In the UK, babies continue to die on the altar of vaginal birth

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It’s inevitable, really. When you elevate the process of birth over the outcome, you have to expect that babies are going to die preventable deaths.

That’s precisely what has been happening in the United Kingdom. Driven in part by the immoral, self-serving UK midwifery obsession with vaginal birth, babies who could have easily been saved by C-section are dying at vaginal birth. Driven by the desire to save money in the short term by reducing the C-section rate, the National Health Service has experienced an appalling explosion in liability costs for dead and brain injured babies.

I’ve written in the past about this deadly obsession with vaginal birth:

Promoting normal birth is killing babies and mothers
Midwife : UK deaths result of failing to meet the needs of … midwives?
New document on British maternity services is fundamentally unethical

Not surprisingly, the amount of money paid for bad outcomes and the cost of insurance coverage have skyrocketed (A fifth of maternity funding spent on insurance):

Public Accounts Committee chairwoman Margaret Hodge said it was “absolutely scandalous” that £482m was spent on clinical negligence cover last year.

The MP’s comments came as a National Audit Office report shows that the NHS in England forks out the equivalent of £700 per birth on such cover.

The most common reasons for maternity claims are mistakes in the management of labour or Caesarean sections and errors resulting in cerebral palsy, the NAO report states.

In other words, the obsession with vaginal birth and the concomitant obsession with lowering the C-section rate have led to an appalling number of infant injuries and deaths.

Those are the stark facts, but sometimes it takes a story to really drive the point home. Beatrix Campbell has lived such a story and today she tells it in the Mail Online, ‘I begged for a Caesarean – but the midwife refused and my baby girl died: As minister holds maternity summit, a mother’s angry open letter. The letter is published in response to a government sponsored maternity being held today.

I wish I could reprint the entire piece because it is both brilliant and appalling, but I can only offer quotes.

My daughter Alexandra suffered a barbaric death at just three days old as a result of appallingly substandard care in 2009.
So I hope today’s seminar will be a soul-searching event. Top of the agenda should be last month’s horrifying finding by the National Audit Office that the number of lawsuits involving ‘obstetric damage’ is rising – as well as ‘significant and unexplained variations in rates of obstetric complications and interventions’.

Behind the jargon there are the stories of babies left with a lifetime of brain damage or, worse, stillborn or dying soon after birth. Stories of babies like Alexandra.

Why does this happen?

What is going wrong? One of the major problems is the conveyor belt mentality that pervades some maternity units.

This is based on the extraordinary idea that there’s a right and wrong way to give birth – natural childbirth is ‘good’, while women who have problems during labour are failing or are even making trouble.

What happened to Alexandra? Her mother was admitted to the hospital for a postdates induction at 42 weeks of pregnancy:

So, 30 hours after the induction had started, with the birth canal still barely dilated, I begged the midwife to organise a Caesarean. I was shocked that the request was brusquely refused as unnecessary. From then on, I was a silly girl making a fuss.

When I requested a second opinion and asked to see the consultant obstetrician, with my husband Craig repeating the request, we were ignored.

If the team had followed national guidance, based on the evidence on what makes for safe obstetric care, I would have had surgery at that point.

Indeed, in its internal inquiry into the death of Alexandra, the hospital acknowledged that our daughter could have, and most likely would have, lived had she been delivered by Caesarean at that point.

Why was Beatrix denied the C-section that she both needed and requested?

At the time of her birth, the World Health Organisation had quotas in place to decide how babies should be born: a hospital should allow no more than 15 per cent of all births to be Caesarean – Britain’s current rate is 25 per cent. That was being ignored as unscientific in many units. After all, how could a decision on safe birth be decided by quota?

Indeed, the quota was withdrawn in 2010 amid a scientific scandal over evidence that it had been drawn up virtually at random.

So Beatrix was forced, without her consent, into a mid-forceps rotation and delivery with Kielland forceps.

Without explanation, I was transferred to an operating theatre where an untrained and unsupervised junior doctor turned Alexandra’s head without moving her body, injuring her brain and spinal cord so badly she was unable to breathe on her own. She was left so severely brain damaged she was on a ventilator for three days before she died in my arms.

What has the health service done in the wake of Alexandra’s death?

Yet four years after Alexandra died we have not received a proper apology from the hospital and we know there has been no disciplinary action against the junior doctor who effectively killed our daughter or the senior doctors who failed in their responsibility to do no harm.

Edinburgh Royal Infirmary carried out an inquiry of sorts conducted by the senior doctor and midwife most closely implicated in Alexandra’s death.

At a meeting with us, they added insult to the terrible injury we’ve suffered by informing us we were ‘just unlucky, very unlucky’.

I was told by a senior midwife that I must keep quiet about Alexandra’s death because the incident might frighten future patients…

In other words, nothing has been done.

So more babies will continue to die on the altar of vaginal birth, and the payouts for obstetric disasters will continue to rise. That’s the price for focusing on process instead of outcome.

Apparently British health authorities are willing to pay extraordinary amounts of money to increase the vaginal birth rate and decrease the C-section rate. And British babies are forced to pay the price with their lives.

  • Amanda Spears

    This dangerous and appalling phenomenon is catching wind across the pond as well. Women in my social circles are touting the doctrine of natural birth and breastfeeding as though it’s sacred truth. My daughter and I would not currently be here if it was not for a c-sec, yet some women look at me as though I have committed a heinous crime or spoke blasphemy. Mind you, I was in labor for 36 grueling hours before my OB finally decided to okay the surgery; which is a story in itself. I agree with your post that a safe delivery should be the central focus of delivery, not the manner in which it is done nor its percentage. Practitioners and patients alike are becoming lost in the numbers, which is causing women and their children to become a statistic. While I agree that natural birth is great, if physically possible, that does not mean it’s better. The method of cesarean was born from failed “natural” birth. Women and their unborn babies were dying, thus there was a need for an alternative. In the same fashion, children were starving and out arose formula. In reality, for those purist, natural birth is not truly natural if taken in its true context, yet it itself has been redefined to embrace the western culture or modern civilization which we live in. Natural use to mean something is in its purist unaltered state, which is unobtainable unless a woman is giving birth in the bush. I chuckle when women are quick to tout their natural birth story, when hearing the story of a cesarean delivery, because lying in a jacuzzi tub or on a posturpedic mattress in a birthing center is just as natural as putting a chicken in a suburban backyard and calling it free range. Bottom line, the method of birthing or feeding a child should not be as concerning: we should just be happy that it is done.

    • Young CC Prof

      I agree. Matter of fact, I think the medical authorities of Planet Earth should just stop tracking, monitoring and publishing c-section rates altogether, because it’s a focus on the wrong thing. Instead, we should be focusing on outcomes, particularly death or serious injury to mother or child during birth.

      Think about it. If you’re comparing hospitals on their cardiac care, how many patients get treatment A vs treatment B is pretty far down the list of what most people look at. Instead, they look at things like survival rates, infection, etc. Only in maternity care do the hospitals get graded on process rather than outcome.

      Maybe it’s because the worst outcomes, maternal deaths, are so very rare. In the USA, there are something like 700 deaths each year related to pregnancy or childbirth, in the entire country. (Not all IN childbirth.) There are over 5,000 hospitals in the USA, which means most hospitals had zero maternal deaths, and presumably only the most specialized hospitals had more than one. How can you study an outcome that’s so rare? You can’t, you need to start looking at more common issues, like birth injury to the baby. Which is STILL impressively rare.

  • http://www.hfme.org/ Thy Miocena

    Scary. I think the philosophy of midwifery is inherently flawed even when they do have better training than in the states. Its not women’s natural fucking calling to push a baby out specifically out of our vaginas. There is nothing less moral about a c-section or interventions in general. I wouldn’t want one anywhere near me in such a stressful time as giving birth.

  • MichelleJo

    I gave birth once gave birth in the UK.The hospital I wasinhad a policy of only checking dilation every4 hours; another stupid, based on nothing rule. I came in at 4cm and was progressing fast, as in number, strength and length of contractions, but the midwife was more out of the room than in, ‘writing notes’. (Is there an NCB rule where you can’t write in front of a laboring mother?) It was my second birth, my first birth had only been a few hours, so I was worried she wouldn’t be there when it was time to deliver. I asked her to check me, explaining why, but she refused, saying there was another 2 hours until I was due to be checked. When I told her why I was worried, she brushed it off saying she would be “able to tell” if the baby was coming, and breezed out of the room. The next time she appeared, I was feeling a bit pushy, and had to BEG her to stay in the room. She turned a bit cold towards me, but she did stay. A few minutes later, my waters burst and the baby was born, an hour and a half before she was scheduled to check me. So no room for using your brains or judgement, just follow protocol, and you’ll get into no trouble. Also, she was the only person I saw from beginning to end, including the actual birth. Felt a bit dangerous to me.

  • Lizzie Dee

    OT, slightly. I guess this story hasn’t made much of a stir in the US – yet.

    http://www.telegraph.co.uk

    Causing something of an uproar here, not surprisingly. More specific information toning it down slightly – but still an extraordinary state of affairs.

    • FormerPhysicist

      Do you have specific link?

    • An Actual Attorney

      http://www.telegraph.co.uk/news/uknews/law-and-order/10496054/Forced-caesarean-was-manifestly-in-Alessandra-Pacchieris-interest-says-judge.html

      This case? I’ve heard quite a bit, but I love the BBC and the Canadian news, so maybe not the best test case…

    • Hannah

      The full Court of Protection judgement (that ordered the caesarean) and transcript is here:

      http://www.judiciary.gov.uk/Resources/JCO/Documents/Judgments/re-aa-approved-judgment.pdf

      The final care proceedings judgement is here:

      http://www.judiciary.gov.uk/Resources/JCO/Documents/Judgments/re-p-a-child-approved-judgment.pdf

      The upshot of it all is that an Italian woman was in the UK, she says for a training course with Ryanair, although the care proceedings judge said the circumstances of her being here were “not entirely clear” to him. She was heavily pregnant, and suffered what was initially reported as a “panic attack” but seems to have been an acute psychotic episode. She was described by the health authority’s lawyer in the Court of Protection hearing as having a “schizophrenic disorder with psychotic features.” She had been treated, in Italy, for Bipolar, over a prolonged period of time, and was described by the judge in the care proceedings as having such with “very intrusive paranoid delusions.” Whether one of these was a misdiagnosis is not clear.

      She ended up being sectioned for five weeks under the mental health act, and eventually had a caesarean under court order. This was initially reported as being at the behest of “social workers,” implicitly for child protection reasons. Actually, it was the health authority, not the local authority social services that brought the case, and they did so because she’d had two previous caesareans and the Obstetrician wasn’t confident that the risks of labour could be managed as he thought she might be uncooperative or even conceal her labour.

      The baby was taken into care after birth, and the mother had had both previous children removed from her care in Italy, and placed with her mother. It appears the mother is unable to take on the third child but the family proposed to send all three children to live with the sister of the eldest child’s father, in America. There was also a proposal for the baby to live with a relative in Senegal, where her father is from (he’s currently in Italy but doesn’t have leave to remain). These proposals were rejected and the baby is being put up for adoption in the UK but the case has been remitted to the chair of the High Court (Family Division).

      As you can see, all very complicated. The people most responsible for pushing it into the media all have “form” for misinformation:

      http://www.headoflegal.com/2013/12/04/booker-hemming-and-the-forced-caesarian-case-a-masterclass-in-flat-earth-news/

      This is the position “BirthRights” is taking:

      http://www.birthrights.org.uk/2013/12/views-on-the-forced-cesarean-judgment/

      • T.

        Honestly, if the baby gets a good adopted family… it would be the best outcome.

        This woman is probably unfit to be a mother, sad as it is :(

        I know it is going to raise flame, but I wonder about forced birth control sometimes.
        *put on abestos suit*

  • Miranda Hedin

    My son was born via C-section after being induced due to PIH. Before going to the C-section he was in distress twice and even had a code called at one point. Without the C/S either he or I (or most likely both of us would not be here today). I get really sick of hearing about how birth “isn’t a medical procedure” or that women have “been doing it on their own for millennium”. The fact is that in our case birth WAS a medical procedure, and thank God for that. And yes, women have given birth on their own for millennium but they have also died along with their children for millennium too and I choose not to become a part of that history.

  • Joyous76

    I just gave birth in a UK hospital last week. I am so happy I developed cholestatis in the last week of my pregnancy, since this meant I was risked out of the birth centre. I dilated very quickly and everyone said it would be done in 30 minutes. Two hours later, with short contractions and not much movement, the Consultant came in and said she needed to be out now, with forceps. I asked, about Kielland and he said no, low ones. The midwives argued with him a bit, but I just consented to everything in about two seconds.

  • Carolina

    I am thanking God and the US medical system that I was in a hospital with no qualms about its 30-something% section rate when my daughter started having late decels soon after the induction. Neither one of us suffered from my c-section (other than a few weeks of easy recovery for me).
    Measure actual bad outcomes, not just section rates.

  • DaisyGrrl

    This is so disturbing. The NCB ideology has crept into public health policy and it is costing lives, money, and patient autonomy. In my Canadian city, we have a hospital that is actively trying to lower c-section rates in the name of improving maternal outcomes (or saving money or something).
    I really wish there was a way to convince people (especially policy makers) that c-sections in and of themselves are not indicative of a poor outcome. A dead baby or brain damaged baby is a poor outcome. Incontinence is a poor outcome. A scar is not.

    • http://Www.awaitingjuno.blogspot.com/ Mrs. W

      DaisyGrrl – where are you? I’m Canadian – I blog at http://www.awaitingjuno.blogspot.com – and I’d be interested in connecting.

      • DaisyGrrl

        I’m in Ontario. I’d rather not get more specific than that online. :)
        I’ll contact you through your blog in the next couple of days – I’ve been meaning to get in touch with you sometime. I’m not at all happy about the state of affairs here and would love to get involved in trying to advocate for change.

  • Meerkat

    This is so awful! I am wondering what should a patient do if she finds herself in a similar situation?

    • KarenJJ

      The idea that a grown women in fear and pain can have her reasonable requests for a second opinion or her pain alleviated is horrifying to me. Midwives are building the sort of ‘patriachal’ care model that they declare they despise.

      • Meerkat

        Yup. Incompetent cowards.

      • http://kumquatwriter.wordpress.com/ Kumquatwriter

        I’ll say it again: A nurse imbued with NCB ideology ignored my birth plan and made my birth experience hellish (delayed epidurial, inserted the catheter angrily and caused me to feel all the labor pain *in my bladder*, told me I couldn’t push the more-epi button without her *permission*…)

  • auntbea

    Why was a doctor who doesn’t know to use forceps allowed to use forceps? While a c-section certainly would have prevented the whole episode, that seems like that is the place where the whole thing broke down.

    • Maya Markova

      I have not been there of course nor have I the expertise, but I guess that staff saw the situation getting out of control and intentionally placed the junior doctor at the frontline, to wash their hands with his inexperience when things go wrong. You see that it works – the mother wants the young man punished.
      I knew an obstetrician who was a great doctor (and great personality) but developed Alzheimer while still in his active years. He was failing in his tasks but failing also to realize this, so he did not quit his job. His bosses, instead of retiring him, used him to give him the difficult cases and then wash their hands with him.

      • The Bofa on the Sofa

        I agree with Maya. I’m not ready to blame the young doctor, who got thrown into a situation way of out control and tried to do something. The system is really messed up to let it get as far as it got.

    • Susan

      I can’t even understand why anyone would still be using Kielland forceps. I actually believe there is still a place for forceps but I haven’t been to a course that mentioned forceps in my 25 year career that didn’t say that there is no longer a place for a mid forceps rotation. It’s hard to imagine it’s that different in England given that you can have a safe cesarean there. The only reason I can see for even knowing how to do these types of difficult forceps deliveries would be if you were working in an part of the world where cesareans were dangerous or hard to access.

  • Felicitasz

    I want to scream.

  • The Computer Ate My Nym

    I’m going to put the blame here primarily on the quota system. NOTHING in medicine should be on quota. Not length of stay, not frequency of admission or readmission, not use of specific medications, not percentage of patients with insurance type X admitted. And guess what? Every one of those examples is based on a quota or proposed quota I’ve encountered practicing medicine in the US.

    • http://Www.awaitingjuno.blogspot.com/ Mrs. W

      It’s this that disturbs me the most – and has me seriously questioning my profession (health economics). These things are easy to measure – and rather than measuring (EGADS, we’d have to collect data!) what matters we don’t. Beware the unintended consequences of well-intentioned but wholly inadequate performance measure – and heaven help you the instant they attach money to it.

      • The Computer Ate My Nym

        The patient satisfaction surveys seem to me to be a good example of this: There’s actually a negative correlation between quality of care, measured by outcomes compared to severity of disease at presentation, and good scores on patient satisfaction surveys. But guess which one Medicare is using to decide which hospitals will be preferred by them?

    • http://shameonbetterbirth.wordpress.com/ Shameon Betterbirth

      some things should be on quotas, some things should not. Like % of morning labs and vitals taken on time- thats a reasonable thing to put on a quota system. C-section births-not so much.

  • The Computer Ate My Nym

    the NHS in England forks out the equivalent of £700 per birth on such cover.

    As a US-American, I have to say, “They’re worried about spending 700 pounds per birth on malpractice? Aw…that’s so cute!”

    Sigh. If only they were so worried about whether or not practitioners were committing malpractice.

    • Hannah

      What would the equivalent figure be in the US?

      • Trixie

        Hundreds of thousands, at least. Maybe millions.

        • The Bofa on the Sofa

          No, this PER BIRTH. Not per case. They are distributing the cost over all the births.

          • Trixie

            Ah, I misread. Thanks.

      • The Computer Ate My Nym

        I have to admit that I don’t know the per case number for certain. I’m estimating in the thousands, but may be off. Any OBs want to comment?

  • http://Www.awaitingjuno.blogspot.com/ Mrs. W

    It is incredibly distressing. Birth is not without risk – it happens one of two ways, women deserve informed consent and they deserve recourse when due to a deprivation of that they are harmed. I feel for this mother – tragically because her baby is dead – the remaining injuries (psychological and physical) – likely mean that her case is “uneconomic” to persue through the courts.
    I’ve heard through the grapevine, that despite the revised 2011 NICE guidance on Cesareans women in the UK are still having an incredibly difficult time accessing them. It is a travesty.

    • stacewyjw

      This is one case where more lawsuits with sky high payouts would help. I know they don’t really do that in the UK. IN the US they would have gotten a large amount, even with the baby dead. Sometimes it does take the very real threat of legal action to keep dangerous ideology at bay.

      We need better economic evaluations. The current ones ignore so many of the long term costs. I am sure that just one or two brain damaged babies would outweigh any savings from CS.

      • The Computer Ate My Nym

        This is one case where more lawsuits with sky high payouts would help.

        Yeah. I hate doing this, but I’ve more than once told an administrator proposing an ill thought out “cost saving” measure that would endanger patients, “If we do this and something happens, we’d have no defense at all in a malpractice suit.” It’s amazing how the simple words “malpractice suit” bring them around.

        • attitude devant

          Keep saying it, Computer!

        • Carolina

          I’m a lawyer for a company, and I use that argument all the time. I am fully in favor of the US tort system. You cannot trust corporations to act in the best interest of the customers. There must be regulation and the threat of lawsuits.

          • Josephine

            I get irrationally enraged (or maybe it’s rational after all) when people go on and on about our “litigious society” here in the US. Well guys, unfortunately our government refuses to protect us sufficiently in all cases (and no government could, really), so it’s either lawsuits or pretty much no recourse short of burning down a company’s headquarters. I know which one I’d prefer.

          • The Bofa on the Sofa

            It’s not so much that the government “refuses” it’s that there’s so much more possible that could be done wrong than the government can account for. You can’t define every wrong thing, because if you try to do that, someone will figure out a way to screw someone over with the defense that, “There’s no law against it.”

            Nah, you need to have recourse when there is no law against it, despite it being wrong.

          • Josephine

            Yeah, you’re right, I didn’t mean for it sound as if I feel it’s the government’s responsibility to legislate every possible potential shitshow. That would be rather cumbersome and inefficient. Only meant to say that every law cannot cover every single incidence of wrongdoing or malpractice or sloppy business practices, etc. Clumsy wording!

          • Carolina

            I agree. I am in an extremely regulated industry and we fear/respect our regulators, but private enforcement is a valuable tool for everyone.

          • The Computer Ate My Nym

            I’m not 100% happy with the system as it stands for medicine: I don’t think it protects either doctors or patients optimally. Nonetheless, I’d certainly rather have it than not. What I’d like to have rather than “tort reform” is a system that provides care for people who are injured without bankrupting the family. Part of the reason any injured baby is a lawsuit, whether there was any wrongdoing or not, is that the family can’t pay for the care (acute medical, rehab, school support, etc) without the money provided by a lawsuit. So some families sue even when they feel that the OB did everything right because they simply have to to survive. That sort of thing needs to end.

      • rh1985

        Yep. I’d rather take our system, even with the frivolous lawsuits we sometimes get. If nothing else, this mother wouldn’t have been denied her c-section for fear of a verdict in the millions.

  • Antigonos CNM

    It is all very, very sad to see the degree to which maternity services have deteriorated in the UK. I chose to study at Cambridge in the 70s precisely because of the excellent international reputation of British midwifery training.

    BTW, I never saw midwives attempting to avoid transfer or denying a referral to a consultant. We worked under extremely clear rules regarding, among other things, when we had to notify the doctors that a labor was not progressing according to established parameters.

    I wonder if the change began when the requirement to be a registered nurse prior to becoming a midwife was removed. Exit medical and nursing professionals; enter the ideologues.

    There was NEVER justification for MID-forceps once C/S became feasible. Kielland forceps were rarely used–I saw them used more in the US, but even before I went to the UK they were regarded as belonging to an outmoded form of obstetrics.

    • Sguest

      I think and hope that it’s a case of some, not all, The results of such ideologically lead care are catastrophic though,

    • attitude devant

      Antigonos, I trained in the US in the 80s. We were shown Kiellands, and in the same breath were told to NEVER use them in ANY setting where c/s was available.

      • Antigonos CNM

        Two things: both of you make important points. I’ve seen beautiful deliveries in the hands of experienced practitioners–here, doctors who had worked during the Ceaucescu period in Romania when getting a C/S was almost impossible. Also, being prepared to go to C/S immediately means knowing what is feasible–and it isn’t a way of saving money.

        Back in my early days, residents had to compile statistics before taking their Board exams, and I worked at a teaching hospital. I’d come on duty, and be told “Tonight it’s Hawks Dennen, ladies!” by the doctors. To be honest, usually they applied the forceps at the very last moment, just so they could add to their numbers (one dr. Joked that he “showed” the forceps to the baby), but what it meant was that they did know how to use them. I’m also old enough (I graduated in 1967) to have worked with doctors who had 20 or 30 years’ experience with all kinds of forceps; today it is much different.

    • CanDoc

      Hmm… I use Keilland’s occasionally, carefully, and with a double set-up in the operating room so that a cesarean can be done immediately if there is any concern that things aren’t going exactly according to plan. Any woman going for a Keilland forceps with me is offerred the alternative of going directly to cesarean section (and about 1/3 of women choose that in my experience). #1 goal = “gentle” delivery. The Keilland’s aren’t the problem. The unqualified practitioner and ideology that favours vaginal delivery over safe delivery is the problem.

  • Lilly de Lure

    OK now I’m scared – that’s where (if I succeed in getting pregnant) I’ll be giving birth!

    • guest

      Don’t be because on the most part it’s a good place to be. However, if you don’t get a good feeling from your midwife get your birth partner to insist upon a) a second (obstetric) opinion and b) new mw.

    • Kiwi

      It’s not bad – had my first child there but was very very busy. I nearly got transferred to St Johns as there were no delivery rooms available (after they started induction that morning). Midwives and Doctors that I met were all great in induction/delivery but postnatal midwives were a bit scary and it was only that there was a trainee there that I got any decent support with breastfeeding.
      p.s. If you plan to breastfeed get details from your antenatal midwife about where/when clinics are held. My health visitors had one once a week and it was great going along asking questions, getting baby weighed and having someone make you a cup of tea! Definitely helped me and others with any issues that arose.

    • Lilly de Lure

      Thanks for the reassurance/information!

  • Sguest

    I had my 2nd baby in that hospital, the consultant lead part. The midwife was awful, made fun of me during my labour. Chatted to my husband about where she’d been on holiday, described me as ‘primal’ to a student….urgh.

    • Wren

      I hope you complained. I think there is a tendency to not complain that leads to some terrible people being allowed to continue in patient care when they shouldn’t.

      • Sguest

        I haven’t got round to it yet, but I will, it wasn’t very long ago. I should add that I got to bring my beautiful baby home with me and for that I am, of course, so grateful. I just wrote that to illustrate the unprofessionalism of some of the people who work there.

        • http://Www.awaitingjuno.blogspot.com/ Mrs. W

          I think that’s part of the problem – it’s hard to “criticize” when you bring home a beautiful baby – but that just allows things to continue.

    • moto_librarian

      I also hope you filed a complaint. This bullshit has to stop.

    • The Computer Ate My Nym

      Primal? Dare I hope she meant “prima (gravida)” and just got confused on the wording?

      • mollyb

        She said her second baby . . .

        • Sguest

          She meant primal. I didn’t have an epidural and it was the student doctor’s first time witnessing such a birth (his first day, I did a good job of putting him off obstetrics I’m afraid).

          I arrived so far into everything, having been on another planet and in complete denial that I was definitely in labour, that I didn’t have time for any pain relief at all. All I managed was to ask for the gas and air and a cup of ice cubes. Ice cubes were great, gas and air I don’t know because I handed it to my husband and he forgot to give it back to me! For DAYS I thought that the midwives had taken that off me too until finally my husband owned up and said that he’d had it in his hand and I just hadn’t asked for it again so he didn’t give it to me!!!

          At the end of everything one of the mw asked me if I was proud of myself of giving birth without any pain relief and I just couldn’t believe what I was hearing. Especially given that at the time I thought that I’d only not had pain relief because they hadn’t given it to me!

        • The Computer Ate My Nym

          Um…duh! Sorry!

  • PrimaryCareDoc

    OT- What is up with all these random parachuters necro-bumping threads today?

    • Josephine

      It seems to be a recurring theme in the last couple weeks. Very annoying.

      • Elizabeth A

        Dr. A commented on an MDC thread last week, and there’s been resulting traffic.

        • PrimaryCareDoc

          Ah. Mystery solved.

  • Mel

    My heart goes out to Beatrix, Craig and Alexandra. A senseless death worsened by a self-centered and callous response by the medical professionals who should know better.

  • moto_librarian

    I am a layperson, but there are clearly red flags even to me.
    - 42 weeks gestation
    - 30 hours of unproductive induced labor with no follow-up with the consulting OB
    - Improper use of forceps
    This story absolutely breaks my heart. We are allowing a fringe group of women to dictate how maternity care ought to be done, and the consequences are appalling. Here’s a clue to you lunatics who worship at the altar of nature: most of us DO NOT want to give birth the way that you think we should. Most of us are grateful for modern obstetrics, analgesia, and other “interventions” that save our lives and those of our children. That a woman should suffer the entirely preventable loss of her child in the developed world in a hospital is outrageous. What do we have to do to remove this moronic ideology and replace it with compassionate, evidence-based care?

    • theadequatemother

      Another big red flag – wtf is a house staff/ registrar doing when they decide to do a mid pelvic rotational forceps in the OR on their own? Would they have been able to move to cs on their own if the baby became distressed?

      We have generally much closer supervision of trainees in NA.

      • moto_librarian

        And why wasn’t he reprimanded in some way for this?

      • Dr Kitty

        The term “junior Doctor” is confusing, it means everyone from the F1 just out of medical school for a week to the SPR with 8 years of specialist training and membership exams and everyone in between.

        A registrar (roughly equivalent to a US 4th year resident) would absolutely be able to proceed to CS without consultant supervision. The F2 on their 4 month OBGYN rotation…not so much.

        I’ve only ever seen Kiellands done by a consultant who’d been doing them since dinosaurs roamed the earth, and wasn’t teaching anyone how to do it.

    • Antigonos CNM

      The minute the patient ended her 40th week she stopped being a patient for a midwife unless she was working under a doctor’s supervision–or that was the rule in my time, according to the Central Midwives’ Board.

  • Mominoma

    Am I right in understanding they induced labor, when the baby was in a transverse lie? Seriously? OMG. I’m not a doctor, but that seems so ridiculously dangerous to me. My heart goes out to Beatrix.

    • theadequatemother

      I don’t think it was transverse lie – it sounds like occipit transverse presentation as opposed to OA or OP

      • attitude devant

        Yep, that’s why the Kielland’s. That’s what they are designed for. But we don’t use them in the US because the trauma to mom and infant is well-known. Persistent OT (occiput transverse) in the States is a recognized indication for c/s

        • Mominoma

          Thank you all! That’s what I get for commenting before finishing my morning cuppa. :)

          • amazonmom

            I saw the sentence about the baby being sideways and assumed transverse, probably because this kid of mine was transverse up until a few days ago!

        • Sue

          Isn’t the move away from forceps one of the reasons for a climbing C/S rate? I call that preventative medicine.

          • rh1985

            I agree, I’d much rather have a c-section than forceps.

        • VeritasLiberat

          Oh, my God. I could have been this woman; that’s what I had my first c-section for. I just made the connection after attitude devant’s post. My baby was persistent OT; 21 hours into the induction my OB and I decided it was time to go in and get the kid already, since there had been hardly any progress despite good contractions. Less than an hour later, we were looking at a beautiful baby with such alert blue eyes…now she is downstairs on the couch reading Shel Silverstein and giggling.

          What happened to Beatrix and her baby is a crime.

    • Antigonos CNM

      I did not see anywhere that the baby was a transverse lie. It is impossible to deliver such a baby vaginally, period. kiellands are more usually used to rotate a persistent occipito-posterior (Scanzoni Maneuver—which requires a VERY skilled operator)

  • Wren

    That is horrific.
    I have to say, this issue is one that varies hugely from hospital to hospital. The one I gave birth in was known for being “too consultant led” and had some unhappy midwives and patients who felt that it should be more midwife led care. They opened a birth centre on site between my pregnancies, but I never used it.

  • Karen in SC

    The numbers of British pounds reported doesn’t seem to take into account the enormous cost of care for the babies that survive with disabilities.

    • stacey

      Of course not, as those costs are born by other agencies.

    • Anonymous

      This is what happens when you have politics dictating medical care. I’m more or less certain that the use of forceps here is completely against the standard of care. What did they have to do? Dust them off?

      • Elizabeth A

        It’s my belief that some of the increase in c-section rates is caused by a decrease in instrumental deliveries. I am, for the record, ALL IN FAVOR of that shift. I had an instrumental delivery with my first, and if I had it all to do over, I’d have a c-section.

        It had been my understanding that the current standards of care were for instrumental deliveries to be “low” or “outlet” only – mid and high forceps deliveries are far more dangerous then c-section. It’s appalling that this woman and her baby were subjected to a hugely risky procedure, performed by an unsupervised doctor with outmoded instruments.

    • T.

      The cost are on ALL live birth. I would suppose that most births go without problems -and money given- but if you have 1 disaster and 1000 good outcomes, you pay 700000 pounds in total, the cost for liber birth is 700 pounds, even if in truth all 700000 went to the disaster…