Please join me in a big round of applause for Abel Andrews, Superhero!!!
Many small children dream of being superheroes, but Abel really is one. Even at his young age, Abel has saved lives and will continue to do so far into the future.
Who is Abel and how did he come to be a superhero?
Abel suffered permanent brain injury due to oxygen deprivation during his out of hospital birth. Abel’s mom Kristine told the story to a local Oregon TV reporter:
On the night her contractions started, Andrews said the licensed midwife with her at the time (Motherwise has a number of midwives on staff) was distracted by her own baby. That midwife sent her home, saying she had a urinary tract infection. Immense pain brought her back to Motherwise clinic that night.
The next day, when Abel was finally born, he wasn’t breathing.
Andrews said the midwives, licensed and unlicensed both, didn’t know what to do with a newborn that wasn’t breathing.
“They just had the look on their face of like trying to remember what they’d read in a book somewhere, like ‘umm, what do we do now?'”
After frantic 911 calls, the baby went to the hospital. Doctors warned, because Abel had gone so long without oxygen during labor, he might be brain damaged. The official diagnosis came a year later: cerebral palsy.
“They didn’t know if he’ll be able to walk, they don’t know if he’ll be able to talk, they don’t know if he’ll be able to sit up, he can’t do that now still.”
It’s a tragic story, all too familiar to those of us who track the increased rate of death and disability due to homebirth.
But it didn’t end there. Abel’s parents, Kristine and Greg, created a foundation, We Are Abel, to “protect and strengthen others” who face brain injury. And they filed a $50 million lawsuit, seeking to hold both midwives and state regulators responsible. They sued the state for failure to use evidence based standards in licensing and regulating homebirth midwives.
Ultimately, the suit against the state was unsuccessful, because the law ensures that most states cannot be sued for reasons like this.
Kristine writes:
November 27th, 2013 I received a phone call from my lawyer to inform me that The State of Oregon has received Sovereign Immunity in Abel’s lawsuit. Two and a half years of isolation, depositions and hope all crashing down around us. I don’t remember what all was said, and I have yet to read the latest manila envelope of neatly typed legal jargon that followed promptly in the mail. When my husband came home I was wailing, surrounded by my half prepped Thanksgiving dishes. Wailing is not crying. It is deeper. Like a scream and a roar from deep in your gut. Primal and raw, normally for the shower where the sound of the water can drowned it all out. But there my husband found me. He held me and I told him what they had said. He sat for a minute and I studied his face watching. Waiting for him to say.. “We were brave. We told the truth. We are RIGHT. They all know it. Abel MATTERS. What happened to our son should be acknowledged. THIS ISN’T FAIR!!!”
It isn’t fair! I’m sorry that Abel didn’t get the financial compensation he needs and deserves, but Kristine and Greg should not think that they didn’t accomplish anything. There’s nothing like a lawsuit, even an unsuccessful lawsuit, to focus a state’s attention. Single-handedly, they and Abel alerted the officials of the state of Oregon in a way that no one else could.
I suspect that everything from Oregon’s decision to collect their own homebirth statistics (which showed an 800% increase in the risk of death at homebirth) to growing scrutiny of homebirth regulations is rooted in the wake up call that the Andrews sent to state officials. Kristine, Greg, and above all Abel PERSONALLY have saved lives, even though they may never know just whose lives they have saved.
But, then, that’s the nature of superheroes. They protect the public with their extraordinary abilities and often are not properly acknowledged for their sacrifice.
So please join me in expressing heartfelt thanks to Kristine and Greg. You are my heroes!
And Abel? Most people never save anyone’s life and Abel has undoubtedly saved many lives and will continue to do so in every year in the future.
Abel is my superhero!!
Kristine and Greg Andrews, I salute you for your courage. Hopefully, your story will alert officials to hold midwives responsible for knowing basic infant CPR skills.
The Andrews have done more to change MWery in Oregon than anyone else. All the work groups and efforts wouldn’t have made a dent without them.
Thanks for speaking out.
Oh please. Kristine and Greg chose to have a non-hospital birth. Their child’s condition is their fault. It’s time for people to stop blaming others for their disasters that occur due to their stupid choices.
Your kind of right. Going to a midwife is a stupid choice. Almost of the disaster stories I hear about deaths and injuries while trusting a midwife to care for you and let you know when you need medical intervention, would have been completely preventable had the birth taken place in a hospital. My problems would never occurred in a hospital, but I was stupid enough to trust Motherwise was competent enough to let me know when I needed help. They let me suffer and I almost lost my life and my son’s life due to their negligence. The investigating midwife for OHLA even told me she could not believe the midwives did not understand my complication was life threatening. She said any midwife licensed or not would know this basic complication required a hospital transfer. I guess that makes Nicole, Christyn and Dana just as stupid as me, although at least I won’t be making that mistake again.
How were Kristine and Greg supposed to know that it was such a dumb idea? Their midwives were professionals licensed by the state, just like doctors.
One of the keys to the libertarian concept of personal responsibility for your decisions is that they are informed decisions. However, properly informed decisions cannot be made when one party lies. In this case, the folks at the birth center misrepresented their qualifications, and it was endorsed by the state. How is the consumer to be able to make that decision then? Since they are not experts, how can they be expected to tell when the others are lying?
The only way to protect others is to go after those who provide incorrect information that impede’s the ability to make a properly informed decision. That is what the parents are doing in this case.
When it comes to life and death, we cannot wait around for the market forces to work. We must ensure that everyone is working with honest information, and we have to stop those who are lying.
Sure, the parents made a mistake in using these providers. They know that now, as do many others (see Krissy’s comment below). But that doesn’t absolve the MWs from their professional responsibilities.
The midwives are lying and so is the state of Oregon, by licensing them as professionals competent to attend home births.
Edited to reflect that.
They chose a birth center, which is not an outrageous idea. You know that the big hospital chain here, Peace Health, operates a stand alone birth center too right? And the stats on credentialed birth centers are good.
There was no way for them to know any different at that time.
But kicking people while they are down is classy.
Oh please Flo Shields, next time engage your brain before commenting. Kristine and Greg chose what they were encouraged to believe were reputable providers, only to find themselves let down in the worst imaginable manner. That is not their fault. It is the fault of the midwives.
I have moderate cerebral palsy and hydrocephalus. I was born prematurely at 28 weeks (up until then, a normal and healthy pregnancy), intended to be a hospital birth. I was born in the car, speeding on the way to the hospital, and as a result of all these things, I have permanent brain damage as a result of a temporary lack of oxygen to my brain. I don’t blame my parents because this wasn’t something they had any control over.
Oxygen deprivation to a baby in labour can and does occur in either hospital or homebirth, but at least in hospital, you can possibly identify it and rectify it much sooner. Homebirth? You are shit out of luck.
“The flower that blooms in adversity is the rarest and most beautiful of all.”
Walt Disney Company
Dr. Amy, maybe it would be good if you listed the first and last names of the midwives in question within the article because it seems that some of them are still practicing and it would be good if a search on Google lead people to this page. Motherwise: Nicole Tucker, Christyn King and Dana Johnson. Also that it’s in Bend Oregon. You did it on this post: http://www.skepticalob.com/2012/04/oregon-homebirth-midwives-sued-for-50.html and it ranks high for their names because it’s in the article, I think.
Really after this post and seeing that there are THREE of us that gave birth within 45 days with bad outcomes from the SAME midwives (granted mine was a near miss, but only saved by the hospital) I am thinking about creating a site that is a directory of midwives where people can post their complaints openly and at the very least warn other mothers, since the system doesn’t seem to be working. Is there something like that already? Even just combining every midwife written about on this site plus the “sisters in chains” list would be helpful. Or would that count as slander?
There is always this.
http://oregonmidwifeinfo.com/midwives/
Good I am so glad someone did this. That is the scariest thing about homebirth midwives I have ever seen. It’s not a few isolated incidents, it’s the majority.
Click on the link of Clare Loprinzi.
“1995 — Following birth of baby the subject of complaint was unable to deliver the placenta. The baby was born on April 17, 1995 at approximately 8:00 a.m. According to the complaint, the mother attempted unsuccessfully to push the placenta out from that time until 2:00 p.m., at which point the plaintiff and the other attending midwife both abandoned the mother with the placenta still implanted in her uterus. When plaintiff returned at about 10:00 p.m. (14 hours after delivery of baby), the mother required immediate transport to the hospital, where she required immediate transport to the hospital, where she received a transfusion of blood, general anesthesia and surgical removal of placenta.”
I used Motherwise 15 days after Kristine. I filed an OHLA complaint against Nicole Tucker and Christyn King, but could not file anything against Dana Johnson because she did not have a license at the time.You can read the reports online. After waiting until my son was 1 years old , 2 “investigators” came to my house and interviewed me for 2 hours, and that was it. I was then told I was not privy to any information regarding my case. Almost 2 years later I got a message from the OHLA’s lawyer asking if I wanted to testify in court against Motherwise. They said they could probably fine them more money if I testified. However, I would receive no compensation and would have to be cross examined. The lawyer said they could subpoena me, but that would just look bad for OHLA. I declined on the principle that OHLA uses this money to keep their fraudulent licensure agency open. The license in Oregon is completely useless for parents that have experienced physical, emotional and psychological trauma from these women. I never received any information regarding my case and was told I could look online to see if the case was closed and read the reports. I never heard from OHLA again. Shame on you Nicole, pretending to “retire”. Glad Christyn is in Vermont, far away from me. Dana, you suck at helping any woman. I hope all of you met my friend Karma, she is quite the bitch.
Krissy, thanks for posting. I think you and Kristine A are so brave. Thank you for shutting down bad caregivers!
What is crazy is that between you, Kristine and myself that’s three moms who had negative experiences within about a month and a half in 2010 (mine obviously was the least). How many other women in Bend/Redmond must have stories about Motherwise? This is unbelievable to me that they’ve seemingly just “gone on with their lives” and left a path of misery in their wake.
There is also another complaint that was filed at OHLA in March 2011 against Nicole Tucker. Both of our cases are listed in the disciplinary actions on the OHLA website. That birth was in December 2010. I don’t know who it was. Anyone can read about the cases, mine has a bunch of other violations not listed in the case. In November 2009 there was a small complaint on Kristi Eckberg’s photography website, she did the photos in the birth center. I don’t know who that is either. It’s still on her website, along with a negative comment by me as well. I also saw a complaint once, can’t find it now, against Nicole, it was about her horrible business practices.
BTW, OHLA does not get involved with business, monetary disputes at all. I had lots of those too.
You know the sad thing? I cried for a week after my birth because I thought I had “wimped out” on home birth. Really I should have reported her for failing to risk me out when I had all the classic and obvious signs of pre-e. I’m thankful for women like you who have stood up to these midwives, I am sure there are many more like me who never complained.
I was upset for a year because they made me feel like I had failed as a woman. Like I had FAILED them. They always alluded to the transfers as woman that had “wimped” out. That was the impression I had too. Like women that let “fear” overwhelm them or were selfish and couldn’t go through pain for their baby. Such a sick and irresponsible mind F*ck. I am sorry that you felt that way and I am so glad that you you “wimped out”! I wish I would have bumped into you there and started talking to you. Sounds like we were having the same symptoms
Crap…I was upset and crying until a couple of months ago when I finally found out that shit hole birth center was closed and out of business. They not only physically hurt me, they abandoned me, lied to me, deceived me…I am mostly upset that they go around on a cloud of naive, mystical, vaginal power trip because they had a home birth. I was made to feel like I was just upset that I sucked at harnessing my uterine powers.
I agree 100%. Your bluntness cracks me up! I need a good laugh about it. Thank you!
It makes me so sad and frustrated to think of us in birth class together so excited and hopefully and naive! I wish I could go back in time, scoop us all and drive us far away from Motherwise. You crack me up with your blunt honesty!
Kristine,
I just want to send a personal note. I haven’t suffered a homebirth loss or injury, but I did publicly take on a sexual predator with a string of victims who hurt me very badly: he was CAM/alt-med provider with a cult-like following and it was a brutal experience. In the end, after 16 months or so, I was not able to have him convicted. It was DEVASTATING. But the litmus test was so high and only one other victim had the courage to go to the police; the rest went to the licensing board and could not be compelled to move forward. I don’t blame them because coming out publicly against these people in alternative medicine is absolutely horrifying. Partly because their followers are so vicious, but also because there is all the guilt and shame of ever believing it, having to admit you fell for it, and having to admit harm was caused. For what it is worth: I AM SO PROUD OF YOU FOR STANDING YOUR GROUND!
Dr. Amy is SO RIGHT (and thank you for saying this, Dr. Amy, because I really needed to remember tonight) that every little step people take against predators is another brick out of the wall. Kristine, you have protected others from that group of midwives and publicly embarrassed them. It appears you forced the one midwife to retire. Now you will empower others to follow in your footsteps. My sexual predator will never practice again in this community, even if I have to haunt him for the rest of his life. And his reputation is ruined for what he did to us victims. So it should be. There is also the court of public opinion.
You should take a deep and abiding satisfaction in the work you did. It does take bravery as a victim of ANY crime with serious repercussions and I do believe med-mal is a crime as intimate as sexual assault (in my case, I suffered both, I suppose, since the abuse/assault occurred only in a medical setting).
I am very sorry you lost and you have my condolences. I hope that you are able to continue to raise the money you need for Abel’s care, and also trust that your good work will be returned to you. For me, it had a high cost, as I am sure it did for you, but it gave me unimaginable strength and healing, and I won the respect of people who later supported me when I needed it most. It was worth it, even if I didn’t win.
Always know that the truth is NOT what law is. Law is what is provable: truth is a moral right, an absolute. And now we all know the truth about Oregon midwifery, in large part because of your work, and also the work of Bambi and other loss moms. I can *kind of* imagine what it took to come forward and go public with your trauma, only as someone who has done it for sex assault, and if it is anything like it, I know the courage it takes, the sleepless nights, and the personal attacks and shaming that follows. So be proud. You are brave. Those midwives are not brave. They’re cowards. Because they know the truth, too. And cowards who refuse to own up to their truth have to live forever with it. You don’t have to live as a coward because, like Dr. Amy said, you are a superhero. There are many times in my life when I can hold my head up under extreme duress and know that I am courageous beyond words. It will give you strength to face what is ahead. I pray that Abel is well cared for and I so wish I could give you a huge donation for his care. Maybe one day I will be able to. Take care and glad to see you back. I, too, was ordered not to talk through out the experience and that was one of the harder parts. Downthread it was mentioned it is god to read your thoughts again. I hope you can find some sort of peace. And if not peace, that any anger you feel fuels you to fight the good fight. T.
OMG, Motherwise was who I used for my 2010 planned homebirth. I know one of the midwives retired last year, I think it was Nicole, can’t find the email for it, but I wonder if it’s related. THANK GOD I risked out with pre-e and had a c-section.
Arg, okay trying this again. Maybe disqus is spamming my comment because of all the links in it. Stripping out the links:
———- Forwarded message ———-
From: Motherwise
Date: Sun, May 5, 2013 at 8:40 PM
Subject: New paths for Motherwise and our Midwives
To:
Hello Motherwise families,
We feel so blessed to have been apart of your births and lives for so many years. Words cannot convey the love we have for all of you, and the bond we feel for you and your family. .
Last year Nicole decided that after attending births since 1996 and training many Midwives it was time to take a break from midwifery and serve families in Central Oregon in a different way. Nicole will be sitting for the International Board of Lactation Consultants Exam in July. She has also become a Certified Hypnotherapist, helping families with fertility and teaching the Fertility Awareness Method. She also plans on returning to her roots and teaching childbirth classes and baby care classes. Nicole plans on keeping her Midwifery credentialing current ( CPM ) so that she may volunteer to serve women in need in other countries once a year. Most of all spending time with her family and new granddaughter.
Dana is continuing on with a home birth practice, Sacred Tree Midwifery. Dana will have birth center privileges at the Bend Birth Center for those families that necessitate it. Dana’s heart has led her to move in the direction of a small practice serving 1-3 families a month. Iara will be staying on to assist Dana with births this summer. Dana plans on taking some time off this fall and winter to focus on her family and help her husband with his business.
Dana is very excited to be offering a indigenous technique of Traditional Womb Centering and massage practiced by midwives throughout central and South America. This practice benefits pregnant and non pregnant woman bringing relaxation, circulation to the abdomen and pelvis, aid in easier childbirth and helps with fertility and menstrual issues. Dana will continue to teach Birthing From Within childbirth classes and providing prenatal and postpartum care in the home.
After working together for so many years, you can plan on seeing Nicole and Dana collaboration and caring for our community for years to come.
We have officially moved out of the Birth Center we all have loved for many years. We are continuing to give care to the last of our Motherwise families at our downtown office. We are still easy to find and to get a hold of. The office is downtown Bend at 325 NW Vermont Place Suite 101.
We invite you to a BBQ this summer to visit with all of you and see how big those sweet little babies have gotten! We will send out an email for time and location soon.
Blessings and Love,
Nicole and Dana
Way to spin your public relations disaster, Motherwise. Not very convincing, though. Kind of like a politician who retires to “spend more time with his family.”
Is it a Freudian slip that they typed “apart” in the first sentence as opposed to the correct “apart”?
Nicole’s CPM license has been expired since Oct. 2013. They had to move out of the birth center because Nicole filed bankruptcy and owes $160,000 on the center. Nicole’s mom had her house foreclosed on because it was used to obtain the mortgage for the birth center. The company that Nicole owes money to thought about going after her own house, but it is a manufactured home in the DRW and they said it is not worth it to pursue. They are not forgiving her loan, but they don’t expect to ever recoup the money owed. Her granddaughter’s father has several mug shots on the internet. It is amazing what you can find out with a simple google search. Blessings indeed.
Krissy — can I get in contact with you? I would like to write something about this, and I can not use your real name if you like. My email is christine.gilbert at gmail dot com. I would like to get your side if possible. I think there’s a story to be told about three women, you me and Kristine running into each other online with births only 45 days from each other and finding out more about our shared midwives.
No way your name is Christine? Let the cosmos unite!
None of them will ever take a patient named Kristine/Christine again!
I am so glad your son is okay. It is scary how often I hear similar near misses about Motherwise, a little birth center in a rather small town. Your blood pressure must have been crazy high for them to risk you out!
I moved afterwards, so I never got to compare notes. This really hit home, unbelievable. I am glad they shut down. Your son is adorable by the way. RE: my BP they didn’t risk me out, the midwives were content to let me continue on…. it was my biophysical profile that showed no movement for over an hour… so I went to the hospital to get more tests and they diagnosed it immediately. Nicole came by, didn’t say much, then after the birth suggested maybe I do my follow up care with the OB. Having my second baby with an OB showed the difference, she caught my pre-e at 36 weeks and managed it very well.
Thank you a million times over. I am sorry for everyone who has been terriably abused by a group who are not only a risk to society by practicing anti social behavior without remorse but do so withput impunity. I am increasingly outraged.
I am more and more outraged. Ina May is not a midwife she is a CON ARTIST who is an english major wannabe. The homebirth movement is infiltrated with con artist. Sociopathic behavior inflicting abuse upon the innocent public over and over not learning from any of the carnage. Well if anti social without a conscious you lack that ability.
It must END it cant go on. The leader from the FARM must be held accountable along with all the others who move state to state inflicting carnage with sick pleasure. This year must become the year that it ends.
The glorification of Ina May puts women in a mindset that leads them down a path of wrong conclusion after wrong conclusion. It is terribly frighting and infuriating. Even hospital birthing classes talk about her book like she is a god.
Hi Amy, in case you missed this: http://nymag.com/thecut/2014/01/copying-other-cultures-a-bad-parenting-strategy.html
Abel, Kristine, and Greg – Thank you for speaking out on this. I have family who are doctors in Oregon (not OB, but one is a Pediatrician) and the lack of regulations on midwives there is just appalling. There are so many happy, glowing home birth/birth center birth stories out there and those who have had traumatic experiences seem more inclined to want to retain their privacy as they process what has happened to them (which is completely understandable). This gives people a skewed view of what the real story is and makes it harder for them to understand why a lay midwife or even a licensed CPM is most definitely NOT as capable of providing quality care if things go wrong as a CNM or OB can. If you can’t hold the state of Oregon’s feet to the fire on this one through the legal system, then I hope more broad coverage of your story will provide enough political pressure to get the state legislature to act. All the best to you and your family.
It is very hard share this kind of grief openly. It is a traumatizing experience and I have had people say very horrible things to mean in defense of midwifery. That is why there should be unbiased regulations based on evidence and facts and numbers.
Kristine, if I may say so, the fact that you were isolated from these discussions and sidelined from your advocacy during the progress of the suit was a most unfortunate side effect. It is so nice to have you speaking out again!
I responded upthread but I really wish I had responded here. I hope you find my post. My thoughts are with you.
Kristine, Abel, and Greg, thank you! Speaking out like you did takes super-hero courage. Your son is beautiful. I wish him and your family all the best.
Andrews said the midwives, licensed and unlicensed both, didn’t know what to do with a newborn that wasn’t breathing.
“They just had the look on their face of like trying to remember what they’d read in a book somewhere, like ‘umm, what do we do now?’”
I can’t imagine the horror of being immediately post partum, in pain, hormone-addled, and seeing those what-do-we-do looks on the faces of those who are supposed to be the professionals in the room. Those who are supposed to know how to help you, supposed to know just what to do. This is unconscionable, it’s substandard care, and this needs to be shouted from the rooftops by all of us. We need to name the midwives by name, name the birth center, name the state body that allows this malpractice to continue. Shame them. Because they should be ashamed for calling themselves health care providers–midwives even!!–and not knowing the *basics* of how to help a newborn who’s not breathing. And the state should be ashamed for allowing it to continue. Unacceptable.
A superhero, indeed.
It’s so sad that incompetent providers take kids who were meant to be just ordinary kids and force them to be superheroes without any repercussions.
Wow, yes you are superheroes Abel, Kristine and Greg. Thank you for bringing this to people’s attention.
I’m so sorry for the injustice you suffered at the hands of these charlatans. Thank you for speaking up, sharing your story so other families may be spared.
Dr Amy, this is a new argument against home birth practitioners. The midwives don’t have insurance so if your baby is damaged there will be no financial compensation to help with the cost of raising them. That’s going to be a pretty strong deterrent to all but the most determined homebirthers. If this story could find its way into the mainstream media that might cause a lot of people to rethink their commitment to home birth.
Just like Abels family, most people have no idea just how callous these midwives and birth centers are. Keep fighting the good fight!
It’s far from a new argument, unfortunately, but it is one that a lot of people haven’t heard. If their malpractice injures your child, they rarely have any medmal insurance to compensate you with.
I keep thinking about the state and their response. Obviously, they are going to do everything they can to avoid paying a settlement. But I wonder what they are really thinking?
Are they thinking, “Ha! We don’t have to pay it! Told y’all we aren’t responsible!”?
Or are they thinking, “Damn, we dodged that bullet. We need to do something to make sure we don’t get stuck in this spot again”?
I fervently hope it’s the latter…
For my sanity, I have to think it is the latter. I choose to believe they are good people who’s job it is to protect the state from lawsuits. So they did their job. I hope that their plan involves more regulations and not just defining that the state is not responsible at all.
My BIL is a pediatric neurologist who is about to move to Eugene to begin his practice. His black humor “joke” is that the homebirth culture in that state will keep him in business with interesting cases. Here’s to hoping he’s wrong and that families like this will help change the culture (he’d really love to never see another baby with a preventable brain injury).
I hope that he never has to treat a single infant with a preventable brain injury.
Gonna take more than “hope” here in Eugene
In all seriousness – according to my OB – Eugene has a very high elective C-section rate. The homebirth/OOH rate is higher than average, but the vast majority of us who give birth here do so in hospitals.
I offer nothing but the praise to the parents like Margarita and Kristine who advocate not only for their own children, but all the others yet to come.
How does someone get an elective c-section? The obgyns I’ve spoken to are all strongly against them. I don’t want to get pregnant if I can’t have a scheduled c-section.
I have absolutely no idea! I was terrified of having one myself.
I wonder that too. I know someone with a history of sexual abuse who feels the same way. Is it hard to find an ob to accomodate?
Most OBs feel that an adult woman making an informed choice for C/S should be supported in that choice.
Check out two blogs on the right for more information: Awaiting Juno and Cesarian Debate. You will find a lot of resources there and I believe there is a FB page.
You should be able to get one, but I’d be very proactive about it from the beginning and make sure your request is taken seriously and documented. Make sure you understand the risks and be able to articulate clearly your reasons for requesting one.
If we ever have another child, I know my husband very strongly would like me to have a C-section. Not just the outcome but the actual birth was very traumatizing for him as well as me. I wouldn’t want to over-correct from the events of our first birth but an elective C-section would definitely be on the table, for everyone’s sanity.
I love the name Abel! He is so darn cute! I’m so sorry he got such a rough start!
The Andrews family members are my personal Incredibles. Every single one a hero.
Thank you, Kristine, Greg and Super Abel!!!!!
My heart breaks for all you’ve been through but you are an inspiration and you most certainly are BRAVE.
This deserves to be repeated: “But, then, that’s the nature of superheroes. They protect the public with their extraordinary abilities and often are not properly acknowledged for their sacrifice.”
This sort of thing just makes me so sad. The libertarian side of me thinks that it’s the responsibility of the parents to hire proper medical care, but they were in a birth center, not at home with some fly by night midwife. I really do think such people and places should have to carry liability insurance since hospitals have to as well.
What a lovely boy and such a shame what happened to him.
The midwives and the center were licensed by the state. Nothing like the imprimatur of state licensure to give one the (completely false) idea that the practitioners and the center are operating under reasonable and evidence-based standards.
They also present an arbitration agreement to us in a way that implied there was malpractice insurance, we would just go through arbitration instead of the courts. It was very skimmed over and down played. While I did not ask enough questions there was enough of a front of normal regulations and protection to make me not question it.
How are people supposed to be able to know whether they have a competent provider or not? You simply can’t check everything…this is why I’m generally in favor of regulation, especially for health care providers, no matter how much I think it a pain in the butt. (And I say this as someone who has spent a good part of the day appeasing the gods of the IRB.)
Exactly. Do I need to go to medical school and get trained myself just to determine if my birth provider knows their stuff or not? A license should mean something.
The libertarian side of you doesn’t know how the world actually works. We are all connected, we are social animals, and your lot in life isn’t evidence of your worth as a person or the rationality of your choices.
I don’t mean to suggest otherwise – I just meant to say that I do understand the argument that is made of not restricting choices, but because we live in the real world and not some academic one, there do need to be protections for people when things go wrong, thus the need for liability insurance. As it is, that’s why homebirthers often sue the hospitals that actually save their damaged children’s lives, because there is no way to sue the midwife who actually did the harm.
not to mention the libertarian approach is premised on equal access to information, which just isnt possible. tons of women are misinformed.
I could be wrong, but my understanding is that the medical community holds each other responsible. Like if you want to partner with someone you require they have malpractice insurance . . . if you want priviledges at a hospital you need insurance . . . But than they have a better business plan and aren’t only trying to do 15 births a year so they actually have assets! Can someone in the medical community confirm/deny that? Also, does malpractice insurance put guidelines on you? What if you are doing something completely crazy? Would they drop you? Not cover it?
My indemnity will cover me for legally practising medicine.
If my insurers feel that there’s a good case against me for negligence or malpractice they would advise me to settle, but, by the nature of the insurance, they will cover me for acts of negligence or malpractice.
That is the point-if I screw up people get hurt, so the insurance is there to protect them. The insurance is also there to protect ME by strenuously defending me if, in fact, someone gets hurt and it was just bad luck rather than my fault.
In the UK having insurance is a legal requirement of practising medicine. I have to show up to date insurance at my annual appraisal.
The only thing that really bothers me is that if you have sex with a patient, it voids the insurance. My provider who sexually abused patients has insurance, but they won’t pay out for me, and the damage he caused, because as soon as he committed that act, he voided his own insurance. It is infuriating, as if sexual assault is not medical malpractice? Arg.
What a terribly creepy loop hole. That makes me sick.
There are several layers of protection. Because I practice in a hospital, I have to follow certain standards and my practice is continuously evaluated. If I follow questionable practices or have some iffy outcomes, I’ll get extra monitoring and possibly restrictions. Because I practice in a ‘safety’ community, my peers and others (nurses, surgical assistants) are encouraged to express any concerns they have about my care or my skills. A lot of the safeguards devolve from the fact that what I am doing is in no way hidden. There are many eyes and ears.
Because I practice in a hospital I am required to carry insurance. If someone is injured, they can be compensated. If I have a bad record, the cost for my insurance rises OR the malpractice insurers may refuse to cover me. At that point I am effectively not able to practice any longer. I also have to keep my specialty certification up to date in order to qualify for insurance and the Board has high requirements for recertification.
Over all that, I have a state Board which is famously strict and regularly sanctions physicians who fail to meet their standards for care and conduct.
So, these midwives and their claims of rigor? Laughable. In fact, I’d laugh every day at their antics if they weren’t causing so much grief and harm.
So if your method of practicing showed an 800% greater chance of HIE in newborns you would be reported by your peers, have to compensate injured, probably not be insurable and lose your hospital privledges?
oh and your license? could you lose your license?
Licensure is revoked usually for behavior issues: things like drug use, sex with a patient, and so forth. People have lost their license for bad practice patterns (look up Jayant Patel) but it tends to be something that is only done when all the other measures (hospital, insurance, etc) have failed to stop them.
One might not always have their registration/license revoked immediately for a pattern of poor outcomes, but they would have restrictions on their practice and requirements for supervision and re-training etc. If these were not effective at improving things, the license might then be revoked.
As Addie says, there is dual oversight from the employing organisation and the regulatory authority.
I think of those people (who don’t improve their practice patterns and continue to practice in spite of being kicked off hospital staff or losing their insurance) as sort of the Undead among medical practitioners. Bullets won’t stop them. It is unusual for someone to persist practicing beyond all those steps….and then the next step is loss of licensure. Robert Biter comes to mind…
Oh, and in the States, you have to contract with the commercial insurers—and they won’t put you on their panels if you don’t meet their criteria. So that’s another level of control.
Over here (Aussieland), patients can also freely access an online national registration database to see their heathcare professional’s qualifications/registration status/reprimands/restrictions/etc. I’m sure that there are some that manage to hide stuff, but the current system does give me some peace of mind.
Not only that but it’s actually a requirement here of registration that we carry insurance.
Yep.
One thing about HB midwives and insurance: who in the blazes would cover them?
I’ve mentioned this before, but I would have to figure that malpractice insurance for HB midwives would be extremely expensive, but for a very important reason: they are committing malpractice all the time!
Just imagine, every single bad outcome that occurs is easily actionable. It is obviously well outside the normal standard of care, so how can it be defended?
Doctors consider the practice too risky, and therefore consider it outside the standards of practice. How could a midwife claim it is not, then?
A problem that occurs in a HB is a no-brainer malpractice case. The insurance companies know it, and the midwives know it. Therefore, the only way to protect themselves from it is to make it not worth it.
In some states a CNM can only practice with a “supervising physician”. So on top of the hospital privileging and medmal insurance layers attitude devant talks about, if a CNM makes her OB uncomfortable, she (we are almost all shes) can be dropped. We are much more highly regulated than CPMs.
I hate seeing so much death and destruction in my own state, but brave people like Abel’s family are the light in the dark. I wish I could do more than a standing ovation.
Such a powerful story. I’m so sorry that happened to them and am moved by their courage and determination to change things for the better.
It’s not fair. I’ve come to the conclusion that the health system, the government, and the legal system are not what I once thought they were – it is a disillusionment that is hard to comprehend. To be naive – to believe that not only you have rights, but that you have recourse when those rights are violated…it’s a harsh wake up call that yes you have rights, but there’s precious little you can do (aside from wail) to get recourse for a violation. It’s easy to feel impotent and overwhelmed.
I applaud Abel’s parents for standing up for what they believe in – applaud them for taking on the fight, I applaud them for trying to do the right thing and perhaps in time, though this battle is lost – they can and have won in other ways.
The first step to changing anything is recognizing that there is a need for change to happen – they’ve done a lot to help that first step happen.
Thank you, Kristine and Greg, for the work you’re doing to prevent the willful incompetence of unqualified birth attendants from harming other families. Abel is a gorgeous little boy, and you’re lucky to have him (which you undoubtedly know!)
Abel is a beautiful child. I am so sorry for what happened. It shouldn’t have happened, and your family deserves justice.
I think Abel is just beginning a long career as a superhero!
Reading Kristine’s blog made me feel sad for the extra struggles she faces as a mother. My twin sister and I were Mom and Dad’s first children. Our placentas had grown together and I was receiving way too much blood while Rachel lost blood to me. Mom went into labor at 29 weeks and delivered us, then developed postpartum pre-eclampsia. We were in the hospital for months. Even when we went home, the doctors weren’t sure how much damage was present. There was some damage in terms of CP for both of us and deafness for Rach. Kristine’s blog posts read so similarly to Mom’s diary she kept during our childhood.
I don’t know if this is any comfort, but it is often harder for the parents than for the kid. My sister and I grew up needing PT, OT, speech therapy. As kids, we could not understand why Mom would get so mad at people at stores who “stared” at us. Since we had no point of reference to not being stared at, Mom’s anger seemed as silly as being mad at the sky for being blue. I also thought PT was in the same category as dance, karate or Girl Scouts. Hearing aids have come so far since we were kids, but my sister turns hers off for a few hours every day to enjoy being herself.
Abel has a road ahead of him. We all do. None of our roads are the same; they all bring triumphs and tragedies. Able’s began with a tragedy – that doesn’t stop future triumphs.
Thank you Mel. That truly gives me hope. Abel is such a funny, happy determined little boy and I am scared that he will lose that the more he realizes what was taken from him. I am afraid he will become bitter or depressed. Your mother is very blessed to have such a thoughtful, wise
daughter. I would love to talk to you more if you would like to look me up on facebook.
I think I just sent you a friend request – my full name is Melinda Rose-Eadie
Pretty darn cute little superhero, too!
Abel is saving lives by sharing his story. Thanks Kristine & Greg.
Kristine, Greg and Abel, you have undoubtedly saved many lives by shining the light of TRUTH on the injustice visited on you by the unqualified charlatans in the homebirth/out of hospital birth industry.
That poor boy. I don’t even know what to say.
While I understand sovereign immunity, it doesn’t cover the midwives. I know midwives can’t get insurance – God knows I’d not want to write a policy for them – but can they lose their licenses in Oregon? Especially if they didn’t know the basics of infant CPR. Or basic professional behavior. Or am I expecting too much out of because of the word ‘licensed”?
Hell, in Michigan, all teachers have to have CPR + AED training for adults and infants before you can be licensed. If I failed to notify CPS for suspected abuse, I’d have my license revoked and be looking at jail time. (That’s as the nearest professional misconduct in teaching that relates to NOT FREAKING KNOWING INFANT CPR!)
They actually can get insurance (IIRC, 10 Centimeters did a post on this very topic that demonstrated that they can get insurance and that it wouldn’t be that expensive for them). That they choose not to, and that they are not required by law to do so, speaks volumes about their (lack of) professionalism.
I pay more than 10% of my gross annual income in indemnity fees.
CPMs can bite me-if you charge 2000 bucks per birth and attend 30 births a year you are making 60k…you can afford the 10k in insurance by charging 350 more per birth or you can make some savings elsewhere.
It is a necessary business and professional expense…stop seeing the dollar signs and make it work.
My malpractice is 25% of my gross income and I practice in Indiana which has some of the most generous tort reforms laws in the country with a very reasonable liability cap of 750,000 per case (thanks to a former governor 30+ years ago who was an MD). I’ve never had a suit filed against me–rare in obstetrics and something that will almost certainly change in the future–and still pay more than a quarter of my income in malpractice insurance.
Dr Kitty, I am interested as to what kind of rules, if any come with having malpractice insurance?
I’m in the UK, you’ll want to talk to the US posters.
The problem is that you don’t even have to have a license to “catch babies” in Oregon. You can call yourself a midwife without any formal training and largely without oversight.
Midwives (both CPM and CNM) can get malpractice insurance.
https://www.cisinsurance.com/Midwives/free-quote.cfm
http://www.themidwifeplan.com/
These plans specifically mention coverage in out of hospital births
http://washingtonjua.com/rates.htm This explains rates. To hear midwives talk about malpractice insurance being unattainable because the cost would be passed on, you would think that it was terribly expensive. This is a nice eye opener about actual cost.
The state midwifery board is a joke. Often midwives will be under administrative suspension (which is an even bigger joke since they can keep practicing) and you won’t be able to tell from their website, which will list them as licensed. There is NO recourse for consumers. None.
I believe in the state of WA the HB midwives are required to have insurance, unless something changed recently.
I think you are right, but there are WA state midwives who write it into their contract of care that the client understands that the midwife does NOT carry this insurance, as the cost would be passed onto the client (this is also the part of the contract that states the midwife may or may not accompany a woman to the hospital in the event that transfer is required) http://www.highlandmidwife.com/docs/Homebirth_MWcare.pdf
“Malpractice Insurance: The midwife does not currently carry malpractice insurance due to the
prohibitive costs which would have to be passed on to the clients.”
I keep seeing comments about not being able to sue midwives because of lack of malpractice insurance. I don’t understand why it matters whether or not they have insurance. Isn’t the point of malpractice insurance to keep you from having to go out-of-pocket if you get sued? Can’t you still get sued regardless?
I think the issue is that most midwives don’t have substantial assets. Lawyers’ fees typically come out of the settlement, and if there is little chance of collecting any money, few (if any) will take the case.
That’s true. The cost of expert witnesses and filing fees alone is staggering. Unless you can pay for it out of pocket just to make a point it is difficult to proceed.
Okay that makes sense! They’re either required to have it or inform their client that they don’t have it!
I don’t think so. As far as I can tell, the law only requires that insurance be available to them. In 1993, the legislature set up a joint underwriting group that all insurers in the state have to participate in. I’d be interested to know how many hombirth midwives actually carry it.
Kristine and Greg, thank you for having the courage to stand up for your son! I am so very sorry that Abel had to suffer because of these charlatans masquerading as health care practitioners, but your son has wonderful parents, Keep fighting the good fight!