few that are around are extremely risk averse.

            ETA: what if pregnant women signed waivers like you might if you hired a
            guide to take you on a dangerous mountain climbing expedition

            They would be just as enforcable (aka not at all)

            You cannot sign away your right to sue.

          • Eddie
            March 24, 2013 at 12:02 pm #

            “The disappearance of homebirth would happen by itself due to the cost of insurance because of the high risk.”

            I think that’s what Alan meant by “backdoor ban.”

            “You cannot sign away your right to sue”

            Yet, ironically, midwives try to get their patients to do that. I guess the difference, as you’ve pointed out is that midwives have no real assets to go after when you sue.

          • March 24, 2013 at 2:13 pm #

            IANAL but are you saying those risk waivers and so on are meaningless? They don’t reduce someone’s chance of winning a lawsuit at least?

          • An Actual Attorney
            March 24, 2013 at 3:22 pm #

            Yep, mostly.

          • March 24, 2013 at 3:57 pm #

            That’s dumb. No wonder our society is seen as overly litigious.

          • Eddie
            March 24, 2013 at 4:11 pm #

            IANAL as well. I once signed a lease with some terms that were legally unenforcable in the rent-controlled area I lived. (Threat of immediate eviction, total loss of security deposit, etc.) I pointed out to the guy that the terms were not enforcable and he smiled and shrugged. They know that many people who have signed such a contract will THINK they cannot sue. As far as the effect in a court room, I’ll defer to an actual lawyer, but outside the courtroom there is an effect as well. I’m sure that is part of the reason why these kinds of disclaimers exist.

            I also had an employer force me to sign a non-compete agreement to keep my job that would effectively render me unemployable for a year if I quit. There are all kinds of crazy contracts out there. Doesn’t make them valid. (In that case, even HR people in that company told me, quietly, their belief was that it was unenforcable because it was so broadly written. Other co-workers actually sought out the opinion of a lawyer before signing it and were told roughly the same.)

          • March 24, 2013 at 6:45 pm #

            I understand preventing people from signing contracts or at least enforcing contracts that stipulate that they will become a slave or indentured servant or something like that. I agree with the idea that there are fairly tight restrictions on what employment or rental contracts can say, because those are necessities of life where people can feel like they are over a barrel.

            But if the liability waiver someone (a mentally competent adult) is signing makes it clear that they do have other options that are safer, then I don’t believe that agreement should be unenforceable. If someone wants to volunteer for medical research, or climb a technical and dangerous mountain ascent with someone experienced working as a professional guide, or wants to homebirth with a midlife, I believe they should be able to use a legal contract to agree “yup, I know I’m taking a serious risk here and I won’t suddenly blame you if it goes south.”

            The complicating factor of course is the foetus/baby. I have said before that if the risk is higher than some level, I am going to consider that something that should not be allowed, period. But I am not sure what that level should be; so assuming for the sake of argument that we are somewhere lower than that threshold, I do think it should be the case that people can waive malpractice litigation rights. (Just requiring such a waiver would dissuade many would-be HBers, I’d expect.)

          • Eddie
            March 24, 2013 at 7:32 pm #

            I mostly agree with you, but no-one should be able to say, “If I am criminally negligent, you waive your right to sue me.” However, I agree that it’s reasonable for any medical practioner to say, “Shit happens despite our best efforts. As long as you were properly informed of risks, as long as you made your own choices, as long as we provided appropriate medical care, you agree not to sue us for bad outcomes.” Maybe not in those exact words, of course. 🙂

            I think it is just rediculous that you can sue an Ob/Gyn — at least in some states — until the child is 18. (I would love to be wrong about this, but this is what I’ve heard.) The state I live in is so litigous about child birth that we are losing doctors. I asked my wife’s Ob/Gyn about this but didn’t get a clear answer as to what precisely the reason is that doctors are retiring early or moving out of the state.

            Basically, I think it’s fine to waive the right to sue over bad outcomes if the care you were given was medically appropriate and you were just “unlucky.” But I don’t agree that it’s OK to waive the right to sue when the care provider is negligent.

          • March 24, 2013 at 10:34 pm #

            Also mostly agree, but what qualifies as “criminally negligent” should be judged differently for a guide taking someone up Mt. Rainier (10 fatalities in 2012 alone) vs. someone taking senior citizens on a nature walk. If the definition of negligence effectively bans attending homebirths even with extensive notification of the attendant risks, that’s too tight a standard and they should either have an exemption or be banned outright.

          • Sue
            March 24, 2013 at 11:12 pm #

            Alan – anyone attending a birth in any location should be fully qualified and licensed, hold malpractice insurance, and be held accountable for their outcomes. In the same way as the professional bodies do for cardiac surgery, wound management, anti-coagulation for atrial fibrillation or treatment of severe asthma, there should be standards of care.

            In my view, the only provider who should legally be able to attend a HB would be a MW or OB with full training and licensing, insurance, and a conjoint appointment with the local hospital, where they participate in clinical work, audit and continuing education. They would be judged against guidelines for risking-out (eg no first-timers) and transfer indications. There should be a file conjointly held at the hospital and a smooth transfer process involving communication with the provider.

            So, not banning, but applying exactly the type of standards the community should expect from providers.

          • Eddie
            March 24, 2013 at 11:43 pm #

            What too many in the midwife community don’t seem to get is that what you describe is ultimately in THEIR best interest, not merely the best interest of the prospective parents and the children-to-be. And that’s a shame.

          • Eddie
            March 24, 2013 at 11:38 pm #

            Absolutely agreed. LIke most here, I would not outright ban nor effectively ban home birth.

          • Box of Salt
            March 25, 2013 at 12:08 am #

            But Alan, the standards for what’s considered “criminally negligent” in regards to birth is already established. It’s the standard that hospitals, OBs, and CNMs in the US are held to.

            Why would we need a separate standard for homebirth?

          • March 25, 2013 at 1:12 pm #

            Because, again, the scenarios are very different. Let’s look at another analogy that is closer in some ways.

            I used to work in a group home run by an agency contracted by the state Dept. of Mental Health for what we officially called people with mental retardation (call it what you want but this was less than a decade ago) and mental illness. Many of our “consumers” also had other health issues. They took various medications throughout the day, and were not competent to administer them themselves. The types and doses of meds were changed frequently, and it was not all pills: some had to be given shots, others used machines to treat lung conditions.

            The company employed a full time nurse, but they had far too many group homes for her to administer all those meds. So we were required before working solo with consumers to take a number of short courses, ranging from ten to forty hours each. It was like a crash course in nursing: we were taught to pass and document meds, take blood pressure and temperature, administer CPR, etc. (to be continued)

          • March 25, 2013 at 1:21 pm #

            Ugh, Disqus. Continuing (2/2):

            So we had more medical training than an average person, but still far less than a nurse. And we only made $7.50 an hour so other than some part time college students and the occasional oddball like me, most of their employees were not intellectually capable of completing an RN programme anyway.

            If there was a med error (which happened from time to time) or someone died (not unheard of), do you think the family would have the same expectation of winning a lawsuit as if the setting were a hospital? I just think the different settings with their differing levels of technology and expertise at hand require different standards.

          • The Bofa on the Sofa
            March 25, 2013 at 11:54 am #

            Basically, I think it’s fine to waive the right to sue over bad outcomes if the care you were given was medically appropriate and you were just “unlucky.” But I don’t agree that it’s OK to waive the right to sue when the care provider is negligent.

            But if the medical care was appropriate, then you don’t have a malpractice case.

            By definition, a malpractice suit is alleging that the care was negligent. The plaintiff needs to show that it is more likely than not that the damage was caused by negligent care. The defendant tries to show that it is more likely than not that they did the correct things, and that the damage was not their fault.

            You don’t need waivers to say that. It’s already what the system is doing.

          • Eddie
            March 25, 2013 at 1:34 pm #

            > But if the medical care was appropriate, then you don’t
            > have a malpractice case.

            Technically true, but imperfectly true in practice, right? The medical system in the US desperately needs tort reform.

            > You don’t need waivers to say that. It’s already what
            > the system is doing

            Agreed. I wasn’t advocating for the use of waivers. Just saying that in that case it is not objectionable to ask someone to sign it. And doing so may be a piece of informed consent to make it clear what the risks are.

          • Squillo
            March 24, 2013 at 4:16 pm #

            INAL either, but I’m guessing it might be considered a contract of adhesion, which can make it harder to enforce in court.

          • March 24, 2013 at 9:14 am #

            Or it would be possible for a care provider to get malpractice insurance, provide care for people who could afford their markedly increased rates and follow their strict protocols, right up until the first lawsuit.

          • Amazed
            March 22, 2013 at 3:47 pm #

            No one is against the right to homebirth. I wouldn’t choose it for myself but I am more than willing to leave the choice to those who want it. But this mother… she did not actually want a homebirth. She wanted the “romantic homebirth” she was promised and assured that she would have. I bet no one told her that bad things happen to low risk women and sometimes it’s the few minutes distance between a labouring mother and the technology makes the difference between life and death, a healthy child and a brain-damaged one while even the most skilled provider can’t do a crash c-section on their kitchen table.. When women are informed what they are choosing, what the consequences might be, then yes, they are choosing homebirth. This mother chose the ideal that she was sold.

            SIC makes me sick.

          • March 22, 2013 at 4:36 pm #

            “No one is against the right to homebirth.”

            Has Dr. Amy said that? Heck, I would be against it as a legal right if the risk were beyond some level. What exactly that level would be is a very difficult question to answer.

          • Amazed
            March 22, 2013 at 6:07 pm #

            Yes, Dr Amy has said it. She isn’t against the right to homebirth, as long as the woman is informed. I cannot see how we can take away the right to homebirth. What, are we going to throw in jail all women who didn’t make it to hospital in time? Are the taxi drivers who had had to catch babies practicing unlicensed midwifery? What about precipitous labour? Or when the woman doesn;t know she’s in labour and when she realizes it, it’s too late to reach the hospital?

            I don’t approve homebirth as a choice. But fortunately, no one needs my approval. Still, I maintain that everyone is entitled to that choice, as long as they are aware that romantic homebirth can end in tragedy and it happens and happened to low-risk women. Women just like them.

          • March 22, 2013 at 10:11 pm #

            Okay, I see your point. But do you and/or Dr. Amy believe it should only be legal with CNMs or physicians or at least European-style midwives as attendants on the one hand, or else just unassisted?

          • Eddie
            March 22, 2013 at 10:19 pm #

            I doubt you could make homebirth itself illegal, no matter what. Are you going to prosecute the parents? I assume you’re asking not whether home birth should be legal or not, but whether it should be legal to act like a medical professional at a planned home birth?

          • March 23, 2013 at 3:33 am #

            Right, or any kind of birth attendant who lacks at least European levels of training and certification.

          • Eddie
            March 23, 2013 at 2:09 am #

            I, for one, appreciate this link. It helps show that Dr Amy is indeed interested not in a particular outcome, but in science and faithfullness to the tenants of science.

          • March 23, 2013 at 3:31 am #

            Interesting. A randomised, prospective study? Bizarre idea.

          • Amazed
            March 23, 2013 at 6:22 am #

            I absolutely believe that homebirth should be legal with only physicians or adequately trained midwives which currently in the USA seems to mean CNMs. Only if and when there is a program that can prepare their equals will I accept equals as being able to provide adequate homebirth services. Everyone else should just go unassisted – many of the OOH births are unassisted just because the baby surprised the mother who was planning a hospital birth.

            Frankly, I see the “but you’re making us go unassisted!” meme as a manipulation and attempt to make someone provide a service that is out of their scope of practice.

          • Amazed
            March 23, 2013 at 6:44 am #

            And until it’s established that a certain standards should be met, I think the only homebirth practitioners should be physicians and CNMs. That’s the only way practitioners and clients alike can see what the standards are supposed to be.

          • Box of Salt
            March 23, 2013 at 6:47 pm #

            “And until it’s established that a certain standards should be met”

            including carrying malpractice insurance.

          • March 23, 2013 at 5:48 pm #

            Sounds reasonable.

          • March 23, 2013 at 9:22 am #

            Legality isn’t the issue, safety is. I don’t think there is any country in Europe that would allow half-baked amateurs, the systems are strictly regulated – but disasters still happen. Maybe not as often, but too often just the same.

          • The Bofa on the Sofa
            March 23, 2013 at 9:43 am #

            Legal for whom?

            As others have told you, it makes no sense to make homebirth itself illegal. However, what you can make illegal is for unqualified practitioners to show up and do assist it.

            We aren’t talking about arresting women who give birth at home, but by unqualified providers showing up to help them.

            Of course, we have seen what happens in those cases. The midwife shows up and says that, if anyone asks, she is only a “birth assistant” or doula, or even just a supportive friend. And you aren’t going to be able to stop that.

            But I will say, if you have a regulation like that, it may not stop midwives from skirting the rules and attending homebirths, but it will cut out a lot of “We were misled to believe that it was just as safe to give birth at home” and “we thought the midwife was just as legitimate” claims. I mean, if your midwife tells you that if anyone asks, she wasn’t really a midwife but was just a personal friend who happened to be there, you can’t claim ignorance anymore.

          • March 23, 2013 at 5:53 pm #

            Right, good point.

          • auntbea
            March 23, 2013 at 7:25 pm #

            But haven’t they already thought of a solution for this? When you have to call your midwife a friend, that doesn’t mean that the midwife is illegitimate. It means that midwives are being persecuted because they speak Truth to Power. More legitimate than ever!

          • DiomedesV
            March 23, 2013 at 10:16 am #

            This is not about the right to homebirth. This is about the right to practice medicine, a right we have long abrogated in favor of safety. You cannot just style yourself a medical doctor without having attended medical school, completed your training, passed your boards, and without carrying malpractice insurance. People who fail to meet these qualifications are subject to criminal and civil penalties. We require that virtually all medical fields, including optometry, massage therapists, PT and OT, chiropractors, and even naturopaths in some states to meet minimum standards of training and to subject themselves to disciplinary action if they fail to meet a minimum standard of care.

            No one is telling anyone that you can’t give birth at home. CPMs have chosen to present the issue this way because it deflects attention from their comparatively poor training and education. There is absolutely no reason why we should allow anyone to practice midwifery–to make clinical recommendations to patients and be compensated by them or their insurance–without meeting a level of training expected of midwives in every other developed nation.

            “Protect the right to homebirth” is a canard. There is no right to practice medicine, except for exemptions for conscience matters, and even those can be regulated by the state.

            Is it really illegal in Missouri? Or is it illegal for CPMs/lay midwives to attend, or even CNMs? These are not the same tend. One restricts the behavior of the mother, and one the ability of someone else to serve as her compensated caregiver.

          • Eddie
            March 23, 2013 at 1:21 pm #

            “This is not about the right to homebirth. This is about the right to practice medicine”

            I think this is exaclty the correct focus, and the right way of looking at it. If someone hates dentists, they have the right to avoid treatment. But they don’t have the right to have someone untrained go to their home for home dental work. (“Hey, Frank, bring over your drill and spackle”) Even though historically speaking, tooth decay is natural. Even in the stone age — before processed sugar and the like — it’s not like people kept all their teeth. While I admit this is a pretty dumb analogy, “Not all teeth were meant to stay in your mouth.” Except that today with modern dentistry, most people can keep almost all of their teeth for their entire lifetime. While the analogy is admittedly very dumb, the logic is identical to those who say “some babies die and that is natural.”

            I’m not going to say that hospitals or doctors are perfect, without arrogance, or cause no harm. But saying home birth is safer than giving birth in a hospital is just ignorant. It should not be legal to enable this behavior by saying you have the skill to deliver a baby unless, well, you actually have sufficient medical-level training to do exactly that. In that case, it’s an issue of informed consent.

          • The Bofa on the Sofa
            March 23, 2013 at 2:34 pm #

            I think this is exaclty the correct focus, and the right way of looking at it.

            As has been noted, this IS what serious people are talking about. It is the midwives who are the ones trying to pitch it as “they are outlawing homebirth!!!!!”

            No, dingbats, we want to outlaw YOU from telling people that you are qualified to assist their homebirth, or do any other healthcare related activities, for that matter.

            And this is absolutely the message of this blog, if you actually read what is said, instead of imposing strawmen.

            The whole concept of “outlawing homebirth” doesn’t even make sense.

          • Eddie
            March 23, 2013 at 2:53 pm #

            Just to be clear, I do understand and agree with everything you say above. I just liked that post because it put it so clearly.

          • March 23, 2013 at 5:55 pm #

            You use the present tense, but I was referring to the situation before 2007. CPMs were made legal then by the trickery of that state senator.

          • anonomom_LLLL_IBCLC
            March 22, 2013 at 7:34 pm #

            Yes, she has. She recognizes that women have the right to bodily autonomy. She is against misinformation and poorly trained birth junkies posing as trained midwives.

          • Lisa the Raptor
            March 22, 2013 at 10:24 pm #

            It’s hard to criminalize mainly because some women just labor fast and can’t make it to the hospital. I always made sure that my husband and family were aware of emergency labor methods and even kept a copy on hand in my house in case my oldest even had to help.

          • Antigonos CNM
            March 24, 2013 at 4:12 am #

            The big dilemma is whether one has the right to risk death or injury for someone else, particularly when the seond person has no ability to choose. If you develop a gangrenous finger, and you choose to have it amputated at home by someone whose main qualification is that he has a sharp knife, one has only oneself to blame if complications result. But in birth, there is another life to consider, and this changes everything.

          • March 24, 2013 at 6:07 am #

            I agree with that, but again: this gets into some tricky abortion politics. And even if most of us can pretty easily dismiss the idea that a 38 or 39 week fetus is more comparable to a blastocyst than it is to a newborn infant, you can still run into trouble when you try to decide where to draw the line. Should a pregnant woman be arrested for smoking, for instance? I’m horrified when I see that happening, but I’m not sure I’m quite willing to see her put in handcuffs.

          • Antigonos CNM
            March 24, 2013 at 10:07 am #

            That’s why I say it’s a BIG dilemma. For myself, I find the tradional Jewish view that a fetus has “personhood” when it is capable of existing outside the womb, to be sensible. Technological advances will never lower that much below 22 weeks, as the organ systems are just too immature — unless this Japanese “artificial uterus” ever becomes a reality.

          • March 24, 2013 at 2:22 pm #

            I haven’t heard about the Japanese one specifically, but I always assumed that this would come to fruition someday and then you have the “Brave New World” scenario.

          • DiomedesV
            March 24, 2013 at 10:59 am #

            Of course pregnant women should not be arrested for smoking. Midwives like to hype the similarity to abortion. But the issue is not the patient and her wishes, the issue is whether anyone can become a medical provider. Women fought for the right to access safe abortion. They did not lobby for the right of any untrained provider to offer abortion in the form of a rusty clothes hanger in a back alley.

            Regulating homebirth is not about making it illegal to give birth from home. It is about regulating who can be their providers.

            Personally, I have no particular animus to homebirth, although that’s more due to indifference than respect. I would never want it to become illegal. But that doesn’t mean I want someone with barely a high school education being compensated by Medicaid for offering subpar medical care.

          • March 24, 2013 at 2:25 pm #

            Absolutely agree.

        • March 23, 2013 at 8:57 am #

          The right to homebirth boils down to the right to risk your baby’s life – and your own health and welfare as well. Now I could be persuaded to agree that people do have a right to do dangerous and stupid things; I have a bit of a problem with the idea that it is admirable to lobby for that right. The more people push for homebirth, the more you perpetuate the idea that it is risk free and desirable.

          No-one is allowed to risk the lives of their children capriciously once they are born and breathing. If you took a sick child to some amateur quack you would be in trouble. Why the pass for those not yet born?

          It seems to me that the simplest move would be real financial penalties – how many birth junkies would take THAT risk?

          • The Bofa on the Sofa
            March 23, 2013 at 9:30 am #

            Now I could be persuaded to agree that people do have a right to do
            dangerous and stupid things; I have a bit of a problem with the idea
            that it is admirable to lobby for that right.

            And we aren’t really talking about the _people’s_ right do “dangerous and stupid things.” We are talking about people getting paid to help those people do they dangerous and stupid things.

            It’s like saying, you can’t stop people from playing russian roulette, but does that mean that we have to allow people to get paid to bring the gun over so they can do it?

            Shoot, you can almost hear the case for it. “People are going to choose to play russian roulette, regardless. However, we make it safer. We bring them an 8 shooter instead of a 6 shooter, which makes russian roullette with a RouletteProvider 33% safer than if it is unattended.”

          • Eddie
            March 23, 2013 at 1:12 pm #

            “Shoot, you can almost hear the case for it” …

            If that was on purpose, it was very funny!

          • The Bofa on the Sofa
            March 23, 2013 at 2:29 pm #

            It wasn’t, but…ok. (it was just my avoidance of saying shit)

          • Peter
            March 23, 2013 at 4:53 pm #

            You said it! Unh-huh unh-huh unh-huh…

          • March 23, 2013 at 5:51 pm #

            I definitely see your point, but hardcore abortion rights supporters will cry foul, and even more moderate pro-choicers (like me: I support parental notification and restrictions on late term abortion) could see a slippery slope issue there.

    • theadequatemother
      March 22, 2013 at 12:38 pm #

      Stories like this make me sick…

      OTOH, I really believe that for American homebirth midwives, or any midwife that works exclusively in the home, as opposed to also having hospital privileges, it would only be a matter of time before they joined this list. You just cannot keep up on your emergency skills if all you do is take an occaisional adult CPR and NRP course. At least if they provide hospital care too they have opportunities to learn from the other cases in the unit, attend M&M rounds and draw on obsetrical colleagues, and seek out opportunities to practice NRP maneuvers on real babies and participate in simulation based team training. I just don’t see how a midwife could maintain competence working solely in the community.

      • Laura
        March 22, 2013 at 3:07 pm #

        This is an excellent point you bring up. I know of a highly respected CNM who has practiced for decades in my area. Apparently, she has not had any “bad outcomes.” Her back up midwife is only a Licensed Midwife, though, who has gotten some negative press in the last couple of years. I have warned women that although So-and-So might be good, her backup is not medically trained and that could be your midwife attending your HB. The look of concern grows on their face as they consider this. I also have to wonder how current and up-to-date this CNM’s skills are as you point out. And there is the occurrence of “provider drift” mentioned before here. Scary, scary….

        • March 23, 2013 at 8:44 am #

          No matter how competent or highly skilled, if you attend homebirths you have got to be in denial that circumstances can arise suddenly where only the resources of a hospital can make a difference. They are taking the same gamble as the mothers, on the “it won’t happen” basis.

    • March 23, 2013 at 8:40 am #

      People keep on choosing these midwives, and blaming the mothers – or the babies.

  39. Mrs. W
    March 22, 2013 at 11:26 am #

    So sad. Tragically preventable. And will Enoch’s death fall in the Homebirth or the hospital birth category?

    You know what might help – if it was a felony for a midwife to do anything other than facilitate a transfer to hospital when it is requested and to require all homebirths be video surveilled. At least then there might be better evidence when things go so horribly wrong.

    • Karen in SC
      March 22, 2013 at 11:51 am #

      If a well baby check was required within 3 hours, I wonder how many problems could be averted. And if you knew you *had* to go in within 3 hrs anyway, maybe some mothers might decide to have NCB at the hospital instead. Plus it could be marketed as a way to avoid taking your newborn to the capital to register the birth (which has to be done in SC for OOH births within thirty days, I think).

      • Renee Martin
        March 22, 2013 at 12:08 pm #

        I think this is a great idea.

      • Isramommy
        March 22, 2013 at 4:44 pm #

        Here our homebirth wingnuts are basically bribed to bring the baby in. In order to receive the government “birth allowance” payment, a home birthing mother must bring her baby in to a hospital within 24 hours of the birth, and then be admitted for at least 12 hours. I think there may also be consequences for registering the child’s birth and national health service if you fail to go for a hospital check, but I don’t really know the details.

    • Squillo
      March 22, 2013 at 11:57 am #

      As far as the CDC stats go, it will be in the hospital/doctor-delivered column. The state stats–which will never likely see the light of day–may reflect an intended homebirth if the death certificate contains that info, but it also depends on how it’s reported (if it’s reported.)

  40. Lisa
    March 22, 2013 at 11:20 am #

    Poor little Enoch. You should be delighting everyone with early smiles right now. It’s not fair that this fraud’s poor judgment cost you your life.

  41. anonomom_LLLL_IBCLC
    March 22, 2013 at 11:11 am #

    “He breathed good … I saw no risk.” Christ, this is her idea of newborn assessment? For a 33-week preemie???? There is not a jail cell dark enough for this murderer. To Enoch Michael’s mother: I am so sorry for the loss of your gorgeous baby boy. I hope you dont mind his story being used in the fight against fraudulent dangerous practitioners, so hopefully future babies will be safe from this woman and others like her.

    • Dr Kitty
      March 22, 2013 at 11:44 am #

      Also “what’s my judgement of small?”
      Meaning “I didn’t weight or measure this baby or plot anything on a growth chart”.

      If only neonatologists knew that the only indicator of health they need is “breathing good”.

      Dangerous, wilful ignorance.

      • Bombshellrisa
        March 22, 2013 at 12:12 pm #

        “what’s my judgement of small” That means her sling scale wasn’t working or she didn’t bring it. Because if you know a woman is delivering at 33 weeks, if you don’t bring the scale and say the baby looks average weight, if nothing happens you are good.

        • Karen in SC
          March 22, 2013 at 12:48 pm #

          but, but, but babies know when to be born, so being early doesn’t matter….babies aren’t library books, right?

        • March 22, 2013 at 9:48 pm #

          the quote above says 40 weeks, 2 days? what did I miss?

          • Eddie
            March 22, 2013 at 9:58 pm #

            The article talks about the same midwife delivering two different babies, “Enoch Michael on Feb 6th 2013 at 40 weeks 2 days” and “Ethan Criswell [snip] who authorities said was delivered seven weeks premature”. Both died. The two names are similar enough that a quick reading may have overlooked the difference.

    • Renee Martin
      March 22, 2013 at 12:34 pm #

      “He breathed good”

      If the regular police don’t get her, many the grammar police will! Oh, the ignorance. I wonder if this is one of the MWs that didn’t even graduate HS?

    • Charlotte
      March 22, 2013 at 7:31 pm #

      UGH! I had a 3 pound 32-weeker and I can’t even imagine not realizing she needed help. She breathed fine too, but only thanks to the steroid shots they gave me in anticipation of her early birth. This midwife is disgusting.

      • Guestmama
        March 22, 2013 at 7:43 pm #

        Same here – my 31 weeker breathed well after the first week thanks to the steroid shots I got. It’s pretty freaking obvious that a 3 lb 33 weeker is premature. You’d have to be blind or utterly negligent not to notice. My 31 weeker was LGA at 4.5 lbs, but still clearly not ready to be born. He looked quite fetal for at least a good month after he was born.

        That poor little baby. Reminds me of Ina May’s preemie…wasn’t he about the same gestational age as our babies? So sad…

        • Charlotte
          March 22, 2013 at 10:12 pm #

          Yes, she was a 32 weeker just like my own. She struggled and died at home when mom refused to call 911 because of her belief that medical interventions – even desperately needed life-saving ones – were too unnatural. It’s a story I can hardly fathom. I very rarely will call any person a monster, but I think she qualifies.

    • March 23, 2013 at 8:19 am #

      Not seeing the risk of dangerous things, and exaggerating the risk of interventions seems more or less the definition of the NCB approach, plus the idea that breathing (eventually) is the only sign to worry about. Apgar allocates 2 out of 10 for breathing, but clearly HB midwives count it as a ten. If a baby breathes, all is natural, and of course, 3lbs is a variation of normal. Probably a blog post/birth story somewhere that insists that care for premature babies is just one more of the unnecessary things doctors do to scare and make money, while wise woman midwives know better.

      Before I had mine, I was given a tour of NICU. Very scary. Tiny babies with arms and legs like pencils, so fragile. Mine was 3 lbs, or just a bit over. She did look OK – beautiful and amazing to me – but a normal six or seven pounder was gigantic next to her.

      I looked up Birth Goddesses the other day. As usual, superficially (which is all you can do on the internet) Not fecund mothers, not universally loved and revered. Fertility goddesses, to be feared and propitiated, because they held the power of life AND death, and like most of the old gods often capricious and cruel. Like homebirth when your luck runs out.

      As for the first mother – one would like to say that her grief is unimaginable, and in its duration and lasting effects it probably is. But one can too easily imagine the moment of realisation that every reassurance was a lie, that low risk is not a guarantee, there is nothing abstract or manageable about a lifeless baby, nine months of happy anticipation of empowerment can not be taken for granted, and nothing can be done to make it right. Nothing CAN be done to make it right, but I think it is healthy reaction to believe that if someone is responsible, they should own that responsibility, and strong efforts should be made to see that it does not go on happening, unremarked and brushed aside.

  42. thankfulmom
    March 22, 2013 at 11:10 am #

    How very very sad. I had a cord prolapse in the hospital and my room filled up with hospital staff when code pink was called (the only one who didn’t show up right away was the anesthesiologist!). The dr. was able to push the cord back inside, and between the nurses pushing on my stomach, me pushing, and the dr. reaching inside and guiding her out my baby is now a healthy normal 15 yog.

    My youngest little 3+ pound preemie went straight to nicu. I can’t imagine seeing such a tiny baby and saying it appears to be breathing okay. Sheesh.

    Those poor parents thinking they were having a “safer” birth at home because the hb community want to perpetuate this lie.

    • Anonymous
      March 22, 2013 at 11:27 am #

      I’m sure the response will be “some babies just aren’t meant to live.” or something like that. Then they’ll point out how she already forgave the midwife. Had it been my child she killed I’d be going through every single channel I could to ensure she not only never practices again but did time. Imagine what would have happened to an OB who was practicing under multiple names.

      • March 23, 2013 at 8:37 am #

        Had it been my child she killed I’d be going through every single channel

        And, as far as one can gather, you would get nowhere. And how horrible must that be? It is the midwife who gets support for her suffering, and a slap on the wrist.

      • Allie P
        March 23, 2013 at 10:18 am #

        “Some babies weren’t meant to live” makes my blood boil. I would punch anyone who said that to me right in the nose, and I don’t care if they are talking about 12 week miscarriages. We don’t have destinies. We have tragedies — and some are more avoidable than others.

      • Aunti Po Dean
        March 23, 2013 at 6:41 pm #

        “Imagine what would have happened to an OB who was practicing under multiple names.” And had killer multiple babies

    • cleak
      March 23, 2013 at 11:42 pm #

      Before my son was born, I really did think that giving birth in bathtub in a relaxing environment with minimal pain sounded lovely. I have white coat syndrome and my blood pressure goes crazy and I’m a hard stick so IV’s and I don’t get along at all. But there was enough fear from hearing stories of my own birth (I was blue and almost needed a transfusion, my Apgar was at like 4) that an OB and hospital sounded like good idea, just in case. I am so thankful for that.
      This poor woman’s story sounds like the worse case scenario for what my son’s birth could have become. His heart rate at one point was in the 70’s, I pushed for an hour with no progress and my wonderful OB was finally able to get him out with a very skilled forceps delivery. Any romantic notions I had about homebirth were immediately quashed, knowing just how easily it could have gone horrifically wrong. Since then I have almost lost my son (due to illness) and even the scare of his life being in danger hurt beyond belief; I would not have survived losing him at birth.
      My heart aches for these women, who are paying the price for some else’s hubris. Who, I’m sure, truly thought that they were bringing their children into the world in the best possible way. I pray they find peace and justice.

    • Antigonos CNM
      March 24, 2013 at 2:47 am #

      One of the “unnecessary interventions” has become the PV exam. A cord can prolapse at any time; frequently the fetal monitoring can suggest this, as well. But there’s no real substitute for “hands on” knowledge. Too often I read nowadays that either the midwife sees no need to know the state of the cervix, or the mother refuses exams, or is just told, when she says she wants to push, to go ahesd, regardless of whether the cervix is even dilated, which can lead to all kinds of problems. It is hard to escape the thought that midwves of this sort avoid exams because they don’t know how to do thm properly.

  43. MicheLaw
    March 22, 2013 at 11:05 am #

    Dr. Amy, Do you know what happened to the Criswell family? I read that Kocher was sentenced to 5 years probation in that case. How is she still delivering babies? I tried unsuccessfully to find articles on what happened to the Criswell parents. I was only able to determine that the initial charge of involuntary manslaughter was reduced to felony child endangerment. A website I found that greatly disturbed me was run by a midwife who followed the trials of midwives involved in home birth deaths. This website closely followed what happened to these midwives who are depicted as victims. But no attention is given to the true victims, the babies and their parents!

    • Karen in SC
      March 22, 2013 at 11:40 am #

      If you are interesting in midwives and the law, look up the ebook “From Calling to Courtroom.” Dr. Amy also wrote a post on it in 2012. Use the search function if you’d like to read that as well.

      • Eddie
        March 22, 2013 at 9:45 pm #

        Wow, just skimming that book, it directly encourages fraud and lying!

        “For those midwives who do carry Pitocin, I would advise them to
        never admit it to anyone who has the ability to testify (that is, anyone
        except your husband). If a midwife ever feels the need to inject Pitocin or administer any kind of drug, such as Methergine, she should refer to such substances as “minerals.””

        That’s just wrong on so many levels. And imagine the midwife who does just that, then transport is needed and now the mother who has no idea she was injected with drugs is injected with more in the hospital. How can anyone with a straight face recommend such immoral and directly unsafe and unsound practices?

    • Isilzha
      March 22, 2013 at 2:43 pm #

      Same here. I’m finding only articles about the parents being charged and not the outcome of the trial.

  44. mollyb
    March 22, 2013 at 11:02 am #

    This is so sad and sick it almost reads like fiction. That poor mother–her grief just bleeds off the page. That “midwife” deserves prison.

    • mollyb
      March 22, 2013 at 11:07 am #

      Also, I can’t get beyond what happened to the other family. “Who am I to say who’s small?” Seriously? My older daughter was 5 lbs 14 oz and she was miniature. I can’t imagine how small a baby who weighed less than 3 lbs was.

      • Amazed
        March 22, 2013 at 12:10 pm #

        Oh my. That’s exactly what my mother thought when she first saw the newborn daughter of her best friend. Baby was 1 month old and my mom’s first thought was “Why is she so small? My babies were born bigger than she’;s now!” Of course, she realized that she couldn’t judge who was small. The important thing that the baby was full-term, healthy and born to relatively small parents. Today, she’s about a head shorter than me.

        Who am I to say who’s small? That’s what a friend, a stranger or anyone should think. Anyone BUT a fucking HCP provider.

        • The Bofa on the Sofa
          March 22, 2013 at 12:43 pm #

          My response was, if you can’t say who is small and who isn’t, you have no business delivering babies. As Amazed notes, she is supposed to be a fucking health care provider!

          The sad part about this is that she isn’t really saying that she can’t tell who is small, but her real message is that she doesn’t think being small matters. It’s all just a variation of normal.

          • Amazed
            March 22, 2013 at 4:02 pm #

            Oh yes. And having many names – five? Six? – is another variation of normal.

            I wonder what this midwife would have thought about Maelys the Monstrous. He’s a historical character from George R. R. Martin’s “A Song of Ice and Fire” series and is supposed to have eaten his twin brother in the womb, thus growing a second head sprouting from his neck. I imagine she would have thought it was just a variation of normal.

            But it’s… well, amazing how many people think that preemies are just like full-term babies, just smaller. They are not and it should be obvious to anyone.

        • Dr Kitty
          March 22, 2013 at 1:59 pm #

          True that. My kid was 6lbs 3oz at birth and we didn’t leave the house with her until she was 2 weeks old and complete strangers would still ask me if she was premature because she was so tiny!

          If you look at a 33week, sub 3lb baby and think”well, he’s breathing, so my work is done, see ya!” you should not be around neonates. The end.

      • LovleAnjel
        March 22, 2013 at 1:42 pm #

        My nephew was under 3 lbs and his twin sister was just under 2 lbs. Babies that premature do not look “right”. It’s not like they are miniature versions of full-termers, their skin is translucent and proportions are a little off. You have to be willfully ignorant to think a babies under 3 lbs looks fine.

      • jessiebird
        March 22, 2013 at 3:17 pm #

        I agree. Anyone regularly around newborns would be able to see if a baby is term, healthy, big or small.

        My daughter was 1190 g(2lbs9oz) at 33 weeks. When I saw her in the NICU, I was scared to hold her, she was so tiny. I thought I would break a little bone. She had no fat and it was so strange that she didn’t have the bottom and vagina creases you see on bigger babies. I didn’t expect that and it was hard because to be honest, I think a decent layer of fat gives a person a more human appearance. She gained and is perfect but small now, bottom creases and all.

        If Ethan was 33 weeks and about 3 lbs, I imagine he looked as scrawny and unfinished as my baby. I am wholly untrained in neonatalogy, but I could clearly see my daughter needed the incubator and feeding tube. She couldn’t even try to nurse for more than a month.

        Poor babies. I am so sorry for the loss of their lives and all the grief their parents must endure.

        One more thought, it sent chills down my spine when I saw this midwife used an alias. Seems deliberately criminal. Lying so fundamentally for her own agenda. It’s some kind of serial pathology–maybe not murderousness per se, but a need for some kind of power and control, or voyeurism or something.

      • Guestll
        March 22, 2013 at 3:54 pm #

        I’ve posted this before, but my mother was born at home in England during the war, at around 33 weeks, weighing 3 lbs. 5 ozs. She was not expected to live, and was swaddled and placed in a roasting tin in an open oven. Miraculously, she did survive, though she required a few operations on her eyes as a small child.
        My late Nana’s journals are quite revealing…”B____’s head is smaller than a teacup” — and that was written when my mother was a few weeks old!

        • auntbea
          March 22, 2013 at 7:50 pm #

          My dad was born two months early in Sierra Leone in 1937. No roasting pan, though. He got a shoe box.

          • Sue
            March 22, 2013 at 10:25 pm #

            A whole shoe box to himself? Luxury! 😉

          • Amy M
            March 23, 2013 at 7:33 am #

            All 12 of us had to share a shoebox! And eat coal! (love that skit, esp. w/Eddie Izzard)

        • Karen in SC
          March 22, 2013 at 10:22 pm #

          wasn’t it your mother that was delivered by a veterinarian during the war? apologies if not, miraculous either way. 🙂

  45. Jules
    March 22, 2013 at 10:52 am #

    Hi, long time lurker here. I finally had to comment because after reading the post, I just sort of stared at the screen for a while. This is horrible. The mother’s grief is so profound that you can even feel it through her words.

    • Becky05
      March 22, 2013 at 9:29 pm #

      Yes, it is just awful. Reading the entire post on the original site is even worse.

  46. March 22, 2013 at 10:46 am #

    I just keep thinking at some point I will become numb to the litany of these stories…..but alas my revulsion never abates one little bit.

  47. March 22, 2013 at 10:44 am #

    “Kocher refused to comment on the allegation she used an alias. According
    to court documents, she has also used the names Sharon J. Kocher, Vicky
    J. Newman, Victoria J. King and Victoria J. Smith.”

    Neither here nor there but…

    Animal hoarders are now considered to suffer from a mental illness. Hoarders have sky high recidivism rates unless they receive treatment. Although animal welfare organizations share information on known hoarders, hoarders can avoid detection by moving (applicable laws are local) and by changing their names or using aliases.

    In my opinion, a midwife who moves frequently or serves an improbably large area should be suspect. A midwife who has practiced under multiple names for no apparent reason should be suspect.

    The same applies to a birth center or midwifery practice.

    • manabanana
      March 22, 2013 at 1:48 pm #

      Not to nitpick, but you missed a few names:

      Sharon Vankirk,
      Virginia King,
      Virginia Kocher,
      Victoria Newman,
      Vicky West,
      and Sharon King

      Per court docs out of Missouri.

      • Certified Hamster Midwife
        March 22, 2013 at 6:19 pm #

        Three last names and only a few first names/nicknames, well, that could just be someone who’s been married a few times and chosen to go by different nicknames at different points in her life. Lots of Vickys become Victorias.

        This many aliases indicates that she’s doing something very wrong, knows it, and doesn’t care.

    • Antigonos CNM
      March 24, 2013 at 2:33 am #

      This is why I don’t think much progress can be made until the education, licensure, standards of practice, general oversight, and laws pertaining to all aspects of midwifery (including maintaining birth registers and data collection) are managed on a NATIONAL level. It’s just too easy to move somewhere else and change one’s name. Of course the lack of a real means of establishing one’s ID (Social Security number is about as close as the US comes) doesn’t help.

      It’s true that doctors are licensed state by state. But the requirements are pretty standard, and doctors long ago realized that it was beneficial to strictly police their own profession. There are the occasional Dr. Biters, but they are the exceptions, not the rule.

      • Sue
        March 24, 2013 at 11:03 pm #

        Antigonos – how can your professional and licensing organisations be made to call these people out? Isn’t it in their best interests to exclude the rogues?

        • Antigonos CNM
          March 25, 2013 at 1:05 am #

          [Personally, since I don’t live in the US, it isn’t a problem where I do live, since the practice of midwifery in Israel IS regulated]

          Once again, the American passion for untrammeled “freedom” is what is mostly to blame. [1] States are in charge of both defining midwifery and regulating it. This runs the gamut from declaring ALL forms of midwifery illegal to allowing ANYONE present at a birth to be called a midwife. [2] There is no consensus on who precisely a midwife is, and as I’ve noted before, there is a veritable “alphabet soup” of credentials out there. [3] There isn’t even a consensus that the CNM qualification should be the only one allowed. Barbara Herrera, for example, who writes the NavelGazing Midwife blog, is a CPM only. Even the American College of Midwives is reluctant to “disenfranchise” direct entry midwives and try to create a lobby for making the CNM qualification the ONLY acceptable and legal one. [4] The “professional organizations” [such as there are] have no power, either on a state or national level. IMO, the impetus would have to BEGIN at the Federal level, with the Health Secretary taking the lead. And for that, statistics would be needed, on a national level, submitted by each state. That alone would require some kind of legislation in Washington, and I bet, on principle alone, there would be states who would balk at it.

          And lastly, the non-professional midwives themselves form a small but vocal lobby as part of the NCB and homebirth movement, claiming they have a perfect right to be what they are. And that goes back to the beginning of my post. At present, the best that can be hoped for would be that the ACM would embark on a public education blitz, which would not only be expensive but would probably cause divisions within the organization, against the use of non-CNM midwives. After all, many of the women who engage midwives out of hospital these days have little or no knowledge of what midwifery actually entails, and cannot make informed choices even if they wished to do so.

  48. An Actual Attorney
    March 22, 2013 at 10:42 am #

    She’s a freaking serial killer! It’s so sad.

    • March 22, 2013 at 10:45 am #

      I’m beginning to think this is true for certain midwives.

    • MaineJen
      March 22, 2013 at 10:45 am #

      My thoughts exactly. She’s a serial killer, but because her victims are babies she’s getting away with it. She needs to be stopped. She’s using the veil of ‘midwifery’ to get away with murder…the use of multiple aliases is very telling.

      • An Actual Attorney
        March 22, 2013 at 11:12 am #

        It makes me wish for Dexter.

      • Renee Martin
        March 22, 2013 at 12:07 pm #

        Serial killer MW Brenda Scarpino aka Brenda Newport is doing the SAME thing. I think she’s up to 7-8 deaths now, and yet people keep hiring her (unknowingly in some cases), defending her, and the state does nothing to stop her.

        Maybe I should call in a tip that she smokes pot or wears red/blue (possible gang color!), so the authorities would check her out (since those things lead to jail more than killing a baby does).

        • Bombshellrisa
          March 22, 2013 at 12:13 pm #

          Brenda Scarpino is a menace. Reading about her makes my blood boil.

        • anonomom_LLLL_IBCLC
          March 22, 2013 at 12:23 pm #

          I wonder if the IRS would also be interested in a business that has so little regard for rules and laws.

          • Karen in SC
            March 22, 2013 at 12:54 pm #

            see above comment. The anonymous tip line can be found at irs (dot) gov and search for fraud.

        • Karen in SC
          March 22, 2013 at 12:52 pm #

          You could certainly call the IRS fraud line if you suspect she isn’t reporting the income from her midwifery business. Amounts over $600 per year are required to be reported and subject to income and SS and Medicare taxes. And of course state taxes.

        • Lisa the Raptor
          March 22, 2013 at 10:14 pm #

          is that Mary Beth’s midwife?

          • areawomanpdx
            March 23, 2013 at 12:58 am #


        • March 23, 2013 at 8:32 am #

          It is a bit of a puzzle that you have a modern discourse along the lines of birth is safe and natural and seldom goes wrong running in parallel with a much older one that accepts that “babies die” – so such deaths should not be investigated too closely, and no-one should ever be held responsible. If anybody really cared about the welfare of women, you would think some better research could be done to figure out just why, and distinguish the inevitable from the just shouldn’t happen.

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