In memory of a baby boy who did not have to die

notburiedtwice black

The ignorance, unprofessionalism, and corruption in the world of homebirth midwifery is beyond belief. Jan Tritten, Editor of Midwifery Today, crowd sourced a life and death situation on Facebook and the baby died. She didn’t think the dead baby was the problem, but when people questioned her role in a preventable death she reacted the way that homebirth midwives typically do. She deleted the Facebook post in an attempt to bury the dead baby twice, once in a tiny coffin in the ground, and then again by erasing him from the public consciousness. And if all that weren’t bad enough, she made it quite clear that she would not disclose the identity of the primary midwife, so that the midwife could be held accountable.

But social media is very powerful and by employing it, we’ve made sure that this baby’s life and death cannot be erased by a midwife who is more concerned with protecting other midwives than whether a baby lives or dies. Because of the publicity, an individual who was searching out where to report this debacle came across my blog posts and learned the story of the Facebook crowd sourcing. Distress at the preventable death of the baby prompted this individual to share as much as he or she knows about it. The facts are every bit as ugly as we surmised.

The primary midwife was, of course, Christy Collins, CPM. She outed herself publicly when she shared details of the disaster on Facebook. I contacted her on her Facebook page and told her that I had details of what had happened and offered her the opportunity to contact me through email to learn those details and correct anything she thought was wrong. She deleted the Facebook post and has not responded.

What really happened? This is what my source had to say (paraphrased):

The parents and midwife had gone for a biophysical profile on Wed 2/19 in the morning. The amniotic fluid was 0, supposedly everything else was normal. The midwife then did a NST with a hand held doppler and told the parents baby sounded good and to go home and drink lots of fluid and take a bath. They repeated the BPP later that afternoon. There was still no amniotic fluid and an NST with hand held doppler was again “good”.

A biophysical profile was repeated the following day, Thursday 2/20. There was still no amniotic fluid, and listening with hand held doppler revealed a heart rate in the 90′s.

The midwife called Dr. X (he provides backup for many homebirth midwives their city) and told him the biophysical profile was normal, but heart tones were “variable.” He told her to immediately come in. She didn’t share with Dr. X that they were at at an ultrasound office attached to Hospital Y. They left that hospital and the midwife got in the car with the clients, put oxygen on the mother and drove 30 minutes to Hospital Z where Dr. X was located. They were immediately taken for a cesarean. They worked on baby for 47 minutes before they stopped.

Christy attended a neonatal resuscitation workshop on Friday 2/21. It seems the case was discussed at this workshop.

Christy’s explanation?

In Christy’s version, it is the physician who is caring for the patient, the midwife is an innocent bystander, and it is the midwife who recognizes that the baby is having a bradycardia.  Christy insists that the doctor declared that the baby had been doomed from the previous day and could not have been saved under any circumstances.

When I asked Christy directly if she was the primary midwife, she told me she would not reveal the identity of the primary midwife, because:

Coming to the defense of others is something I will do if I feel that their actions were defensible. With what I have heard, and with what others posted, they were. It was presented by the midwife poorly, but the actions taken up to that point and past appear to have been within OB protocol …

Coming to the defense of OTHERS?

What information do I have to confirm the source’s claims?

  • The identity of the doctor who performed the biophysical profiles.
  • The identity of the obstetrician who delivered the baby.
  • The name of both hospitals.
  • The details on the workshop where the case was discussed (and where another midwife who also revealed details on Facebook was present).
  • Considerable material in Christy’s own words.

This is not the first time that Christy Collins has found herself in trouble. Christy is one of the “Sister in Chains,” a group documents that the “persecution” of American homebirth midwives, apparently for no better reason than a pile of dead bodies and a few injured mothers. It does not mention a single dead baby by name; in fact, in the case of many of the deaths, neither the babies, not the fact of their deaths are mentioned at all.

According to their Facebook page:

… [T]his group exists for the sole function of supporting persecuted midwives, doctors, students, doulas and families who are facing undue sanction for choosing or supporting birth choices. Nobody is saying anyone is perfect, but we ask only that sanctions faced by out of hospital supporters and parents be equal to those faced in hospital…

The list of sisters is a roll call of homebirth midwives who presided over the deaths of babies at homebirth. It includes:

Christy Collins, CPM (midwife), 2011

Charged with practicing medicine without a license. Took a plea of misdemeanor practicing midwifery without a license. Ordered to pay nearly $10,000 in restitution to the state and put on probation for three years.

Looks like Christy left her troubles behind and crossed the border to Nevada to continue practicing midwifery there.

It’s hard to imagine anything more damning that Collin’s own words (written to a third party):

I wish I could go back in time, and have said stronger words – enough to make you hate me, and fell you had no choice but to go into the hospital the day before. I could’ve lived with you hating me, over this feeling of devastation.

I know we say that we don’t know if it would’ve been any different; maybe he would’ve been very sick, but alive. I don’t know. But I wish I wouldn’t pushed much hard and said the things that we never want to hear the ‘experts’ say…

Instead of … telling you to “be prepared that the perinatologist doing the NST is likely to tell you that your baby could die if he doesn’t come out;” those should have been MY words. You might have been really pissed at me for pushing you into a corner where you felt you didn’t have a choice, but … I wouldn’t care… I am angry at myself for being the midwife who tried to be as firm but gentle as possible when advising to go in when I could’ve waved the dead baby flag…

I wanted so badly to see a change in fluid … while you just wanted time/space to think … If I hadn’t agreed, and used the words “your baby could die because of this …”, maybe he would still be here.

My back up doctor was amazing and the whole team worked so fast. Then the longest 47 minutes of our lives while they worked on your baby who had clearly been soaking in mec for weeks. Acidosis … bad blood gases … the worst of which had occurred in the last 20 minutes. An induction yesterday, just one day after a perfect NST may not have mattered anyhow we were told…

Baby sounded perfect the next morning and we had the same BPP result after you rehydrated. You still wanted more time. I said I didn’t feel we had any, and read to you what even other midwives had to say. That I wasn’t the only one who felt a sense of urgency. Only 20 minutes later, your baby showed distress. And hour later, your baby was out … and gone.

I wish I would’ve been so harsh with my words the day before, that you would’ve hated me. Maybe you would be nursing your baby, angry about your induced birth experience, and refusing my visits. Instead you and the daddy slept with your dead baby all night in a hospital bed …

I blame me. I would rather have you hate me for pushing you harder into a bad birth experience … so you could hold a live baby instead.

Midwifery implies choices. Informed consent. Informed refusal. No woman would refuse an induction if she knew what having a dead baby felt like. In the future, I’ll pressure until my client hates me. I won’t care.

Let us mourn for a baby who didn’t have to die and a family who didn’t have to suffer a horrific loss.

Then let us resolve to hold Christy Collins, Jan Tritten and the homebirth midwifery community accountable for this senseless tragedy.

  • Ugh

    Sad to say I remember when she brought a similar situation in the faculty and the MD had to deliver ANOTHER of her dead babies. It angers me that she is still working. I’m just appalled at her poor behavior and commend the doc that takes her cases and tries to make the best out of he horrific situations. How many more hve to does before someone, anyone stops her?

  • Jennifer Delaney

    This quote slays me and makes me angrier (because I am always angry over this issue)”“be prepared that the perinatologist doing the NST is likely to tell you that your baby could die if he doesn’t come out;”
    what this actually means is “I wish *I* (the midwife) had waved the “dead baby card” at you, because that, in fact, was exactly what was happening. And if only I had acted like an actual medical professional and insisted upon appropriate medical care, your baby would probably be alive. Well, Christy, it’s clear you KNOW you screwed up and it’s clear the baby is dead, the parents are suffering and YOU are a pitiful screw-up, NOT a medical professional or in fact, any kind of professional. I guess all those “meeeen” OB’s weren’t so awful after all, about playing the “dead baby” card…. perhaps they just actually knew more than you and your fellow CPM’s, and knew that babies actually CAN die due to negligence such as yours.

  • The Bofa on the Sofa

    Taking that letter at face value, you know what strikes me?

    SHE KNEW THE BABY WAS IN DANGER and refused to do what was needed to save him.

    That’s what she is saying.

    If I were the parent and saw this letter, that’s what I would have taken from it, and I would be royally upset.

    She knew the baby was in danger but didn’t tell the parents because she didn’t want them to hate HER. IOW, to protect herself from being hated! She let their baby die because she wanted the parents to like her.

    Seriously, that’s what we get if we take her at her word.

    If I am the parent, that is what I am getting from her letter.

    • Danielle

      “SHE KNEW THE BABY WAS IN DANGER and refused to do what was needed to save him.”

      I don’t know if apology letters are legally important, but the letter is quite nearly an admission of guilt:

      “I knew there was a problem and I did nothing” sounds far less defensible than, “I didn’t know, and had no way of knowing, that something was wrong.”

      • The Bofa on the Sofa

        Yep, that’s what it sounds like.

        I don’t think that either answer is all that defensible, though. “I didn’t know anything was wrong” is a sign of incompetence. “I know there was a problem and did nothing” is a sign of … cruelty, I guess.

        Neither is consistent with “acceptable for a health care provider”

    • Meerkat

      You know what else shocked me? She is either really brazen or really dumb, because she was not afraid to send this piece of evidence to the parents. She is admitting she messed up, in writing! It didn’t occur to her that it might be used against her at some point?

      • The Bofa on the Sofa

        How she could think that this might make the parents feel better is beyond me.

      • anion

        My vote is for the latter, personally. Leaving aside the basic fact that if she wasn’t dumb as a box of rocks she would have, you know, transferred care and allowed this baby’s life to be saved, and leaving aside her lack of basic literacy skills…getting involved on social media to begin with was really idiotic, from the “What would you do?” email to “Oh, this wasn’t me but I totes know the midwife and y’all are mean because she was ON TOP OF THIS, and here’s a bunch of lies and half-truths about it for the record that seem strangely detailed, but again, this was soooo not me at all, I just have to defend someone else because I’m such a good person and all and it wasn’t me or anything like that.”

  • grieving family

    I do know about the incident first hand. I was there, its all true… Christy claims she knew what she was doing. The family trusted her… but what she failed to mention to ANY of us was she was on probation and was charged a fine years back and didn’t even have a liscense. Due to her lack of knowledge she let the beautiful baby boy die… and now she makes it seem like she lost her own baby- we no longer have anything to do with that horrible person and we pray for justice to be served so no other family have to go through our pain…

    • Karma Kidney Stone

      I’m so sorry for this loss. I cannot get this baby and family out of my thoughts and prayers, and I know I am not the only one. Please know that there are people who are trying their hardest to make sure that this baby is not forgotten, and that things will change for the better. We will not forget this beautiful baby, and his family.

    • http://momofmanyfeet.wordpress.com Bambi

      If we can be of any support, Amy can put us all in contact with you. You are NOT alone in this, not by a long shot.

    • anion

      Grieving Family, if you truly are part of the family in question or close to them, please tell them how horrified and sad everyone here is for the loss they suffered, and how angry we all are at the liar who murdered their baby.

      And please, please urge them to report this to the authorities. Tell them to contact their local district attorney, the NV Attorney General, and every state and local legislator they can find. It’s a lot to ask of a family dealing with what they’re dealing with, but they really truly can make a difference and keep this from happening to other families, if they’re willing to speak out and see this “midwife” prosecuted.

      This site has–and is collecting more–plenty of evidence: screenshots of the Facebook thread, of Christy’s lies and coverup attempts, of her attempts to blame the mother(!!!) and the OB… and plenty of support for this family, if they ever decide they want or need it.

    • Guestll

      I am so sorry for your loss. I have wept for your baby boy, and I don’t even know you; I cannot even imagine the grief your family feels.

      Please know that you have an advocate for your baby boy in Dr. Tuteur. She will not let this matter rest. There are several loss mothers who post here who would extend advice, counsel, and empathy to you in your time of need.

      I understand that this is a terrible time for your family. But the more time that elapses before you publicly come out, the less focus there will be on this tragedy. It is hard — it is VERY hard — but you would have the support you need, the wise words of women who’ve been in your shoes, and the knowledge that the death of this lovely boy did not happen in vain.

      Sending you prayers for deliverance from your pain.

    • AllieFoyle

      I’m so sorry for your family’s loss. What happened was a travesty and a disgrace. It’s difficult to find words, but we are all outraged and heartbroken on behalf of the baby and family.

    • Dr Kitty

      We are all so, so, sorry for the loss of this precious little boy.
      We are so sorry that we never want anyone else to have to go through the same experience as his family.

      Which means we’re doing all we can to stop him being forgotten.

      I hope his family can take a little bit of comfort from that.

    • Danielle

      I know it changes absolutely nothing, but I want to say that I am heartsick over what happened. I know others cried as well.

    • yentavegan

      I am aching for your family. I hope you can gather strength and fight the injustice done to you and yours.

    • NoLongerCrunching

      I am so sorry for the loss of your precious baby boy. I pray for peace for your family and justice against those responsible.

    • Comrade X

      I am so so sorry for your loss. Please know that there are many people out there who cry with you, and who will have your backs when and if you find the strength to seek justice for your beautiful boy. May you and your family know healing and peace.

    • Trixie

      I have nothing to add that hasn’t been said. I am so terribly sorry for your loss. We will not forget your family or your beautiful, precious baby. You have an advocate in Dr. Amy, and you can email her privately if you wish.

    • An Actual Attorney

      I am so sorry for your whole family.

    • Jennifer Delaney

      I’m so so very sorry for your loss. Please, tell us what kinds of things would have made a difference in the choice of care provider? How can we, as a community, get the word out on why you should NOT hire a CPM due to lack of education/experience etc. Please message me on FB also, if you are able. I am so very sorry for your loss and your family in this tragic time. It breaks my heart. Perhaps someday the knowledge that there are those of us who are actually diligently working towards eliminating this substandard care may bring you some small measure of peace.

    • Guest

      I am so very, very sorry for your loss. This makes me just sick. I wish I could say it wasn’t commonplace, but this story is all too familiar. It happened to a very close friend of mine as well. Hugs.

    • MJ

      I am so very sorry for your loss and the dreadful circumstances surrounding it. Everything must be so difficult right now. Please know that here is a group of committed, clever, strong, inexhaustible people who will fight for your family and that beautiful boy. If you need support to fight this injustice you could not do better than have these people at your back or your side. And if you simply need support to get through each day of grief, there are families here who have walked this path before you – and they are some of the most empathetic, generous, courageous souls I have ever come across. We want to help, our thoughts are with you.

    • guestguest

      Please accept my sincerest apology for witnessing your personal loss over the internet from half the world away because of that charlatan who betrayed your trust and confidence. I do not think I will ever get over the guilt I feel because of that, and I hope that knowing your pain resonates in all of us here brings you and your loved ones at least some solace.

      I am so, so sorry.

      • anion

        Yes. And please know that (forgive me) unlike the midwives rushing to cover this up and blame the mother, no one here thinks this is her fault.

        *And she shouldn’t either. This was NOT her fault.*

    • Meredith

      I’m so sorry for you and all of the family.

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

      I am so, so sorry for your family’s loss. Please let us know if there’s anything we can do to help. I think everyone who watched this unfold is grieving for him too.

    • rh1985

      I am so sorry for your family’s loss.

    • Meerkat

      I am so sorry for your loss.

    • fiftyfifty1

      My thoughts are with your family.

    • DaisyGrrl

      I am so very sorry for your loss.

    • Medwife

      I am so sorry for all the victims here. You are in the thoughts of a huge number of people who are united against the cause of your pain.

    • Dawn

      I am so sorry for your family’s loss.

    • GuestE.

      I am so sorry this happened to you and baby boy. Please know you are not alone. Please tell us what we can do to help.

    • MLE

      Your loss is intolerable. We have all been in a fraction of the distress you have experienced, watching this unfold helplessly, imagining how you must be feeling, and the additional strain a letter and attitude like that must have put on you. It might be strange to find that what happened to this baby is the subject of so much attention from strangers, but it is the least that he and his family deserve. Like many others have said already, if there is anything this group can do to help, you have only to ask.

    • Amazed

      I am so sorry for your family’s loss. No matter how Christy Collins try to twist it, we all saw who is to blame and that is not the mother, father, or the family. It’s her alone.

    • moto_librarian

      I am so very, very sorry for the loss of this beautiful little boy. I still feel ill when I think about the fact that so many midwives on the initial FB thread felt that nothing needed to be done, and that now, no one will accept accountability. I guarantee that if this had been through the fault of an OB, every single one of those women would be baying for blood.

      Please let us know what we can do to help ensure that the loss of this baby was not in vain.

    • Mel

      I am so very sorry for your family’s loss.

    • The Computer Ate My Nym

      I am very sorry for your and your family’s loss.

    • thepragmatist

      I am so sorry for what you’ve been through. Please find the courage to go to the appropriate authorities so that this woman is not just publicly shamed, as we are doing, but also stopped.

      I’ve not lost a baby to a charlatan but I’ve been hurt very badly by one: it might be hard to come forward at first, but it is worth it to know that no one else is being hurt. As much as you can, take care of yourselves, and let the mother know every day it was not her fault.

    • Burgundy

      I am so sorry for your lose.

    • HyperHall

      I am so sorry for what happened. I urge you to report this to the authorities. This is a disgusting charlatan who will just keep putting other baby’s lives at stake. She needs to be held accountable so no one else can be hurt by her.

  • anion

    And I can’t stop looking specifically on the sentence: “I am angry at myself for being the midwife who tried to be as firm but gentle as possible when advising to go in when I could’ve waved the dead baby flag…”

    There is NO indication that Christy advised the mother to “go in.” (I assume she’s talking about going in for an induction.) No indication at all. None. Zero. As others have said, if she was trying to advise the mother to go in, the question she asked on Facebook would have been, “How do I convince the mother to get induced without scaring her?” It would not have been, essentially, “Do you guys agree with me that the risks are really overstated here?”

    Notice she’s not quoting any actual conversations in which she suggested going in and the mother said no. It’s all “You wanted more time,” but nowhere is there an actual “When I said, ‘We really ought to have you induced,’ and you said you didn’t want to do that,” sort of thing. It’s all implication, telling the mother what she was feeling without proof, painting herself as the poor helpless midwife dragged in the mother’s reckless wake, trying desperately to find a way to get the mother to listen.

    • AllieFoyle

      Yes, so much of it comes across as trying to paint a certain picture, to reframe events in such a way that it appears that the mother’s desires to avoid intervention were driving this situation, when who knows what was really said or how the midwife presented the situation to the woman. The “you wanted more time” bit is clearly implying that the mother was resistant, but who knows what she was told or encouraged to believe. As a patient, if a care provider allows you time to think things over, that’s a signal that the situation is not urgent or time-dependent. The false lament about not waving the “dead baby flag” is basically an admission that she failed to inform the mother that the baby was in serious danger. There was no “Informed consent. Informed refusal.” This woman didn’t need a midwife with a firmer hand; she needed a competent professional who knew when and how to act. What a tragedy that she didn’t receive that.

      • guestguest

        It is NOT an isolated incident. It is NOT a one time only rogue lay midwife. Even such a letter is something that people who are part of this blog have directly experienced in the past. I was gutted last night when I read another correspondence of a mother who lost her baby in a homebirth with her midwife – Christy Collins might as well copied these letters.

        A home birth like this one in which a baby died with people witnessing it over the internet in this day and age being ignored by all progressive female bloggers and net writers ( or those who claim to be that), and all discussions being deleted from all the places where women interested in homebirth go to find support and *objective* information is like Emperor’s New Clothes – no one dares speak their mind on this subject for fear of being labeled anti women’s rights.

        I hope that some day, when and if their grief allows them parents of this baby boy will raise their voice to help prevent any parents ever again receiving a letter like that one. Perhaps then the champions of female choices and legislators will listen.

        • guestguest

          edit:

          I am now convinced that Christy M. Collins, CPM, is a psychopath *birth junkie* who will do anything to keep on getting her high, just like a serial killer.

          She posted a comment on facebook only a few days after she killed this baby boy through her negligence where she explains what midwifery is to her, quote:

          “being able to bask in the passion and love of lives being in your hands…and wanting to do it over and over again”.

          No remorse, no regret, not even the common decency to keep her foul mouth shut on the subject of what incompetent midwives like herself are allowed to do without supervision or legal consequences.

          Her comment is posted in the thread on Midwifery Today fb page: https://www.facebook.com/MidwiferyToday/posts/10151496671045266 – until it disappears, so I attached a screenshot of it too.

          • anion

            Jesus.

            What an unbelievable thing to post days after you destroyed three lives due to your negligence and hardline adherence to idealogy. What kind of person goes online to crow about their power over life and death in that situation? Would a drunk driver who killed someone go online a few days later and say, “What I love about driving is the power you have over life and death when you’re behind the wheel?”

          • rh1985

            She has to be a narcissistic psychopath. I can think of no other explanation.

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

            The abuser I was with, on whom I drew for my analysis of the letter, is a narcissistic psychopath. I concur with you.

          • http://momofmanyfeet.wordpress.com Bambi

            That is f-ing insane.

          • Jocelyn

            I just read a lot of the other comments on that thread. It made me very angry. These women are idiots, and they’re killing people.

          • MJ

            That thread is horrific. They really are children. Most of us, as we grow older, realise that often there are very good reasons why you can’t do exactly what you want when you want to. These women seem hellbent on reshaping reality so they never have to confront that fact and grow the eff up.

      • RebeccainCanada

        You know what gets to me though? The midwife and midwifery community create an environment, brainwashing almost in which hospital is unthinkable! It reminds me of a Focus on the Family, their programs were always, “hey you are broken and don’t know it, and only we have the special knowledge with the special solution, buy our BOOK!” They create the problems then have the only trustable solutions.

        When you are the mother in the situation, you’ve been lulled to sleep with the books they loaned to you, the printouts they don’t want you to keep, the loooong appointments where they lull you with fear about Doctors, and how only they are truly evidence based providers. They always lie and say that you make the decisions…. In reality they do, they push all the buttons. More time? Why because she couldn’t understand after all the brainwashing about how birth is normal, how everything will be easy and glowing? Now you expect her to snap out of it and deal with reality?

        How about taking responsibility in the first place that you lulled her to a place of perfect complacency, right where you wanted her.

        • AllieFoyle

          Right. She sure wants everyone to know that the mother wanted more time. What she doesn’t say is anything about the context of those conversations. We know she wasn’t “waving the dead baby flag” because she says so herself. So did she almost certainly communicate to the mother that she actually had time to safely sit around and think things over for a while? Of course. Did she perhaps suggest it herself as the most sensible course? I would not be at all surprised.

          • anion

            Well, we know that upon initially discovering there was no fluid, she sent the mother home to “re-hydrate and take a bath.” Were I the mother in that situation, being given that advice would definitely indicate to me that this isn’t a big deal.

          • Comrade X

            Very true. If a trusted medical professional suggests to me that my situation is best dealt with by going home, having a relaxing soak in the tub, and then chilling on World of Warcraft with a few tall glasses of diluted cranberry – that’s pretty much a clear signal for “Not A Big Deal (TM)”.

    • http://thefresstyler.blogspot.com/ Hannah

      I think this is her incredibly clumsy attempt at damage control. It is sickening. It is also stupid, because it is a written admission of guilt.

  • AllieFoyle

    If this is all true, the most damning thing (from a long list of inexcusably poor choices) is the decision to drive the mother from one hospital to another, wasting those precious 30 minutes. What justification can there possibly have been? I can’t think of anything except a strong desire on the midwife’s part to avoid the censure and scrutiny of hospital staff she knew would be critical and to make sure that the birth happened on friendly territory where she wouldn’t be called out on her egregious decision to encourage the woman to avoid delivery in light of clear danger signs.

    Everything else I can dismiss as stupidity, lack of training, or clinging to dogmatic beliefs, but that action sticks out to me as so obviously a conscious decision to place her own professional well-being above the life of this baby…it’s just unconscionable.

  • Amazed

    At least this creepy letter gives us some insight into midwives’ way of using those. I was actually stupid enough to wonder why the midwifery board or whatever punished Faith Beltz to write Liz a letter (it was Faith and Liz, right?)

    Well, now I know. What a refined punishment for Liz for daring to leave their ranks and speak out.

    The more I learn about those bitches, the more they disgust me. And frankly, mothers like the MCD member I quoted in my comment on Dr Amy’s next post make me quite uncaring of what might happen to them.

  • batmom

    This has been on my mind all day. The poor baby. I’m a layperson — my expertise is having one baby, who needed an OB’s skill with forceps to get out — and even I knew that no fluid at 42w meant L&D, now.

    All that had to happen to save this baby was someone doing an actual BPP earlier, when her water was low but not critical, and inducing. “Soaking in mec for weeks?” My ass. She should have been induced, because someone should have noticed that her placenta was old; and she might have had a C-section, but she wouldn’t have been snuggling her dead little baby.

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

    It took a lot of work, but here is my line-by-line analysis of Christy’s letter. It is way too long for a comment, so I made it a blog post. Feel free to share. https://kumquatwriter.wordpress.com/2014/03/01/christy-collins-rewrites-history/

    • auntbea

      As adroit as that was, I actually wish I hadn’t read it. It’s making my skin crawl,.

      • CanDoc

        Agree. Skin crawling. BUT reading between the lines in the letter with someone who actually thinks about these things (that’s you, Kumquat), brings forward a lot of subtlety and context that I completely missed during my read-through. Thank you for sharing and posting.

    • Trixie

      Very well done! And horrrifying. My god, that poor mother.

    • Anj Fabian

      “I would rather have you hate me for pushing you harder into a bad birth experience”

      She’s been immersed in that culture so long that this phrasing, which sounds odd to the uninitiated, comes naturally to her.

      To us, it’s ridiculous to talk about what kind of “birth experience” would have given the mother a live baby. To those in the culture, the birth experience is so important that even losing a loved one doesn’t eclipse it.

      • Karen in SC

        “Pushing you harder into a bad birth experience” says it all. Only an NCB nutter would prioritize the experience over a healthy baby.

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

          It assumes the experience in the hospital would have been bad, it very well might not have been, and certainly the experience that happened is worse than what might have happened otherwise.

    • MLE

      Absolutely chilling. It shows how cold and calculating she is that she could carefully craft this in the hours or days following the death. She isn’t shaken in the least!

    • AdelaideGP

      Spot on, Kumquatwriter. Christy Collins really is a piece of work! Thanks for posting.

    • Amazed

      Great job, Kum. My own analysis would be very close to yours. This letter was a mastery of deception and blame-shifting.

    • guestguest

      Thank you for that, I know it must be hard to immerse yourself into all of this.

      The most chilling thing about the way Christy Collins speaks in terms of language is how she uses plural forms when deflecting responsibility and manipulating others into believing her version of events.

      In that abhorrent facebook post she used it to share the responsibility of ignoring the imminently bad outcome with her fellow quacks (“what do WE truly feel are the risks”), and in the letter she used it again to hide herself from being singled out as the person responsible by stating that everyone involved supposedly shares her opinion that the outcome was inevitable (“I know WE say that WE don’t know if it would’ve been any different;”).

      She also used it to inject herself into the grief of the parents (“Then the longest 47 minutes of OUR lives”, ” )

      Ugly, evil, manipulator at work there.

      • MLE

        Yes, that line about the 47 minutes remade me see red (red-er?). As if what she was feeling came anywhere close to what mom and dad were experiencing.

      • Comrade X

        Bloody well spotted. It’s called “forced teaming” and it’s a linguistic tactic apparently often used by serial rapists to try to manoeuvre a potential victim into a more vulnerable situation or setting. The idea is that it’s meant to subconsciously imply an intimacy or camaraderie between the perpetrator and the victim in order to lower their defences or perceive you as “on their side” in some way.

        Wow, this is just so hideous.

    • anion

      Excellent analysis.

      For me the key sentence is “instead of telling you to ‘be prepared that the perinatalogist doing the NST is likely to tell you that your baby could die if he doesn’t come out,’ those should have been MY words.”

      It’s a flat-out admission that she KNEW what medical advice would be, and that she encouraged the mother ahead of time to disregard it. Who knows how strongly she put it, or how much discussion there was about it? Discussion in which Christy backed up those words with phrases like, “They’re just worried about liability,” and “They think babies are like library books,” and “cascade of interventions,” and “you’ll end up with a c-section?” I seriously doubt she made that one simple statement and let it go at that. I seriously doubt–she all but admits she didn’t, and her actions wrt FB are a further admission–that she used that statement to open a serious discussion about the possibility of the peri being correct.

      But by bringing it up, she’s encouraging the mother to remember the mother’s own response to that statement, which was likely fearful or uncomfortable, and thus encouraging the mother to think, “That’s right, I went into that test thinking that I didn’t want those things. I chose to handle this the way I wanted. I would have hated Christy if she’d tried to talk me into an induction because *I* was so set on non-interventions and letting things happen ‘naturally.’ I was dismissive of the idea that the peri could be right, and would have just been angry had Christy agreed with him. I hired Christy to protect me from that sort of thing. She was just doing what I told her to do.” Whether those thoughts are true or not, Christy has planted them in the mother’s mind.

      And all of the nonsense about “you would have hated me,” further backs up that idea (I know you said it repeatedly, I’m just completing my thought): that the mother was absolutely set on one course of action and wouldn’t have tolerated any disagreement, and that poor Christy had no choice but to go along if she wanted to be there for the mother at all and continue protecting and helping her.

      “Pushing you into a corner where you felt you didn’t have a choice,” further emphasizes and encourages the mother to think of herself as someone fighting for the course of action she wanted, valiantly battling against those who disagreed, with only Christy standing beside her; it encourages the mother to think she would have felt abandoned if Christy had disagreed. And by doing so it encourages the mother to absolve Christy of blame and take it on herself.

      It is so very vile.

      • anion

        BTW, I too had to stop reading at the part about spending the night in the hospital bed (I can’t even bring myself to complete the phrase). Utterly heartbreaking.

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

        Yes! Would you mind copy/pasting that as a comment on the post itself? You’ve added some nuances I didn’t highlight.

        • anion

          Thank you! Done. :-)

      • Alenushka

        My doctor does not care if I hate her when she gives me info about my treatment options because it does not matter. What matters is that I as patient understand the risks and benefits.

        • fiftyfifty1

          “What matters is that I as patient understand the risks and benefits.”

          This is exactly what we are taught in medical school- that we are obligated to make sure that the patient understands the risks and benefits. A common example is our obligation to educate a patient about the risks and alternatives before a (non-emergency) surgery. Not infrequently, a patient will try to “waive their right” to a discussion of the risks by saying something like “Doc, you don’t have to tell me all this. I’ve already decided on the surgery” or even “Don’t tell me all these risks, I’m a nervous person and would rather not talk about it”. As a medical student I remember thinking that that was fair enough; I had given them a fair chance to discuss the risks and they had declined, and now they could sign off on the informed consent paper. Besides, I didn’t want to add any distress, right? I remember telling this to my preceptor at the time and having her correct me. I am *obligated* to make sure patients are aware of risks and benefits and alternatives to the medical decisions they make. I am *obligated* to make sure they understand. “I don’t wanna make you mad” (or scared, or bored, or confused) is not an excuse.

    • Meredith

      Amazing work. Thank you for bringing your experience to bear and for spending so much time with those poisonous words.

    • Amazed

      Oh, and I’ve got a problem with the very premise of the letter. It’s written in a way that was meant to present Christy and her Facebook advisors as competent providers who knew what was going on but oh, Christy was the poor victim of the mom’s selfish determination to have this homebirth, come hell or high water.

      I really don’t think it was the case. Facebook was clear. They were a bunch of dangerous incompetents. In this revolting letter, Christy aimed to preserve their professional image and respectability, so everyone the parents would show the letter would be awed by their great knowledge and sad plea brought only out of the goodness of Christy’s heart. Christy was the victim here, that’s the insinuation.

    • fiftyfifty1

      Kumquat, do you think manipulators know in their own minds exactly what they are doing (i.e. “Oh, here I’ll shift the blame subtly onto her by saying this. Oh, here I’ll bring up a vivid image of her dead baby to make her emotional so she won’t think clearly etc”) or is this something that they do only semi-consciously or instinctively?

      ETA: not that it really matters I suppose. They do it in either case.

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

        I think it varies. Most manipulators I have known are definitely aware enough that they are manipulating and usually have some favorite tactics. The real monsters are fully aware on a line by line basis, others just have instincts.

    • LadyLuck777

      Excellent dissection. Gut wrenching guilt mongering on the part of the midwife. She should be ashamed.

    • http://momofmanyfeet.wordpress.com Bambi

      I think this may be why this thing has triggered me like it has. You nailed it. I can’t help but wonder how many other parents get letters like these.

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

        It’s triggering enough that it gave me nightmares, and I’m totally outside this AND I’ve had years of therapy. It’s disgusting.

    • Jocelyn

      Dr. Amy, might it be possible for you to send this to whomever that letter was sent to?

    • anh

      Kumquat, this is awesome. I decided a long time ago after reading your blog that you are the Most Interesting Person on the Internet and this just proves it. Thanks for sharing your experience and applying your insight to this situation.

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

        Best. Compliment. Ever.

        Thank you!

    • Meerkat

      Wow, thank you for this amazing analysis! I read the letter rather quickly, and my initial impression was dismay at this terrible attempt at an apology. I actually thought she tried to apologize and really botched it. It didn’t even occur to me that somebody could be evil enough to send this to a grieving mother.

    • AllieFoyle

      You are spot on about the manipulation and gas-lighting. The dynamics of this midwife-client relationship–at least from the midwife’s POV– and those of an abusive relationship are disturbing.

      I wonder if this letter isn’t also an attempt to create some kind of record. It feels very much like a way to set down a version of events that paints the midwife in the best possible light (loving and concerned but just not firm enough to force her into a bad experience). She’s making a concerted effort to frame the mom as being a certain kind of person–resisting intervention, wanting more time to think, likely to become irrational and vindictive if she were told things she didn’t want to hear, someone who had made informed choices and refusals– when, by the midwife’s own admission, the gravity of the situation was either downplayed or never communicated to her.

      Look at the language she uses to describe the potential (and completely imaginary) reaction of the mother: hate, hate, hate, pissed off, angry, refusing visits, more hate… She wants someone to get the impression that the mother is not a nice, normal, stable person. Normal, stable people do not hate people for giving them unwelcome but true information that can potentially save their child’s life. The implication is clear.

      And then in contrast, she presents herself as “firm but gentle”, concerned but just not forceful enough to overcome mom’s irrationality and potential hatred. …If she had just pushed a little harder, waved that “dead baby flag” even at the risk of being hated!

      And she’s careful to specify several times that the mother wanted time to think and to state it in such a way as to make it sound as though the mother was aware of the dangers and resisted anyway, when we know that the midwife herself was so unaware that she appealed to midwives on Facebook for information. She couldn’t possibly have given her enough information for informed refusal since–she didn’t even know it herself! She states that she read what the other midwives had to say, but that makes it sounds as though she was relaying some sense of concern and urgency, instead of, as we know from FB, passing along an embarrassing bunch of nonsense about stevia, etc.

      It’s a slimy, manipulative attempt to rewrite history in a way that makes her look as good as possible, downplays the effects of her actions, and casts blame and character aspersions on the mother.

      • Comrade X

        ^^^^ This ^^^^^

      • Jocelyn

        Allie, could you copy and post this as a comment on Kumquat’s blog post, too? I’m going to send the blog post to someone and I’d love your comment to be on there, too.

        • AllieFoyle

          Sure, as long as Kumquatwriter doesn’t mind.

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

            Kumquatwriter never minds comments, additions and sharing!

          • Jocelyn

            Thanks!

      • anion

        I think it absolutely is an attempt to create some kind of record. She’s picturing her eventual trial, and being able to say, “Well, see, I wrote that letter right after it happened, and obviously at that time the mother had fought with me to stay out of the hospital, no matter what she says now.”

        Good luck with that, Christy. Too bad the rest of your lies are all on record, too.

  • Meerkat

    Wow, the letter to the grieving mother is really disturbing. Christy, like a true “professional” that she is, implies that her only mistake was not being forceful enough to make her patient do the right thing. She is admitting that she knew the baby was in trouble and basically lied to the patient. She lied to her because she was afraid the patient would hate her??? Heck, forget professionalism. How about basic human decency? Integrity?
    Can you picture a doctor saying something like this to their patient:
    “Dear Mrs. Jones, I am so sorry your cancer has spread. I wish I could go back in time. I would not worry about you hating me and tell you about your cancer. You would hate me, go through difficult surgery and chemo, but have a great prognosis for the future instead of realizing you have only a couple of months left to live. But not to worry. I will get it right next time.”

  • thankfulmom

    I don’t think she really cares about the dead baby, nor do I think she is going to change what she believes. This from her website” “Agreeing to non-medically indicated inductions before 42 weeks and
    continuous fetal monitoring are the two most common procedures resulting
    in the cascade of interventions that lead to true or perceived fetal
    distress, failure to progress, and/or a diagnosis of cephalopelvic
    disproportion. Those three “problems” have resulted in an average 34%
    c-section rate, and henceforth have placed the United States at the top
    of the list for some of the most unacceptable maternal and infant
    mortality rates of all the developed nations. With major surgery comes
    the risk of major complications.”

    • Jessica S.

      She clearly hasn’t a clue what she’s talking about, referring to “infant mortality” in the context of births.

      • prolifefeminist

        She’s referring to infant mortality instead of perinatal mortality because that’s the line she’s been fed by the HB propaganda, and she’s lacking enough in critical reasoning skills that she hasn’t questioned it any further. That’s understandable for a lay person, but someone who’s claiming to be a midwife oughta dig deeper!

        That’s one of the things about requiring midwives to go through nursing school first – it helps to weed out the people who don’t know how to think critically. It isn’t a foolproof system, but it sure as hell helps.

        • LMS1953

          I don’t mean to hijack this politically. Senator Harkin from Iowa went on a tour of Cuba recently and came back with effusive praise. He lauded the infant mortality rate, especially compared to ours. Senator Rubio from Florida (whose family had defected from Cuba) gave an impassioned reply. He said that the infant mortality looks low in Cuba because if a sickly baby is born in Cuba they just let it die and don’t even count it in the statistics. Also, if there is any inkling of a problem with mom or her fetus in pregnancy they are quick to abort the pregnancy in Cuba. In fact, Rubio contended that Cuba has one of the highest rates of abortion in the world. Regardless of one’s politics, this is a good counter when the crunchies deal the infant mortality card from the deck of Woo.

      • thankfulmom

        Even I caught that, but only because I’ve been reading Dr. Amy’s clear explanations on this blog for the last five years. Amazing that a course in midwifery doesn’t teach basic information that Dr. Amy explains on her blog to interested readers.

        • thepragmatist

          This is why these women are so sly. They are so very sly. The manipulation of information is so smooth that only a trained eye would pick it up. EG. I would read adverts in the baby handouts for midwifery and they would boast about these low c-section rates. Well, obviously, because where I lived they have to transfer care. SO of course, they have a low c-section rate and that looks really appealing to the untrained eye. It’s misrepresentation and there has to be something to counter their claims. “Less of our patients use analgesia”… what if OB/GYN’s advertised: “We will make your birth experience as painless and as comfortable as possible.” But they can’t, not here, because they are forbidden to advertise, so that the midwives look as if they are the perfect provider of care and the OBs can’t say a word about their “high c-section rates” and “interventions”. I’ve talked to my OB about writing a series of friendly explanations of intervention to put in her office in a more conversational tone, even humorous. But also, there just has to be more time spent with certain pregnant women. It is a transformative life event. My OB routinely runs an hour behind time, and I’ve come to just expect lateness, because she takes her time with every patient– they all matter and I get my time, and it is so valuable (I have other help problems). This level of care requires that, at least within the context of socialized medicine, we FUND women’s health better. But individualized treatment with highly trained professionals, such as OB/GYNs, is expensive. I do not, personally, feel that midwives should be even running autonomously. Here they make some serious errors in judgment and then the OB/GYN on call has to be the bad guy. It’s bad for science-based medicine and women. I think midwives should have the same powers of a nurse-practioner working under a specialist. Would the nurse-practioner of a cardiologist do the heart surgery? NO. So you know, midwives would have a place in caring for ALL women, under the eye of OB/GYN, and that’s just the way it should be. The hubris of the midwife, who is not nearly as well-educated as the OB/GYN, is always a point of contention for me. Worse yet, they feel superior to the medical doctors, for the most part, and avoid consulting unless absolutely necessary, as far as I see. I am fortunate I had two midwives who work well within the system and who weren’t afraid of providing care WITH an OB. I still got the short end of the stick, because when I made the choice to have a midwife, it wasn’t because I wanted a lower standard of care, or woo-medicine, it was because I believed the MIDWIFE to be on the same level as an OB/GYN, since they are presented as having prescribing powers, educated, etc. Needless to say, again, my son was born with crashing blood sugars and I researched it and I’ve not been able to get a chance to go over it with my OB/GYN (my care returned to my midwife after my wonderful OB did my MRCS) but I’m pretty sure there’s no other explanation for his crashing sugars (and they crashed close to the line where IV fluids would’ve been required.) I think I, like my entire paternal side of the family, developed GD at the end of pregnancy and it just was not noted. It must’ve been. I can’t figure out why my son’s sugars would’ve crashed if not for a metabolic issue– he was born a normal weight, with a giant head, but normal everything at birth. I took a medication but there is no causal relationship to metabolic issues from that med. And further to that, I suffered in severe pain and vomiting my entire pregnancy with a midwife who didn’t even tell me (perhaps didn’t even know!) that there were ways I could’ve felt better immediately within the medical model of care. And my OB did that.

          TL;DR Midwives here present themselves as equal to OB/GYNS but they cannot provide the same standard of care, and I never would’ve chose one, otherwise. I chose a midwife because I wanted female only care, in a more intimate setting and associated medical care with negative events (and it is a sterile, and times very unpleasant environment). I DID NOT decide to forego medical care because I decided to use a provider who was sanctioned by the state as a health provider. So this is the problem women are running up against. You don’t know what you don’t know. If I knew what I knew then, I never would’ve been running and jogging on pelvic recti. All my midwife said about the shape and state of my pelvis was, “This is going to take a long time to heal.” But she didn’t tell me what to do, where to go, how to fix it, or what the implications could be (a tear in a disc in my spine). She didn’t tell me there is a relatively harmless little pill that would’ve stopped my vomiting five, six times a day. She didn’t tell me what to look for, and then– and this is the crux too, because so many complications of child-bearing show up later– she didn’t tell me what to look for as I healed or when to seek help so I just went on with a very bad injury. What she should’ve done was advocated for me– told my doctors I needed x-ray, MRI, and physical therapy. I assumed that she would do that so I just felt like I wasn’t adjusting well to normal changes in my body and ignored what would become a pretty big problem for me.

          So much for a TL;DR section. Haha.

          • anion

            I am so sorry that happened to you! It is utterly shocking and disgusting, the lack of care and attention given to the physical and sexual health of women during pregnancy and postpartum. (Heck, I’m dreading having to go in for my pap smear in a week and a half because of the humiliating way they do them here.)

            One day I’ll tell the story of a friend of mine and her UK midwife care, which is horrific. It involves third- or fourth-degree tearing during labor, improperly stitched hours later in a hallway with stitches that dissolved too early, and exposed nerve endings as a result. We dubbed it (forgive the crudity) “Frankenpussy.” She suffered tremendous pain and complete lack of sexual function for two years until she finally went back to the US on her own dime and got numbing ointment and a quick outpatient surgery.

            And, later, two maternal request c-sections. :-)

          • Jocelyn

            Ugh, I am so sorry! I had HG with both of my pregnancies and it is AWFUL, even with treatment! I am so, so, so sorry your midwife didn’t help you. I’m glad you know about medication for it for the future; also, you might find the HG website helpher.org helpful. The forums there helped me during my last pregnancy.

    • MLE

      To that I counter – with great power comes great responsibility.

  • Ash

    “angry about your induced birth experience, and refusing my visits.
    Instead you and the daddy slept with your dead baby all night in a
    hospital bed …”

    Is it just me or is does this allude to saying that an induced birth would have left the parents angry but since the baby died, they got to spend a peaceful night together?

    • theNormalDistribution

      I don’t think so. I think she was admitting that a dead baby is worse than an induction but attempting to imply that they’re similarly bad outcomes.

      ETA: (Because then she can say that she caused a bad outcome, but it’s because she was trying to prevent a bad outcome.)

    • Meredith

      I *think* she’s just trying to up the pathos in her letter by harping on the baby’s death (as if the parents weren’t already aware!).

      It’s almost like she views this letter as some sort of tear-jerking literature where she’s the tragically misunderstood prophet.

      Oh right, that’s classic narcissism — wallowing in the gruesomeness of a tragedy. How did I miss that the first time around?

    • rh1985

      My baby was born the same day and it kills me to think about how while I was meeting my healthy, alive (thanks to a c-section) baby these poor parents were holding their baby who was dead because of this horrible woman.

    • Danielle

      I don’t think she meant to imply what you suggest. I do think there’s something off about discussing the parents staying with the dead baby all night. I feel like that is so emotional and intimate and private that its something only the family should be allowed to speak about. Using it to elicit the dramatic effect she wants is insensitive.

    • SuperGDZ

      I promise you the parents didn’t sleep at all, let alone “all night”.

  • Something From Nothing

    It was more important to her to have the client like her, than it was to have a good outcome? She sounds like a teenager! Reading things like this helps me put the issues that I have with our canadian midwives into some sort of perspective.

    • AllieFoyle

      It’s doubtful she even cared that much about the woman liking her. At best it was probably more that she had some kind of narcissistic need for the mother to revere her for helping her avoid some nebulous dangers of the medical system that she brainwashed her into fearing in the first place. Everything about this stinks of the motivation of preserving her own feelings of superiority and esteem and then later, saving her own skin at the expense of the baby’s chance for life.

      I can’t imagine the pain those parents are going through. Sending a blaming, self-serving letter like that to them–if that is indeed what she did–is cruel, callous, and repugnant.

      I’m so sorry for their loss and I hope that midwife is never allowed to prey upon and betray the trust of another vulnerable family again.

    • theadequatemother

      I don’t see how most women wouldn’t be grateful that a problem was caught in time with their baby and a disaster averted. Saying that she didn’t want the mother to “hate” her is a subtle way of blaming the mother. Aka saying the mother was so invested in NCB that it shut down the possibility for discussion.

      • The Bofa on the Sofa

        It’s serious projection. Would the mother REALLY have “hated her” if she had insisted on acting earlier?

        • thepragmatist

          Furthermore, I would hate someone who killed my baby. You know, play the tape through, there.

  • fiftyfifty1

    Here’s what she’s really saying in her letter to the mother:

    This is your fault. You are the bad person.
    I tried to correct you, but you wouldn’t respond to my correction.
    A person as bad as you apparently can’t be trusted.
    My only mistake was trusting you.
    Next time I meet a mother that makes as bad of decisions as you do, I’ll force the issue.

    What a head trip.

    • Durango

      I just can’t get over how she keeps saying that she held back because the mom would be pissed, or would hate her, or be angry. “I didn’t do the right thing because I was afraid of you.” These people are so far from being professionals.

      • http://safermidwiferyutah.wordpress.com/ Safer Midwifery Utah

        They can afford to act that way because what real consequence does she face? Oh yeah, none.

        • theanastasiabeaverhausen

          Do you think it’s possible to sue for wrongful death? Wonder if anyone has tried that?

      • Amazed

        She’s lying. She didn’t have a damned idea what the hell was going on. But it would look bad saying so in the letter. It might look like… she didn’t have a damned idea what the hell was going on. That might hurt her and her fellow incompetent sisters-hopefully-soon-in-chains’ careers. Patients might reconsider giving them their money! So let’s shift the blame on the mom.

    • Guest

      The narcissism of that letter is shocking. This woman sat up all night holding the corpse of her infant son and your decide to write her a note about how you are going to change professionally?

      • http://momofmanyfeet.wordpress.com Bambi

        Can we not refer to the baby as a corpse, please??

    • Jessica S.

      It’s so unprofessional, not to mention immature and insecure, to send this word vomit of a letter to the parents this early, although perhaps even at all, ever. It’s one more indication that it’s more about her than a healthy outcome. It would be inconceivable to have a doctor or a nurse practitioner, etc. act with such insecurity and immaturity. Not to say it could never happen, but I’m sure problems would develop pretty fast that would put that person out of business. With CPMs and the like, they can skirt consequences, like Safer Midwifery Utah stated below.

    • Meerkat

      Yes, and at the end she talks about informed choices, so she also says:
      You knew what you were signing up for.

  • thankfulmom

    I am surprised that six health insurance companies pay her, Aetna, Anthem,Blue Cross,Cigna,GEHA, United Healthcare. How does someone who is not a real health care provider get paid by insurance companies?!

    • DaisyGrrl

      Especially after what happened in California? What part of “this person is willing to break the law in order to practice quackery” says good insurance risk?!

    • moto_librarian

      Insurance companies may be the best group to lobby about the lack of qualifications of CPMs. They do not want to pay shit providers. Cutting off the money might do more to stop this crap than anything else.

      • Karen in SC

        If Dr. Amy’s contact can supply the insurance company covering this emergency c-section, that may be a start.

        • moto_librarian

          While it is not relevant to this case, think of the number of babies who wind up with extended NICU stays because of HB. The bills are astronomical!

          • Meredith Watson

            I think I may have accidentally down voted you In my attempt to reply! I think about that all the time and That is to say nothing of the lifetime cost of care for a baby permanently injured in a home birth!

          • theNormalDistribution

            You can tell because if you’ve downvoted, the downvote arrow turns red. Just downvote again and it’ll reverse it.

          • Meredith Watson

            Thanks. I need Disqus for Dummies!

          • The Bofa on the Sofa

            Of course, it doesn’t matter. They don’t count downvotes anyway.

          • theNormalDistribution

            I noticed that a couple of days ago, but I thought it was a glitch. Apparently not:

            http://help.disqus.com/customer/portal/articles/658811-how-voting-works

            Looks like downvoting is only used to keep comments from reaching the top, which is kind of pointless. I get that they’re trying to address the issue of mass downvoting by trolls, but who sorts by “best” comment anyway? It makes everything unreadable.

      • Bombshellrisa

        You are on to something here! The provider list for my insurance groups all the midwives togethor, also erroneously has all the CPMs listed as CNMs. I have no idea how to get the insurance company to correct this, as it’s misleading to the consumer.

        • MLE

          They would want to know for sure. You could try calling a general provider number and telling them you want to speak to provider relations or network management regarding what sounds like misrepresentation. I don’t know what state you’re in but I could assist. Maybe Dr. Amy could give you my email address?

          • Bombshellrisa

            I am in the Seattle area-and yes, if you can help I would appreciate it.

          • MLE

            I sent Dr Amy a note asking her to pass along my email to you.

      • Ash

        I think Aetna is going to catch onto the dangerous practices of CPMs quickly. It’s very interesting how they publicly publish their rationales for covering (or not covering) procedures.

    • thankfulmom

      Did a little more reading…a cpm can get paid by the insurance co. if they are in a contract with an OB (who has malpractice ins.).

      • Amazed

        Lucky OB. Now, he can pay for the midwife’s (lack of) judgment.

        I have to say I find it hard to sympathize with someone who does back-up for a Sister in Chains. Being male, he cannot even become such a Sister.

        Oh, and I hope he sees Christy’s facebook pathetics and learn that he was, in fact, the primary caregiver and she was on the top of the situation. Might give him a pause before signing with the next babykiller wannabe.

        • LMS1953

          The San Diego OB wonder guy is listed among the sorority.

      • LMS1953

        So, the point of having an OB back-up is that you call her/him up in lieu of polling fellow crunchies on the internet, correct? I wonder if the insurance companies had the foresight to include a list of exclusion criteria for which they would not pay for a home birth – post dates, breech, twins (the typical cases excluded in European and maybe even Canadian models). If not, perhaps the insurance company itself could be sued for contributory negligence. I also wonder what the extra malpractice premium surcharge is for the OB to cover HB CPMs and if he declared it on his application. Why on earth would he donate that surcharge to the altar of Woo? He couldn’t possibly make enough from the emergency C/S transfers to cover the surcharge. The “fair” thing would be to have the CPMs pay a pro rata share of the surcharge, but that might be considered fee splitting. Finally, since Collins posted the insurance companies on her homepage and that coverage is dependent on physician contractual backup, those physicians should have been listed on her homepage. Barring that, the insurance company should be required

        • thankfulmom

          I actually found the list of insurance companies who would pay her on healthgrades.com Interestingly, there are no sanctions listed against her on healthgrades.com

          It makes zero sense to me that an M.D. with decades of training would be back up for a women who got online training and a preceptor to fulfill the clinical requirements of the online school. Wouldn’t someone who has been through med. school understand the need for real training? I don’t understand what the back up physician would gain from this…except a potential lawsuit.

          • prolifefeminist

            The OB who served as my backup when I attempted an HBAC with a CPM had literally NO IDEA what the CPMs scope of practice was. No idea. He said he didn’t know if she would do certain interventions at home (like amniotomy) even though i was a postdates VBAC. And this is a popular OB at a large medical center near a big city! There wasn’t a formal backup agreement between him and the midwife, but still – he accepted me as his patient in the event that he was needed (which he was) and knew that I was trying to HBAC.

            I’ve decided I’m going to write him a letter outlining the reasons he should have refused to take me on as a patient, and point him to the #notburiedtwice page.

          • Karen in SC

            I think that is an excellent idea!

          • thepragmatist

            I understand this, but what if he had not taken you on as a patient? You may have buried a baby? Maybe he is aware and doing harm reduction. Still a good avenue to pursue, unless it means that this woman starts practicing WITHOUT back up.

        • DaisyGrrl

          Just a note on Canadian models. I live in Ontario, and breech, twins, and postdates are outside of their scope of practice (at least at home and almost certainly at hospital too). Ontario midwives may attend VBACs (and claim a 75% success rate), but may not attend HBACs if the mother has had more than one c-section (I don’t know if this holds for hospital births).

          • Guestll

            Ontario RMs can and do deliver postdates, in both hospitals and at home. I have two friends who delivered at 42+ at home with RMs, and I delivered at 41+5 in a hospital (my choice, could have had a homebirth).

          • DaisyGrrl

            Apologies. I re-read the study and you are correct. According to this study (http://www.aom.on.ca/files/Communications/Reports_and_Studies/Birth_Ontario_Home_Birth_Hutton_Sept_09.pdf) if labour starts before 43 weeks, you’re good to go for homebirth (although physician consult is required by the College of Midwives for all pregnancies lasting longer than 42 weeks). My mind is boggled.

  • CanDoc

    See, here’s the thing. Christy Collins realizes that she’s made a terrible mistake. She feels terrible for it. She’s owning it. And she’s discussing how it will forever change the way in which she practices.
    This is how clinicians become safer, more cautious. As tragic and unconscienable as the outcome may be, in fact, Christy’s insight here is better than most after a tragedy.

    • Trixie

      In what way, exactly, is she “owning it”?

      • Anj Fabian

        Didn’t you see how she vowed to transfer care after 42 weeks?

        Neither did I.

    • OBPI Mama

      I don’t know if they learn from it longterm though… They may change a little for awhile… until another client has a similar case, BUT with a good outcome. Then they get all mixed up into completely trusting nature again. This has happened with my former midwife on a few cases (shoulder dystocia, ultrasound, GBS+ “natural” remedies)… They are so non-evidence based that they are easily swayed with the wind.

      Plus, did this Christy midwife post about how babies aren’t library books AFTER that baby died? That doesn’t seem like ownership to me..

    • Danielle

      It’s fair to say she made a mistake and knows it — although that letter she sent tries awfully hard to “apologize” while shifting blame to her client. It’s a little like reading an apology from a manipulative abusive spouse: “What I did was wrong. I wish you would stop making me to bad things to you.” She ought to have put that letter on the self for a few hours, re-read it, and tore it up.

      What leaves me cold is that while she gets that she was not forceful enough/careful enough in this particular case, she clearly has a whole ideology about postdates pregnancies and just letting women’s bodies decide when the time comes — along with language about truly “risky” situations out of her depth being “sooooo” rare — that may be blinding her to having good judgement about these cases. Her “resolve” to be tougher in the future won’t help much unless she knows a problem when she sees it or know when to call up the doctor and take directions.

      It’s not the intensions that I question (I seriously doubt most midwives are trying to put babies and women in jeopardy), but rather that there’s a worldview being embraced that prevents pro-natural birth midwives from responding appropriately to risk. Unless Christy repudiates her approach to pregnancy and childbirth, her contrition, although admirable, is insufficient.

      • Anj Fabian

        I read through her testimonials. It’s the trust birth rhetoric, over and over again.

    • Trixie

      Also, “clinician” is a strong word for a convict who graduated from a correspondence course.

    • Anj Fabian

      Just one mistake?

      I think we could tally up error after error and the only one that Collins appears to have acknowledged was not being willing to tell the mother that she needed to deliver the baby immediately.

      She didn’t even ponder the possibility that she made any, or rather MANY other mistakes.

    • AlisonCummins

      She’s not owning her ignorance though, or her lack of jugement. I think that’s something that doctors get drilled into them through residency in a way that other HCPs don’t: That patient depends on you for their life and well-being and if I sign off on this ignorant, lazy-ass recommendation you’ll have killed them! You don’t get to do that. Try again.”

      • LMS1953

        That is exactly right. Remember the Neurosurgeon in the Atlanta ice storm who walked 6 miles through those conditions to get to a patient who needed emergency surgery? His words were: “Not on my shift” [the patient will not die on his shift]. That is a remarkable common thread that connects the fraternity. Not always, but usually.

        • AlisonCummins

          Please don’t comment on my comments or I will stop commenting altogether.

          • LMS1953

            Is that a threat or a promise?

          • The Bofa on the Sofa

            Don’t you dare.

          • Trixie

            Calm down. He was agreeing with you.

          • theNormalDistribution

            Can you clarify for me who will be silencing whom in this case?

          • Bomb

            Seriously? That screams spoiled brat. If you can’t stand someone responding to you when you can just ignore them, take your ball and go home.

          • The Bofa on the Sofa

            Um, no. LMS has made personal threats against Allison in the past. She is justified in her objection to having interaction with him.

          • theNormalDistribution

            I don’t think so. I read the whole comment. He puts “political views” in quotes because he thinks they’re facts. I took it to mean that he was saying that everyone who disagrees with him is going to suffer in the end, because he’s right. By Allison’s logic, CLEARLY he was threatening violence. He wasn’t even talking to her.

            She didn’t ask for clarification. She responded by suggesting his penis wasn’t getting enough deference and made a point of noting how vulnerable she is because she uses her real name. Now she is telling him he’s not allowed to respond to her. Does that sound like the response of someone who is genuinely feeling threatened to you?

          • Bomb

            I read the supposed threat too, and wow, how people can blow shit up when they want drama. If you don’t want to be supposedly vulnerable, take up a username like 99% of everyone, or is she the only Allison Cummings in the country now? Thus easily found and politically berated? This is just stupid unnecessary bullshit on a really important post.

          • thepragmatist

            Yes, I really dislike that in general… I enjoy this place precisely because we can withstand the arrogance or stupidity of someone and still agree when we have to. I don’t want another heavily moderated board on “women’s issues” where we can’t just be ourselves. I don’t find LMS frightening, I just think s/he’s completely and totally wrong. Ha. So be wrong. LOL! Who the hell cares? I like colourful characters, thanks. The internet is becoming more and more banal with the intrusion of the polite police.

          • Trixie

            I agree. As absurd as I found LMS’s comment, I don’t think it was an actual personal threat. More of a “you’re all going to hell in a handbasket and I’m the one who knows the truth so you better listen to me” kind of way. Stupid, but not threatening.

          • Bomb

            Ignore the trolls, don’t sit in the sandbox crying that they are talking at you. I have no fondness for LMS, but demanding they not respond to your comments, like this is her personal kitchen is ridiculous. If they made personal threats they should have been banned, similar to googly eyes. If Doctor Amy didn’t feel it warranted a ban, the. Put on some big girl panties and deal, or as I said before, take your ball and go home.

          • auntbea

            I debated responding to this, because, though I think this is a complete misinterpretation of what LMS said, I generally don’t go around trying to tell people how they should feel. But I have decided that the implication of this statement — that someone on this board was threatened by someone else, and no one, including Dr. Amy, stepped in — is both offensive and, if left to stand, fairly strong ammunition for anyone who wants to classify as zealots with no empathy or integrity.

            Coming on the end of LMS’s political argument, in which Obama’s perfidy leads (once again!) down the path of ruin, his statement, ‘Chastise me for expressing these “political views” at your own peril” is analogous to a sign reading, “Swim at your own risk.” That sign is a warning, but not a threat: should you decide to get in the pool anyway, no one is coming along to throw in a toaster to punish your trangression. No reasonable person would see such a sign a personal threat, nor should we consider LMS’s statement to be one.

          • thepragmatist

            I missed all that drama (damn having a life! grrr! I usually miss the good stuff…) but I would normally take that to mean: If you are going to come and tango with me, better be ready to dance. EG. I will decimate you in debate, with facts, evidence, and my arrogance (lol!). I have occasionally made such statements but certainly not as a serious threat on someone’s life, but as a bait to debate… or to let someone know they are taking things too personally in a debate of ideas. But I wasn’t here for the argument and just skimmed it as I have been catching up.

          • AlisonCummins

            Helpful interpretation. Since LMS1959 never clarified, we’ll never know.

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

          I always think of Dr. Cox being a heart broken mess after some problems on Scrubs

          • Jessica S.

            Oh my word, you are my hero. I can’t listen to How To Save A Life with getting teary. (If the rabies case was the one you’re thinking of) And I sob every time I watch that episode. I’m like that with TV shows, tho. I’m a sucker for a well-written/directed/acted scene and shamelessly applaud with my tears. Ha!

            On an adorable side note, my three year old sings “How To Say Good Night”, he thinks those are the words. :D

          • The Bofa on the Sofa

            The episode with the rabies case is extremely powerful. I remember when that was first on, how moved I was.

            It was bizarre, because I was watching it from the perspective of being a huge Nicole Sullivan fan, and so just enjoying the episode with her in it. Then it took a twist, and suddenly you felt everything for Cox.

            That was a standout episode on a great show.

          • Jessica S.

            Another episode the really stands out is the one where Jordan’s brother dies, and they end up at the cemetery when Dr. Cox had been “imagining” they were going to his son’s (?) bday party instead. I really need to dig out my DVDs and have a binge session. :)

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

            That’s precisely the one I meant. Breaks my heart every time.

          • prolifefeminist

            I don’t know the episode you’re talking about, but I just have to say that the phrase “shamelessly applaud with my tears” is awesome.

          • araikwao

            Me toooo!!!!

      • Danielle

        Feeling bad and being firmer next time only works if she reviews her actual practices and identifies where poor judgments were made. It’s one small example of the larger natural birth/home birth issue: home birth only gets safer if its practioners have some mechanism for figuring out what standards improve their outcomes and appropriately “risk out” women.

        I’m neither a midwife nor an OB, just a mom, so I can’t speak to exactly what the standards should be. But to my mind this means –at minimum–that midwives should be very willing to tell women who are developing risk factors that home birth is no longer reasonable in their case. That means dropping the “evil hospital/doctors” schitck so that you aren’t encouraging women with risk factors to be afraid of getting medical help. It also means disclosing to all clients in clear language that the can be unpredictable last-minute complications that will, if they manifest, make giving birth at home riskier. Then women can decide if the home birth experience is appropriate for them.

        Even this doesn’t please me much; it seems to me that it would make so much more sense to push for hospital environments where women feel more comfortable and can try to have the “experience” they want. They can attempt natural birth and have the same BFF support women they want, but without being away from all the OBs and specialists. In many areas, hospitals and medicine generally are already recognizing the utility of this an approach that is friendly to the emotional needs of patients. If the home birth folks would stop trying to keep people out of hospitals and instead start thinking about how to make hospital care more humane — seeing themselves as collaborators rather than competitors — they’d do a lot more good. The one thing they are good at in my mind is getting that women have pycho-social-spiritual needs that medicine sometimes discounts or doesn’t see.

        • LMS1953

          I think HB will always be with us. I am perplexed how a new smart phone can come out every few months with ever more expansive applications yet the hardware of external utero-fetal monitoring has had no fundamental change in 40 years. I have occasionally come across wireless monitors but they are not the norm. There is absolutely no reason what with blue tooth/cell phone technology that any woman on the face of the planet could not have her fetus’ heart rate monitored and reviewed by an expert however distant. Yet we still have CPMs think that they can do a NST with a handheld Doppler.

          • theNormalDistribution

            For a second I was thinking “send me the equipment and I’ll write you an app!” although it wouldn’t actually be as simple as that.

            I think there’s no remote monitoring around for it because there’s just no need. The vast majority of mothers give birth in hospitals. This is totally conjecture, but don’t you think having the illusion of safety of remote monitoring may actually encourage more mothers to birth at home and could increase the death toll? Even with skilled practicioners, homebirth is pretty risky. There’s no guarantee that a midwife would get the mother to the hospital when she needs to be. That’s why there are health warnings against mothers using hand-held dopplers. Maybe home birth will always exist, but I think we have a vested interest in encouraging women to birth in the hospital.

          • Trixie

            Heck, if you even had them in every hospital, especially waterproof ones that worked in the shower or tub during laboring, you’d remove a huge objection that NCB uses to scare women into home birth.

          • prolifefeminist

            The hospital I had my second baby in had telemetry fetal monitors – they were great. I could walk the halls and be monitored the whole time. I wish they were standard in all hospitals for women who aren’t using pain meds that prevent walking.

          • araikwao

            Yes, I wondered about this, I thought NST was done with CTG?

        • thepragmatist

          In many areas, it’s gone so far to the NCB side that you can’t get appropriate analgesia anyway. Rooming in is standard fare. Baby friendly is a euphemism for “we cut all the funding we could out of this segment of social services– enjoy the food you brought from home, the parking tickets because you didn’t want to leave the side of your wife, the frenetic nurses who resent you for being in pain, and bring a support person, because without, you are SOL. I hate when neoliberal, oligarchic governments get their hands on a movement that was supposed to be about choice. Ditto with offering community living to disabled people who otherwise would live in an institution. Great, except now they live in squalor, or they are homeless. Another example here of using a good idea to feed a bad agenda.

      • thepragmatist

        I love that and it is true. I have a very conservative family doctor who I frequently argue with. We have big blow out arguments a couple times a year during which we have to resolve whatever issues have been brewing, because his conservatism and my needs are not always aligned, and because we misinterpret each other– we’re not the greatest fit, but we try. Anyway, I would rather a cautious doctor than one who was a cowboy. And my OB/GYN laughed ruefully at the hospital rule that video couldn’t be taken in the OR– she said, “If I screw up, I’m going to be caring about a lot more than whether you have it on video.” I have a lot of respect for physicians for this reason. I’ve been in a job where the life of others depended on me, working with young people, and the choices I made in a work day could change the trajectory of someone’s (a child’s) life. It was stressful enough without performing meticulous and artful acts of surgery, keeping track of medication interactions, remembering 50 or 100 or 200 different patient’s lives and needs, and doing this all with a good bedside manner. I respect the profession enough that I’ve enrolled in maths to consider switching to sciences because I want in to medicine. Being sick and disabled and also a marginalized woman has lit a certain fire in me about science-based treatment in general, because it should not just be for some. But it is. Especially here. Anyway, physicians have such a stringent code of ethics. Similar to lawyers (at least here). And so it should be. We have read MANA’s interpretation of ethics. Killing a baby is just part of the trip.

    • sadguest

      I disagree. She’s only looking at what she could have done on the 19th (she says she would have pushed the mom to go in the day before). But that’s not insight – that’s just her saying if she had it to do over again she’d still let the mom blow past 42 weeks without medical care, she’d still wait until the baby was near hopeless before getting the poor thing some help, she’d still be reckless with the baby’s life. If she had real insight she would focus less on the circus that started on the 19th, and more on what she wasn’t doing in the weeks prior. Someone with real insight would say, “That baby could have lived. I can’t believe I let that happen, I’m going to start transferring at 41 weeks just to be safe.”

    • Ellen Mary

      You miss that this is subtle mama blaming. In Christy’s narrative, the mama was driving the ship & she was just hanging on for dear life saying timidly ‘but, but, but . . .’ That scenario is incredibly unlikely, like so much so as to be ludicrous!

      I am a 3rd time mama, so well versed on medical matters, and had several medical professionals on speed dial to advise me, and I still deferred to my current CNM & OB when I was worried about my baby, like to an extreme fault. I am not saying everyone is like me, but I am saying a Primipara is the one saying ‘I don’t care about my baby, let’s drive 30 minutes away’ under protest from her care provider? How likely is that scenario to you?

      • Durango

        yes yes yes! She’s blaming the mom all over that post: the baby has been swimming in mec for weeks (good job, “Midwife” catching that), that Christy held back the truth because the mom would hate her, that choosing midwifery you are in fact choosing a higher possibility of death, etc.
        She’s also trying to absolve herself by saying that the baby, whom she previously wrote was in mec for weeks, was perfectly fine right before he died.

        • prolifefeminist

          Her ping ponging statements about the condition of the baby in the weeks, days, and hours leading up to his tragic death show that she didn’t have a fucking clue HOW he was doing in there.

          What’s that Christy? Your intuition told you that he was fine? Just “cooking a bit longer”? Enjoying this special end of pregnancy time with his mama? No, you fucking moron – he was struggling to stay alive AND YOU MISSED IT. You were so busy thinking positive thoughts and reassuring mom that “babies come when they’re ready” and focusing on “tuning in” that you missed every single goddamn warning sign that this baby boy was in trouble. Even when you broke down and recommended (reluctantly agreed to?) testing, and the peri sounded the alarm, you STILL ignored the obvious and counseled the mom to ignore it as well. Only at the very end when this little boy’s body began to shut down did you start to take it seriously – but even then, you LEFT THE HOSPITAL YOU WERE IN and wasted 30+ precious minutes driving to a far away hospital because protecting yourself for scrutiny and hate was more important than this precious little boy’s LIFE.

          I don’t even think there’s a word for such disgusting, selfish behavior – this goes far beyond narcissism alone. The calculated move she made at the end to waste precious time switching hospitals when the baby was actively dying is so fucking callous I really don’t know what you’d call it.

    • wookie130

      I completely disagree.

      First of all, if she were “owning it,” there would a) be some type of apology that was apparent, and b) 80% of her statements in that narrative were actually about the baby’s death being the MOTHER’S fault. She was hardly “owning” anything.

      I truly hope she never practices again, but it sure sounds like she’s going to try to carry on, as if nothing ever happened…because in her mind, it was not HER mistake, it was more the mother’s.

      And is Christy a “clinician”? Is THAT what a CPM is? Because in my mind, an actual clinician is TRAINED, EDUCATED, PROFESSIONAL, and EXPERIENCED…not some birth junkie who has made a hobby out of delivering babies operating under the guise of a “professional.”

    • moto_librarian

      I have to disagree. She still fails to grasp that knew of her central beliefs, that babies “don’t have a due date,” is what precipitated this entire disaster. If she had made it clear that going post dates is in of itself a risk and begun monitoring at 40 weeks, this tragedy would almost certainly have been prevented. I have no faith that she has learned the central lesson of this whole sorry mess: how to distinguish high risk from low risk.

    • guestguest

      Her “insight” displayed in that letter to the parents is fake and is part of her attempt to keep the parents under her influence and prevent them from going to police and filing charges against her for killing their son.

      She allowed this baby to die a needles death through her incompetence. What is even worse, she and her fellow try-stevia quacks allowed this baby to die out in the open on the internet, for all the world to see in real time.

      She coerced in advance the parents to ignore medical advice that would have saved their baby on many occasions, did not monitor the pregnancy properly and used facebook to *educate* herself on what to do next.

      She even pretended that random posts on social media are somehow adequate source of information for parents to make informed consent or informed refusal decisions when she read them the replies to her question that was posted on Jan Tritten’s fb profile.

      She delayed life-saving medical treatment by withholding information from the back up doctor and needlessly making the mother travel from one hospital to another in an attempt to cover her tracks.

      I will only believe she is owning all of these terrible, terrible mistakes when I see her post on facebook, on her business pages, on Midwives Today, on the profiles of all the people where she commented when she denied responsibility and all of the web forums that she frequented to catch potential customers a letter like the one above, minus the parts where she shifts the burden of blame onto the parents saying:

      I made terrible mistakes.
      I am responsible.
      I am sorry.
      I will accept all legal and other consequences of my incompetence.

      Instead she only promises that she will behave differently in the future.

      Instead her accomplices who literally helped her kill this baby over the internet and cheered her on with ignorant mumbo-jumbo are busy deleting any trace that this ever happened.

      “The Lie of Being Born” lack of regulations and education standards that has allowed this to happen by allowing Christy Collins to call herself and practice as a *Certified Professional Midwife* needs to stop.

    • PrimaryCareDoc

      She’s not owning it AT ALL. She claimed on Facebook “the midwife was ON TOP of the situation.” She claimed on Facebook that a doctor was the primary person in charge. She posted a poem about how babies are not library books and don’t have due dates.

      • The Bofa on the Sofa

        Not only is she not “owning the situation” her statements have denied her involvement!!!!

        That’s not owning it at all.

        Now, I think it does show that she knows that she messed up bigtime, so bad that she refuses to acknowledge being part of it.

    • auntbea

      When I initially read her email that’s what I got out of it too. But reading the rest of the replies, I came to the realization that that conclusion presupposes she is telling the truth and nor just covering her ass in a precarious legal situation. The poem about post-dates she posted after a baby died, essentially, of being post-dates is what clarified for me that she had learned nothing.

    • Amazed

      Actually, I think Christy Collins realizes that she’s made a terrible mistake by letting the word of her incompetence get out. She’s now trying to hide behind the parents’ backs. No doubt Jan and co’s next chant will be, “Leave these poor parents (and by extension the midwife they’re protecting) alone!”.

      It’s a responsibility-avoiding strategy and nothing else.

    • fiftyfifty1

      I disagree CanDoc. I think Christy’s latter is displaying major gaslighting that you’re not picking up on (probably because you yourself are not a gaslighter and because you yourself would feel genuinely terrible in this situation). As I posted above, here is the subtext of Christy’s “apology” letter as I read it:

      This is your fault. You are the bad person.
      I tried to correct you, but you wouldn’t respond to my correction.
      A person as bad as you apparently can’t be trusted.
      My only mistake was trusting you.
      Next time I meet a mother that makes as bad of decisions as you do, I’ll force the issue.

      That’s how I read it anyway.

    • Florence

      Is it? I mean it is obvious that she feels awful ( as she should) but will she really change?? only time will tell

    • Guest

      CanDoc I could not disagree more. This letter is classic gas lighting. This letter — if authentic — is an exercise in narcissism and blame-shifting, imposed on a woman who just lost her baby and really has other things to think about right now than whether Christy Collins feels bad.

      • thepragmatist

        Yes. Yes. Yes. The only appropriate response would be, “I am so very sorry this has happened. I am doing everything I can do to make sure it never happens again. It was not your fault and I am absolutely beside myself that you are grieving the loss of your child. Please take gentle care of yourself and accept my sincere condolences.”

    • Melissa

      If Collins wants to practice safer she needs to go to school and become a CNM with the requisite medical training to be able to know what is going on without having to ask facebook for opinions. Nursing school will also teach her the importance of professionalism and not trying to be your patient’s best friend. Even more dangerous than her lack of medical knowledge was Collins’ refusal to level with her patient out of fear of making her mad.

      • Medwife

        That door is closed to her, I think.

    • Meredith

      I thought that too, at first. But then I returned to some of those graphic phrases she uses in the letter (like “soaking in mec” and “the dead baby card”) and decided that if she says things like that to (as far as we can tell from the syntax of the letter) the newly bereaved parents, she probably doesn’t understand the pain she’s caused them.

    • http://momofmanyfeet.wordpress.com Bambi

      That is NOT owning it. It is pure manipulation. I’ve been there.

    • araikwao

      That’s what I thought& hoped too, that she’d actually reflected on th situation and would change her practice accordingly. The below comments suggest we are overly optimistic..

    • CanDoc

      To all who commented with thoughtful insight, thank you. I love the comments at this blog precisely for this reason. Criminally naive or sociopathically narcissistic or both? Probably not even Christy herself knows the answer to that. I just hope that her soul spends some dark nights contemplating how her actions could have changed the outcome and the limitations that her knowledge and skill set have when it comes to providing safe maternity care. I’m hoping this was a personal journal-type entry to a “third party” and not directly to the grieving parents, not at this time.
      I feel the ball at the edge of the precipice, beginning to roll. Hoping for some momentum to take this much-lobbied CPM objections somewhere.

      • PrecipMom

        I’m going with “narcissistic sociopath” because it too tightly fits the “suffering porn” paradigm. I didn’t spot it and agreed with your take until I read through the letter a few times.

  • Amazed

    You would have HATED me…

    You know, I stupidly thought it was just mothers who saw their midwives as their best friends. It certainly looks that it goes both ways. Why the hell would a midwife need her client (they don’t view them as patients since birth is all beautiful and love-orgasm-ecstasy fest, not a medical event) to love her? She’s supposed to have friends for that?

    • Comrade X

      Dear person-who-apparently-wants-me-to-love-her-and-be-her-best-friend,

      Just a small piece of advice. If you repeatedly lie to me, you will entirely scupper your chances of becoming my BFF. If you knowingly endanger my life, or the life of any of my children or other loved ones, you will entirely scupper your chances of becoming my BFF. Please bear this in mind. Thanks.

      Love,
      Someone-who-is-more-interested-in-staying-alive-than-sparing-your-precious-fee-fees

      • Amazed

        Dear-birth-goddess-wannabe,

        I’m afraid you’ve got the wrong impression of me. I only want to be your BFF for the time of your pregnancy and birth, so I can satisfy my birth junkiness. I really don’t care about your BFFship if you fail the ultimate test. I know it’ll be your fault because female bodies are wonderful and beautiful and yours will have obviously failed. Who’d ever want to be BFFs with such a failure?

        Love,
        Your faithful midwife

    • LMS1953

      I know it sounds chauvinistic and paternalistic and all that – but I cherish the doctor – patient relationship. Lawyers, hair dressers, palm readers and prostitutes have “clients”; doctors have “patients”. I do my best to provide appropriate informed consent but realistically, that concept is a bit of a charade. Witness the times that when something bad happens by the doctor going against her/his best judgment, the lawsuit is filed with the “if I had only known” card. The doctor-PATIENT relationship works best if the PATIENT says “I don’t know, doc, what do you think? You’re the expert, that’s why I came to you”. And for the DOCTOR to have enough integrity to recognize appropriate alternatives. When pregnant women are viewed as “clients”, babies will die needless deaths.

      • CanDoc

        YES. YES. YES. This, a million times over.

      • Amazed

        I don’t think it sounds chauvinistic and paternalistic at all. In fact, I’ve been told that I was old-fashioned and boring because I don’t see my relationship with my doctors as one of equality. Equality regarding mutual respect, yes. But they are the ones who know what needs to be done. Period. Yes, I know I’m placing myself in the position of the inferior one. Guess what? I’d rather be inferior to a real life doctor than a bunch of Google ones.

        This isn’t to say I am not involved in my care. I ask questions. I ask about options. Sometimes I even bring up some points of my Google thesis and ask about the doctor’s opinion. But I am not kidding myself that I am equal to my doctors where knowledge is concerned. Their care about me should be about my physical survival first. We can deal with the wounds dealt to my fragile mind by serving me some truths I really, really don’t want to hear later. Provided that there is later because as seen by tragic case we’re discussing here and the evidence of some posters below, not everyone is lucky to have one.

      • Ennis Demeter

        I actually think the lawyer/client relationship has paralels to the doctor/patient one, with similar disastrous results if the expert advice is ignored. It is also strictly governed by an ethical code and bedeviled by amateurs who pretend to know all about the law.

        • Trixie

          I think you could make a similar argument for CPAs.

        • Susan

          I agree that lawyers come close, because it at times does mean life and death, or freedom… whether they do their job appropriately.

      • Susan

        I have said the same thing, essentially, to nursing students as a nursing instructor, which really bucks the established norms in nursing. I agree, you owe more to a patient than a client, and it’s a life and death relationship. It’s about what we owe them that we call them patients, it’s not a denial of their agency.

      • thepragmatist

        As a patient, I really appreciate this. I have a very close relationship with one of my specialists (I have multiple) and I adore her on a personal level, as a human being. She goes by her first name and puts people at ease, but there’s no doubt if you were to cross her with something totally inane she would tell you, flat out, it was totally inane. I distrust professionals who downplay the power dynamic– ditto lawyers, too. Any professional who holds a lot of experience and expertise in what’s becoming a hyper-specialized, technologically complex, and socially complex society has a DUTY to recognize the power dynamic in their relationship with their patient OR client, in the case of someone like a lawyer.

        So regardless of how much I adore my OB as a human being, and no matter how much she respects my intellect, or my capacity to write, or whichever, the reality is that she holds my life in her hands at times. This is something we are acutely aware of in our dealings with each other and something I think we, as a society, don’t want to talk about when it comes to medicine. We want the illusion of autonomy so badly that we don’t get the autonomy we deserve to have: that is the autonomy to have all the information delivered in an understandable and clear way so that we can make choices WITHIN the limited scope of a layperson. When my OB tells me something I’ve thought up in my spare time ruminating on my medical conditions is completely BS and not going to work, I don’t have bruised feelings. I don’t go to my mechanic and tell him how to fix my transmission. I just want to know if he can and for him to tell me truthfully if there’s any point to it. This is the same across most fields, really, but medicine has the greatest power differential of all: you are most vulnerable when sick and in pain, and a mistake from a physician can kill you or make you very sick. I don’t want that responsibility and it would be unfair to foist it on me: I can’t heal myself. I don’t have the information or expertise.

        But as human beings, out here in the world, we are both women, mothers, feminists, etc. We have similar political persuasions and passions. There is mutuality there. THAT is the human relationship; the doctor/patient relationship always has to come first, unless she or I end that relationship. The midwives put the cart before the horse. It is harmful for women to downplay how powerful they truly are in the midwife/patient relationship. The mother doesn’t have the lead, not truly, since the mother can’t possibly know everything the midwife or OB/GYN has seen. It is NOT informed consent to pretend that this power differential doesn’t exist. I will never forget the honesty of my OB who said: “There may be times when I have to do things to you against your will and you need to think about how you will feel if I have to do something you do not want, because I am going to save your life or your baby’s life if I have to.” I had so much respect for her honesty then, to recognize the truth and put words to it. It allowed me, then, to really know what I was consenting to. It’s pretty stark but it is true, so let’s not beat around the bush about it. Again, other specialities of medicine don’t even have to pretend. You just trust that if you are under the care of an anesthetist on the table that they will do whatever they have to save your life whether you like it or not. Well, it’s not going to be any different with your birth provider. It shouldn’t if you value you and your baby. Recognizing that there can be genuine mutual affection and compassion (mutuality) within a relationship with a very large power differential is something I’ve turned over and over in my head a lot since the remarkable MRCS I had. Never has my life been so in the hands of another person and never have I been so aware of that power differential. That said, because I understood it to be there, I also have never felt as empowered in a medical context. My OB/GYN doesn’t victim-blame. Minimizing the power differential is a great way to set someone up to be gaslit and blamed when things go wrong. My family doctor occasionally veers off into that mode of thinking and I have to steer him back onto the road, because I am a persuasive and strong-willed patient who wants to know everything about what is wrong with me and how I can fix it and wants to be a participant in my care, and some physicians mistake this for me desiring “handling”. I don’t. I want recognition of the power differential. I want compassion and I want to participate. I probably DO know more, in some way, than my family physician about my various conditions, but it is ultimately his responsibility to make sure that I am cared for, that my cocktail of medications do not kill me, that we’re not missing something, and to foresee trouble down the road. This is such a hard job, I would never want it.

        I think sometimes I would like to write about feminist medical ethics and the provider relationship, because I find it fantastically complex. And interesting. I’m going back to University and actually considering an about-face in my studies because I am so interested in this. It’s part of why I love it here, to get insight into a world that is shrouded in its own mystique and rituals and is very insular, but that produces a very rare sort of relationship where one person holds an enormous amount of power over another, and we can wax sentimental about how doctors “save lives” and are heroic, but it’s a lot grittier and complex than that, especially if you are disabled and involved a lot with medicine. You learn quickly that the power dynamic between providers and yourself is a quagmire at times of blurry ethical dilemmas, harm reduction, etc, and come to appreciate the complexity of the decisions providers must make EVERY SINGLE DAY. And I am a complex patient with very unique needs, so I see both the best and the worst of physicians.

    • no longer drinking the koolaid

      I’m a midwife and I have a few people that were patients that I now consider friends. But, I never understood the really close relationship that some midwives seem to have with their clients. I thought it was just me, thinking I had never been the huggy-touchy-feely sort, that I was not capable of those sorts of relationships.
      Looks like I was just being professional in keeping it as a business relationship.

  • PrimaryCareDoc

    Woke up this morning feeling sick because I was dreaming about this poor mother and baby all night. :(

    That email…it’s like a textbook example of gaslighting. Oh God, that poor, poor mother.

    • anion

      I know. I can’t stop thinking about the parents. I can’t imagine how that mother feels; I can’t imagine how strong she must be to even get out of bed. I honestly am not sure I’d be able to do the same.

      But I’m glad she has friends like the one who contacted Dr. Amy, who care enough to stand up for her and try to hold the murderer accountable.

  • Trixie

    It looks like Collins just moved to Vegas sometime last summer. She was all over BBC trying to drum up business back then. So it’s a reasonable assumption that this family was one of her first new clients as they would have been newly pregnant when she was setting up shop. I wonder if her backup OB knew about her conviction in CA.

    • Trulyunbelievable2020

      This is the least of the damage she’s done, but she’s clearly harmed the reputation of a doc who trusted her. That was a probably a mistake on his part, though.

      • fiftyfifty1

        huge mistake

        • The Bofa on the Sofa

          I seriously hope the doctor gets his lights sued off. It will send the other doctors thinking about backing up midwives running.

    • Amazed

      Am I the only one who finds the line of how poor (literally, like un-rich) midwives help moms out of the goodness of their hearts terribly suspicious given the ease with which they move from state to state after being stripped of their ridiculous license? I mean, I cannot just pack my things off and move to the other edge of the country just because – and I am not poor. I have a life I’ll have to move on… and when the only thing I’ll get out of the deal. is the gratitude in this beautiful, strong woman’s eyes when I get lucky… err, professional and manage not to kill her 43-weeker, you can be quite sure I’ll stay where I am and keep winning the money I need to put bread (organic one, mind you) on the table.

      • Lena

        I’ve always wondered the same thing about these midwives. How can they just pick up and move-and find work!!-so easily?

    • Trixie

      Here, she tries to talk a mother who was reading Hurt By Homebirth back into using a CPM. http://community.babycenter.com/post/a44469304/can_anyone_share_their_home_birth_experience

      • Anj Fabian

        Oh, it’s not the midwives’ fault:
        “Most of the negative homebirth stories you read are with midwives who
        pushed the limits too far because they didn’t have a supportive back-up
        OB/GYN to transport to when it was needed.”

        So, um. She had her “supportive back-up OB” this time. What will her excuse be?

        • The Bofa on the Sofa

          Why do you need a “supportive” OB? Who cares if the OB supports CPMs or homebirth or not, their responsibility is to their patient.

          If the patient is in a situation where she needs a doctor, then who cares whether that doctor loves the midwife or not?

          • anion

            By “supportive” they mean an OB who won’t inform the mother how close she and her baby came to death, or talk her out of that Healing HBAC the midwife wants to get off on next time.

          • thepragmatist

            Bingo. I don’t want an ideologue for a physician. I want a physician for a physician. The only thing the physician should be “supporting” is my best interest and nothing else.

      • http://momofmanyfeet.wordpress.com Bambi

        She has been in 4 states??? And 2 back up docs??

        • Trixie

          Makes you really wonder what she was doing between 2011 when she was convicted in CA and 2013 when she started up in Vegas.

    • fiftyfifty1

      ” I wonder if her backup OB knew about her conviction in CA.”

      Should have known if s/he didn’t. Google Christy Collins and the second site that comes up is Sisters in Chains. We physicians have a responsibility to the public not to give these charlatans a veneer of respectability and an illusion of safety.

      Also somebody had to have ordered that BPP. Maybe it was Collins herself (I don’t know if CPMs can order tests in Nevada). But if it was a physician, that physician should be held responsible. Whoever orders a test is responsible for making sure the results of that test are properly communicated to the patient.

      • stenvenywrites

        If there’s a suit, and there ought to be one, the parents’ lawyers will go after the one with insurance and money, and failure to do a background check is gross negligence on his part. Also, I don’t know how Nevada works with CPMs, but for licensed physician extenders such as NPs and PAs with a particular scope of practice under supervision, the overseeing physician is legally responsible for instructing the supervisee under what conditions she needs to ask for help, and all of the pertinent data she needs to share with him. IOW, if she didn’t tell him about the 0 fluid, that’s still his fault because he was supposed to have taught her that 0 fluid is something she should report.

  • Trulyunbelievable2020

    Ms. Collins posting in September on how to avoid an induction:

    “There’s NO SUCH THING as “let.” You hired your doctor and he/she works for you. Just say no. Normal pregnancy is 38-42 weeks and there are NO validated studies that say it’s not normal to have your baby at 42 weeks. I went to 42 (and past!) with most of mine and many of my clients do too. It’s NORMAL. A “big baby” and being past 41 weeks are NOT medically indicated reasons for induction. This is why we have a scary 40%+ c section rate in LV.If baby were ready, baby would be here, and no, there’s nothing you can take/eat to make baby come sooner unless baby was going to come anyways. Good luck. Your body, your baby, your birth.”

    • Karen in SC

      Disgusting.

    • Julia

      “Your body, your baby, your birth.” Um, it’s actually the baby’s birth.

      I’m the mother of a healthy 2-year old. I had an induction at 41 weeks due to low fluid. After getting the cervidil, I sat in my hospital bed reading up on “low fluid induction” on the internet and was bombarded with woo. I was seriously second-guessing myself. The story about this poor boy and his parents shows the awful tragic consequences of this woo. And I shudder to think how many “near-misses” there are that we never hear about.

    • LMS1953

      So if a “client” brought in this graph and said, “I have done my research and I want to be induced if I have not delivered by 41 weeks” would Collins have “let” her and arranged it with her backup buddy?

    • me

      How can less than 10% of the babies born be responsible for a 40% c-section rate? Fewer than 10% of babies are still gestating at 42 w (with early u/s that number drops to about 3%). All 3 of my children went to 42 w (boy aren’t I lucky). The first was induced simply for being 42+1, the other two did come on their own at 42+0. But I held no illusions about it being “normal”…. it’s a complication that increases risks. And the whole ‘if baby were ready, baby would be here’ crap? tell that to mothers of premature children. This woman is certifiable.

      • fiftyfifty1

        “But I held no illusions about it being “normal”.”

        Really? Are you the same “me” who argued ad nauseum that it was safe for you because going late ran in your family, and you had done it before, and only one of your babies had turned out macrosomic, and anyway you “knew better” about the dates and got all offended when your OB told you nothing good happened after 40 weeks, and switched providers because her policy of induction at 41 weeks pissed you off?

        • me

          I never said it was “normal”. Or not elevated risk (it is), or perfectly safe (it’s not), or that I didn’t need tests of fetal well being (I did), or that I could ignore the results of the tests of fetal well being (I didn’t). I did agree to induction at 42+1 with my first, without any other medical indication, simply because we were past 42 w. I only briefly considered HB after my first child (complications with epidural and episiotomy nearly scared me off of hospital birth), but I reconsidered PDQ.

          Depending on the definition, 9lbs 2 oz is not macrosomic. Of course there are two definitions floating around out there (either 4000 g or 4500 g), so yeah, by one definition she was, but the other she wasn’t, but way to be disingenuous there, dude. Maybe TPTB could make up their minds.

          My former doc’s policy didn’t “piss me off”. I wasn’t comfortable with it. Especially in light of my history. I knew what my third child’s birthday would be. I called it at the first prenatal. When my older children’s pediatrician congratulated me and told me she’d look forward to meeting the new baby in May, I told her, more like June 1st. Guess what her b-day is? I did object to a one-size-fits-all policy that doesn’t look at the individual patient, but rather ignores any and all pertinent info other than a date on a calender, esp when that date is suspect to begin with.

          Not to mention, while my former OBGYN was a wonderful GYN, she was an a$$hole as an OB. As a GYN she always answered my questions, explained options and treated me with respect. Imagine my surprise to find Dr Jeckyl had left the building, and here was Mr. Hyde, just because the rabbit died. That was extremely off-putting, and even if she was been willing to consider my history, I likely wouldn’t have stayed with her. IDK why she even does OB if she obviously dislikes it so much.

          I did know about my dates. I knew when I had sex. I knew that I ovulated later in my cycle than normal. I didn’t get offended that she didn’t “believe” me. Like Doctor House she must be one of those that firmly believes that all patients are liars. Yes, that created philosophical disagreement between us; I, like 99% of the population doesn’t particularly like being presumed to be a liar. She also had privileges at a hospital that, while closer, was smaller, didn’t have a NICU, and didn’t have any CNMs with privileges. So I left her practice, and found (quite easily, btw) a women’s hospital (large, well known teaching facility) literally attached to one the highest ranked children’s hospitals in the world with an extensive CNM program. And transferred care. At my first prenatal with one of the CNMs, she not only didn’t get all snippy with me, but she listened to me, answered my questions, addressed my concerns, and while (of course) she didn’t “guarantee” that I’d be allowed to go to 42 weeks, she did say that it was a possibility.

          And when u/s confirmed what I’d known all along, my EDD was tentatively changed (was still “officially” May 18, but they noted that the u/s put it at May 24 – within the MOE, but not by much). When BPPs came back with perfect 10 scores and there were zero problems with the pregnancy, no one had any issue with my continuing. I was scheduled for another BPP the day my daughter was ultimately born, and we would have induced possibly that day or the next.

          I didn’t run off to a HB mw or refuse appropriate screening in an effort to avoid induction. I sought out a provider who could see past a blanket policy and use critical thinking skills to provide individualized care. But, hey, I get that not everyone wants that.

          • me

            Wanted to add: there is a difference between population risk and individual risk. When the CDC says there is a 25% chance you will die of a heart attack, they aren’t talking about you, personally. That is the population risk. When you factor in things like family history, personal history, medical conditions you may or may not have, age, ethnicity, gender, and lifestyle factors, your individual risk could be much higher, or lower, than the population risk.

            I would have appreciated my former doc looking at my individual risk. Maybe she still would’ve been uncomfortable, and that’s fine. That’s her choice. But her refusal to consider individual risk factors in treating an individual patient seemed a bad omen of her overall practice philosophy. I was glad I made the switch to a provider who was willing to consider my individual risk factors. I remain glad of that. It doesn’t mean I don’t realize that going 42w isn’t “normal”. It just means that in deciding on individual treatment of my individual complication, I wanted a provider willing and able to assess the individual. that’s all.

      • Therese

        Most babies that are induced are induced before 42 weeks…so the fact that only 10% make it to 42 weeks doesn’t really apply.

    • Lori

      The obsession with the C-section rate over the safety of babies is really alarming.

      • LMS1953

        Witness the baby who was “internally decapitated” by an OB in Port Arthur, Texas with a difficult forceps delivery right after this past Christmas. I have got to believe he was motivated by the desire to avoid an “unnecessary” C-section. If possible, that case was yet more gruesome than this one.

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

          More gruesome, but in a totally different way. That was one person making a hideous error. This is a chain of gaslighting, ignorance, hubris, evil and months of grooming. It’s a cascade of fuckery.

          • LMS1953

            Yup. But I as an OB feel an encroachment of the Woo what with 39 week Nazis and ACOG promulgating “avoiding the first C-section”. Board Certified judgment is no longer allowed in deference to nanny state hubris.

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

            That seems reasonable. Your use of “encroaching” says it well. I see it more as a survivor of cultic manipulation and emotional abuse, so I guess we all react viscerally to “the devil we know.”

          • Arwen

            This was the problem with my doctors. I had a lot going wrong with my last pregnancy, but none of it fit neatly into a category. Was it preeclampsia? My protein was veering into dangerous waters but then would veer back. Midway through I had terrible contractions, which resolved without delivery. I had constant irritable uterus and massive swelling.

            Turns out I had an undiagnosed auto-immune disease. But at the time, pre-e seemed to explain at least some of this. I wanted to have a c-section at 37 weeks, before I went boom. I saw nothing good about waiting for an emergency. I was not only denied the 37 weeks, but I was denied the c-section. They didn’t “do” MRCS. Because of the woo. I might have another baby, and c-sections make it harder to have another baby. That was what they said.

            A lot of folks around here have a lot of faith in the medical establishment, but I don’t. That doesn’t mean I think the solution to bad care is even less care. But I don’t for one second think that doctors are immune to fads and woo and organizations like the March of Dimes. That needs to stop.

          • thepragmatist

            Hey, this happened to me except I had a great OB/GYN who didn’t see me as a crazy, hysterical, whiny brat. But instead wouldn’t give up until she figured out what was wrong with my body and helped me get care. It took two years and she was the only person who believed me. Otherwise, I’d still be trapped in a prison of pain without any idea why, thinking I was crazy. I’m so sorry this happened to you. You would think physicians would be more wary of auto-immune disorders being triggered by pregnancy. I have hyper-laxity of my ligaments and pregnancy set it off. I’ve never recovered from the relaxin. My joints are still messed up, three years later, and a DX of hypermobility syndrome with attendant complications and various sites of inflammation. It’s painful and now I’ve got arthritis, too. Prior to pregnancy all I knew was that I was very good at yoga, ha, and flexible, and injured myself in weird ways (snapping ligaments and spraining things all the time, even doing things that were very benign or I’d done many times). Needless to say, by the end of pregnancy, I couldn’t pick up a coffee cup because my hands were so weak that they could not bear the weight of the mug. I couldn’t get out of bed without propping myself up first and then rolling out, because my elbows and hands would just collapse. While it’s improved some, I came out of it with damaged joints and a tear in my spine and vicious pain that still has not abetted. I was not crazy, and it was with much disappointment that my primary physician had to accept that, EVEN with treatment for the anxiety I was having (from being in awful pain all the time!) I was still in awful pain all the time. Ha. What happened to me is typically a woman’s issue and I was told again and again I just wasn’t adjusting to the “changes in my body”. It was not that.

          • Arwen

            …Are we somehow related? So much of what you’ve said is my story too. I was worse in some ways, but probably better off in several others–it sounds like you’ve been through hell.

            I think that’s something that really frustrates me about this whole homebirth thing. You have the people who are, in some cases, most equipped to tell those who practice modern medicine where they’re going wrong. Instead, the homebirth moms seem to want to opt out of the system entirely instead of aggressively pushing for more and better care.

            I get that it takes a ton of grit, a thick skin, and a massive quantity of patience to navigate through our health care system in order to find HCPs who takes a woman seriously if she’s not fitting neatly into little boxes. Believe me, I get it. But again, the solution for bad care isn’t less care. One solution is a group of people, much like the one here, pushing back against those who would try to address their bad care by making others experience less care. Another one is for us exhausted, already overloaded people–and those who care about us–to keep screaming until we’re heard. Until we’re respected. Until women achieve quality health care on par with that of men by default. It’s not an easy road, but I think we’re making slow progress.

          • thepragmatist

            Firstly, I agree with you 110% and I think that differentiates Third Wave Liberal Feminists from our Cultural and Radical sisters. We do not want to break the existing system down, we want to tear down the impediments to access. It’s evolution, not revolution.

            For your last paragraph, I want to thank you: I want to print this out on put it on my wall. I want to believe we ARE making progress. Slowly. We have a long way to go.

          • Arwen

            At least we have the means and the fora to talk about the problem, and people willing to talk about it. People who, like us, have experienced everything from little annoyances to total horrors in our health care system. People who know people like us. And people in health care who give a damn about folks like us whose health histories require scrolling past the first page, whose lives can’t be summed up in a mere file folder but rather in accordion files stuffed with file folders.

            I do think it backfires somewhat to describe all homebirth moms as anti-medicine and anti-science. I can easily see where someone would be so fed up with being treated as a head case, having her actual medical needs ignored, that she just leaves the system entirely. I know people who are phobic of doctors. And sometimes, their care was so irrational that an irrational response is rational. Getting them to therapy is next to impossible, because a therapist is still a health care professional, and they’ve been abused by health care professionals.

            That said, people who prey on pregnant women with a doctor phobia, giving them completely inadequate, to the point of criminally negligent care, instead of doing everything in their power to get them under the care of the most competent, compassionate people with the appropriate degrees and letters after their names that they can find, deserve the deepest condemnation.

          • thepragmatist

            The encroachment is well underway in the UK and the Commonwealth, including Canada and Australia. The USA is the last hold-out, really. Blame privatized medicine for that. In publicly funded medicine, once an idea “goes viral” it’s hard to stuff it back in the box… especially if those in power are interested in austerity and there’s a way to cut corners. For example, we have a ton of midwives here, in our regional district, and only 3 OB/GYNs at the moment to serve at least 100,000 people (I’m guesstimating, but I’d say our population is about that).

            We’re waiting for technical support here and waitlists to see your OB/GYN are ridiculous (mine steals time to talk to me between patients and has occasionally taken calls at the side of the road after a day in the OR!)… and instead of being outraged at this, the women I know are petitioning the damn government for more midwives! GAH!

            What they don’t realize is that they are getting ripped off, because we are replacing genuine medical help with a sub-standard level of care and that the current government is much more interested in stripping public moneys from women’s health than they are in midwifery. Midwifery is just a cheap short-term fix for not putting the money into women’s health. A relationship with a midwife lasts the length of a pregnancy. A woman may need her OB/GYN again and again. I feel like, as a woman, my relationship with my OB/GYN is as primary as the one I have with my family physician. I will need gynecological care at least periodically (no pun intended LOL!) through all stages of my life. Further to that, we’re not saving money if babies are being brain damaged, but I am not sure anyone is paying attention!

          • Comrade X

            If the State is going to try and be a nanny, it could at least try to be a half-way sensible one, who doesn’t kill her charges.

          • Rita

            And there’s no one defending that doctor.

          • PrimaryCareDoc

            Right. You don’t see any doctors crying out to save their “brother in chains.”

          • thepragmatist

            Can I just say, I must use the term “cascade of fuckery” in my day to day life now, Kumquat. Thank you. Ha.

        • Trixie

          At least they were able to immediately identify the person responsible and fire him and ensure that he won’t work again.

    • thepragmatist

      Well, this is just absolute hogwash. THERE ARE STUDIES AND IT IS WELL- ESTABLISHED PROTOCOL FOR A REASON. Sorry, but this is infuriating to me. When I counsel women, inductions come up as the biggest fear-inducer again and again. These women do not know that actually, the induction will most likely provide them with a safe delivery of a live baby, but associate them so strongly with a negative outcome that I have to be very careful in how I talk about it or I will get shut down. All thanks to myths like this. When I reverse-engineer a birth with a woman who has been traumatized, she often comes into the conversation blaming the induction for whatever trauma, but usually, after dissecting the story, the induction no doubt either greatly improved the chances of her delivering the baby vaginally OR were a last ditch effort to save the mom a c-section. And I never talk about still birth because I would lose my credibility! (That’s the dead baby card, heaven forbid we mention the actual most terrifying outcome!)

      I very much remember when all the NCB brainwashing came undone for me and how it felt to realize all of this, piece by piece.

  • Andrea

    Can someone please explain what is a NST with a hand held doppler? Is it not a CTG?

    • Anj Fabian

      A CTG would be what we call cEFM – continuous external fetal (heart rate) monitoring. aka “a strip”.

      The consensus is that you simply can’t do a NST with a hand held doppler. You can say you are doing one. You can fake doing one, but you aren’t recording the critical information, you aren’t producing anything like the same results that a NST does.

      • LMS1953

        Precisely, Anj. I recall a patient came in for a routine visit at 38 weeks. I listened to the FHTs with a Doppler and they were fine at 140. But just as I was lifting the Doppler off the abdomen I heard the FHTs drop – lub…dub….lub…..dub. I put the Doppler back on and again the FHTs were fine at 140. I sent her to L&D for a NST which showed poor beat to beat variability. I then did a CST and after the first few contractions there were late decels. An emergency C/s was done and we got a vigorous baby with 8/9 Apgars and good Cord ABGs. However the pedi pointed out to me a very low fetal hemoglobin of 8.5. She asked me to obtain a K/B test on mom which revealed a large fetal- maternal hemorrhage. The baby was transferred up the road a ways to the tertiary NICU. The neonatologist advised mom that there would have been an IUFD if delivery had been as little as an hour later. The couple was very grateful for the cascade of intervention. And I gained a great deal of respect for the significance of loss of variability.

        • Karen in SC

          What a great story about what a skilled OB can do! I’m sure the couple was very happy.

          • Andrea

            That is an amazing anecdote! Lucky baby! I am an Aussie (hospital) midwife and NST is not lingo I have heard much. Only CTG. I presume NST is a non stress test, ie an antenatal trace. Which you would expect to be normal, as the baby is not under the stress of labour?
            Once I remember a student midwife noting the FHR as “normal variability” when there was no mention of a CTG being applied – I questioned how did she assess variability then? Reply – watching the FHR on the Doppler screen. Errrrr wrong!, you cannot assess variability from that! Had a big chat / education session on CTG and she learnt a lot. Christ knows who taught her variability could be assessed with a Doppler.

        • Jessica S.

          That’s incredible!

  • MrG

    Jan Tritten has an underutilized Twitter account:
    https://twitter.com/jantritten
    See some entries in the screenshot. It deserves more traffic.
    We should answer her questions and ask more.
    That is a good place to start communicating with her, @jantritten maybe with hashtag #unsafeCPM

    • PrimaryCareDoc

      What is it with the poor spelling and grammar???

  • Insider

    http://community.babycenter.com/post/a45429271/home_births

    Under the user name VegasMidwifeMom, Christy writes:

    “We carry the same medications/O2 that you find in the hospital, and (in this area) we’re usually minutes from a hospital. It is sooooooooo rare to have an emergency transport. SO, so rare…. it does not often go horribly wrong when at home. It goes horribly wrong way more in a hospital with all the inductions, c-sections, medications, and lack of mobility contributing to normal, physiological birth. Women’s bodies are so smart and work beautifully when left alone to birth in their own time :)”

    • Jessica S.

      “Women’s bodies are so smart and work beautifully when left alone to birth in their own time :)”

      Except when they don’t. And if by “horribly wrong” you mean “not the warrior birth we idolize”. Seriously, she must justify away instances like this recent case as the “sooooooooo rare” ones and then block it out, continuing the cycle. Otherwise, she’d have to face the fact that she’s devoted her life to a craft that’s built on false beliefs and pseudoscience.

      • Danielle

        I think it is pretty amazing that a women’s body can nurture a growing baby for 9 months, while it grows from a single cell to a little person with a complex brain and delicate systems all working in sync.

        If she needs a little help to deliver the baby happy & whole and with minimal physical damage to herself, so be it. He body has been amazing for 9 months, and it’s still amazing a c/s scar, or a prick from en epidural needle.

        Saying emergencies are “sooooo rare” is not just medically untrue, its really kind of a slight against female bodies that are not performing the way that Christy prefers.

        • Amazed

          Medicine is so smart and work beautifully when needed to help those who only 100 years ago would have died an ugly death in the smart and beautiful process of birth.

        • Jessica S.

          Isn’t that the truth! I am amazed at how often things DON’T go tragically wrong, if you consider the entirety of hosting a separate being inside of you and then somewhat of a guessing game of how things will play out once delivered. Modern medicine is amazing in how much they can predict, and I welcome it. My mom reminded me the other day that my great-grandmother gave birth to a 13lb baby. We were remarking about how c-sections weren’t the way those babies were delivered back then and how sad it was the number of babies – and moms! – that were lost due to lack of medical advances. (Not just large babies, of course, but that was the topic b/c my son was almost 11lbs, via CS, so we were discussing how baby #2 would be delivered.) And she remarked that a lot (most??) of those babies were born at home, that’s just how it was. It seems so backwards to want eschew these life saving advances and put yourself and baby at risk unnecessarily, unlike “back in the day”, when there was no other option. Very shallow understanding of progress.

          • thepragmatist

            Yes, my Grandfather had four siblings. None of them made it past birth or infancy. FOUR, all buried in the back yard of their house, and I imagine, given how my Grandfather spoke of the expense of doctors during his childhood, probably at home, or with minimal intervention.

      • The Bofa on the Sofa

        “Women’s bodies are so smart and work beautifully when left alone to birth in their own time :)”

        Objection! Improper foundation!

        So my wife’s body has lots of problems “when left alone.” Her eyesight is awful, and her thyroid doesn’t work properly, either. Why should anyone assume that it would work “beautifully” when left alone to give birth?

        • Jessica S.

          Exactly! My eyes are crap, my thyroid underperforms, my iron levels suck when I’m pregnant, and my body wasn’t much help working my first down where he “should’ve” been. So lucky him, he got the first class removal without being squeezed through a canal. Thank goodness we don’t actually have the capacity to retain memories and give meaning to events that early in life. Birth would be high on my list of things I’d want to forget!

          • The Bofa on the Sofa

            I did not know my wife posted under the name Jessica S?

            Because from what you describe, you could very well be.

          • Jessica S.

            Ha! I like her already!

          • theNormalDistribution

            I imagine if your bebe could remember his birth, it would be a lot like being dragged out of a warm bed and into a bright room when he had been having a nice snooze.

    • Karen in SC

      Is there any research that lack of mobility affects duration of labor? I get that it may help with pain, at least be a distraction, but anything else been proven?

      • fiftyfifty1

        Some studies say yes, that it is shortened by a modest amount. Other studies find no effect.

        Anecdote alert: The hospital never tried to restrict my movement or position at all. I was hooked up to an IV (antibiotic for GBS) and an external fetal monitor belt, so there were wires to think about, but they never restricted my position. Late in my labor when baby had some decels they suggested I try the “lying on my left side” position as that is the position where blood flow to baby is greatest.

    • Trixie

      http://community.babycenter.com/post/a47430604/i_need_a_good_ob_or_midwife_referral?cpg=2&pd=-1
      All lab work is done in her office? How is she even qualified to draw blood?

      • thankfulmom

        It is probably done under her back up doc’s name. Perhaps that is how she got the ultrasound at the other hospital, at “his/her” request? I’m guessing he is on staff at more than one hospital. I wonder what he will think of this fiasco? If he continues to be her back up, will he insist on regular weekly testing after 40 weeks? Will he still be allowed to practice at the hospitals since he agreed to be her backup?

      • Anj Fabian

        You can do SOME lab tests, like urine dip sticks.

        Most offices offer simple, rapid result, positive/negative tests. Unless an office invests time in training, equipment and proper quality control, I wouldn’t trust their test results.

        Doctor’s offices will run a rapid strep test, but if they want a culture, they send the swab to a lab.

    • anion

      Um, Christy, if you truly are “carry[ing] the same medications that you find in a hospital,” I’m pretty sure you’re breaking the law.

      • Therese

        Depends on the state…there are states where midwives are allowed to carry medications like pitocin, methergine, etc.

    • LMS1953

      Since CPMs focus sooooooo much on absolute versus relative risk, they like to use the word “rare” a lot. So I tried to look up the medical definition of rare. The FDA has one as pertains to “orphan disease”

      (B) preclinical testing involving a drug is designated under section 526 of such Act and before the date on which an application with respect to such drug is submitted under section 505(b) or under section 351 of the Public Health Service Act.
      (2) The term “rare disease or condition” means (1) in the case of a drug, any disease or conditions which (A) affects less than 200,000 persons in the United States, or (B) affects more than 200,000 in the United States and for which there is no reasonable expectation that the cost of developing and making available in the United States a drug for such disease or condition will be recovered from sales in the United States of such drug, (2) in the case of a medical device, any disease or condition that occurs so infrequently in the United States that there is no reasonable expectation that a medical device for such disease or condition will be developed without assistance under subsection (a), and (3) in the case of a medical food, any disease or condition that occurs so infrequently in the United States that there is no reasonable expectation that a medical food for such disease or condition will be developed without assistance under subsection (a). Determinations under the preceding sentence with respect to any drug shall be made on the basis of the facts and circumstances as of the date the request for designation of the drug under section 526 is made.

      So, 200,000 out of 300,000,000 would be .67 out of 1000. Or 67 out of 100,000. Maternal mortality is about 10 to 20 per 100,000 depending on one’s demographics in the US. So it is indeed “rare”. But the vast majority of problems that kick moms out of low risk HB consideration are by no means rare. In medical terms they are more appropriately called “common”. But in woo-speak the more “o”‘s you put after so acts like 10^(-N) exponential notation I suppose. This was clearly false, fraudulent and misleading advertising with the use of rare in this context. There should be a regulation that no CPM can call a condition or risk “rare” if it occurs at a rate of more than 1 per 2000.

    • auntbea

      “we’re usually minutes from a hospital” Although not necessarily minutes from the hospital I will insist you go to.

      • Playing Possum

        Whenever people say “minutes from xxx”, I always think … huh. My concrete side can’t deal with it. 120 minutes? 563 minutes? Those are minutes too!

    • Arwen

      What the hell does “physiological” birth even mean? It sounds like ableist bullshit to me.

      • Stacy21629

        No kidding…especially when the people spouting it are pretty non-physiological themselves.
        This mom wrote a blog and HuffPost piece called “I’m High Risk and I’m Having a Home Birth”. Despite her endocrine/thyroid disease and gestational diabetes for which she has refused insulin therapy (BECAUSE it would risk her out of home birth…) she believes in “physiological birth” and is planning a homebirth in May. She’s frustrated with her shadow OB care because their recommendations “are not compatible with the approach I’m taking to this pregnancy.” So basically, if she just believes really hard that everything will be ok, it will. I guess all the moms with stillbirths just didn’t have the right “approach” to their pregnancy.
        http://amywest.co/2014/02/26/pregnancy-update-3rd-trimester/
        http://amywest.co/2014/01/14/pregnancy-update-is-it-may-yet-edition/
        How can people not see these GLARING contradictions? “Birth is a normal physiological event…except for the laundry list of medical issues and complications I have!”

        • LadyLuck777

          Wow. She is not logical. And it can take up to six weeks for the thyroid medication to regulate, so getting labs three weeks later may be misleading. She wants to be in control more than she wants herself and her baby to be healthy.

        • Arwen

          I still don’t see how the word “physiological” should even come into play. To me, it sounds like someone’s planning a “foo” birth. What is “foo?” A nonsense word. What is a “foo birth?” There is no definition, because the word makes no sense in context.

          I appreciate your trying, Stacy, but this strikes me as a “falling-down-the-rabbit-hole” figure of speech. The only way to know what it means is to go fall down the rabbit hole.

  • Renee

    A very chilling comment from Christy:
    “In the future, I’ll pressure until my client hates me. I won’t care.”

    **So she plans to keep on delivering babies? After she KILLED one in the most negligent, horrible, and utterly preventable way? She is just going to pick up where she left off, maybe go to a workshop or two, put on by other total dangerously uneducated fools like her? WOW. Not one comment about “maybe I ought to get a CNM/education/etc”, or anything.

    Also love how she BLAMES THE MOM. She says she wasn’t “forceful” enough, etc, and I am sure her reassurance was what killed. Yet that whole comment from her was basically saying she simply did what mom wanted…… PUKE. Declaring she didn’t give enough info now is too goddamn late.

    SHE NEEDS TO QUIT. ASAP. I would prefer to see her jailed and banned from all health care positions for life, even forced out by fellow MWs (HAHAHA), but we all know how this will go. Nothing will happen to her, she is in a state with “full autonomy of MWs”, which is code for:
    “I can do whatever the f#@* I want, kill at will, and no one can do
    anything about it!” (Wonder if she sticks her tounge out and rolls her eyes after saying this?)

    Also, this fake MW has already proven that she is willing to break laws, and then go where there aren’t laws to stop her when she is caught. Even IF she gets in trouble, when its over she can simply pack up and go elsewhere. I am sure she will still have her CPM. Maybe she will relocate to our great state, where killers come to feel at home among the other killer MWs…

    Lat thought here:
    Her hand wringing, and blame shifting, over the BPP results at 42+ is totally irrelevant! Even IF it had been true, that the baby was doomed the day prior to when she got a CS, It really does not matter: the baby ought to have been delivered much, much sooner!!! She was NEGLIGENT not inducing at 41 weeks, and CRIMINALLY NEGLIGENT not inducing at 42W.

    Besides, what kind of HCP says 0 fluid is acceptable? That was cause for an immediate, emergency CS the instant they saw that the first time.Not a suggestion to send mom home to drink water and bathe. HOW IGNORANT of anatomy and fetal development do you have to be to think this is a solution? OMG, I am a layperson with ZERO experience, and even I knew this. JFC.

    Ignoring the dangers of post dates (a MAJOR killer/disabler in HB babies)- 41 weeks is generally the max a responsible HCP will wait without using the dead baby card, At MINIMUM, 42W.

    THIS IS WHAT HAPPENS WHEN YOU LET FAKERS HAVE FULL AUTONOMY. Even basic rules could have made an enormous difference. I am sick over this.

    • anion

      She acts as though the uterus is like a car’s transmission, and when it’s low on fluid it can just be topped up.

    • fiftyfifty1

      “Even IF it had been true that the baby was doomed the day prior to when she got a CS,”

      And it’s TOTALLY UNTRUE that the baby was doomed the day before. Yes, it is possible to estimate how long meconium has been present. If it has been there a long time the baby will have staining of the skin and under the fingernails etc. And meconium aspiration is a real medical problem with very true dangers (Dr. Tuteur recently posted on this). But every doc who provides OB care knows cases of stained babies who do fine. The majority of mec aspiration babies live with no long term consequences.

      I find it telling that homebirth midwives poo-poo the risks of mec when it suits them. When they find it in the fluid during labor it is a “variation of normal” and “almost never causes a problem”. But when it suits them (as in this case of clear medical malpractice) it is a sure death sentence.

      • The Bofa on the Sofa

        How could have the baby been “doomed” the day before? At least according to the midwife, the baby was so good the day before that there was not even a need to get him out!

        A biophysical profile was normal, according to them. So they thought the baby was so good that there was no emergency.

        Now they are saying they were wrong?

        I don’t know why that should make it any better. If the baby was really doomed the day before, then they really fucked up when they diagnosed it as “normal”

        It appears that “doomed” is now “just a variation of normal”

        • thepragmatist

          It is, don’t you know. Check out MANA’s manifesto of malevolent negligence… errr… “ethics”… a dead baby is just something to let go of. Makes me sick.

    • B

      ” I won’t care”

      I don’t see any evidence from her own words that she cared in the first place.

  • Efty

    It’s unbelievable to me that CPMs are even allowed on the US. Here I’m Canada the only midwives are Registered Nurses with additional training and hospital back up. She is very clear about the fact that she cared more about ‘being liked’ than about the outcome for the mum and baby. It’s sickening. Babies should not be dying at the hands of untrained unprofessional women in the US in 2014. These ‘midwives’ clearly have no respect for the human body and how it works otherwise they would never treat people so callously. It’s a travesty.

    • Jessica S.

      Well put. You’re absolutely right. I’m grateful for the determination of Dr. Amy and the other people here who are devoted to creating better standards and educating the populous of fact-based practices – the bedrock of TRUE informed consent!

    • CognitiveDissonaceHurts

      But there are women in Canada who are dissatisfied with the medicalization of midwifery, and who would prefer a midwife more in keeping with the CPM style. These are the women who, thanks to being bolstered by the internet, will decide to have an unassisted birth or a homebirth attended by a doula (who is essentially acting as a lay midwife). They will lie to the OB or midwife giving them prenatal care about what their real intention is for delivery. The numbers are small, but it is only a matter of time before tragedy strikes.

      • Mtbakergirl

        The thing for me is, if you want to have an unassisted birth, go ahead. There is no denying that you are aware of the risks (even if you may not understand them). You are entitled to do whatever you want, you are not entitled to have a “health care provider” pretend alongside you that your actions are safe and in your child’s best interest.

        • CognitiveDissonaceHurts

          Unfortunately, some of these women would never dream of being unassisted if they weren’t being fed information from online lay midwifery sites or in real time from Childbirth Educators and Doulas that say that their actions are safe and in their child’s best interest.

    • Mari

      Midwives in Canada are not registered nurses, they have a midwifery degree and can still be very woo. I went to nearly 43 weeks with a midwife. Check out superannuated goodness’s comments on a recent post for a peek into the minds of some Canadian midwives. They are sometimes hardly better than CPMs. No ultrasounds. Fudging due date to let you go longer.

      • thepragmatist

        I had a friend of a friend (close enough I can see her newsfeed and I chat with her occasionally) have a baby over Christmas, and her midwife didn’t want to leave dinner to come so told her to go have a glass of wine and lay down. She begged and begged the midwives to come because she has a history of precipitous labour. She had her baby alone with her two kids in the house. The midwives ignored her pleading for almost 24 hours. Yeah, not into the woo at all. Nobody but me seemed to find this a terrible, terrible issue. In fact, there were all kinds of “Go Mama!” responses, but the poor woman spent the time leading up to the birth terrified and birthed alone, in her house. She wasn’t happy about it. I’ve heard all kinds of stories of people receiving subpar care from midwives here, both from inside the medical establishment and the women it is supposed to serve. No, I do not like the licensing and regulatory requirements of midwives here at all and do not think they should be practicing autonomously. I was satisfied, on an emotional level, with my midwife, and she was probably one of the most level-headed ones in town, but she still did things that I think were probably not very bright. Like she let me skip the 3 hour screening for GD because I was vomiting and fainting so much (and she did nothing about that either) when I told her that my family was rife with GD and Type 2 diabetes and I am hypoglycemic.

  • areawomanpdx

    And honestly, it doesn’t matter if the baby had been stewing in meconium for a couple of days. It’s still her fault — any prudent practitioner would have offered/recommended an induction after 41 weeks and certainly by 42. The lack of amniotic fluid and hackjob of a NST at 42+3 are only the cherry on top of the shit sundae for this poor infant.

    • Certified Hamster Midwife

      “shit sundae” is a tragically unfortunate choice of words.

    • Box of Salt

      I am going to quote Geddy Lee again here:
      “If you chose not to decide, you still have made a choice.”

  • attitude devant

    One of the things that really pisses me off about this case is that the midwife tried to claim the

    • Playing Possum

      I would think the death cert would say COD hypoxia, antecedent causes meconium aspiration and post-dates. I shudder to think what insult caused the meconium, especially since it was probably prolonged.

      I wish you were still teaching residents!

      • attitude devant

        LOL! Thanks!. I think the (hypothetical) residents would be pleased NOT to have me because I was something of a hard-ass.

        • areawomanpdx

          You always learn the most from the hard-asses, whether or not you like them at the time.

          • fiftyfifty1

            I’m not so sure. I think it depends more on the teaching ability of the teacher than the style. I had some screamers who were great teachers, and some who weren’t. I had some soft-spoken teddy bear types who were great teachers, some who weren’t. It probably depends some on the resident too. A responsible resident doesn’t need to be screamed at. A quiet “that’s not the way you should have done it, because you almost harmed the patient” is all the correction a responsible resident needs. Mortifying words and never forgotten!

          • attitude devant

            I was fairly soft-spoken, so I think they were often surprised that I was a total stickler.

          • fiftyfifty1

            Good point. Hard ass =/= screamer.

          • Amazed

            Oh yes. But hard-asses do have a way to make sure you take care to learn the stuff. Won’t work if they are not real teachers, though.

            My mom is a mew-mew. She gets things done with her students. My grandmother was the stern grandmother. She got things done with her students. Five minutes after meeting me, the kids my mom teaches at her home wants me to be their teacher because they know they can wind me round their little finger. Don’t know how the little devils feel it but they do. Each one of them, without failing.

        • Amazed

          Oh, I whined about hard-asses all the time! They were one of those who taught me many, many things.

          Now wonder what on earth I was expecting of them. Being my mom? I already have one, thanks.

    • Danielle

      If she’d been a resident, she’d have already been shadowing doctors for some time already and would have been hearing constant commentary about how to handle various situations, so chances are, she’d not have made mistakes nearly this big.

    • fiftyfifty1

      Residents get fired for less than that. I was a senior resident to a first year resident who lied about a couple of lab values (said he had checked them when he hadn’t and reported normal values when they had actually been abnormal), also was found out when he missed some work and claimed he had an appointment but was seen by a fellow resident out in the community. He got canned for those alone and he never killed anybody.

    • CanDoc

      Agree. The meconium aspiration is the final event in the cascade of asphyxiation, ending with fetus gasping in utero, drawing thick mec into lungs. Which, if the baby dies in utero, in fact doesn’t matter clinically – the baby is dead from asphyxia before birth. BUT, if the baby lives, having lungs filled with viscous particulate mec THEN results in the meconium aspiration syndrome and associated perinatal morbidity. (Having said that, a prudent coroner may question whether this baby may have been salvageable if better oxygenation could have been achieved, hence meconium aspiration in the final diagnosis.) Awful.

  • Jocelyn

    Is Jan Tritten’s facebook page gone, or is it just me?

    • areawomanpdx

      it’s still there. you must be blocked.

      • Jocelyn

        Ah, well. I guess I shouldn’t be surprised.

        • Sue

          My post suggesting some education on oligohydramnios is still there…wonder if she’ll oblige.

    • Montserrat Blanco

      I am blocked too!!!!! I must be Satan for suggesting that she looks in Pubmed instead of posting on Facebook. I said something nice about how to calculate a rate as well… Lovely

  • KarenJJ

    Is Christy Collins at all friends with the other midwife that posted with a warning about midwives sticking together? (Trying to find that image but I’m posting on the fly and haven’t found it yet)? It’d be interesting if it was someone posting that knew about the circumstances behind Christy’s incompetence.

  • thankfulmom

    That bit about feeling a sense of urgency and reading to the mother what other midwives had to say…weren’t all the replies clueless ones and no one said to head to the hospital asap? Seems like she is rewriting the events to absolve herself of any responsibility.

    • Zornorph

      I was just about to ask about that. The other midwives (for the most part) were telling her that all would be fine and there was no need for a dreaded ‘intervention’. It’s also her admitting that she crowd-sourced for tips on how to manage the situation. What an evil woman.

    • R T

      I remember one or two saying they should go to the hospital, but most said not to worry.

    • Jessica S.

      Thank you! I was thinking that, too. That really bugged me.

    • Danielle

      A few did say to go to the hospital, although most gave answers to the effect that the situation was not dire.

      So it depends on whether she read whole thread, or pieces.

      Either way, even if the replies had been stellar, why FB? Get on the phone with the doctor or better, yet, play it safe and check into the hospital already!

  • tiffanyjade

    That email is a cya cop out. She is trying to imply that she recommended going to the hospital and the mother kept rejected the idea. I don’t believe her.

  • Ellen Mary

    So sad that there were AT a hospital! Wouldn’t a tech have been doing the BPPs? One of the most ironic parts about this is that there is a possibility that if the mama had induced @ some point, she might could have had a baby AND a vaginal birth. Instead of no baby & a cesarean. :*( Which is truly the worst possible outcome imaginable. Healing from my C was hard. But the main consolation was the possibility that just maybe it was life saving. Somehow I just don’t believe she would have gotten in a car & driven 30 minutes to another hospital if someone was not encouraging her to?

    • areawomanpdx

      yes, the evidence shows that induction by 41 weeks reduces morbidity, mortality AND cesareans.

    • Renee

      Techs are NOT ALLOWED to tell the parents anything about or related to a diagnosis. They can chat about how the baby looks good, is growing properly, the sex (if parents request it), basically, small talk. Anything else is not allowed.
      That is how I KNOW when there is trouble- when the tech does not make small talk. I have never had this happen when things were perfect.

      • thepragmatist

        Oh God, tell me about it. There is nothing as chilling as total silence in the room when the tech is checking you out. This has happened to me once and it was awful. Thankfully, I already knew what was wrong with me, so when they came into tell me, it was just that and not something additional (I thought it was something additional.)

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

    Just so we don’t forget what a lying murderer Christy is, here is the screen cap of her initial lying self serving excuses. Note in particular that she said the 3 “BPPs” were done at a hospital and they went “promptly” to an emergency CS. 30 minutes of driving plus who knows how long beyond that?

    • Anj Fabian

      So what many people have been wondering is that the usual standard of care for postdates 40w+ is NSTs and BPPs usually twice a week.

      So…
      If these BPPs were the “first”, that implies that the woman had not had ANY postdates monitoring until she was past 42 weeks, and the midwife was flying blind for two weeks.

      • LMS1953

        Yup, very astute observation.

        • Trixie

          But she was ON TOP OF THE SITUATION

          • LMS1953

            I never could get her “bathtub” analogy to try to find fluid where there was none. Perhaps she ought to read about the physiologic changes a fetus undergoes when s/he asphyxiates and turns into an IUFD.

      • Guest

        Yes – this is very important to point out.

      • antigone23

        This doesn’t surprise me at all. Homebirth midwives often seem to think that going overdue is not a big deal and no intervention is needed until at least 42 weeks.

        • OBPI Mama

          42 week intervention? NO!!!!! That’s too early! My former midwife just told a friend of mine they’d start an herbal induction at 43 weeks if the baby doesn’t come by then. I got a huge knot in my belly when I heard this. She is 42wks3days and I’m so very worried.

          • Jessica S.

            That’s terrifying.

          • Trixie

            WTH is an “herbal induction”?

          • OBPI Mama

            I have no idea. I asked my friend and she didn’t know either… I’m guessing herbs… maybe with castor oil?

          • jenny

            probably black or blue cohosh. (which is dangerous.)

          • Trulyunbelievable2020

            It’s only dangerous if you have black OR blue cohosh. If you mix them together, steep them in some sweet raspberry leaf tea, and then season them liberally with the garlic you’ve been keeping in your vagina to ward off GBS, you should be just fine!

          • antigone23

            Yeah back during my first pregnancy when I was still considering going “natural” (but at a hospital!!), I took a childbirth class with a local doula. I was basically looking for pain management techniques. Anyway, the class was on November 20th, Saturday. She said that the class might have to be interrupted because one of her OCTOBER clients could go into labor any minute. And she hoped it would be that weekend because on Monday she’d have to go in for the dreaded induction. I was absolutely horrified. The woman ended up going into labor the following day (at at least 43 weeks, assuming she was due 10/31). And…to top it all off, it was a HBA2C. Fortunately everyone was fine but the fact that this was just nonchalantly accepted as ok was really disturbing to me.

          • OBPI Mama

            Baby is here and well. Whew!

          • Amazed

            Thank God.

          • anion

            Indeed. Thanks for letting us know, OBPI!

          • OBPI Mama

            Yes. And I was just visiting a dear 87 year old lady today (she is a widow on her own) and she was telling me of her firstborn, a still born that was decaying inside of her (came out all black) and about how she almost died from infection. Her friend had lost 2 babies out of her 4 around that time to (I don’t know why)…. As I was driving home and thinking about my friend who just gave birth and of these dear old ladies, I am just amazed at how much we are so removed from newborn death and because of that, how we do such unsafe things thinking a healthy baby is a right and not a blessing.

          • Amazed

            When my 83 year old grandma speaks about the time “I was at the hospital” and I know she doesn’t mean her hospitalizations fighting cancer (twice! I’ve got a tough old bird of a grandma.), I know she means the times she either miscarried or stayed at the hospital between life and death for 40 days postpartum with her only surviving child.

            I am amazed by our willing blindness, too.

          • OBPI Mama

            Back in the good ol’ days… livin’ life how nature intended…

          • Amazed

            Yes. Recently, I fought a virus that made me cough my lungs out. I couldn’t help but wonder how anyone can willingly subject their children to a real whooping cough. But hey, all those who lived in the good ol’ vaccine-free world were healthier and happier! Totally anecdotal but out of all people I know who lived in this world, not even one wants it back. And besides, they all think nature is a bitch and is not to be trusted.

          • thepragmatist

            Indeed. And a healthy respect for doctors and medicine. My Grandmother was also terrified of germs. Because she had survived through a war and TB killed a lot of people, she used to pick me up and move me on the bus if someone coughed. She’d keep me close and make sure I kept my hands in my pockets. She always wore a light scarf to put over her mouth on crowded transit. It was difficult for her to imagine that diseases had been successfully managed, since in her life time she had watched so many friends die during the war from contracting infectious diseases under famine conditions, while starved.

          • Jessica S.

            Oh, so GOOD! And THANKS for following-up, those stories stick in mind.

          • Amazed

            October! And November 20th! You’re kidding me… right?

            Not a question, in fact. I know you aren’t.

            Revolting.

      • Jenny McLelland

        How could an NST be normal and good with 0 AFI? I thought that 0 AFI was inherently bad, and that any test that revealed 0 AFI couldn’t be a test that the baby “passed.” And my NST heart checks were 30 minutes minimum – I thought the key to a NST was that the baby had to do some stuff and have a change of heart rate during that time frame.

    • MLE

      I am trying to find the screenshot that I think Dr Amy posted in the comments somewhere, in which Christy says that the mother wanted more time before transferring to an OB, and now “it is believed” that she knew there was nothing that could be done for her son because he was meant to die (implied) and therefore the mother “wanted more time” before he was taken away from her forever. So again, the mother is to blame.

      • Renee

        SICK SICK SICK

        • wookie130

          It absolutely is, Renee. This poor little one. And now his parents must suffer from his loss, for the rest of their lives. I can’t imagine. I truly believe that the fate of Christy’s “career” is in their hands, if they chose to retaliate. Otherwise, she’ll just carry on with “business” as usual. Disgusting does not BEGIN to cover it.

  • Adelaide GP

    That email from Christy Collins is full of weasel words. My God. Talk about blame shifting and iron punches with velvet gloves. Poor parents to fall for this level of “midwifery” “care”. Disgusted.

    • Jocelyn

      Kumquatwriter, this comment makes me think of you since you have experience with manipulators. What’s your opinion on that aspect of the letter?

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

        I want to write something longer about the letter, be cause a lot of it is disturbingly similar to the kind of letters I’d get from my ex/cult leader. Enough that I need to step back from it first because it makes me too anxious.

        • Jessica S.

          You’re a strong woman, but I imagine I don’t need to tell you that. :)

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

            Thank you! It’s a little scary to write. I can’t help deconstructing the events, and remembering what it’s like to be in an emergency with someone coaxing and grooming you. It’s chilling. But I am working on a line by line breakdown of the letter.

          • Box of Salt

            Thank you.

        • thepragmatist

          Yes, this initially gave me a panic attack because I could feel the manipulation coming from it. It’s sly and gross.

  • Karma Kidney Stone

    Does anyone know…

    What were the cord gas values? What were the APGAR’s, most importantly the 10 minute? Did the baby have any blood gasses and what was it and how was it collected (arterial, capillary)? Was there a heartrate, was it considered a live birth or a still birth?

    • http://safermidwiferyutah.wordpress.com/ Safer Midwifery Utah

      dude they spent 47 minutes trying to resuscitate. There is no way they came out with a decent apgar.

      • Anj Fabian

        The live birth or still birth question is valid from a legal POV.

        • LMS1953

          During that 47 minutes, they probably got at least a feeble heart rate – I think that would make it a live birth.

          • fiftyfifty1

            ” got at least a feeble heart rate ”

            Jesus, that’s painful to think about. Poor baby.

        • guest

          That is another NCB tactic. Delay the transfer to hospital to create a stillbirth. A stillbirth does not get investigated. These people are despicably devious.

          • Jocelyn

            That is evil.

          • guest

            Evil certainly describes it.

      • Karma Kidney Stone

        They still document APGARs. They matter in the medical record to show a full picture of how the baby is doing. The hospital is going to have an M&M about this, and I’m sure all the physicians involved are aware and documented very carefully. All of those things give a pretty good picture of how long the baby was in distress. And given the 30 minute drive to the hospital (and who knows how long they sat and chatted about it first), I think it is pertinent.

        • Jocelyn

          The 30 minute drive…I can’t get over the 30 minute drive. What a selfish, idiot midwife.

      • Playing Possum

        In the inquest into Janet Fraser’s failed homebirth, the baby had PEA, which although being a rarely survivable rhythm, was considered enough to be a “sign of life”. Ergo, the death was referred to the coroner.

        I really wonder whether this was considered a livebirth or a stillbirth. Because there are cases where a baby has “no signs of life” at birth but then is successfully (albeit usually only briefly) resuscitated and establishes a “sign of life”, and I think they call those neonatal deaths.

        • guest

          Definitely not a stillbirth.

    • attitude devant

      I’m sure the cord gases were horrible. This narrative is most consistent with an asphyxia-related death.

    • LMS1953

      From the CDC:
      “NEVADA
      Live birth defined:
      ‘‘Live birth’’ means a birth in which the child shows evidence of life after complete birth. A birth is complete when the child is entirely outside the mother, even if the cord is uncut and the placenta still attached. The words ‘‘evidence of life’’ include heart action, breathing, or coordinated movement of voluntary muscles. (Section 440.030, Revised Statutes)

  • LMS1953

    http://www.yelp.com/biz/womens-specialty-care-las-vegas

    I promised not to name names. But if you click on this review I got by googling “midwife friendly doctors in Las Vegas” and read through them, there is little doubt who he is.

    • Amazed

      I hope his malpractice insurance is also midwife-friendly. Maybe he’ll reconsider his stance when the next birth worker shows on his doorstep then.

    • LMS1953

      http://www.reviewjournal.com/life/health/las-vegas-doctors-women-try-change-c-section-approach

      Here is a story from April, 2012 where he had to run down the hall to do a stat C/S because………you guessed it, a 42 weeker was having severe decelerations. I guess it is his specialty, along with water births.

      The image shows the route to the delivery hospital

      • Trixie

        I’m confused — it says he’s at Summerlin but elsewhere a poster said this baby was born at Centennial Hills?

        • LMS1953

          Centennial Hills is close to CPM Collins office and is likely where the BPPs were done. Summerlin Hospital is where the midwife friendly OB does deliveries. He is the only OB in Vegas who offers VBAC. He offers water birth. I can’t imagine it could have been anyone else

          • Trixie

            I’m just going off what the person who posted here yesterday said, who is presumably Dr. Amy’s source. That person said the baby was delivered at Centennial Hills.
            Also, how could there be only one OB in a whole city who offers VBAC? Is that right?

          • Susan

            I agree to not say who he is unless we know. But that article sure gave me the Dr. Wonderful uh-oh feeling….

          • LMS1953

            A quote from the article:
            “In Nevada, just 261 women who had prior C-sections — 160 of them from Las Vegas — gave birth in 2010 without surgery. That translates to just 0.77 percent of total deliveries.”

            He might not be the only one – I got that from a yelp reviewer. He’d be lucky to have much more than a 50% to 60% success rate. Hence it would take about 300 TOLACS to get 160 VBACs. Maybe his 3 or 4 person group is the only group in town who offers VBAC. The numbers seem doable that way.

          • Bomb

            There is no point in throwing together a flimsy case against a doctor you found googling. Vbac success is usually around 80% not 50-60%. You don’t know the area or the doctors here.

          • LMS1953

            http://www.aafp.org/afp/2007/1015/p1192.html

            This article says 60% to 80%. My experience in “non-tertiary” centers is that you are lucky to get a 50% to 60% success rate. When there are only 3 or 4 anesthesiologist on staff and there is only one in the building after 1500 to 1700 hours, you are pretty quick to pull the trigger. You have to have at least a 75% success rate to be at all cost effective and when you push the envelope to attain that, you get a higher risk of a multi-million dollar lawsuit settlement for a ruptured uterus.

          • Bomb

            Summerlin is tertiary, they have round the clock everything and a level 3 NICU. Centennial is not. Last I checked they don’t even use real anesthesiologists there, but rather CRNAs, I doubt they are doing many vbacs there.

            Different state, but Idaho’s vbac success rate was 87%. I don’t see why Nevada’s would differ greatly. Almost everything I’ve read anywhere states average success is 70%+.

            What exactly is your experience?

          • Trixie

            Still the wrong hospital. Also, this guy is pretty clear that he’s 100% against HBACs. Christy loves HBACs so why would be back her up? I just think it’s not likely to be him.

          • Bomb

            The post says they delivered at centennial, not summerlin. There are plenty of shit doctors in Vegas, believe me. There are also more doctors that do vbac, even if they aren’t readily googled.

          • Guest

            Between reading further on the Yelp reviews and the Babycenter posts, you learn that Dr. Harter has moved his office out to the Centennial Hills hospital, and that he is now delivering the majority of his patients there. I am guessing it is him, but the question is how relevant that piece of information is. If he only became involved on the day of the baby’s demise and had not been consulted previously, I strongly feel the midwife is fully responsible.

      • Bomb

        Anyone giving birth at summerlin that gets the room with the tub can have a water birth. It’s not his private room to do business in.

      • Susan

        A link to the probable class…

        Updates | Neonatal Resuscitation & Transitions – Karen Strange

        karenstrange.com/category/updates/‎

        Cached

        Instructor Update 2012 Winter/Fall Neonatal Resuscitation: Right Care, Right Time, Every Time, Regardless of Place “The … Las Vegas, NV – Feb 21, 2014.

    • Susan

      I don’t know. I have a problem with those doctor slambook sites myself…. horrors he wheeled in an ULTRASOUND machine…

      • KarenJJ

        I googled a new specialist once and found that he had only one review and it was a bad one – apparently he wasn’t very interested in hearing about woo for treating lupus. Sounded like my sort of doctor : )

        • Zornorph

          It’s never lupus.

          • Bombshellrisa

            It’s probably yeast and toxins

          • KarenJJ

            It wasn’t in my case :)

            Funnily enough my syndrome was on House once (sort of – they took the name and the symptoms and condensed it into about a weeks worth of problems and then dialled the drama up to 11). One of the few patients that Dr House lost.

    • Insider

      http://community.babycenter.com/post/a35481001/wate_birth_at_centennial_hospital?cpg=2&csi=2398794207&pd=1

      Under the user name VegasMidwifeMom, Christy identifies her backup doctor: “I am a CPM (homebirth) midwife and Dr. Harter is our back-up OB … -Christy C.”

      Two posts up from Christy’s post, a mother reveals why Dr. Harter moved from Summerlin Hospital to Centennial Hills: “The nurses said he’ll still deliver at Summerlin but with the vbac laws, CH is easier for him to deliver me at. He did not tell me this btw. He’s awesome.”

      • Trixie

        Wow. Okay then. I see that the article LMS posted is from 2010, so there’s the discrepancy in hospitals explained.

    • PrimaryCareDoc
  • The Bofa on the Sofa

    We know that Jan Tritton was in Vegas at the time. Do we know whether she was directly involved? She certainly implied she was, until it became clear that it was not going over well.

    • Trixie

      Do we know that it was Vegas? We knew she was away but do we know where?

  • Trulyunbelievable2020

    I can’t stop looking at the Facebook page for Collins’ business. This baby dies on the 20th. By the 22nd she’s blathering on about co-sleeping, On the 23rd she’s linking to an article about how amazing Jenna Elphman is. On the 24th she’s singing the praises of breast milk, trying to find babies that one of her clients can practice on so that she can get certified as an “infant massage trainer” (and you know that they don’t just give that kind of certification to anyone!), and, most shockingly linking to an absurd poem about how it’s ridiculous to worry about pregnancies going late. Fast forward to just an hour ago and you find a quote from Jane Goodall about how we have so far to go to realize our true capacity for love.

    Seriously, what the fuck is wrong with this woman?

    • Karen in SC

      And the day after the tragedy, attended a neonatal resuscitation workshop! Irony thy name is midwifery!

      • Trulyunbelievable2020

        That’s actually about the only thing she’s done that hasn’t outraged me!

        • Reb, former LM

          Have you ever checked out Karen Strange’s NRP classes? I suspect her curriculum would actually make you feel doubly outraged.

    • PrimaryCareDoc

      I thought the same thing. It’s the only thing that gives me some doubt as to whether or not the right midwife has been named. Posting that poem about going postdates 4 days after losing a postdate baby is…sociopathic.

      • Trulyunbelievable2020

        All of my doubts disappeared along with the thread on the Midwifery Today FB page.

      • Jessica S.

        I understand what you’re saying. It’s almost like I don’t want to believe it because it seems so very sociopathic.

      • Becky05

        Keep in mind that this midwife likely views a stillbirth as something uncontrollable that “just happens.” It is horrible, but it wasn’t something she did that caused it. It isn’t seen as something avoidable.

        • KarenJJ

          Then what on earth is she doing trying to be a “midwife” then.

          • Becky05

            Keeping the birth place sacred? Accompanying the mother through her journey? Something like that.

          • PrimaryCareDoc

            “Holding the space.”

          • Becky05

            That’s the term I was thinking of!

          • Trixie

            Knitting?

          • KarenJJ

            Now that’s a worthwhile venture…

            Maybe I’ll just save some money and keep my space free.

        • Box of Salt

          “it wasn’t something she did that caused it”

          No: it’s what she didn’t do

          In the immortal words of Geddy Lee: “If you chose not to decide, you still have made a choice.”

      • Renee

        This is frequently done with killers. They just keep on kepis on as if nothing happened! Killer MWd Darby Partner and Laura Tanner were on FB BLAMING THE MOM, when they were not posting their usual drivel.

      • Comrade X

        She posted the poem AFTERWARDS?? Jesus, I didn’t think this clusterfuck could get any worse. That’s ice cold.

  • Trulyunbelievable2020

    Whatever happened to the whole, “The mother knew the baby was dead but wanted to spend some more time with him” line? I think that the thing that gets me the most about this– beyond even the reckless disregard for the life of this baby– is this woman’s constant deception. How do you just blatantly lie like that over and over again? It’s incredible.

    • anion

      I noticed, as well, how “So we headed over to the hospital and chose a cesarean,” which sounds like a fun, leisurely little shopping trip, is now “The mother was on oxygen and was immediately taken for a cesarean.”

      Lies and lies and lies. All to hide the depth of her incompetence and lack of care.

      • Thankfulmom

        I thought they went in their own car. Does she keep oxygen tanks in her car? Or was she on oxygen at the second hospital and quickly taken to the OR for a c/s?

        • anion

          It seems pretty common for midwives to carry oxygen tanks (although whether those tanks will be full is anybody’s guess). It further enhances their experience at Medical Professional: The RPG.

          I just saw where Dr. Amy’s source said Christy gave the mother oxygen as she drove the mother to the hospital.

          • thankfulmom

            Oh, so she plays ambulance driver too. Wonder if the hospital where they had the ultrasound had a nicu.

  • AmyP

    Dr. Amy wrote:

    “The midwife called Dr. X (he provides backup for many homebirth midwives their city) and told him the biophysical profile was normal, but heart tones were “variable.” He told her to immediately come in. She didn’t share with Dr. X that they were at at an ultrasound office attached to Hospital Y. They left that hospital and the midwife got in the car with the clients, put oxygen on the mother and drove 30 minutes to Hospital Z where Dr. X was located. They were immediately taken for a cesarean. They worked on baby for 47 minutes before they stopped.”

    !!!

    What is it with CPMs and transferring patients to far-away hospitals? This is a very pronounced pattern.

    • Danielle

      Only trusting their one “contact” who is “midwife-friendly?”

    • anion

      They head for the hospital least likely to yell at them or report them, because what matters above all else is saving their own slimy skins. Screw the mother and baby; the midwife’s freedom is the only thing truly important.

      • Jessica S.

        It is quite literally a sign of abuse – isn’t that what abusive parents/spouses/partners will do, drive to a far off ER to avoid a pattern?

    • Bombshellrisa

      Agreed-the CPMs here are willing to take the risk of transferring NOT to the hospital “just down the street” but to one that is further away, down a stretch of freeway that is always busy and often stop and go AND a toll bridge away. The reason? The hospital that is so close doesn’t tolerate the midwives dumping patients at the ER (these midwives charge a $750 fee to accompany the woman to rhe hospital and stay there as a doula) and holds them accountable for their shady practices. For fun, Google “Puget Sound Birth Center” and then see the estimated time to get to University of Washington Medical Center. Now imagine having to make that trip in a car, after laboring for hours and pushing for six hours (wish I could make this stuff up but it’s a scenario that has played out more than once). All because your kind and caring midwife doesn’t want to get in trouble

      • Jessica S.

        I had my first, and will have the one currently “baking”, at UW! Doesn’t really have anything to do with your comment, but I loved my experience there. I love the network as a whole! But it is a little nerve wracking, getting there during any busy time – never mind the possibility (depending where you’re coming from) that one could get stuck on the 520 bridge for 30+ mins if the deck is scheduled to open for boat traffic.

        • Bombshellrisa

          I love UW too! Can’t beat how close they are to Children’s too, for extra peace of mind. I had that thought, getting to UW from the Eastside gets even dicier when 520 closes the bridge or weather closes it like it did a couple times this winter

          • Jessica S.

            I know, I feel super blessed to live in this area, surrounded by such great medical care facilities. My niece was cared for at Children’s. She had a very rare cancer, and sadly died several years ago, but I’m certain we would’ve had even less time with her had it not been for her care team. And the way they treated her, goodness! They let her make herself as comfortable as she needed, practically turned her room into a mini-apartment. She had just turned 18 when she headed into the intensive treatment and it was a real identity crisis – am I a child, am I an adult? Anyhow, the point is, Children’s is amazing and I’m so grateful they cared for her and the rest of our family during that time. I love the pacific northwest! :)

          • Bombshellrisa

            We are lucky! There are so many good hospitals and excellent doctors and nurses. My six week old son was delivered by a hospitalist at Issaquah Swedish and even that was a pleasant experience. So I wonder with all these resources available, who the hell would want to have a hack attend them during pregnancy and delivery?

          • Jessica S.

            Amen!

      • prolifefeminist

        And then the poor persecuted midwife blames the hospital system for this because they won’t accept bullshit CPM “certification.”

      • Jessica S.

        Ok, I didn’t realize that Puget Sound Birth Center was the birth center in Kirkland! (I live in DT Kirkland) So it’s Evergreen that doesn’t take kindly to transfers being dropped at their door? (And good on Evergreen if they’re holding the midwives accountable!) Evergreen has their own midwifery program, right, that isn’t affiliated with PSBC? At any rate, it’s pretty despicable to imagine midwives actually making their clients endure that kind of torment – and RISK – simply b/c, as you said, they don’t want to get in trouble. It really should be against some sort of something – law, regulation, practices, whatever. Whatever happened to “owning” outcomes? Or is that only for parents and babies? Crazy! I know someone who opted to go with Evergreen over the birth center and now I’m REALLY glad she did.

        • Bombshellrisa

          Yes THAT birth center. The owners are all CPMs, although there may be CNMs who have privileges there. And you are right, the birth center is in no way affiliated with Evergreen but give their clients a false sense of security because they are located so close to the hospital. I know that these midwives were behind the push to have hospitals give CPMs hospital privileges (yeah, no hospital is THAT desperate to have someone deliver a baby). From what I have heard, Evergreen is trying to hold those midwives to a standard for transfers.
          Btw, “owning an outcome” is only for those parents who choose c-sections and epidurals-not for those warrior mommas! Because they consider epidurals and c sections an outcome in and of themselves. The baby is only secondary!

    • Susan

      Yes, I agree. They seem to often transfer to the “crunchy rep” hospital instead of the safest, highest acuity or closest.

    • Renee

      Some hospitals REPORT sentinel events,including deaths, HIE, and near misses. Other hospitals do not.
      Guess which ones they choose, no mayyrt the added distance?
      They also travel if they “feel disrespected or persecuted for doing HBs”

      I wanna tell them “If you cannot get over others having bad feeling about your “profession” you need to quit ASAP. You are not mature enough to be in the healthcare field at all- not even the kind that changes bed pans.”

  • LMS1953

    It appears that there are 7 hospitals in Las Vegas with hospital F on the map being the closest to the CPMs office

    • LMS1953

      Home Sweet Birth is 8 minutes from Centennial Hills Hospital

    • LMS1953

      Southern Hills is 24 minutes from Centennial Hills

      • Bomb

        With traffic all of the hospitals are at least 30 minutes away. I’ve driven from centennial hills to valley, umc, and summerlin, about a thousand times.

  • sadguest

    My apologies if this has been covered elsewhere, but can someone explain what this baby may have looked like if the mom had been induced at 40 weeks? 41 weeks? I don’t have a medical background, so I don’t have a good sense of what changes as a mom moves from full term to post term.

    Also, if the mom doesn’t see a physician until it’s too late to save the baby, how is that the physician’s fault? for modern medicine to do anything you have to, you know, go to hospital before it’s too late.

    • Marie

      It’s hard to know, but certainly very alive. There’s been nothing to suggest there was anything congenitally wrong with the baby. We are left to assume a failing postdates placenta, a baby desperate for nutrition and using up all that lovely 40 week brown fat, and aspirating meconium and MAS causing all sorts of problems. Baby probably starving along the way. That the baby died like this suggests to me that he suffered. It takes a lot to kill a baby this age. At 40 weeks, maybe the only subtle thing would have been fluid a little lower than normal, etc, if anything. We don’t know because the mother was not being properly monitored at all. There was no REAL NST, so we have no idea how healthy the baby seemed earlier. Routine induction at 41 weeks would most likely have been a healthy baby, and mom might have wrung her hands at the unnecessary induction. He died when he should have lived.

      • Jessica S.

        God, it is unbearable to imagine.

      • sadguest

        Damn, what a nightmare. That’s terrifying. Thank you for explaining, Marie.

      • Dr Kitty

        The baby was alive during the last ultrasound. There is no reason to think that immediate delivery couldn’t have saved him.

        IMO The delay between the bradycardia and delivery was what really affected the outcome.

    • Renee

      ALIVE.
      It would have been alive.

      My laypersons opinion (which is right more often than the CPMs…): Had they induced at 40W, baby would have been fine.
      At 41 weeks, it was probably still fine,
      At 42 weeks, it could have had some mec aspiration, and IF fluid was already very low, maybe some oxygen deprivation. Maybe not.

      At the first post dates BPP, baby may have been brain damaged (and how much, if any???). I read somewhere that a fluid score of 2 has a 85% rate of some asphyxia. How severe the oxygen deprivation was, and for how long, would be a variable I am not knowledgable enough to comment on. Mostly because I am not sure how long a baby can be oxygen deprived before it dies.

      I am sure I do not want to think about the oxygen deprivation, and how many days baby must have struggled before its heart gave a sign even the ignorant murderer could recognize as dangerous (but not too scary, as they drove 30 extra minutes, makes me wonder what that 30 minutes during the bradycardia added to this tragedy… Who does this???)

      I also do not want to think of the distress that caused the last mec. Or the baby slowly suffocating, while lying in, and breathing in ONLY its own waste (since no fluid, right?) HORRIBLE, I cannot even think about it, I cannot imagine living it. The CPM needs to think of this mode of death long and hard before she goes on to accept new patients, I mean, victims. It is like a nightmare.

    • Montserrat Blanco

      I live in Spain. Most of the deliveries are handled by midwifes properly trained (3+2 years degrees) in public hospitals with OBs on site in case anything goes wrong. Health care is public and deliveries are for free for every woman.

      I can tell you what happens here. At 40 w you get a non stress test and an US. If everything is OK they will probably repeat it at 40 w+ something and for sure at 41 w. At that point the OB will start talking about an induction even if everything is OK.

      From that point you get non stress tests and US every other day to make sure everything is fine.

      At 42 w you will be offered an induction again. If you refuse probably the head of the Department will discuss it with you. Obviously we will not strap you to the bed to perform an induction but you are thoroughly informed by OBs of all the possible risks.

      If the baby shows ANY sign of a problem at ANY point the OB will strongly recommend an induction or a C-section. Zero fluid woul probably be a CS at my hospital.

  • Amazed

    Based on the letter, I believe the “third party” was the parents who contacted Dr Amy themselves. I hope this fact alone points at them not accepting the blame their loving midwife is trying to shift on them.

    • anion

      I can’t believe she has the nerve to do that (well, to do any of this). As I said before, when I needed emergency surgery I asked the surgeons and ER doc if I couldn’t just take some time to think, or see if maybe it wasn’t as serious as that. Because they were not ignorant quacks, they absolutely refused to allow that. I would have died if they’d allowed it, see, and they knew that.

      I knew it, too, but when you’re a patient in that situation, feeling extremely vulnerable and scared, you say a lot of naive things you wouldn’t ordinarily. You go against what your common sense and intellect know is right because you want so badly to not be in the situation you’re in. When this mother expressed a desire for more time, she was secretly thinking somewhere that if you allowed her that time it meant things were really okay and everything would be fine. She was secretly wishing she didn’t have to make the decision and that you would make it for her. She wanted reassurance, and you gave it to her, and in doing so you let her baby die.

      (And the thing is? Once the surgeons said, “No way,” to my ridiculous request, I was okay. I had to face what had to be faced, so I steeled myself and let them prep me. I bet this mother would have done the same, but you didn’t give her a chance.)

      I notice also that once again there’s no mention of the fact that she allowed the mother to go so far postdates. That first BPP was done at over 42 goddamn weeks, which already should have been causing you major concern. You ignored that, let the baby die, destroyed the lives of those parents, and then went and posted some simpering bit of doggerel on your FB page about how babies aren’t library books. You did that immediately after you were shown graphic evidence of how untrue that is.

      • Jessica S.

        I know, the poem just puts it over the edge of comprehension for me.

      • Amazed

        I absolutely believe she pulled the letter out of her you know what. The mother didn’t hate her when she finally thought it MIGHT, just possibly might, be a good idea to head for the hospital. The mother didn’t hate her when she was told she needed a C-section.

        Nothing in this story points out at an irrational mother valuing experience over life.

      • Renee

        I agree. When the OB found my cervix funneling, and baby about to deliver at 19weeks (at a routine anatomy scan, BTW), he did not mince words as he showed me the US. I did not understand what I was looking at, and he did not sugar coat the explanation. All I heard was “you will go into preterm labor by weeks end, causing a stillbirth, without intervention.”

        He put me in a wheelchair and said to a staff person “take her across to the hospital NOW”. I asked if I could maybe get some stuff from home, or come back in the morning. I didn’t really understand the urgency, I was too overwhelmed, and thought I had a few days.

        He said NO WAY- GO NOW. It is critical. I was admitted 10 min later, and was back in surgery to get a cerclage in about 2 hours, tops. Surgery was successful, follow up care, was successful, baby is not almost 2.
        This doc saved my baby. I would not want one that said “ok, if you feel its OK, you can wait” knowing death is at the doorstep.

        • Amy M

          Yep. I went into pre-term labor at 30wk, with my twins. I didn’t fully get it either, because I didn’t feel any contractions or anything. I asked if I could go home and get some stuff. Doctor said “no, go right to the l&d, do not pass go.” He did agree that I could wait in his office for my husband (his office was literally a block down from l&D, so I was pretty much there), as long as I sat quietly. Looking back, I think I’m glad I a)wasn’t as aware of what could go wrong as I am now and b) trusted the OBs and listened to them anyway.

          • Jessica S.

            I apologize in advance of my comment, which is irreverent in light of such a serious situation, but this line made me giggle: “as long as I sat quietly”. It reminds me of when I say that to my 3 yr old: “Fine, but you must sit quietly or else.” I’m just picturing the same from your doctor.

            I’m very happy it turned out ok! :)

        • anion

          So glad your doc put your health and safety above whether or not you got a little upset at him (an “anger” or “hatred,” which, as I’m sure you and Amy M know, would almost certainly have disappeared as soon as your healthy baby was born and you saw he was right).

          I just don’t get thinking, “I don’t want her to hate me.” Who TF cares if she hates you, as long as she’s alive and has a healthy baby? Did Christy not think the mom might be a tad upset or angry if her baby died? Does Christy think the mom is glad now that Christy withheld the OB’s opinion from her?

      • Comrade X

        I forgot about some library books recently, kicked myself when I remembered, took them back to the library yesterday, and had to pay a fine.

        I was a little annoyed.

        But here’s the thing: NOBODY DIED.

        I inconvenienced myself, and possibly someone in South Tyneside who has a yearning to read some Scandinavian Noir murder fiction. That’s it.

        The comparison is beyond obscene.

        • anion

          …I kind of have a yearning to read some Scandanavian Noir murder fiction, actually. Title/Author please?

          • Gene

            Let the Right One In. I also just finished Harbour (written by same guy). Was good, though the last 25 pages was a bit muddled.

          • Comrade X

            So far I’ve sampled Jo Nesbø, Henning Mankell, and obviously the “Millennium Trilogy” by Stieg Larsson.

      • fiftyfifty1

        “she was secretly thinking somewhere that if you allowed her that time it meant things were really okay and everything would be fine. She was secretly wishing she didn’t have to make the decision and that you would make it for her.”

        This happens all the time in regular practice (e.g. chest pain, signs of sepsis, GI bleeds etc). Patients very frequently ask to go home and get their things first. When I was first in practice this used to confuse and annoy me “What! I’ve told them that this is life threatening. Why are they so fixated on getting their nightgown?!”. But then I realized their mental situation is just as you described it so well above. It’s denial. It’s magical thinking brought on by the stress. It’s “this can’t be happening, this can’t be this serious”.

        But all you have to do is say quietly and calmly “No, you need to go to the hospital now. I’ll call the ambulance.”

        • anion

          Thank you. :-)

          The thing is, if I’d had a friend in that situation, or heard about someone else doing the same thing (before it happened to me), I would have asked if they were crazy or suicidal, asking for more time. Of course you can’t have more time, are you kidding?

          But when it’s you…that fear and desperate need for things to be normal and okay is overwhelming.

          • fiftyfifty1

            And the thing with this particular situation is we only have the (lying, negligent!) midwife’s assertion to go on that the mom even did ask for more time. The more likely scenario is that the grave nature of the situation was never actually conveyed to mom. As so many have already pointed out, Christy’s question wasn’t “how do I get this mom to see the light and transfer” but rather a crowd sourcing for opinions about whether they thought the lack of fluid was really important or not.

            In other words I doubt this mom was even in denial- sounds more like she was just kept in the dark.

          • Box of Salt

            I wish I could remember where Dr Amy posted Chrisy Collins’ since-deleted facebook messages.

            I seem to recall her complaining that the doctors would wave the “dead baby flag.”

            The comment suggested the midwife was protecting the mother from that flag.

            I find myself at a loss for words because (if all this is true) I actually cannot imagine what could have been going through Christy Collins’ head at the time. I can’t.

          • anion

            I read that, too, and actually she pretty much says it in the letter quoted in this post: she warned the mother to “be prepared” that the perinatalogist doing the test would tell her the baby could die without an induction.

            When you warn someone to “be prepared” for X to say something, you’re essentially telling them, “X is going to try to scare you/deny what you want, so be strong and don’t let them.” She set that mother up ahead of time to be skeptical of any attempt to intervene. So yeah, I agree that the mother didn’t know the real danger; when she was told, “I think we need to induce to save your baby’s life,” what she heard–because she’d been specifically told to hear it–was, “I want to induce you because of my predictable neurotic desire to interfere with nature’s perfect plans, with a healthy dose of fearmongering, just like all of my surgery-loving moneygrubbing colleagues have and which your heroic midwife is here to protect you from.”

            I can’t get over the idea of warning someone in advance that an attempt to save their baby’s life is something they ought to steel themselves against. And then going on FB to ask other people to help you justify that warning.

    • Trixie

      No, it could be that the parents forwarded the email to a group of people.

  • LMS1953

    I think a just punishment for Christy would be to have her wear an ankle bracelet for the rest of her life such that her whereabouts will be known at all times so that she could never attend to a home birth again. Then she should be required to present this case before every state legislature in the country

    • Stacy21629

      Or if she’s in cell block 52A we’d also be pretty sure of her whereabouts at all times.

      • Renee

        She would also be locatable if she got a nice dirt nap….

    • http://safermidwiferyutah.wordpress.com/ Safer Midwifery Utah

      I think its crap that you can get disciplined as a midwife in one state and just move somewhere else and avoid paying your judgement. I wish there were a federal law prohibiting practice without resolving legal issues in any state in the union.

    • Zornorph

      I think that she should be smothered in shit.

  • Danielle

    This is so disturbing. Every bit of it.

    I’m confused by one detail in the story: if they were going into a hospital to have the BPPs done, isn’t someone besides the midwife looking at the results? Wouldn’t concerning indications bring a physician into the room to play the “dead baby card” or at least say, “this doesn’t look good, I want you to go to L&D?” Anyone know how this usually goes? The midwife’s letter suggests she was worried about a perintologist using scare tactics.

    Perhaps having a physician at hospital A and getting tests done at hospital B provided them with the “autonomy” to avoid being brought into L&D. Warn the mom not to believe the perintologist at Hospital B, but fail to call the midwife-friendly OB at Hospital A until the third test?

    I’m speculating of course. I’m just puzzled over how they avoided triggering”the hospital system” to respond.

    • Anj Fabian

      What’s really disturbing is that they seemed to have had a system for using hospital resources while evading oversight.

      It might have been via their collaborating OB or someone else who had privileges. I don’t pretend to understand the chain of command, but I would love it explained to me.

    • Karma Kidney Stone

      It’s just a guess, but I think a BPP has to be ordered by a physician. She may have been able to go in just for an ultrasound scan, and ask them to look at the fluid. I have serious doubts if the baby could physically practice breathing if there was zero fluid. There has to be fluid to expand the lungs. So that would be another mark off the BPP. and, a real NST is part of a BPP, and that is not done with a doppler. Saying the mom had several BPP’s is just another lie.

      Also, when I was having BPP’s for my very high risk pregnancies, I seem to remember they could only be done 2 times a week, and not every day. NST’s can be done more often, but a BPP is considered valid for several days. OB’s want to weigh in?

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

        I’d guess that they just did a US and called it a BPP.

        • The Bofa on the Sofa

          Hey, if using a Doppler constitutes an NST, then certainly an US can be called a BPP.

          • KarenJJ

            That’s what I was wondering. The midwive’s use of medical terminology is not to be trusted.

    • Becky05

      No one can force you into anything. The midwife, in her own words, had prepared the woman to believe that the doctor she would see for the BPP would try to scare her into intervention, so she’d be primed to resist it.

      • Comrade X

        So she brainwashed this lady into refusing professional offers to save her baby’s life? How is that not manslaughter or something, at the very least?

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

    I keep rereading because I am still reeling. Bad blood gasses in the last 20 minutes? Why did you drive 30 minutes to a different hospital, you murderous, selfish bitchwife? We’re you afraid the on call OB would hate you too?

    Feel any better now we ALL HATE YOU?

    • Amazed

      Oh Kum, we don’t count. We’re so… unnatural. No, scratch that. We’re anti-natural. Why should a Sister in Chains care about such a lowly hatred?

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

        True. They’re beautiful lionesses, warrior goddesses who are strong and in tune and natural! I’m a lemon. Imperfect, Faithless, Broken. I don’t even deserve to have children because I wish I’d had a damn C section before labor.

        Fuck them. They ain’t my sisters.

        • http://safermidwiferyutah.wordpress.com/ Safer Midwifery Utah

          Yep. They are the kind of “feminists” who will stab another woman in the back to get ahead.

        • Renee

          They are such warriors and strong women that they drive 30 minutes further, in life or death situations, to avoid a doc, or staff, that is “not nice and disrespects me and HB”

    • MLE

      That’s what I keep screaming in my head. He was alive. HE WAS ALIVE!!!!!! Yes his heart rate was in the 90s but HE. WAS. ALIVE. and YOUR first thought was, where is it safe for me to dump you??? How dare you write this shit to this family!

  • Captain Obvious

    NSTs done with a hand held doppler? BPP that are fine despite zero AFV? Not acting on a persistant 6/8 BPP, why do the testing if you are not going to act on it? (I speculate the BPP was worse than 6/8) Performing BPP at a different hospital than where your backup OB works? Leaving a hospital, I said leaving a hospital with a baby in distress to travel 30 minutes to a different hospital to perform an emergency CS? Sister in Chains indeed

    • LMS1953

      She didn’t want to encounter the OB on call at the first hospital who might have hollered at her and reported her. All the more despicable

    • Comrade X

      Someone should be in fucking chains, that’s for sure…

      • Amazed

        I’m willing to bet it’ll be the poor sod who agreed to provide backup. After all, Christy herself thinks he was the main provider and the law might just agree.

        But hey, evil OBs don’t waaaant to provide baaaaackup *howl*.
        Wonder why this is.

  • LMS1953

    Who is the Nevada state rep for whatever district covers Las Vegas. The details of this case needs to be forwarded to him/her ASAP

    • http://safermidwiferyutah.wordpress.com/ Safer Midwifery Utah

      I compiled a list of nevada state senators here. http://safermidwiferyutah.wordpress.com/2014/02/28/preventable-home-birth-death-not-in-utah-after-all/

      I included all districts because this could have happened in any district. Its horrible.

      • LMS1953

        Great job with your webpage!

        • http://safermidwiferyutah.wordpress.com/ Safer Midwifery Utah

          Thanks! I try pretty hard. Before the details came out it was a very real possibility that this happened in my state. I hope that if something bad happens here Nevada residents are willing to pitch in for us like I am for them. We’re all just people.

          • LMS1953

            Didn’t a vagabond CPM recently murder a baby in Utah with the illegal and inappropriate use of Cytotec she got from her pharmacist son? How did that pan out? She should be in jail and her son should have lost his license.

          • http://safermidwiferyutah.wordpress.com/ Safer Midwifery Utah

            She was given probation and an order not to attend any births in the state of utah. That’s it. I’m trying to pressure a legislator responsible for voluntary licensure to do something about it because she is running for election again. There is nothing to prevent the next tragedy. Unfortunately that baby died just before the legislative session in 2012 so it was not really possible to build adequate support for a mandatory licensing measure at the time. I’m trying now without a super recent tragedy, but I’m pretty sure it will take another death before anything happens.

            ETA: this is my original article about it http://safermidwiferyutah.wordpress.com/2014/02/23/holly-richardson-and-the-rogue-midwife/

    • anion

      And PLEASE, PLEASE contact the NV Attorney General’s office, and CALL 211. I have just visited their (her; the NV AG is a woman) and found this page, linked to right on the homepage (“Unlicensed Healthcare”):

      http://ag.nv.gov/Hot_Topics/Unlicensed_Health_Care/

      This is an issue they are aware of, concerned about, and working on. They have an Action Plan and other brochures and documents available for download.

      ****You can report this crime anonymously by calling 211****. The information is about 3/4 of the way down the page.

      Seriously, I cannot say this emphatically enough. REPORT THIS TO THE NV AG. DIAL 211.

      • Renee

        YOU MUST POST THIS IN THE FB GROUPS, ASAP!!!
        It really is vital enough for all caps.

        • anion

          The FB groups? Sorry, which ones?

          (Please repost it anywhere you think it ought to be!)

  • MLE

    You wish you had made her gate you by playing the dead baby card? YOU set the mother up to hate you when you made her afraid of interventions!!

    • http://safermidwiferyutah.wordpress.com/ Safer Midwifery Utah

      Her main concern is the mom ‘hating’ her instead of presenting accurate information. Her main concern is what to do ‘next time’ instead of stopping. She can’t just wash her hands of the results of her practices- she should not be allowed to practice in the first place if “gee I should alert the mom of imminent mortality” is a lesson she has to learn by screwing up first. Its disgusting!

    • prolifefeminist

      This is what happens when you value “the Birth Experience” over THE BABY.

  • AL

    I had a suspicion is was her based on your first contact with her. Wow. Awful. Disgusting. I’m glad someone contacted you to share the details.

  • peanutmama

    My gosh. How terrible. This should NEVER have happened! No wonder she didn’t want to say who the midwife was because it was HERSELF! It makes me so sick. Nothing, NOTHING is more important than a live baby who can be given a fighting chance. Screw the birth experience. Even if it means I have to walk over hot coals and broken glass to ensure my baby would be alive and well, I would do it. SO UNBELIEVABLE!

  • Mariana Baca

    Wow — what a load of victim blaming on Christy’s part. “I’m sorry I didn’t tell you your baby would have died, you would have HATED me for that…” I.e. the mother is too *emotional* to deserve correct and complete medical information. Also, being more concerned about the midwife’s *hurt feelings* than the danger the baby would be in??

    • KarenJJ

      They don’t respect women as being autonomous, intelligent beings. Like paternalism all over again but from midwives.

      • Mariana Baca

        I wouldn’t even call it paternalistic, but adolescent. Bullying, clique-ish behavior, narcissism, etc.

  • Bodnoirbabe

    I am heart sick and full of rage. The absolute gall of this woman and her cohorts is disgusting. I hope this death haunts her to the end of her days. I want her to suffer as much as that poor mother is suffering. The ain’t of anger I feel about this is incredible.

  • anne

    My most sincere condolences to this family. The image of the parents holding their dead son all night long won’t ever be erased from my mind. A loved and wanted baby boy is gone.

    They deserve answers and justice. After reading this blog for so long a case like this seemed inevitable but I’m still shocked.

  • Stacy21629

    Thank you Dr. A for all your hard work.
    This revelation is sooner than I anticipated. Here’s hoping that since this cluster ended up in a hospital where mom, dad, midwife and baby would have encountered SCORES of nurses, doctors, pediatricians, neonatalogists, etc that SOMEONE on the “inside” will file a formal complaint/investigation. That’s one “saving grace” think to the fact that this happened – this baby didn’t die in their living room. He died in a VERY public place surrounded by VERY educated people who will know that this should not have happened.

    • Playing Possum

      I second that, Dr A. Thankyou!

      Was the death referred to the coroner?

      • Stacy21629

        Since it happened in a hospital I would suspect that it is mandated to. Again, another “good” thing about this baby not dying unseen at home.

        • Playing Possum

          I really hope so. In some states a late request to the coroner for an inquest can be done even if it wasn’t done at the time of death. They’re often more rigorous at examining the big picture than the minutiae of the last few minutes of life.

          • Playing Possum

            Looking at the county ME office website – doesn’t look like it was a necessary referral. An interested party (like the family or the attending) would probably have to make a referral in order for an inquest to occur.

  • guest

    Collins monitored this baby to death. How can you criticise medical interventions’ on the one hand but attempt to use them for your own agenda’? This is sick.

    • Guesteleh

      “Monitored this baby to death” is a seriously poor choice of words.

      • Alissa

        Seems appropriate to me, considering the midwife sat and watched as the baby suffered and died needlessly. It’s a devastatingly accurate choice of words.

        Why have the tools and do the monitoring if you’re not willing to act on them?

      • Stacy21629

        But unfortunately fitting.

      • Guesteleh

        Apologies, I misread the post. You’re right, it’s fitting.

      • guest

        No problem, I think it is an excellent choice of words.

  • DaisyGrrl

    Thank you, Dr. Amy, for getting to the bottom of this. What a tragedy. A baby dies and the midwife spends her time covering up her involvement while the midwifery community circles the wagons and the parent blaming begins.

    I do not believe for one second that the parents had the information they needed to make an informed decision. The email from the midwife pretty much confirms that she not only withheld vital info (through ignorance or malice), but did her best to undermine any actual medical advice they might receive. This sickens me.

    I hope the parents have the support of their family and community at this time. I also hope that if nothing else, the first thing that comes up in a google search for Christy Collins is this mess so that anyone considering her services is appropriately warned.

  • Susan

    I am taken aback, like many of you, by her concern about the mother hating her. As if it’s about what your patient thinks about YOU. You tell them the truth and the whole truth. You do what Dr. Amy did, and I have done, and hand them a piece of paper that says “I have advised you that I feel you are risking your baby’s life if you make this decision” and ask them to sign it. You are clear that you are not just covering your butt, but you are very concerned. Real professionals are professional enough to KNOW that doing the right thing means sometimes, patients won’t like them.
    Truth is, to me, most sane people are so happy to have that healthy baby in their arms, and appreciate your care, that they don’t grieve their “experience”. I doubt very much this mom would have been different.

    • CognitiveDissonaceHurts

      And yet, even when given that paper to sign, we can be so steeped in our beliefs that we really believe that WE know better, and that you are just over-reacting. I know. I did it. And now I shudder at the risks I was taking on the life of my beautiful daughter. And how the health professionals in my family reeled as a a result of my actions. I was BLIND to my ignorance. Thank God for His mercy despite my stupidity.

    • Dr Kitty

      Having to arrange ambulances for people who don’t want to go to hospital…
      Telling people they might have cancer…
      Telling people to eat less, exercise more, stop smoking, use condoms, quit drinking…
      Telling people I will not support their prescription pill addiction…

      Much of what I do does not endear me to my patients.
      It still needs to be done though.
      I’m OK being the bad guy, because it is the right thing to do, and because IT ISN’T ABOUT ME.

      If CPMs don’t get that, there is no hope for them.

      • Playing Possum

        Yep. It’s heartbreaking being the worst person in someones life. But you do it because you know you can do it well, and with compassion, and to make that moment a little less terrible.

        I hate that idea that professional HCPs do things that make the patient feel bad because they like it, or because they want to, or because they’re callous golf-loving butchers. They do it because it has to be done, and they’ve (kind of nobly), accepted the role because they will do them with the least amount of harm. It’s part of the job, and frankly, refusing to be the bad guy because of hurt feelings is just pathetic. It’s really freaking hard being the bad guy. I’ve seen venerated and gnarly surgeons cry when a patient dies, entire ward staff have meetings to debrief about a beloved patient. It hurts. It really hurts. That’s what part of being an HCP is about. If your feelings are too hurt by telling a family their baby might die (coward!), then you need to find a new profession.

        • Susan

          I tried to vote this up twice….

          • Jessica S.

            I agree!

        • Dr Kitty

          As if you can care for someone for months and just walk away…

          Being professional doesn’t mean not caring. It means caring enough to do what has to be done, and not so much that you can’t do it.

          I have gone home and had lifted a glass and cried tears over very much cared for patients who have passed away. The idea that I don’t care is insulting.
          The trick is not to let feelings get in the way of doing what is best for your patient.

          I honestly don’t think CPMs understand this concept.

          At the end of the day it doesn’t matter whether I go home feeling good. It matters if me being there made the patients’ lives better or not.

      • PrimaryCareDoc

        Yup. This is why I always say that if all my patients like me, I’m not doing my job.

        There is plenty of research to show that higher “patient satisfaction” leads to worse outcomes.

        • Renee

          If I want a buddy, I will go see my BFFs.
          If I want medical advice, I go see a doc.

          While I will not tolerate inappropriate, unprofessional behavior, we do not have to be BFFs. I really want someone that knows their stuff, and is not afraid to tell it like it is.
          I am a grown ass woman, I can take it. I cannot take a preventable death because you were too much of a buddy to spell dangers out.
          Getting a smart doc that also cares about their patient, and has good bedside manners- great!!! But skill is most important to me. If you miss something that kills or harms me or my kids, our friendship will mean nothing.

    • Michelle

      I lost my toddler son in a car accident three years ago. I have a searing memory of the trauma surgeon in the ER telling us that there is a good chance he wouldn’t make it. It’s true that I hated him in that moment for the seemingly cold way he delivered the news to us. In retrospect, he had a job to do. It wasn’t the time to let emotions interfere. He came up to the PICU the next day after people had done all they could do and cried real tears with me and my family. It’s possible to do the right thing, say the hard words, and feel the real feelings. It’s what professionals do.

      • Jessica S.

        I’m so sorry, Michelle. I can’t imagine experiencing that kind of loss.

      • Susan

        I am so sorry too Michelle.

      • Playing Possum

        Michelle, that is so freaking awful. I’m so sorry.

      • Comrade X

        So sorry, Michelle. May he rest in peace, and may you and your family know joy.

      • Meredith

        I’m so sorry for you, Michelle. Thanks for having the bravery to speak out against unprofessional healthcare providers.

      • Thankfulmom

        Michelle, I am so sorry for your loss. I too lost a 14 month old son. Our doctor wrapped an arm around me and we cried together over my son. I’m thankful for the professionals that can show their sadness for us.

        • Meredith

          I’m sorry for your loss, Thankfulmom.

          • FormerPhysicist

            As am I.

        • Jessica S.

          My thoughts go out to you, too, Thankfulmom. I’m glad moms share there losses here, I want to know about the little lives that were so important, and too short lived. They are worth every mention, every time.

        • anion

          Thankfulmom, I’m so sorry for your loss.

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

        Sorry for your loss.

      • Dr Kitty

        I’m so sorry for your loss.
        You are absolutely right about how real medical professionals deal with heartbreaking situations.

      • moto_librarian

        Michelle, I am so very sorry.

      • Jessica S.

        Your story reminds me of when my brother and his wife lost their first baby just one week before she was due. It was a cord accident, and nothing could’ve prevented it. She was receiving regular monitoring and they were at a regular appt when they discovered there was no heartbeat. The point being, some 15+ years later, I still remember my brother telling me that the doctor wept along with them and spent as much time with them as they needed to process it. It’s touching to know how much HCP care for their patients.

      • anion

        Michelle, I am so very sorry for your loss.

      • Amazed

        I am so sorry for your loss.

      • http://momofmanyfeet.wordpress.com Bambi

        I am so sorry

    • FormerPhysicist

      I’m so sorry for your loss.

  • Trulyunbelievable2020

    Trigger warning: this may make you vomit. Here is what was posted on February 24 on the Home Sweet Birth (Collins’ business) Facebook page:

    Pregnant Pause

    My baby’s not a library book,
    So he’s not overdue.
    My baby won’t take to long to cook,
    ‘Cause he’s not veggie stew.

    My baby’s not an elephant.
    And I am not fit to burst.
    The time and date aren’t relevant
    We’re blessed with days, not cursed.

    My baby can’t read dates yet
    Because he’s very new
    There’s no cause to fuss and fret
    If he doesn’t come on cue.

    So stop your worry.
    Stop your asking.
    There’s no hurry.
    We’re just relaxing.
    In this golden pregnant time.
    This pause… just his and mine.
    Now, you leave us be…
    We are just fine.

    • Dr Kitty

      That just…
      Yes, vomiting is the correct response.

      • Trixie

        Vomiting and the urge to punch

    • LMS1953

      With google maps it will be a relatively easy to find the hospitals as it was the CPMs office. Hospitals have webpages and find-a-doctor search engines. OBs who are crunchy enough to back-up CPMs will have a webpage to brag about their enlightenment. He needs to be outed and his negligence brought to light. Granted, witch hunts are inappropriate in a civilized society and I do not intend to name names. But I expect the jurisprudence system to get in gear and bring justice both civil and criminal to all involved.

      • Renee

        NAME AND SHAME. It is the only way woman will be warned. Cannot expect anyone else to warn them, sadly.

    • LMS1953

      For a brief time I was in a group practice of which CNMs were an integral part. I was absolutely crucified for using a Friedman curve for managing my patients or when I was consulted on their “clients”. “Doctor, this is NOT a train station”. When it was apparent I was not “collaborating” well with them, I was handed Ina Mae’s book. They revered her as a patron saint. Their eyes got glassy as they contemplated the idea that they too could have a maneuver or procedure named after them.

    • anion

      That’s just…oh my god.

      I can’t fathom her thought process there. Either she posted that deliberately in an attempt to convince herself and others that she did nothing wrong, or she did it because she truly believes she did nothing wrong, or the death was so unimportant to her that the connection there didn’t even occur to her.

      I can’t decide which is worse.

      • The Bofa on the Sofa

        I assume she was doing it as a defense mechanism, to convince herself that what she did was acceptable.

        She posts this crap, everyone says you go girl!, and she can say, I was just working the party line, don’t blame me! We all agree that babies don’t have due dates!

    • Chi-Town_MotorCity

      I want this to be read aloud by the prosecution at her trial.

    • antigone23

      Obviously this baby was NOT FINE at all, but you know, much easier to ignore the ample evidence that the risks of continuing a pregnancy past 41 weeks outweigh any possible benefit.

    • Ash
    • Certified Hamster Midwife

      I so badly want for her to be NOT the midwife, because the poor taste of posting this poem so soon after the baby’s death makes me physically ill.

    • Renee

      This is AFTER SHE KILLED A POST DATES BABY???
      She is a sick, sick woman.

  • Meredith

    All today I’ve kept looking at my daughter — pretending so earnestly to write, choosing which clothes to wear after her bath, climbing onto my lap with a big smile on her face — and thinking: “These midwives don’t care about her. They don’t care if babies live or die, they don’t care if mothers and fathers never get to enjoy their toddler the way I do now.” It tears me up inside.

    • NoLongerCrunching
      • Meredith

        Ugh, good point!

    • Ducky

      I think many midwives do care, and quite a lot. Though not sure in this case how someone could even use the phrase “dead baby” in processing her guilt, but people can go to some pretty horrible places when they do something horrible.

      I think the sense of identity some women get from being a midwife blinds them to their own incompetence, which can make them think they really did what was right by the baby and that it is just a matter of “these things happen”.

      The same thing happened with the management at BP before the huge oil spill. They had greenwashed their brand so thoroughly they themselves were blind to how reckless their behavior was. Groupthink can be pretty toxic.

      • Meredith

        No, I don’t suppose many midwives actively dislike babies (although see NoLongerCrunching below), but to me, caring involves getting an education, understanding the consequences of your actions, and in short, taking some damn responsibility. The feelings mean nothing if you don’t back them up with actions. You’re right — groupthink is toxic.

      • SarahSD

        I agree with you. I think there is brainwashing/groupthink going on. But I’m having a hard time caring about the midwives’ feelings or perspectives right now.

      • LMS1953

        Midwives of all stripes in all nations care more about the Woo than the outcome. It is a rare study that does not show at least a two-fold increase in newborn mortality in a cohort of low risk women in a birthing center delivered by CNMs as compared to a cohort of ALL deliveries in a hospital setting. I guess that is acceptable collateral damage to advance their agenda.

  • rh1985

    This poor baby boy shared a birthday with my newborn who is here and healthy thanks to a timely c-section. I am crying for these parents right now. :-(

    • moto_librarian

      The waste of it is simply heartbreaking.

    • anion

      Oh, man. :-( (Hey, I just realized that’s my ex-boyfriend’s b-day, too; my first real love.)

      When I was pregnant with my second, an online friend of mine’s young stepmother also became pregnant. Our due dates were within a week and a half of each other, and we were both carrying girls.

      Unfortunately, her half-sister came about two months early, and she had a rare genetic disorder (epidermolysis bullosa, the “paper skin” disease). She only lived a couple of weeks. I still think about that baby (whose name I’ll never forget) every single year on her birthday.

      I try to make a donation to DEBRA in her name, too, but I don’t always manage it. It made me feel better then, though, and it still does; if you’re up to it and in a position to do so, it might help you, too.

      • rh1985

        I used to follow a blog for a baby with that condition. He survived for a while but died around two or three years old. Very sad condition, hopefully some day there will be a cure.

  • Susan

    “and read to you what even other midwives had to say”
    is she saying she read the facebook bozo comments to the mother?

    • Comrade X

      Please G-d let that not be the case.

      • attitude devant

        Of COURSE she is

    • Dr Kitty

      What, the motherfucking Stevia comment?

      *sorry, I’m very, very upset about that “your choices killed your baby” letter. Swearing seems appropriate.

    • DaisyGrrl

      I hope every idiot that posted in that thread learns that their comments directly contributed to that baby’s death.

    • SarahSD

      It sounds like she hoped some of these comments might have changed the mother’s mind. Or at least that is what she is now claiming, in the letter. Everything about this situation is so disgusting and sad.

  • Medicine intern

    Homebirth midwife learns why real health care practitioners choose to give proper care instead of telling patients what they want to hear. Funny how the idea finally makes sense to her. Seems pretty obvious to most people.

    • aster

      Nope– she will not learn the lessons real practitioners learn until she has to settle a malpractice ruling for millions of dollars like they do.

  • NoLongerCrunching

    >”In the future, I’ll pressure until my client hates me. I won’t care.”

    Since when is the client’s feelings toward the practitioner relevant to what to advise the patient? Shouldn’t the FACTS, and not whether the client is going to like you or hate you, be what informs your advice?

    • Florence

      maybe that’s why OBs have such a bad rap…they say it like it is!

      • LMS1953

        Playing the Ace of Spades in the Game of Woo is seldom popular.

    • SarahSD

      Not in NCB fantasy-land where feelings are all-powerful and determine the outcome of birth. Oh wait, that’s just the line they sell pregnant women – the service of “holding the space” (ie ignoring risks because usually things go ok). Too bad it’s a big lie.

      • CognitiveDissonaceHurts

        That’s right, we can’t even talk about contractions or breaking of the waters because that’s too negative. It has to be surges and releasing the membranes, as if that has anything to do anything.

        But if you had ever been in a group of NCBers, you would understand the pressure to never say anything negative about the whole process. It’s INTENSE! And it feels like an attack on the ‘sisterhood’.It is the culture than has developed in the NCB movement. But it is no excuse for what happened.

        • SarahSD

          I have been in these groups, and I understand the pressure firsthand. Of course it’s no excuse for what happened! On the contrary, it’s implicated in what happened because this culture thrives on misinformation and relies on the denial of informed consent. This “midwife” basically admits it.

    • Amazed

      Oh my, I truly, truly hope that for her, from now on, “future” and “clients” won’t belong in the same sentence.

    • Elizabeth A

      That pressure even if they hate you is a decision most docs get to in med school.

    • Medwife

      She wants to be BFF with her “clients”. It’s an unprofessional relationship. No shock since she is not a professional.

  • lola

    It said a doctor did the BPPs…. I’m a little confused here. Wouldn’t they have some obligation? I’m unsure of the chain of command.

    • Ducky

      Yeah this is kind of strange. I don’t get it. I also don’t understand why the BPP was done at a clinic attached to a hospital that the back-up OB does not work at.

      This highlights for me that we really need one integrated medical system with CNMs and OBs… not CPMs patching together services from different providers in order to retain autonomy.

      • Thankfulmom

        I would imagine the doctor couldn’t force the woman to go to L&D. He probably tried since the midwife then went to fb to get other opinions. I’m wondering how someone who isn’t a patient gets in for a bpp?

    • Playing Possum

      Maybe the ultrasound tech was reporting to the backup OB but the midwife pre-empted the report and called in a “fine” BPP? Maybe the midwife did her own assessment based on her real time observation of the scan? I don’t for a second think that any of the NSTs were “good” or “fine” – if they were correctly done, then they were probably misinterpreted with regards to ominous patterns.

      • Renee

        There were no NSTs.You cannot do an NST w a doppler. Period. A doppler is useful for very basic, limited stuff, like seeing that there is a heart beat, and if its not low. BUt anything more is just not happening.

        • me

          And if there was no NST, there was no BPP. The NST is a critical part of the BPP. So the baby failed at least two categories of the supposed BPP – no fluid (huge red flag) and with no NST, we can count that in the fail category as well. The max score he could have gotten is a 6 (and he may not even have gotten that high a score). A score of 6-8 means you need to be retested in 12-24 hours. Scores of 4-6 are poor and you should be held for further monitoring and/or delivery. This poor baby scored 6 (maybe lower) twice . He was definately NOT fine.

    • guest

      If only there was a chain of command. Everyone is too concerned with being nice.

  • Trulyunbelievable2020

    Am I just missing it, or was the (already heavily censored) thread on the Midwifery Today Facebook page just deleted?

    • moto_librarian

      Yes, it was. I am also banned from commenting (I have been flagged as “abusive or spammy”).

      • Trulyunbelievable2020

        So have I… so have I.

        • Amazed

          Gone for me, too. Pity I still don’t know how to take screencaps with Google Chrome.

          However, I have no doubt that someone else took those.

          Poor baby, poor family. And after the “midwife”s words, no doubt many NCBers will say “poor midwife!”

          Well, I won’t. I won’t.

          • KarenJJ

            They’re getting quicker at this. I just started reading at breakfast and it’s gone already.

    • PrimaryCareDoc

      Yup. It’s gone.

    • Meredith

      I didn’t think it was possible for my opinion for Midwifery Today to sink any lower, but here we are.

  • Meredith

    Can you imagine receiving this letter after your baby just died? “Soaking in mec for weeks,” “I could’ve waved the dead baby flag,” “you and the daddy slept with your dead baby all night in a hospital bed.”

    This email is nauseatingly callous, inappropriate, unprofessional, tone-deaf — you name it. What comfort are those poor parents supposed to receive from it?

    • moto_librarian

      None. They are supposed to accept full responsibility for the death of their child. The midwife is never accountable.

    • Florence

      Pretty much it is blaming the parents…in a super passive agressive way! you wanted him to die…I should have used stronger words…. kind of …too little too late!

      • Amazed

        But she gently encouraged them! They were too dumb to listen *imagine me puking here*.

    • PrimaryCareDoc

      I’m still not clear on who she sent that letter to. Did it go to the parents?

      • Meredith

        I’m guessing the parents, from how it’s phrased, and that Dr. Amy is tactfully (imagine that!) trying to avoid dragging them into this as much as possible.

        • CognitiveDissonaceHurts

          Dr. Amy, if you have been in contact with the parents, please do all you can to help them sort through this tragic mess.

        • Dr Kitty

          That was my thought.
          That the third party confirming the details was the parents, who don’t want to be involved in this crazy mess (and who can blame them).

          My heart goes out to the parents on the loss of their little boy.
          They were lied to so badly, and their MW has sent them that abomination of a letter instead of begging for their forgiveness.

          I am not going to pretend our system here in the UK is perfect, but that…would not have happened, and if it somehow had, it would be investigated and steps would be taken to prevent it happening again.

    • Geo Rivera

      Agree. Better to remain silent. But I guess she had conscience issue and guilt. I -as a mother of two – would most likely require psychological help

  • Anon1

    As a nurse, and a professional, if I had poorly presented signs and symptoms of impending doom to the attending physician, with the result being death of my patient, I could be fired, sued, or have my license revoked. To be a professional means accepting the consequences of poor clinical care.

    And I am a little confused how a BPP could be done and not have a final read by a perinatologist, as that is how we do things here. My own child had a crappy BPP that resulted in immediate induction, and who gave me that assessment in person- the perinatologist to whom the ultrasound tech reports any poor findings.

  • GiddyUpGo123

    She says she blames herself but that whole passage just makes it sound like she’s blaming the mom. “Oh if I’d told you the truth you would have hated me [so it's your fault I didn't tell you the truth]” “You still wanted more time [so it's your fault that your baby ran out of time].” It’s just one big excuse/blamefest disguised as regret, but the only real regret there is is that she’s now being blamed for killing a baby.

    • Florence

      Exactly! she blames the mom for making the decisions that cost her baby’s life….disgusting!

  • Susan

    Did anyone catch this…
    “Nobody is saying anyone is perfect, but we ask only that sanctions faced by out of hospital supporters and parents be equal to those faced in hospital…”
    Uh huh, yeah, we want that too.

    • YogaMathMelon

      Hey, the two sides of the HB debate are in agreement. It should be easy to flesh out the details from here, right?

    • Playing Possum

      Oooh. Yes. Incredibly detailed and unmerciful examination of the event. Then loss of privileges, insurance, license. Exile from your professional cohort. Loss of your earning capacity. Media reports of your incompetence. Civil actions.

      Because having a death on one’s conscience isn’t apparently enough punishment for these people.

      But in an evil, perverse way, that will elevate her status in that nasty little group of “professionals”. Evisceration by a coroner and the Australian media only made Lisa Barrett even more popular and brave.

  • Rochester mama

    Why is an ultrasound office attached to a hospital doing tests on a midwife pt whose backup OB works at a different hospital? Why didn’t anyone there raise a concern after the first one?

  • Florence

    WOW!

  • Geo Rivera

    What a tragedy. Poor parents..poor baby.. I cannot stop sobbing over my phone… And this letter..the dead baby card…CARD…CARD. When the facts.. As hard as horrible as they are should have be presented to the parents. I guess the midwife was “hoping” this to be another “variation of normal”. ..as is probably her midwifery book did not had a course of action. I feel as well for the midwife in question..that woman possibly does not have remorse..because what other histories within the home birth community we do not know about that are filed in the “baby was not meant to live” folder…so for this woman although sad fact..should be normal.

    • Geo Rivera

      But reflecting a little bit..and me being very close to the midwifery community (which by the way I only have one friend left) I can assure you..this midwife was more trained than some I have known… She knew what was happening and remained silence..Most of midviwes they do not know when baby is in distress and when baby is born death they said..he died of natural causes. And they are so calm when they recall it..it is almost sickening. At least this woman candidly posted the question through favebook..most would not even done so..to be afraid of other midwives scrutiny and ridicule.

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

        We need some kind of “Blacklisted By Woo” T-shirts.

  • YogaMathMelon

    “Instead of … telling you to “be prepared that the perinatologist doing the NST is likely to tell you that your baby could die if he doesn’t come out..”

    Yes, be prepared to be told that your baby could die if not born now, but trust in me! Trust birth!

    He just had no chance.

    • Susan

      yeah that, admitting that she coached the mom to ignore the perinatologist.
      unfingbelievable.

      • guest

        Nope, not unbelievable at all. Happens all the time.

    • DaisyGrrl

      That part jumped out at me too. This midwife did everything she possibly could to keep the mother out of the hospital and away from interventions. This poor mother never had the chance to make an informed decision. Not only did the midwife not have the proper information – the midwife was running interference between the mother and the information she needed in order to make said decision.

  • Theodora

    I’m confused. Do ultrasound offices allow CPMs to use their equipment and perform their own tests? Don’t they have trained people employed for this reason?

    • Bomb

      I wouldn’t be surprised if she did her ‘Doppler nst’ in a damn minivan in the parking lot.

  • Sandy

    Would the baby most likely have survived if he had been sectioned the day before? If he had been ingesting meconium for a while, I can’t imagine a good outcome. Granted, letting the pregnancy go to 42 weeks was definitely questionable.

    • The Bofa on the Sofa

      Why are the midwives bringing up meconium? I though meconium was no big deal?

      • slandy09

        Meconium passage is a sign of fetal distress.

        • Jocelyn

          :) Bofa’s being sarcastic.

          • slandy09

            My mistake :)

          • Anj Fabian

            We’ll be seeing a lot of new faces here now. Probably best to avoid the sarcasm during this tense time.

          • anon13

            and refering to a recent blog somewhere in NCB land discussing why mec “isn’t” that bad…A letter to the baby asking it not to poop cuz that means evil intervention, or something. I only read the title…

          • The Bofa on the Sofa

            I modified my comment to clarify

        • Medwife

          Or just being post dates. However the mec got there, the baby sucking it in is possible/likely.

    • guest

      Yes.

  • Bomb

    I want to know who Dr X is so that I can be damned sure to fire him if he’s my OB. All of this information should be turned over to news outlets, as a matter of public protection.

    There is a certain OB that delivers at Centennial that I looked into at one point that I would almost bet money on as being the supposed backup, but I can’t say for sure.

    • Playing Possum

      I was thinking that he/she’s probably managed to skate past tragedy so far due to the brainwashed clients happily trading off their infants’ neurons for bad care and the midwife massaging events to fit their narrative.

      I doubt they’ll be a back-up ob for much longer after this.

    • R T

      Like I said, you have no idea what Dr. X’s role was in this other than trying to save the baby. If she’s in a state that does not require transfer of care at 42 weeks, there’s no way there is a back-up OB requirement. It’s probably a doctor who will take transfers without berating the midwives or parents, but it does not mean they are overseeing these midwives.

      • anion

        Especially since Christy says outright that she went to those “professionals” on Facebook because the OB was trying to “wave the dead baby flag.”

        It sounds like he tried to warn Christy, but she didn’t tell the mother. The mother wasn’t his patient; what could he do? (Except work his butt off to deliver the baby quickly and all that, and then have Christy try to shove the blame off on him like he was the dunce tearing open packets of stevia while heroic Christy realized there was a problem with the baby’s heart rate.)

      • Bomb

        Of course I don’t know what their involvement really was, but if they consult with, take transfers, or otherwise cater to these wannabe midwives that is reason enough for me to fire them. Based on the account above it sounds like the midwife LEFT a hospital to drive 30 minutes to a hospital with her supportive DrX. That is a major judgement mistake on her part, partly enabled by someone that made her feel ‘safer’ elsewhere. So yeah, they’d no longer be taking my money. I stick to OBs that strictly advise against home birth in a totally unregulated state.

  • attitude devant

    There is no such thing as an NST with a handheld Doppler. She can’t even get THAT right

    • CognitiveDissonaceHurts

      This. I just can’t get over that detail. I admit to having been crunchy for 30 years but when I read about the negligence in the cases where moms and babies are dying, EVEN I KNOW that this is way, way off base! You don’t let moms labour for days on end. You don’t let them push for hours. And you sure as heck don’t try to pretend that you are performing a NST on their babies with a doppler.

  • theadequatemother

    Those details make the story worse and worse.

    How can you do an NST with a handheld doppler? You can’t make any comments on variability without an EFM printout, right? So that’s one part of the NST that would be missing. If I did prolonged handheld doppler listening I don’t think I’d be able to comment on anything other than the baseline. If the doppler had an electronic HR read out maybe I would be able to count accelerations.

    When I trained a BPP included an NST. So did this patient get a BPP? Or did she just get a third trimester US?

    The midwife was clearly ignorant. Does she even know what a BPP IS?

    With a score of 8/10 on the BPP, which would have been the case with “no fluid” and evrything else normal, the correct action is induction. Not “time to think.” Recommend the f’ing induction. Strongly.

    • The Computer Ate My Nym

      Especially at 42 weeks. What good thing could possibly happen to the pregnancy at that point? It’s past time: get the baby out.

      • theadequatemother

        Hey the midwife SHOULD have recommended induction at no later than 41 weeks in a healthy pregnancy (not that this particular midwife can identify a healthy fetus). That would have reduced the risk of a cs in a client who wanted to do everything possible to max the chance of vaginal. Of course hey would have had togive up on the idea of a homebirth.

        • anon13

          There should be a future post on the studies that show induction at 40/41 weeks REDUCES the risk of a c-section. If you wait until too late, you are guaranteed one; a healthy baby not guaranteed.

        • sarahh.rosanne@gmail.com

          My last baby was 41w4d when my water broke- I was certain of the conception date. I was very concerned at 41 weeks but it seems a lot of CNMs, physicians and hospitals have shifted to increased monitoring at 40 weeks. I was told induction was not recommended until 42 unless there was another indication. I was in labor for 31 hours after my water broke. Again I was concerned but told that policies had changed and if the labor was progressing they wanted to monitor the baby and postpone augmentation, avoid c-section. I felt like I was being put in a position of having to ask for something against their advice.
          My son was very healthy but there seemed to be a disagreement between L&D and pediatrics about allowing the labor to continue so long (this was after his birth). His pediatrician refused to discharge him when my midwife released me and I sensed animosity. Why are hospitals adopting these “wait and see” policies if they aren’t safer, or at least as safe as recommending induction?

          • antigone23

            I think the viewpoint that we have “too many inductions” and “too many c-sections” is absolutely becoming mainstream. It’s harped on by the media all the time. So I imagine they are feeling increased pressure to lower their rates.

    • Susan

      Yes, it’s really getting worse and worse. The most important parts of the BPP are the AFI and the NST. Frankly, she didn’t have an NST because it can’t be done with a Doppler and the AFI is indication enough that the fetus need to be a newborn. What good thing is going to happen with an AFI like that post dates? Fools. ( and the doctors are going to get blamed… no doctor with an ounce of desire to protect themselves would “back up” a CPM )

    • LMS1953

      I was just about to post exactly the same question about using a hand held Doppler to do a NST. A normal NST has the following criteria: 1) at least two fetal accelerations associated with perceived fetal movement in 20 minutes. If absent, you should give mom some juice and perform acoustic stimulation for another 20 minutes since babies go through 20 minute sleep cycles. 2) the baseline fetal heart rate should be between 120 and 160 although it could be as low as 110 if other factors are reassuring 3) there needs to be good baseline beat to beat variability. The accelerations need to be at least 15 bpm for 15 seconds. It is impossible to document such accelerations with a handheld Doppler, nor their association with fetal movement nor beat to beat variability. At best you can document a baseline. Studies have shown that a NST coupled with a normal AFI (>/= 5 or a single vertical pocket >/= 4) is as predictive of fetal well being as a complete 5 part BPP. Hence the AFI part is quite critical.

      In this context, loss of beat-to-beat variability would be extremely ominous. The hypothesis is that the baby was so compromised and so hypoxic and so acidotic that it would not have survived an induction a day or two earlier. That is not the point. A proper NST done a day or two earlier would have shown a flat baseline without variability which would have at least prompted a CST (contraction stress test) if not an emergency C/S. The baby probably would have survived a prompt delivery at that time. By 24 to 48 hours later, the organ damage became irreversible and the agonal event was well documented. Fortunately for the parents, since there was a sympathetic (to CPM back-up) doctor/OB involved they will be able to file a malpractice suit against the MD(s) which they will undoubtedly win. No amount of money will bring their son back or assuage their grief. But it will bring this deplorable care to light with all names brought out of the shadows so appropriate sentinel event policy and procedures can be installed so a tragedy like this will never happen at these hospitals in Las Vegas again. Hopefully it will springboard to the state legislature of Nevada for appropriate laws to be passed. Cross fingers, perhaps this case could lead to nation-wide reform as cases that set precedent tend to do. If all that happens, then Baby Boy’s death would not have been in vain and he will have saved more lives than if he had grown up to be a doctor. Perhaps his agrieved parents can take some solace in that. May the grace of God be with them.

    • Playing Possum

      Me too! I was about to say the same thing! Like the whole “heart rate was fine until sustained bradycardia and dead baby” trope. There is this pathetic version of medicine composed of techniques and ideas they cherrypick without realising that they exist in a very very broad and complicated system. It’s so … naive. It’s not even better than nothing! It’s worse than “listening to your gut” or “holding the space”.

  • Vanessa

    These women should be in prison. Why have they not been charged with gross negligence and accessory after the fact??

  • NoLongerCrunching

    Why not share the name of Dr X? Does he bear any responsibility here?

    • Karen in SC

      Why, he told them to come in. He was told the BPP was normal. It’s not clear what other information he had (i.e. 42 weeks, no fluid)

      • theadequatemother

        If I was an OB and I was contacted by a midwife about one of her clients, my answer would always be, “Come in, NOW.”

      • Bomb

        The fact DrX is backing up this homebirth midwife at all is reason enough for me to fire him/her. It shows a gross lapse in judgement.

        • R T

          You don’t know that the doctor is “backing up” the midwife. Just because this doctor is the one this midwife decided to confide in, does not mean their was any formal or even informal agreement between them. There are several OBs and Perinatalogist in my area who the midwives will recommend if you need to be transferred, but they don’t “back up” any midwives. They’re willing to try to fix the mess the midwives leave behind, but they aren’t supportive of what they’re doing, if that makes sense. My Perinatologist is extremely opposed to homebirth, but he’s the one all the midwives recommend.

      • Guesteleh

        I want to know who did the BPP and why that physician didn’t counsel the mother that she needed to be seen by an OB immediately.

  • alannah

    Dr Amy, I really hope that you have thoroughly verified this. If it turns out that someone fed you this story on purpose to discredit you they will be very successful. It would be a great loss if this blog lost its credibility. If you are right: great job. I really hope you are.

    • Amy Tuteur, MD

      That’s why I gave Collins and opportunity to hear what I had learned and to correct anything she thought needed to be corrected. She deleted my offer and did not contact me.

  • Amy Tuteur, MD

    Please don’t go to Collins’ Facebook page and leave comments. Let us decide together the most effective way to hold Collins and Tritten accountable.

  • PrimaryCareDoc

    Is that an email she sent to the parents? Who was that written to?

    • Trixie

      I suspect Dr. Amy can’t share that detail without revealing things about her source that she has been asked not to reveal.

  • onandoff

    I love how she pretends like she’s taking responsibility for the baby’s death, but totally white-washes her incompetence while still totally placing the blame on the mom. *gag*

    • Jenny R.

      Yeah… her whole spiel was just beyond sadistic. ugh.

  • NoLongerCrunching

    Am I wrong, or did she originally deny being the MW when asked directly?

    • Trixie

      She denied it.

      • Guest

        I’d love to see what would happen to an OB who killed a baby, denied he was the patient’s OB and then blamed the mother for the baby’s death. No actually I would not love to see that. Enough dead babies.

        • Dr Kitty

          Actually, Dr-patient confidentiality would mean that unless the patient gave the OK the dr couldn’t admit they were the treating physician.

          Truly.
          If some asks me if X is my patient, unless X tells me I can share the information I have to deny it.

          There are a few exceptions for law enforcement and if the public is endangered, but a FB inquiry won’t do it.

      • NoLongerCrunching

        Far be it from me to give Dr Amy advice, but I’d like it made clearer in this post that Christie was DIRECTLY ASKED if she was the MW, and she NO, a bald-faced lie.

  • Guest

    “No woman would refuse an induction if she knew what having a dead baby felt like. In the future, I’ll pressure until my client hates me. I won’t care.”

    Maybe all those evil OBs aren’t late for golf so much as they really care that babies don’t die.

  • Trixie

    This is her business Facebook page. Just FYI https://www.facebook.com/HomeSweetBirth

  • anh

    I know swearing isn’t generally tolerated here but who the fucking fuck does an NST with a fucking Doppler?!?!?!? Your perfect midwife ears can hear and compute the variations of the heartbeat?!?!?
    Asshole! If you push your client to save her baby she is not going to hate you!!!!

    Little one, I’m so sorry this happened. I am so sad for you. You deserved better

    • Elle

      Unfortunately, so much of the midwifery clientele is built of women who were quite possibly pushed to save their babies (via inductions, C-sections, etc.) but have been convinced by NCB zealots that those things were unnecessary. That’s why it must be so contrary to be a midwife and suddenly have to eat all those words and tell a client that actually, those doctors are more often than not RIGHT.

  • no longer drinking the koolaid

    Is the midwife one of carla hartley’s trust birth buddies?

  • Trulyunbelievable2020

    Someone mentioned that she’s adopted a poem about post dates babies on Facebook. Does anyone know if this is correct?

    • Trixie

      Yep, she did.
      She’s since locked down her FB page.

      ETA: No, I was wrong. It’s still up on her business page, Home Sweet Birth, from 2/24

      • auntbea

        That pretty much destroys any claim she has about learning from this or pushing future clients to induction until “they hate her” now don’t it.

        • Jocelyn

          Can/did someone get a screenshot of it?

    • Anj Fabian

      Take one of those sappy poems and every other line, put a choice quote in parentheses.

  • NoLongerCrunching

    Rest in peace, little one. I’m sorry for what happened to you and to your poor mommy and daddy.

  • Karen in SC

    I keep thinking what about the DUE DATE? Why did it come and go without checking? Can you really “pass” a BPP with ZERO fluid?

    • Kristie McNealy

      No, because you’d fail on the amniotic fluid volume. You also can’t really even say you’ve completed a BPP without a real NST.
      http://www.perinatology.com/Reference/glossary/B/Biophysical%20profile.htm

      • Kristie McNealy

        Actually, I guess it’s technically possible, because if everything else was PERFECT!! you’d score an 8, but without an actual NST . . .

    • The Computer Ate My Nym

      From what I’ve read (and I’m not an OB), an 8/10 BPP where the two points lost are for fluid volume is considered an indication for induction. The text gives some wiggle room for very close monitoring, but really in a 42 week old fetus? What’s the point of further monitoring?

  • Jocelyn

    This is sickening.

  • Medwife

    Fuck. Fuck fuck fuck. How completely disgusting.

  • Trixie

    Heartbreaking and truly unbelievable.
    I can’t believe she still thinks there should be a “next client.”

    • Medwife

      The only way this could be worth reading is if it ended “I will no longer be involved in the care of pregnant women.”

      • Trixie

        “And I will spend the rest of my days tirelessly campaigning for the abolishment of CPM midwifery in memory of your son who did not have to die. I understand if you can never forgive me, but I apologize without reservation from the core of my being.”

        • Chi-Town_MotorCity

          Better yet, “Guilty, your Honor.”

  • moto_librarian

    And what kills me the most is that maybe, just maybe, this baby would have been born alive had this midwife sucked it up and had her patient admitted at the hospital where they had the BPP done. But no, in an attempt to cover her own ass, she took her to another hospital 30 minutes away.

    If the parents ever read this, I am so, so sorry. This should not have happened.

    • Bomb

      Knowing the geography of the area and the surrounding hospitals, the hospital they transferred from would have almost certainly been preferable to Centennial Hills, even without the 30 minute drive.

      Fucking incompetence and idiocy.

    • Guesteleh

      But who did the BPP? And why didn’t that person counsel the parents? I’m confused.

      • Jessica S.

        Me too.

      • R T

        Could have been just an tech who legally can not give medical advice. They do the scan and the report goes to a doctor. My perinatologist uses techs sometimes when he’s really busy, but they are located in his office and the results go to him to read within minutes. Many midwives in Los Angeles use a clinic where techs do all the scans.

    • prolifeminist

      And the midwife absolutely KNEW the baby was in terrible trouble because she put mom on oxygen for the 30 minute transfer to the other hospital. Disgusting. Truly disgusting. Probably thought the backup OB would do a better job of keeping a lid on her negligence.

  • violinwidow

    Ah, my heart breaks again…four years of advocacy, too many deaths, too many broken mothers. Damn these killers to Hell.

  • AlisonCummins

    The pregnancy was 42.1 weeks with accurate dates. It doesn’t matter what any of the tests said, she wasn’t supposed to be pregnant any more period. The discussion about whether yesterday was already too late is irrelevant.

    • The Computer Ate My Nym

      Good point. The response to a pregnancy that has gone 42 weeks is induction, not monitoring. A BPP at 41 weeks might be reasonable, but 42 weeks? Just get the baby out.

  • http://safermidwiferyutah.wordpress.com/ Safer Midwifery Utah

    I made a list of email addresses for state senators in Nevada. Please let them know that this case represents a need for change. http://safermidwiferyutah.wordpress.com/2014/02/28/preventable-home-birth-death-not-in-utah-after-all/

    I am not the best at formulating a form letter, but if anyone else wants to take a stab at it I will add it to the post. I might email some news stations in nevada later tonight too. My baby is starting to wake up so I can’t work on this until later tonight/possibly tomorrow during nap time.

  • Trulyunbelievable2020

    So she wishes she had played the “dead baby card?” Huh, a little late for that, isn’t it?

    • The Bofa on the Sofa

      This is what I was thinking. Listen to her, she admits she should have acted more like what a doctor would…

  • Guest

    Oh my God that poor mother. That narcissistic, whining midwife.

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

    I have been angry on behalf of this family, but this made me start sobbing standing here in my driveway on my phone. How hideous, even in her email, to blame the mother! What a horrible, vile, murderous, unconscionable BITCH. I wish I was religious so I could comfort myself that she’ll burn in Hell!

  • Monica

    She read to her what other midwives had to say? Not the midwives that said it would be okay I’m assuming. Sounds like she’s more concerned with people disliking her than lives of babies and mothers. Well, surely her actions have assured that she’s hated. Perhaps not yet by those parents, but many even in the homebirth community sure aren’t looking too favorably on her.

  • moto_librarian

    “In the future, I’ll pressure until my client hates me.”

    I am going to do everything in my power to see that she never has another client again.

  • Trulyunbelievable2020

    Wait, are you saying that she told the backup OB everything was normal when there was actually no amniotic fluid? That’s insane.

  • http://momofmanyfeet.wordpress.com Bambi

    This is deplorable. My heart is breaking for these parents. I swear all these midwives read the same “Client Manipulation 101″ book.

    • http://momofmanyfeet.wordpress.com Bambi

      And an NST with a doppler. Are you kidding me?? She screwed up, big time.

      • areawomanpdx

        Really. Did she sit there for a half-an-hour with the Doppler, a watch, and the lightning fast calculator in her mind to make sure there were an acceptable number of accelerations of the right length? That baby deserved more than such shoddy bullshit.

  • Melissa

    There is so much projection from midwives who are trying to predict what their “patients” want to hear. How does Collins KNOW that the Mom just wanted more time and space to make a decision? How does she know that the Mom would have been angry at being told the truth? She doesn’t. But since the primary concern in CPM club is “don’t say anything that might upset anyone” she denied this mother the ability to actually make a decision.

    The whole “don’t upset anyone rule” also goes in both directions. I wouldn’t be surprised if the Mom involved were to say that she was trying to stay calm and optimistic because she didn’t want to disappoint the midwife or look like she wasn’t trusting her. This is what happens with the MDC echo chamber comes to life.

  • Comrade X

    This is absolutely appalling. I hope mum and dad have got the support they need, and that these pretend care-providers face the consequences they deserve.

  • Dr Kitty

    The story isn’t any better when you know more details.
    Those poor, poor parents.

  • YogaMathMelon

    “…your baby who had clearly been soaking in mec for weeks.”

    **shudder** That poor baby.

    • Jocelyn

      That was the line that was the worst for me to read. Unimaginably awful.

      • YogaMathMelon

        Agreed. I cannot wait for the bus to drop off my kids so I can hug them until they yell for me to let them go. *tears*

    • The Computer Ate My Nym

      Was it though? Can any of the OBs comment on the probability of this statement being right? Also, what causes oligo like that?

  • http://safermidwiferyutah.wordpress.com/ Safer Midwifery Utah

    She shouldn’t push until they hate her, she should STOP PRACTICING because obviously she doesn’t know what the hell she is doing. Seriously. She should push for more laws to make this kind of thing never, ever happen again, and prevent people like her from being able to make these mistakes. Someone insured and properly trained never would have hesitated to tell them that waiting was likely to cause death.

  • Anj Fabian

    I’m going to read that passage again. I don’t recall “I’m sorry.”.

    • Anj Fabian

      She never comes out and says. it.

      She also thinks that other women would want her to provide their care after this fiasco.

      Perhaps, with time and a step outside of the echo chamber…

    • theNormalDistribution

      I hate how much she says she blames herself when she’s really blaming the mother. “I could’ve waved the dead baby flag” – I could have done that awful thing that awful doctors do. “You still wanted more time.” – it’s all your fault.

      Very poor attempt to cover her ass, if you ask me.

      • Jenny R.

        victim blaming extraordinaire, that one. disgusting. Goes beyond ass-covering to me, …she’s being downright sadistic to the mother.