Caught in ethical violations, Jan Tritten and other homebirth midwives are backpedaling as fast as they can

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Sometimes I think the best argument against American homebirth midwifery is merely to expose their utter lack of ethics, their willingness to lie for their own ends, and the sheer stupidity involved in posting inappropriate behavior to the internet and then trying to deny what people can see right in front of their eyes.

At of this moment, 229 people have signed the petition to Jan Tritten, Editor of Midwifery Today, expressing revulsion as her grossly unethical, unprofessional behavior that resulted in the preventable death of a baby. The petition is being promoted even in some surprising places such as on the Facebook page of a homebirth midwife.

But Tritten still thinks she can absolve herself of moral responsibility in this baby’s death and she’s going about it in the most moronic possible way. Did she write that she was caring for this patient? Oh, she had nothing to do with the care of this patient. She was just writing in the voice of another midwife. I’ll let you decide.

Here’s what Jan originally wrote:

Jan Tritten 1

What would you do? Primip with accurate dates to within a few days who has reassuring NST at 42.1weeks, as well as reassuring placenta and baby on BPP, but absolutely zero fluid seen. 42.2 re-do of BPP and again, mom has hydrated well, but no fluid seen. Baby’s kidneys visualized and normal, and baby’s bladder contained normal amount of urine. We’re in a state with full autonomy for midwives and no transfer of care regulations past 42 weeks. Absolutely no fluid seen…what do we truly feel are the risks compared to a woman whose water has been broken and so baby/cord has no cushion there either. Cord compression only? True possibility of placenta being done although it looks good? Can anyone share stories/opinions? …

Here’s what she says now:

Tritten Screen_Shot

The questions on this page are messaged privately to me and put up anonymously. They are not my cases. This is to help mothers, midwives, doulas and physicians in their work. It is to opinions from many different practitioners and parents.

Really? Could have fooled me.

I see no indication anywhere that this was anything other than a case in which Jan was deeply involved, in real time, and was grossly unprofessional in crowd sourcing a life and death decision on Facebook. Jan can deny it as much as she wants, but her own writing says something very different, and very damning than what she is saying now in an attempt to save herself from public opprobrium, and worse.

For the time being, until Jan prevents actual evidence, not weasel words, I am taking her initial writing as the truth. She was involved in this case and she was morally, if not also legally, culpable in this baby’s death.

But Jan is hardly the only one back pedaling as fast as she can.

“Wanda Smith Midwife” was mentioned in passing on the my original post for her “advice” offered to Tritten:

Wanda Smith Midwife absolutely no experience with “0″ fluid, but have had two go quite over with very low fluid (under 5), one was 18 days over, quite uneventful home birth, and one was 19 days over with heavy mec and true knot, that did give a us a little trouble, but she stilled birthed vaginally (my emphasis)

But Wanda Smith Midwife suddenly remembered that her actions in both those cases violated midwifery regulations in Virginia where she practices.

Thinking quickly, this genius came up with the following:

Ladies may this be seen by everyone. I was the first to respond to the original post. Like many on this thread, I made an assumption. I assumed that this mom was in hospital or was being referred in. I assumed the midwife was seeking stories for outcomes, NOT seeking advice as to stay at home with an obvious dangerous situation. My answer was not thorough, and I am horrified by how I look by reading the docs blog. I gave two cases, one 18 days over and one 19 days over, both with a low AFI = not ZERO AFI. Each case was transferred into the hospital, because each had reached the end scope of my practice guidelines. Though each passed BPP guidelines, with an 8 out of 8. AFI was low but still WNL. We (Parents, OB, & Midwife) made decisions according to combined data, post dates pregnancy & LOW AFI, to induce labor with continuous EFM. My births had excellent outcomes. I have never been and will never be a do or die home birth midwife, and those that interview me know and I state, “if you are a do or die home birther, I am not the midwife for you.” Please, please do not assume that all midwives are uneducated, can’t read US reports, don’t know when to refer, don’t attend peer review, and don’t have practice guidelines. I also am not making the assumption that any midwife is sitting around waiting for internet responses instead of being proactive. None of us know exactly what happened to cause this death. It is tragic for everyone. I certainly will never respond on public forum again, for multiple reasons. (my emphasis)

Lying about it now just makes it worse, Wanda.

You wrote the following on the Facebook page associated with your own website, Gentle Birth Roanoke:

With JOY and tremendous ADMIRATION for one strong momma Gentle Birth Roanoke welcomes “SNOWbaby” Henry. He was born this morning at 9:14 am and weighed 8 lbs. 6 ozs. at 18 days over his due date. His wonderful parents are so pleased to be resting after two days of labor and hosting their midwife team overnight. Thankful for prayers, snowplows, and kind citizens who made it possible for us to safely get to and from this birth. w/Dawn & Cindy = pictures of our travels to follow. (my emphasis)

And the doula wrote about the birth, too.

Wanda Smith Midwife

Coincidence? I think not, but even if it were, it shows that Wanda Smith has violated the terms of her midwifery license.

Jan (and Wanda), I cannot thank you enough. You are working hard to demonstrate the fact that American homebirth midwives are not medical professionals. They have no safety standards. They violate the terms of their licenses and they lie about, too. Personally, I think that the worst thing about the lies is not that they are offered, but that homebirth midwives are as dumb as posts, imagining they can lie about what anyone can read for themselves and no one will notice.

Bad news, ladies: The days of getting your birth junkie highs while not giving a damn about the health and safety of your patients are coming to an end. Keep talking; keep violating your own practice standards; keep letting babies die and not offering a shred of remorse about your own involvement. You are doing my job for me.

People are disgusted and they are signing the petition to let you know.

Jan Tritten, stop the pathetic, self serving attempts to deny responsibility for the preventable loss of an innocent baby’s life; it’s sickening. Instead, start apologizing and begging forgiveness from the family you have harmed.

108 Responses to “Caught in ethical violations, Jan Tritten and other homebirth midwives are backpedaling as fast as they can”

  1. Willow Farm
    July 4, 2017 at 12:10 pm #

    You are assuming a whole lot about a person by a few internet extracted statements. I personally knew Wanda. She has passed away. I hope you are not thrilled. It is sad that this post still comes up along side memorials for her. Continuing to smear her specific name serves nothing but feeding your hatefulness. This country carefully tries people thoroughly and considers them innocent until proven guilty. The snapshot you have formed for her is not fair or accurate. You are jumping to many conclusions about how she practiced.
    She carefully brought both of my children into this world. I had full parallel medical care throughout both terms.
    My first labor was 47 hours ruptured membranes. “You should have transferred!!” I can hear you scream, assuming that we didn’t. Well, we did transfer. There was still no emergency. My OB allowed me to labor the last 24 hours under her watchful eye. There is still tremendous risk involved with a C-section, you know. And that risk has to be weighed by a *present* professional, (not one sitting in front of a computer, screen-shotting facebook.) I delivered safely under Wanda and an OB.
    My second pregnancy started with what we and two other doctors saw as twins. Wanda told me she wouldn’t be delivering them, but would doula for me at a hospital, (I know, I know, it kills you to hear she wasn’t the demonic force you portray her to be.) As the pregnancy went on, there was only one baby. She turned breech at 37 weeks. Again, Wanda pulled out of the birth option. When the baby turned, my OB gave the thumbs up for a homebirth again. She fully trusted Wanda’s communication, monitoring, and judgment. My daughter’s labor was a 6.5 hr homebirth.
    You don’t know the monitioring she did. You don’t know the transferring she did. She assumed the person posing the question on fb was already under a doctor’s care because she practiced that way. If you want to accuse someone of such horrendous crimes and having blood on her hands, why you don’t present facts, such as her mortality rate of her births as opposed to social media screenshots?
    You have blood on your hands for continuing to speak ill of the dead. You are the one lying by continuing to paint a false picture of how she practiced. Leave the poor woman and her grieving children alone. You ARE being a troll.

    • Sarah
      July 4, 2017 at 12:23 pm #

      Setting aside your comments about Wanda for the moment as I’ve no horse in that race, how does Dr Amy have blood on her hands by speaking ill of the dead? Like, what’s the causative mechanism for how that could happen? I’m interested to hear.

      • Willow Farm
        July 4, 2017 at 12:36 pm #

        Why would you look for a literal causative mechanism in my comment, but not analyze Dr Amy’s? And why do you want to “set aside” my comments about Wanda? That is the most important part- clearing someone’s name when she is being falsely accused and cannot defend herself. Have a heart. The assassination of one’s character can get a little bloody. All of these statements are figurative, “blood on their hands”, “bloody money”, etc You hardly believe that Dr Amy thinks Wanda”s hands are literally red or that she ever even physically touched a person in the situation and had literal blood on her hands. Use your mind both ways. Your bias is showing.

        • Willow Farm
          July 4, 2017 at 12:40 pm #

          I am also only requesting that she pull Wand’s specific name in this situation. It is unnecessary at this point, and she is leveling unprovable accusations toward her character. I will be happy to edit my comments if Amy edits hers. At this point I feel it is important to present some other sides of Wanda besides how she is being painted, (that’s another figure of speech, btw.)

          • rosewater1
            July 4, 2017 at 1:24 pm #

            Death is very rarely-if ever -a cause for rejoicing. Clearly you aren’t, and I am sorry for your loss.


            Death doesn’t absolve us of blame or guilt for bad acts.

            There does seem to be cause to question Wanda’s behavior and decisions in particular cases.

            Very few people are bad 100% of their lives. Even Lisa Barrett was a respected midwife at one point.

            Wanda opened herself up for criticism when she posted online regarding midwifery and patient care. That doesn’t end with her passing.

            Also, you do realize that YOU are resurrecting an old post and bringing it up again?

          • Willow Farm
            July 4, 2017 at 1:37 pm #

            It sits right below her memorial on google even without my resurrection of it. The least I can do is add my perspective here since I feel that it is grossly incomplete and leaps to many unfair conclusions etc. She clearly learned her lesson about chiming in online, per this article’s quote that she would never post online again. I knew her and truly believe that she assumed the patient in question was also under medical care. Even the snow birth that was mentioned, you don’t know that she wasn’t in communication with an OB. You don’t know all the facts. Just as she is being criticized for putting in her two cents when she didn’t know all the facts. You don’t know.

          • Melaniexxxx
            July 4, 2017 at 10:03 pm #

            resurrecting a 3 year old post and suggesting the write has ‘blood on their hands’ for exposing shitty practice is bizzare behaviour, and doesn’t lend you/Wanda any further credibility.

            Did Wanda suicide directly after reading this post, stating it and only it was the cause of her distress/death? Because otherwise, NO, there’s no blood on anyones hands except hers

        • Sarah
          July 4, 2017 at 1:13 pm #

          I have analysed Amy’s, but I don’t see anything in her account that leaves me puzzled about causative mechanisms. I do in yours.

          And sure, blood on their hands is a figurative statement, but it also has a precise meaning. It isn’t just a generic insult to throw about. It doesn’t mean red stained hands particularly, although I guess it can in some scenarios, but it means someone bears responsibility for death or injury.

          With that in mind, I want to know how you think Amy has blood on her hands because of the criticisms she’s made of Wanda. Are you accusing her of having caused Wanda’s death, or some injury to her? Because if you are, that’s pretty fucking serious and you need receipts. If you’re not, and you’re just throwing around random insults in a rubber and glue way, better to stick to something more generic.

          • Willow Farm
            July 4, 2017 at 1:19 pm #

            I was very clear in my reply to you that I was speaking in figurative terms regarding the assassination of one’s character.

          • Sarah
            July 4, 2017 at 1:47 pm #

            This is the opposite of very clear, though.

            It seems like what you’re actually saying is that you don’t really think Dr Amy has blood on her hands in the usual, figurative sense of the term. Ie, that you don’t like her speaking ill of the dead (was she dead at the time?) rather than anything else.

            In which case, don’t use the phrase blood on your hands. Again, it has a particular meaning. The fact that it’s a figurative one doesn’t mean you can just use it to mean any bullshit you like.

    • Amy Tuteur, MD
      July 4, 2017 at 4:45 pm #

      Are you suggesting that Wanda didn’t violate the terms of her midwifery license?

      • Willow Farm
        July 4, 2017 at 6:56 pm #

        I am not suggesting anything. – particularly concerning cases that I know nothing about. As I have said several times. I am adding my experience with her into this post. I don’t know if anyone on here has ever met her, much less worked with her. My experience is as I stated and it speaks for itself. To say that she “lied” when she assumed that the mother was under additional care as she commented is very ugly. And, I don’t think anyone can prove that she was lying when she explained her perspective.

        It is the suggestions and accusations about things that cannot be proven that I find fault with, and you will not push me to say anything otherwise. I have said my peace and feel that I have added a balance to the perspective of how she practiced when I knew her. May she rest in peace.

        I have no further comments. As you can see, most of the responses were hateful, off-point trollings anyway.

        • Melaniexxxx
          July 4, 2017 at 9:59 pm #

          No one cares about your individual experience, though, they care that she has practiced unethically and contributed to deaths of newborn babies

    • Nick Sanders
      July 4, 2017 at 11:29 pm #

      For someone complaining about presumption based only on web posts, you’re sure doing an awful lot of it.

  2. Alisha Akers
    June 16, 2014 at 2:38 pm #

    I had Wanda as my midwife and she urged me to transfer with my youngest child. I asked her “what she would do” and she said go to the hospital. I can only wonder, should a midwife have to discontinue care for a patient that is not following her medical advice.I know physicians do it all the time so not to soil their reputation. I wonder how many times the physician above has dropped her patients when they refused to follow her medical advice and what the outcome was. Would it be better to have no one with any experience there to accompany the birth of a mother and child when the parents want to forgo medical intervention? I fail to see where a practitioner has any higher moral standard by abandoning their patient than a midwife who stands by to help.

    • MaineJen
      June 16, 2014 at 3:25 pm #

      Doctors dismiss patients all the time for failure to comply with treatment. At a certain point, if a care provider has given all the good advice and made all the arguments they can think of, and the patient is still hell-bent on a self destructive path, the patient can be let go. I don’t think this applies to emergency situations. But I have seen it happen. It’s sad and no one feels good about doing it, but at that point it becomes the patient’s responsibility. It’s like someone signing themselves out of the hospital AMA; they sign a waiver that they alone are responsible for any bad outcome, because they have been warned about what will happen if they leave without treatment.

      • Melaniexxxx
        July 4, 2017 at 11:57 pm #

        Exactly – patient autonomy is paramount, and if they want to leave hospital AMA it’s totally acceptable

        There is NO moral/ethical obligation upon physicians to provide substandard/dangerous care just because a looney homebirther demands it

    • LibrarianSarah
      June 16, 2014 at 3:57 pm #

      Doctors “dropping” patients has less to do with their reputation and more to do with them being sued for hundreds of thousands of dollars for not being convincing enough when the shit does hit the fan. CPM’s don’t have that problem because their lack of insurance make them pretty much untouchable civilly. It’s not worth price of a lawyer to bother suing.

      Just to be clear, are you defending the woman who broke state law and blabbed about it on facebook or the woman who crowd-source a medical emergency that resulted in a babies death?

    • Melaniexxxx
      July 4, 2017 at 11:55 pm #

      Doctors don’t cease treating patients because they are worried about their “reputation” but because they cannot be coerced into malpractice by patients wilfully ignoring medical advice. Doctors aren’t vending machines that you can bash buttons on and dispense medications or treatment – they are highly trained professionals who have a duty of care to act in their patients best interest. It is NOT in the patients best interest to give stupid, substandard treatment the patient ‘wants’ because they ‘say so’. DO NO HARM ffs. Unless it is an emergency situation, there is NO moral obligation that compels doctors to treat patients, and there is NEVER any ‘moral obligation’ to give inadequate care

  3. TA
    April 9, 2014 at 7:15 pm #

    Wanda was a wonderful midwife, half literate troll fits nicely.

    • Karen in SC
      April 9, 2014 at 7:40 pm #

      That first baby died due to a quarter-literate previously convicted troll.
      Wanda sounds just as bad, violating laws in her state. Go, you.

  4. Jane
    February 24, 2014 at 10:40 pm #

    Thank goodness for people like you in the world Amy, bravo !

    • Candice Beck
      March 28, 2014 at 10:43 am #

      She’s great, for half literate trolls.

  5. Deena Chamlee
    February 24, 2014 at 7:57 pm #

    sad so so sad.

  6. ngozi
    February 24, 2014 at 3:28 pm #

    Even if she was just posting a question from another midwife, shouldn’t it had been obvious that the baby was in trouble and told the midwife that instead of having to ask people on Facebook?!?!

  7. MaineJen
    February 24, 2014 at 11:44 am #

    It continually amazes me that the midwives on these pages
    are outraged NOT by the death of a baby, NOT by the incompetence of the care provider…but by someone *pointing it out* to them. “How dare you notice the real-time tragedy unfolding in a completely public forum!
    How dare you call out the incompetent decisions of the midwife! How DARE you tell us how shocked you are…in such a MEEN way! You’d catch far more flies with honey. Just be outraged more quietly, and in a way that doesn’t inconvenience us, if you don’t mind.”

    “My answer was not thorough, and I am
    horrified by how I look by reading the docs blog.” You should be horrified, lady. You should be completely horrified not only that this happened, but that YOU CONTRIBUTED by offering two positive outcomes that it turns out weren’t even applicable. The midwife could have based her decision to let the woman stay at home on YOUR encouragement. You should be completely
    horrified and ashamed, and backpedaling now only makes it worse.

  8. Sue
    February 24, 2014 at 1:22 am #

    It’s there is black and white: ”my hands feel nothing but baby”. MY. HANDS.

  9. Meredith
    February 23, 2014 at 6:14 pm #

    Look, Jan Tritten, if your best-case scenario (I repeat, BEST-CASE) requires that you asked Facebook for their stories and opinions when somebody asked your opinion about an ongoing medical emergency, you have ALREADY FAILED.

    Failed at midwifery, failed at ethics, failed at life.

    • Young CC Prof
      February 23, 2014 at 6:51 pm #

      You know, sometimes I hang out in medical forums. And every now and then, someone posts something that sounds like a true emergency, possible heart attack for example. I don’t discuss ANYTHING with this person, I say, “Get off the Internet and go to the hospital right now.”

      Offline, if someone is having a medical emergency, the only appropriate discussion is the one about the logistics of getting to the best medical attention as quickly as possible.

      • Sue
        February 24, 2014 at 1:24 am #

        I have never, ever seen a medical professional live-source a critical health care issue. Review in retrospect, sure, but in real time – deal with it or get help now.

        (Specific exception – telemedicine consults to remote locations, no issue there).

        • Anj Fabian
          February 24, 2014 at 12:58 pm #

          They had access to ultrasound and NSTs. so we know they had expertise to hand – if they had bothered to use it.

    • February 23, 2014 at 8:03 pm #

      She is an editor of a trade magazine, too. There is a certain amount of responsibility in that.

  10. Are you nuts
    February 23, 2014 at 5:22 pm #

    You know what would creep me the hell out? If my OB posted details of my birth on Facebook. I assume (hope) that Gentle Birth had signed consent to post patient info in Facebook, but I would like to think that my labor and delivery for my OB would be such a routine experience that it doesn’t deserve a mention.

  11. Trixie
    February 23, 2014 at 4:09 pm #

    To whoever it was on FB who first caught Wanda Smith in her lies and called her out: Well done. You win the internet today.

    • MLE
      February 23, 2014 at 7:19 pm #

      I think it was Sarah Lewis as far as I can tell

  12. Squillo
    February 23, 2014 at 3:32 pm #

    And these are the folks who say women need to “own their births.”

    How about owning your words and actions, ladies?

    • NoLongerCrunching
      February 23, 2014 at 4:59 pm #

      So much this! Deleting your own words just screams guilty conscience and/or fear of being held accountable.

  13. Guest
    February 23, 2014 at 3:32 pm #

    Can Wanda Smith Midwife also learn the definition of a BPP. In the first post (now deleted) she mentions she has had 2 babies who had fluid not 0 but <5. She then says they had BPPs of 8/8 in the next post. An AFI <5 means you lose 2 points on your BPP. So the most they could have is 6/8. If she wants to include the NST, then it would by 8/10. How can someone trust a midwife liek that who doesn't even know a simple definition. She should not be using BPPs if she doesn't know what they mean. I wish someone in Virginia could report her for doing deliveries on babies who are not out of her scope of practice (because we can all see that one baby born 18 days post-due date was born at home on 2/14).

    • Guest
      February 23, 2014 at 3:44 pm #

      That was supposed to say NOW out of her scope of practice.

  14. Squillo
    February 23, 2014 at 3:31 pm #

    My answer was not thorough, and I am horrified by how I look by reading the docs blog.

    Try being horrified by your own incompetence.

  15. Squillo
    February 23, 2014 at 3:29 pm #

    What Tritten and her merry band of morons don’t seem to recognize is that there is no scenario in which they are not proved to be incompetent and unethical hobbyists with no business pretending to care for women and babies.

    If I hadn’t seen the posts with my own eyes (before they were sent down the Memory Hole), I don’t think I would have believed even someone as stupid as Jan Tritten could seriously have written them.

  16. almostfearless
    February 23, 2014 at 3:19 pm #

    The ONLY answer is to abolish the CPM. Period. You have the editor of the most quoted midwifery journal in the US, actively covering up evidence in the death of a child.

  17. Amy Tuteur, MD
    February 23, 2014 at 2:26 pm #

    Wanda’s patient gave birth in the hospital? Really?

    • February 23, 2014 at 2:49 pm #

      I think the post needs to be edited with the top screen shot at least.

      • Amy Tuteur, MD
        February 23, 2014 at 3:27 pm #

        Do you mean that I should add the top screenshot to the post?

        • February 23, 2014 at 3:29 pm #

          I just like having proof right in the post – screen shot should be in there as backup for those who are coming in new and don’t read the comments.

          • Amy Tuteur, MD
            February 23, 2014 at 3:55 pm #


          • Thankfulmom
            February 23, 2014 at 4:08 pm #

            Yes, seeing in her own written post: “Wanda Smith Midwife absolutely no experience with “0″ fluid, but have had two go quite over with very low fluid (under 5), one
            was 18 days over, quite uneventful home birth, and one was 19 days over
            with heavy mec and true knot, that did give a us a little trouble, but
            she stilled birthed vaginally.”

    • no longer drinking the koolaid
      February 23, 2014 at 3:13 pm #

      wand specifically said that the parents had hosted the midwife team overnight. That would seem to indicate that they slept at the family’s home.

    • Sue
      February 24, 2014 at 1:27 am #

      With the BACH FLOWER REMEDIES! Perfect!

  18. Ennis Demeter
    February 23, 2014 at 1:46 pm #

    I know squat about medicine, but I know what real medical professionals when asked for their medical opinion about a specific case: If this is an emergency, go to the emergency room.

  19. prolifefeminist
    February 23, 2014 at 1:44 pm #

    “one was 18 days over, quite uneventful home birth”


    “Each case was transferred into the hospital, because each had reached the end scope of my practice guidelines.”

    Should we just flip a coin to decide which of Wanda’s statements is the lie??

    These people are just fucking unbelievable.

  20. Young CC Prof
    February 23, 2014 at 1:31 pm #

    Originally I said that I hoped the mother can be kept out of this wank. Now I hope she learns all about it as this incident busts the CPM myth wide open.

  21. Amy Tuteur, MD
    February 23, 2014 at 1:21 pm #

    From Navelgazing Midwife’s Facebook page:

    • February 23, 2014 at 2:00 pm #

      I believe that Megan is NGM’s daughter. And, IIRC, she had an elective C/S for primip breech with her first baby, a decision which caused NGM to reassass some of her own positions regarding both homebirth and CPM competency.

      • Lena
        February 23, 2014 at 2:46 pm #

        IIRC her baby wasn’t breech, but it was a prolonged labor with little progress that led to the CS. Since then, NGM, while agreeing that that CS was necessary, has been advocating HBAC. (And she definitely stopped practicing as a CPM before Megan’s pregnancy).

        • Trixie
          February 23, 2014 at 4:06 pm #

          NGM still believes in HBAC? Even after the MANA stats?

      • Lena
        February 23, 2014 at 2:57 pm #

        I just checked, it doesn’t look to me that the Megan who commented is NGM’s daughter.

  22. February 23, 2014 at 1:01 pm #

    I can’t wait until CPMs can’t practice anymore and these clowns have to find a different career.

    • February 23, 2014 at 1:32 pm #

      I don’t think I would trust them to shovel dog poo

      • February 23, 2014 at 1:34 pm #

        Oh be fair, Bambi, they’re SO talented at shoveling bullshit…

        • prolifefeminist
          February 23, 2014 at 1:38 pm #

          Thanks Kumquat – you just made me snarf my coffee

          • February 23, 2014 at 1:39 pm #

            Thank Bambi for the perfect setup 🙂

        • Guestlll
          February 23, 2014 at 1:47 pm #

          Hahaha, THIS.

      • Trixie
        February 23, 2014 at 4:10 pm #

        Now now, they’re great at scooping poop out of baby pools.

  23. FormerPhysicist
    February 23, 2014 at 1:00 pm #

    It doesn’t really matter if it was Jan Tritten’s patient or not. If she’s asked for advice, the only thing to say is “go to the hospital NOW and transfer care”. If she didn’t say this, she’s culpable, whether she ever met the patient or not.

    It’s similar to why I rarely call the nurse hotline from our health insurance. If there’s ANY doubt, they tell me to head to the ER. I can usually make that decision without calling the hotline.

    • Dr Kitty
      February 23, 2014 at 1:08 pm #

      I went to my local A&E with what I thought was appendicitis.
      “Did you see your GP first?”
      “No. I am a GP, I have right iliac fossa pain, fever and evidence of peritonitis, I didn’t think I needed to”.
      “Fair enough, let’s get you some morphine and a surgeon”…

      • DaisyGrrl
        February 23, 2014 at 1:19 pm #

        I’m curious, when I presented myself at the local ER with severe abdominal pain, vomiting, and diarrhea, the triage nurse wasn’t terribly impressed with me – wanted to know why I hadn’t taken gravol or waited it out. I stuck around to see a doctor who pretty much instantly said “appendicitis!” I’ve had a couple of friends who have been turned away by triage one or twice before seeing a doctor and also having a diagnosis of appendicitis.

        I’ve always been under the impression that sudden onset of severe abdominal pain is an indication to seek emergency care (especially when food poisoning is unlikely). Is that not the case? I don’t want to unnecessarily tie up emergency resources, but I also don’t want to dismiss symptoms out of hand. And my provincial health care hotline will almost always advise going to urgent care/ER if you call.

        • Dr Kitty
          February 23, 2014 at 1:58 pm #

          It is easier to be taken seriously, as I was, if you have a high fever, a low BP and a heart rate of 140.

          Severe abdominal pain is absolutely a reason to seek urgent medical care.
          Triage nurses triage.
          They don’t diagnose.

          Generally speaking, if you try usual home care measures (Gaviscon, pepto-bismol, simple pain relief) and your symptoms don’t improve, someone needs to take a look at you.

          • DaisyGrrl
            February 23, 2014 at 2:38 pm #

            Oh, absolutely. Wasn’t expecting a diagnosis, but also wasn’t expecting such opposition to seeking care from a doctor. I don’t usually get fevers so that didn’t help much (my last fever was actually during the appendicitis 10 years ago and it was a low fever). Plus you’re a doctor so you have the knowledge to be able to say “this is serious!” and know that you’re probably correct.

            I was just curious about it because I’m not the only one that had difficulty being taken seriously by triage. While I appreciate that they have to assess patients as presented and obviously prioritize based on seriousness of symptoms, my overall impression was that the nurse thought I shouldn’t have been in ER in the first place. Add that to my friends’ experiences (one of whom had to go to ER three times at two different hospitals before she saw a doctor), and I was just wondering if my thinking was wrong and I should have tried to access care in a less urgent setting.

            Thanks for answering.

          • Dr Kitty
            February 23, 2014 at 3:44 pm #

            D&V and mild cramps is probably viral gastroenteritis or food poisoning. I’d advise oral rehydration solution, anti emetics and some paracetamol, and ER if things worsen despite that.

            D&V with severe pain, decreased urinary output, high fever or inability to tolerate oral fluids needs assessed.

            If anyone has abdominal tenderness so that if I press on their tummy they shout, grimace or try to hit me, they are going to the ER.

          • DaisyGrrl
            February 23, 2014 at 4:13 pm #

            Okay, cool. I was in severe pain and we had to stop the car twice so I could vomit on the way to the ER (15 min drive and I had already emptied my stomach). I was not going to be able to take anything orally. That reassures me that I wasn’t completely nuts to seek care when/where I did and also gives me a good guideline should anything similar happen again.

          • Sue
            February 24, 2014 at 1:36 am #

            Triage nurses where I work don’t send people away – unless they’ve just come to the wrong part of the hospital by accident.

            It’s not that common to have both vomiting and diarrhoea with appendicitis, (more commonly gastroenteritis) but that’s not a reason not to seek ED care. Many ppl with gastro need IV therapy.

            The old-fashioned triage nurse acting as a ”wall” belongs in the past.

        • AlisonCummins
          February 23, 2014 at 2:02 pm #

          I think the combination of vomiting and diarrhea is also an indication to see a doctor. No mater what the cause is it’s dangerous in and of itself.

          • DaisyGrrl
            February 23, 2014 at 2:28 pm #

            What made me decide to go to ER was the three symptoms combined. I figured best case, nothing was wrong and I could have IV hydration along with meds to control symptoms. Worst case, I would be in the right place!

    • Young CC Prof
      February 23, 2014 at 1:35 pm #

      They don’t always say ER. Once they said Urgent Care. And then, because I was new to the neighborhood, helped me find one that took my insurance, which was actually pretty helpful.

      But yeah, if you are a reasonable human being and concerned enough to call, you will generally be told to seek medical attention right away.

      • Captain Obvious
        February 23, 2014 at 2:58 pm #

        If you call any office or on call nurse line the message usually goes, ” you have reached Dr soandso’s office, we are closed right now. If this is an emergency, please goto the emergency room or call 911. Otherwise leave a message or call back during office hours.”

    • February 23, 2014 at 2:24 pm #

      If her story is true then she ALSO decided to conceal the identity of whoever is responsible so that no one can report it.

    • KarenJJ
      February 23, 2014 at 10:42 pm #

      We’ve got one of those healthlines and I have to say I’ve found them largely useless too. The ONE time they recommended I just get seen by a doctor that day, the doctor sent me on to emergency.

  24. Anj Fabian
    February 23, 2014 at 12:48 pm #

    So Wanda Smith lied? That’s not a crime, although lying on the internet is likely an indication of how comfortable she is with public mendacity.

    • AlisonCummins
      February 23, 2014 at 12:57 pm #

      I think the problem is that she bragged about violating midwifery regulations in her state — bragged about breaking the law — and then lied when she realized that she might be called on it.

      In her mind the problem is not breaking the law, it’s being caught.

      • Anj Fabian
        February 23, 2014 at 1:14 pm #

        Rule 1) Don’t do it.
        Rule 2) If you do it, don’t get caught.
        Rule 3) If you get caught, see Rule 1.

    • MLE
      February 23, 2014 at 1:00 pm #

      But is operating outside the guidelines set by the state a crime? I don’t know what the repercussions would be for her but she obviously feels the need to perpetrate a cover-up.

      • AlisonCummins
        February 23, 2014 at 1:17 pm #

        Legally I doubt it’s a crime, but nobody suggested it was. That doesn’t mean it’s not illegal.

        • Anj Fabian
          February 23, 2014 at 1:23 pm #

          I’m not sure which version of the story is a lie!

          It could be the home birth that is a lie to allow the fantasy of every woman getting the home birth of her dreams – and the midwife gets to keep her reputation as a home birth hero.

          Citations needed.

          • MLE
            February 23, 2014 at 1:36 pm #

            That crossed my mind as well because her website doesn’t include “born at home!# :-)_!” in the announcement.

          • February 23, 2014 at 1:50 pm #

            More often same though. They’re lying one way or another, and that ain’t ok. Especially in regard to obviously unsafe situations. And the vagaries and “you misunderstood!” really is reminiscent of my ex cult leader, who uses this exact strategy while gas lighting and brainwashing his victims.

          • Guestll
            February 23, 2014 at 1:50 pm #

            If you dig deep enough, you will find that it was a homebirth. Not a hospital transfer with continuous EFM.

          • February 23, 2014 at 1:56 pm #


          • PrimaryCareDoc
            February 23, 2014 at 2:31 pm #

            Certainly sounds like a home birth, since she talks about the midwife team being hosted over 2 nights.

          • Amazed
            February 23, 2014 at 2:32 pm #

            She even claimed it was an uneventful homebirth.

          • The Bofa on the Sofa
            February 23, 2014 at 2:42 pm #

            57 hr labor is an “uneventful homebirth”?

          • Young CC Prof
            February 23, 2014 at 2:53 pm #

            I have to wonder, what would cause a home birth midwife to describe a birth as “eventful.” The unexpected arrival of a traveling circus? Or the Spanish Inquisition?

          • Dr Kitty
            February 23, 2014 at 3:01 pm #

            Indeed. It would have to be something NOBODY could have expected.

          • Sue
            February 24, 2014 at 1:37 am #

            AN ”eventful” HB might be where the person had to transfer and refused to pay the MW’s bill, maybe?

          • schnitzelbank
            February 27, 2014 at 1:44 am #

            Nobody expects the Spanish Inquisition

          • Amazed
            February 23, 2014 at 3:01 pm #

            Babies aren’t library books. And I seem to recall the midwife from BOBB answering, “Never” to a question of how long is too long for a woman to be in labour.

        • MLE
          February 23, 2014 at 1:44 pm #

          I assumed by Anj stating it wasn’t a crime that some aspect of this post suggested to her that Dr Amy was implying it might be?

        • AlisonCummins
          February 23, 2014 at 2:05 pm #

          I think the blog post suggested it was illegal, which I believe it is. Lots of things are illegal without being crimes.

      • DaisyGrrl
        February 23, 2014 at 1:21 pm #

        I bet it’s putting her license at risk (if she needs one to practice). So, not necessarily criminal consequences, but consequences nonetheless.

  25. Paula
    February 23, 2014 at 12:38 pm #

    Three weeks ago, I had a bilateral mastectomy. I have searched and searched the Internet, but have not been able to find my surgeon’s appeal for what to do next (during surgery, of course). Clearly I need to find a more conscientious surgeon, since it appears he relied solely on his training and experience to perform my surgery, and not at all on popular opinion about how to proceed. (I also haven’t found any “oh wait–I didn’t mean I was operating on a REAL PATIENT–this was just a question a surgeon friend messaged me privately!”)

    • Dr Kitty
      February 23, 2014 at 2:00 pm #

      Best wishes for a speedy recovery from your surgery Paula.

      • Paula
        February 23, 2014 at 3:31 pm #

        Thank you! I am doing great, and going back to work tomorrow. I wish it were the same for the parents of the baby supposedly not delivered by Jan Tritten.

        • Haelmoon
          February 23, 2014 at 6:17 pm #

          Same here. Had a laphyst five weeks ago, had a pelvic abscess that recurred and had peritonitis at five weeks with a severe ileus. There was even debate of a repeat scope with general surgery when I was getting worse. However, this was not crowd sourced on the Internet, but rather direct consult ions with other physicians, letting me, the patient, know what was being discussed and what the options were. All discussions well researched, and private, not involving everyone one in the hospital (I managed to surprise a lot of colleagues on my strolls during recovery when they realized I had been in hospital so long, given I am a staff physician there, especially when I showed up in LDR to watch the hockey game this morning – they all thought I was on vacation). Privacy and respect for expert knowledge is what I wanted as a patient.

  26. amazonmom
    February 23, 2014 at 12:05 pm #

    The unmitigated gall of these baby murderers makes my BP go up. Hmm, something is wrong with the baby, let’s sit back and discuss on FB while the baby DIES???? I’ve managed to recruit more than a few people to the anti CPM cause with this.

  27. peanutmama
    February 23, 2014 at 11:54 am #

    sounds about. this entire thing has made me sick to my stomach. i wish people would stop defending these people! they take us for fools!

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