Let’s hold them accountable!

Social media concept

This morning I wrote about the tremendous amount of web traffic to the story of the baby who died while Jan, Tritten, the Editor of Midwifery Today crowd sourced the medical decision on his mother’s care with her Facebook friends. The response is a testament to the power of social media: blogs, Facebook and Twitter.

I also wrote about the fact that the homebirth community is silent on this baby’s death (like the deaths of all the babies that have died at their hands) and their plan appears to be to do nothing about it, investigate no one, hold no one to account.

Let’s not let them bury this baby twice, once in a tiny coffin in the ground and then again by erasing him from public consciousness. To prevent that, let’s leverage the power of social media to finally hold homebirth midwives to account.

I’ve been banned from just about every homebirth website and Facebook page, but they can’t ban everyone, can they?

I propose a Facebook and Twitter campaign to grab the attention of the people whose current plan for handling this baby’s death appears to be to do nothing, wait for people to forget, and then get back to business as usual.

Let’s send Facebook messages, Tweets and emails to:

Jan Tritten
Jan Tritten’s Facebook page
@JanTritten on Twitter

Midwifery Today
Midwifery Today’s Facebook page

The Midwives Alliance of North America (MANA)
MANA’s Facebook Page
@MANACommunity on Twitter

and
Melissa Cheyney, CPM in her role as Head of the Board of Direct Entry Midwifery in the state of Oregon (where Jan Tritten lives).
Email: melissa.cheyney@oregonstate.edu (She does not appear to have a separate email address at MANA or the Board of Direct Entry Midwifery)

What should you write? I leave that up to you, but for those who aren’t sure, I have a suggestion:

Can you tell us what you plan to do to investigate the death of the home birth baby whose care Jan Tritten crowd sourced on Facebook?

Short, simple, polite and to the point.

These midwives and organizations can ban and delete me, but they can’t ban and delete everyone. In memory of the baby who died a preventable death, let them know how you feel.

If enough of us get involved, perhaps we can prevent the tragedy that befell this baby from happening to any other babies.

297 Responses to “Let’s hold them accountable!”

  1. help
    February 27, 2014 at 5:57 pm #

    I am a friend of this family and feeling lost as what I should do. They are not upset with the midwife and think this would have happened whomever they were seeing. The midwife was Christy Collins, this happened in Las Vegas, NV. The baby died after an emergency cesarean, never left the operating room alive. Centennial Hills Hospital has not reported this. There was an OB that was called after the last ultrasound test and he urged them to go immediately to the hospital. This was the1st point anyone other than Christy was involved in the care.

    Christy was sanctioned in California, but moved to Nevada where there are no laws governing home birth or lay midwives. So, she was able to practice without restriction.

    I’m afraid I would add to the grief of these parents by reporting something. I’m not even sure who to tell. The hospital didn’t report anything.

    http://www.sistersinchains.org/our-sisters-in-chains.html

    • 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

    • Jocelyn
      February 27, 2014 at 6:00 pm #

      Thank you for coming forward! I am so, so sorry for the family.

    • Amy Tuteur, MD
      February 27, 2014 at 6:03 pm #

      Please feel free to contact me at DrAmy5@aol.com, so we can discuss all the facts and preserve the family’s privacy.

      By the way, do you know the baby’s name. I’d like to refer to him by name; it’s the least we can do to honor his memory.

    • Trixie
      February 27, 2014 at 6:09 pm #

      If there ever comes a point where the family reads this, or you talk to her about it, let her know that everyone here feels great sympathy for the loss of their baby, and wishes them as much peace as possible as they mourn.

      Christy Collins can burn in hell.

    • Box of Salt
      February 27, 2014 at 6:11 pm #

      I am sure that I am speaking for most of regular commenters here:

      Please pass along to the family that we are sorry for their loss.

      • Certified Hamster Midwife
        February 28, 2014 at 2:06 am #

        Yes, I’m sure that everyone here is aching for this family.

        If any of you are reading this, please know that we don’t want to make your pain worse. We post here because we don’t want any more babies or families to suffer needless deaths, and we don’t believe that anyone should use Facebook to crowdsource decisions when a child’s life is in the balance.

  2. Vera
    February 26, 2014 at 3:37 am #

    A birth centre in NZ is being raked over the coals in the coroners court and the national newspaper over the inadequacy of care provided to a young mum and baby, both of whom ultimately died. This midwife was new to practice (CNM equivalent) and her fellow midwives did not adhere to national practice guidelines. This is what being held accountable is:

    http://www.nzherald.co.nz/nz/news/article.cfm?c_id=1&objectid=11210389

    The Midwifery Council of NZ is not hiding; my friends are still choosing (informed consent based) birth centre midwife led care. MANA take note, professional standards and ensuring competence of midwives does not turn women away.

    • Stacy21629
      February 26, 2014 at 4:21 am #

      A related article with a very apt headline: Midwife ignored scan guidelines. http://www.nzherald.co.nz/nz/news/article.cfm?c_id=1&objectid=11205097
      Someone should post THAT to the MT thread…THIS is what should happen when a midwife ignores ultrasound scan results and a baby dies.

    • Stacy21629
      February 26, 2014 at 4:23 am #

      ANOTHER fitting comparison…here’s what the presiding midwife was doing while this mother and baby were dying:
      “the midwife] was sending multiple texts of a personal nature, particularly about her recent holiday.”
      http://www.nzherald.co.nz/nz/news/article.cfm?c_id=1&objectid=11204342
      So she was also on the internet while she should have been caring for a mother and baby in labor.

    • Stacy21629
      February 26, 2014 at 4:31 am #

      And one more comparison…this mother also died from an amniotic fluid embolism in New Zealand…but she was in the hospital surrounded by competent care providers. While she still unfortunately passed away, the baby was saved.
      http://www.nzherald.co.nz/nz/news/article.cfm?c_id=1&objectid=10881589

      • Vera
        February 26, 2014 at 4:39 am #

        Yeah, NZ does need to do a lot more in midwifery care but at least we have ACC (universal accident insurance), excellent healthcare and vocal coroners.

      • LMS1953
        February 26, 2014 at 7:18 am #

        Stacy,
        Stacy, I really don’t think mum died of an amniotic fluid embolism. That is a diagnosis only made at autopsy. The newspaper report attributed an anesthesiologist with making the diagnosis – which can only properly be made by a pathologist. AFE is usually a fatal complication that is not preventable. It is a “go to” diagnosis given as a basis to absolve the provider from responsibility for a maternal death since it is sporadic, unpreventable and fatal. Sort of like when an insurance company declares a claim “an act of God”.

        No, this is a rather obvious case of post partum hemorrhage (PPH). The slipping in an out of consciousness was due to hypotension from hypovolemic shock. The cause was likely from uterine atony from a large baby delivered after a protracted labor – there may also have been an unrecognized obstetric laceration. There was criticism of no IV access hence no IV pit (at most she got IM pit – probably not in view of the cluelessness of the midwife. I have found a reluctance of CNMs to start IV access (just a heplock would do). They wouldn’t even get a CBC on admit. The reason: it doesn’t foster positive affirmations, pregnancy is not a disease, how did we ever get here as a species if we can’t trust birth. The usual bullshit. I tried to explain to them that the leading cause of maternal death in the US was obstetric hemorrhage and that a heplock and CBC were very minor measures to take. I was given Ina Mae’s book to read.

        Anyway, mum’s terminal event was disseminated intravascular coagulation (DIC). There is so much bleeding that the coagulation factors are consumed and blood can no longer clot. That is why she was bleeding out the endotracheal tube.

        Conclusion: I have little more respect for the CNM title as the CPM one. They are both infested with Woo that supersedes rational medical practice and this appears to be a coordinated international phenomenon. They both spout the same bullshit. They both often fail to comprehend the scope and limitations of their skills.

        • LMS1953
          February 26, 2014 at 7:27 am #

          BTW, the baby died at 3 days of age of hypoxic brain damage. Large baby, long labor, inadequately monitored – all to avoid the cascade of intervention and the inexorable fall into the maelstrom of a C-section.

          • The Computer Ate My Nym
            February 27, 2014 at 10:35 am #

            Is there more than one case here? The article linked says that baby is doing well at 2 weeks. It also sounded like the autopsy wasn’t complete yet so can’t say for sure whether it was AFE or not.

        • guest
          March 1, 2014 at 1:34 am #

          The DIC is not necessarily consumptive, it is classically linked to AFE. I do agree AFE is a PM diagnosis.

    • Karen in SC
      February 26, 2014 at 8:45 am #

      I’ve read the stories shared on Action to Improve Maternity, a NZ blog about midwifery care. I’m not sure all midwives in NZ give true “informed consent” and seem to ignore evidence based protocols as attested by the tragic stories. The organizer of that site is working to get the word out about unsafe practices.

      • LMS1953
        February 26, 2014 at 11:38 am #

        Who would have guessed. It seems to be an international problem. The Woo is a powerful master indeed.

        • guest
          March 1, 2014 at 3:54 am #

          Just like any cult. it will reach a proportion of idiots everywhere.

      • Vera
        February 26, 2014 at 4:24 pm #

        I wonder if its DHB specific, because that certainly hasn’t been the experience of my friends and family (although, there but for grace…) who really wanted midwife care but the midwives refused to take them unless they also had OB care. Even so, it’s really not good enough if it is DHB specific, but some of the AIM points don’t jive with what I know from working in maternal mental health either.

    • February 26, 2014 at 12:52 pm #

      It seems there are issues with midwife-led care in Australian hospitals, too. If you go in the public system, you get midwife-led care unless you are high risk, and I have hear horror story upon horror story wherein women are sent home repeatedly for not being ‘dilated enough’, allowed to contract for days, being told that their pain is a ‘productive pain’. In the case of two of my cousins, at the same birthing wing, they both ended up with emergency c-sections after being in labour for days, in one case with both mother and daughter being close to death when an obstetrician brought in. It depends on the hospital, but some of them are really promoting midwife-led care, and it seems that some of them hate OBs as much as home birth midwives.

      They’re also sending women home 6 hours after giving birth. Because it is ‘safer’ to be out of the hospital. Meanwhile a good friend of mine hemorrhaged at home after being sent home within hours of giving birth in midwife care at a hospital.

      It seems women in Australia choose to pay to go private to get their own doctors after experiencing midwife-led care. It’s happened repeatedly in my own circles. It’s a shame woo is infecting professional circles as well.

      • Vera
        February 26, 2014 at 4:30 pm #

        One of these days, I am going to set up a non-woo Plunket service and only employ people who use evidence without playing on people’s emotions about childbirth, breast feeding, etc, to start diluting the professional woo crap.

        I know if I was in northern NSW, there is no way I’d accept public midwife care – thank goodness for private healthcare!

        • February 28, 2014 at 11:16 pm #

          My cousin said she will move mountains to give birth privately next time around. She said the treatment from the midwives was great and kind, before things went to shit, and then she was just treated like a weakling for not being able to take the pain or will her cervix to dilate past 4cm. When she asked for the epidural, one of the sisters told her she ‘may as well book the c-section in’. It’s appalling.

          Living in the US, I really appreciate that universal healthcare exists in Australia, but it is a crying shame that public care for maternity and birth is increasingly midwife-led because it isn’t improving outcomes for women from what I can see and have read.

          • realitycheque
            March 1, 2014 at 1:47 am #

            Also in Australia and I have seen a similar level of NCB crap infiltrating the mainstream system. I know of babies who have died at the alter of NCB under midwife care.

            I foolishly had a home birth, and my MW (who is well regarded within the birthing world) spouted so much woo, it’s not even funny. “Babies aren’t library books”, “Your body won’t grow a baby too big to birth”, “Twins and breech are variations of normal”, etc. ZERO informed consent about the true risks, all crap about how homebirth was “safer” than hospital birth.

            I was also referred to a Hypnobirthing class by a public health service, where I was told that labour pain was “all in the mind”, and given fear-mongering misinformation bout epidurals, cesarians and other evil (life saving) interventions.

            The woo is becoming ever-more prevalent and it scares the crap out of me. More and more I am seeing otherwise sensible women falling for nonsense and developing fear of obstetricians and interventions.

      • guest
        March 1, 2014 at 1:29 am #

        This is a really scary development in Australia, A once sensible system is being infected by woo. Woo is taught in University midwifery and practised in public hospitals. The government of Queensland is promoting ‘”midwifery care with obstetric rescue” a policy by stealth. I can only assume they believe it is cheaper – we’ll have to wait and see.

  3. MLE
    February 25, 2014 at 10:48 pm #

    Hey everyone – Donna on the Midwifery Today FB page is asking for a list of “concerns.” I outlined the basics around both the situation itself and Jan’s response but could use backup.

  4. Stacy21629
    February 25, 2014 at 5:25 pm #

    These midwives are so completely uninformed that when they need information they don’t even know where to look. The top post on the MT Facebook is asking for details on a particular drug…here’s an idea – CHECK THE DRUG INSERT!!!
    Good grief. I would never claim to know everything about veterinary medicine, but one of the most important things I DO know is WHERE to go to FIND that information if I need it.
    Not only is this midwife woefully unable to provide her clients with informed consent, she doesn’t even know where to go to FIND that information.

  5. J.
    February 25, 2014 at 2:37 pm #

    I live in a developing country with a terrible healthcare system. When I had my children, bribes were required before one could even enter a maternity hospital — and patients had to purchase whatever medicines and equipment was needed themselves, if it was available in local pharmacies at all.

    I was generally horrified by everything that went on in hospitals at that time (and believe me, the problems were very real and not like the stuff out of the Business of Being Born). I chose homebirth, genuinely believing that it was the safer option.

    I have been horrified by Amy’s harsh comments, especially those that accuse anyone who chooses homebirth of being a narcissist who cares more about her own comfort than about her baby. Yet, I kept reading this blog.

    A small community of people who do not wish to subject themselves to the very real horrors of the local healthcare system turned to homebirth as an alternative to maternity hospitals, with the logic that if it’s safe in America, it’s safe here too. This group of women is inspired by people like Ina May Gaskin and probably Jan Tritten.

    Homebirth advocates in the US have an impact far beyond the US, in other words. I am horrified by MANA’s actions, by the CPM “credential”, and by people who call themselves midwives thinking using the internet as a tool to guide their decisions is perfectly fine. I see that those harsh words are the result of a very legitimate anger.

    This is truly disgusting. There is probably not much people from other countries can do to help abolish the CPM credential, but I thought I’d let you all know that we are also here, reading what is going on and affected by by the fake midwifery movement in the US.

  6. Stacy21629
    February 25, 2014 at 2:28 pm #

    Anyone in the Harrisburg, PA area? Should picket their conference at the end of April…

  7. LMS1953
    February 25, 2014 at 11:41 am #

    My draconian proposal for protective custody for recalcitrant mothers was actually inspired by an EMT who posted on Jan’s thread who said he would call the police to have the mother forcibly taken to the ambulance if necessary.

    As regards “slippery slopes”, if only a very small percentage of women would be so deranged as to say they would rather have a dead baby than a C-section, then that is a good Bell Curve/more than two standard deviations outside of normal behavior as to constitute abnormal behavior and psychiatric illness. It is expected that when people have a psychiatric illness and are a danger to themselves or others, that we intervene on their behalf and take measures to make the best “reasonable person” decisions for them. Slippery slopes go down both sides of the hill. If we do not accord the baby in a laboring womb at term the status of “other”, we will soon wallow in the murky bilge of post birth abortion (which is being championed now by the usual suspects.

    • February 25, 2014 at 11:49 am #

      I don’t disagree. I think that many, if not most, mothers in this scenario would absolutely go to the hospital if they were confronted with the real risks, especially if they we re strong enough to even indicate a court order.

    • AllieFoyle
      February 25, 2014 at 12:28 pm #

      But there is no real indication that the mother in this case was “recalcitrant” or mentally ill. She sought out care, underwent screening tests, and ultimately went to the hospital and submitted to a c-section. There’s no indication that she was unconcerned with the well-being of the baby. Rather, the failure appears to lie with the HCP who did not advise her of the grave risks associated with the lack of fluid and who needlessly delayed getting her care that could have been lifesaving.

      This is an issue of poor provider standards and accountability and probably informed consent.

      • LMS1953
        February 25, 2014 at 12:54 pm #

        Excellent point, Allie. This mother should have a mechanism to have the CPM criminally charged with negligent homicide/manslaughter to the same degree as if a drunken driver caused an MVA that killed her baby while they were en route to a routine pediatric visit for a bilirubin check at 3 days of age.

        I was chiefly addressing those posters on Jan’s thread who said that a mother’s autonomy was so absolute that she should be allowed to let the baby die before allowing a C-Section to be done. I think such women who are so obsessed with the process of birth and birth as empowerment and performance art (over the *outcome* of birth) are the XX equivalent of XY child predators. They are both narcissists who pursue self-gratification at the expense of vulnerable children. They don’t go to the hospital because the cascade of intervention will deprive them of the opportunity to orgasm in labor (I kid you not). Rape is an opportunity for a man to feel empowered at the expense of his victim. Home birth to the point of infanticide is an opportunity for a delusional woman to feel similar empowerment. They should both be subject to similar corrective measures to protect society from their narcissistic needs

        • February 25, 2014 at 1:20 pm #

          WTF do you mean “the xx equivalent of xy child predators”??? THERE ARE XX PREDATORS. TONS OF THEM. And really, you are totally ignoring the woman who exists and has the pregnancy going on inside her actual body. Its nothing at all like molesting children. By your logic we should force everyone to donate organs and blood because they are being narcissistic and predatory by not sacrificing their body to unwanted medical procedures for the good of another person. You know how problematic that would be, so please stop.

        • AllieFoyle
          February 25, 2014 at 1:25 pm #

          I apologize if I missed the context of the discussion. I haven’t read the posts to which you refer, but I’ve certainly heard the argument before. Probably there are some people with the motivations and psychopathology you describe, but I can’t imagine they are very numerous, honestly. I expect many of the people you would categorize this way have been brainwashed by misinformation from dubious health care providers and do not understand or are simply unaware of the very real risks that exist in pregnancy and childbirth.

          Poorly trained people being allowed to pass themselves off as professionals, spread dangerous misinformation, and provide unsafe, irresponsible care is the real problem here.

          >>>”This mother should have a mechanism to have the CPM criminally charged with negligent homicide/manslaughter”

          Um. Would you advocate pressing criminal charges in the case of other fatal medical mistakes? I’m not sure that is what is needed here.

          She should certainly have a way to hold the midwife responsible, as she would if the midwife were subject to the same liability and licensing concerns that real professionals are. Other women should also be protected from placing their care into the hands of similarly unsafe providers. If midwives were required to be trained, licensed, and held to standards of practice this wouldn’t be an issue.

    • February 25, 2014 at 1:18 pm #

      That is total bullshit. You might as well tie down Jehovas Witnesses and infuse them with blood products using the same logic. The right to refuse medical treatment is a civil liberty that the ACLU has had to defend on behalf of pregnant women multiple times. Women are not incubators for children that need to be forced into compliance, they are people with their own beliefs and choices. You cannot label choices you don’t like as being mental illness and then force treatment on that basis. Do you not see how this would be used to abuse all kinds of patients?

      • guest
        February 26, 2014 at 6:23 am #

        Late term abortions are still illegal in most countries, so autonomy is not absolute. Some might (and do) argue that there is a fine line between killing your term baby as a part of performance art and late term abortion. It should be illegal too.

      • ngozi
        February 27, 2014 at 10:09 am #

        You took the words out of my mouth, because I personally know doctors who would abuse this.

    • me
      February 25, 2014 at 1:20 pm #

      Obviously pregnant women are not immune to psychiatric illness, and I wouldn’t trust a CPM to diagnose that any more than I would trust one to know that you don’t “sit on” a 42w+ baby with low fluid. That being said, I still don’t feel your proposal helps anything. A better proposal is what has been proposed here MANY times: proper licensing, proper oversight, safety standards, and more recourse wrt suing bad HB midwives. Part of safety screening should include screening for maternal mental health issues.

      Yes, in your extreme example, a woman preferring a dead child to a c-section, it is blatantly obvious that you aren’t dealing with a mentally healthy individual. But, again, you go down that slippery slope. Where does it end? Some people might argue that refusing CEFM in labor is “crazy” or that refusing u/s screening for down’s syndrome is “crazy”. Some could argue that a mentally healthy mother would never change the cat litter or eat ham from the deli. Some would argue that “sane” women would submit to sterilization if they have known risk factors for pregnancy complications. And on the other end, what’s to stop the anti-abortionists from using such legislation to force women to keep unwanted pregnancies? As soon as you make the fetus “other” and argue that it has rights that supersede the mother’s, guess what….

      Besides, as pointed out, in this case, it surely doesn’t sound like the mother was refusing treatment/transfer. Had the mw’s post said ‘gee, I know the situation is dire and I want to transfer, but the mother refuses, what do I do?’ we’d be having an entirely different conversation, and your proposal, while I’d still disagree, might make more sense in that context. What we have here is a mw that went fishing on FB for replies that would back up her own agenda. This mw wasn’t looking to help this woman have a baby; she wanted to help this woman have a HB. If anyone here is mentally ill, it’s the mw that persuaded her client to ignore obvious, serious risk factors to pursue ideology. Before we think of creating laws to limit women’s autonomy during pregnancy, let’s fix the laws (or lack thereof) that allowed this midtwit to take on a client in the first place.

  8. Danielle
    February 25, 2014 at 10:51 am #

    Slightly off-topic, but someone on the page cites a case similar to mine and asks if it is ground for bailing for a hospital birth:

    “I am wondering if a succenturiate placenta, or extra lobe, is contradictory to an out of hospital delivery due to risk of retained placenta. The only actual statistic I could find was a 5% incidence of hemorrhage which doesn’t seem extremely high. Any resources or info appreciated. Multipara mom, no history of third stage complications. Some extra postpartum bleeding but ever emergency.”

    I don’t know the answer to that question, and I won’t pretend to know it. I was not planning to deliver at home so I didn’t have to sit down with anyone and discuss the issue.

    I will only note that when I delivered the placenta, the OB was excited to show it to me. At that time, he mentioned that there was a risk of hemorrhage (which is the first I knew anything about that part; only the risk of retained placenta had been mentioned previously).

    The resident was even more excited. I quote: “That is amazing! You should send that thing to the lab!” (OB’s reply: “All they’ll do is send me a report saying that this a mature placenta. As if I don’t already know what a mature placenta looks like.”)

    No idea what the risk factor was or wasn’t. (If true, isn’t 5 percent kinda concerning?) But aside from needing “intervention” to move along a non-progressing labor and to get my distressed baby out fast (cord problems, low fluid)… the potentially mutinous monster placenta seemed like a fair enough reason to be in the hospital.

    • Irène Delse
      February 25, 2014 at 1:14 pm #

      I’d say the 5% risk is cause for serious concern. That’s 1 in 20, not a rare occurrence.

      • Mariana Baca
        February 26, 2014 at 8:36 am #

        I think some people don’t intuitively understand percentages.

        • February 26, 2014 at 1:00 pm #

          I think that’s genuinely a factor. Math is hard, guise.

    • An Actual Attorney
      February 25, 2014 at 10:32 pm #

      I really don’t know how to even start with someone who thinks 5% isn’t that big of a risk for a serious complication.

      • PrimaryCareDoc
        February 26, 2014 at 7:44 am #

        I was thinking the exact same thing.

        • anion
          February 26, 2014 at 8:38 am #

          I really want/ed another baby, but I turned forty a few months ago, and the age-related one-in-two-hundred risk I’ve seen quoted of having a baby with genetic disabilities/problems is too high for me. I cannot imagine taking a one-in-twenty risk with a baby’s life unless I had absolutely no other option.

  9. auntbea
    February 25, 2014 at 9:57 am #

    So far no deletions on Midwifery Today that I can see…Thread’s been up overnight. But there is suspiciously little activity from the locals either on that thread or any other — have they abandoned their own ship?

    • Anj Fabian
      February 25, 2014 at 9:59 am #

      Mums the word.

      Does that mean the midwife involved is someone too highly ranked to be thrown under the bus?

      • Amazed
        February 25, 2014 at 10:01 am #

        Anj, do you know about a midwife who isn’t too highly ranked for this? IIRC, there are rallies, funds, and battle cries for all those poor Sisters in Chains.

        • Anj Fabian
          February 25, 2014 at 10:05 am #

          True – they rallied around Rowan Bailey, who I would have thrown under the bus without a second thought. Who would want to claim a midwife so clueless that the baby was dead for over a day before the transfer? A transfer that was not suggested by the midwife or supported by the midwife!

          Who would want to claim that level of incompetence as a valued member of the community?

          • Trixie
            February 25, 2014 at 1:51 pm #

            Have you looked at their list of presenters for the upcoming Midwifery Today conference? You pretty much can’t even lecture there until you’ve killed or maimed at least one baby.
            It’s kinda like how you get to be a member of the Unsullied on Game of Thrones.

          • Dr Kitty
            February 25, 2014 at 3:46 pm #

            Nope. The Unsullied are slaves who are beaten, mutilated and traumatised into complete obedience and the choice is obey or die.

            MWs just kill with incompetence and impunity, mostly by doing whatever they “feel” is right, and if you attend enough births you can tout your “experience” no matter your outcomes.

          • Trixie
            February 25, 2014 at 3:52 pm #

            Yeah, I know. But the final test of the Unsullied is whether they can kill a newborn. I realize it’s not a perfect metaphor.

          • Dr Kitty
            February 25, 2014 at 4:08 pm #

            I gotcha 🙂

          • anon13
            February 25, 2014 at 4:28 pm #

            Really, on Game of Thrones? killing newborns? Ugh

          • Trixie
            February 25, 2014 at 4:35 pm #

            Well, it’s a whole long story. Once they’re freed from slavery, a benevolent queen ends the practice for good.

          • Dr Kitty
            February 25, 2014 at 4:40 pm #

            Not on screen, no.
            GRRM is all about the sick twisted bloodshed.

            GOT is our own cottage industry here. I’ve treated more than one extra with an armour related injury.

            BTW the actor who plays Hodor is the resident DJ at one of Belfast’s biggest Gay clubs.

          • BeatlesFan
            February 26, 2014 at 3:26 pm #

            DJ Hodor? That’s fantastic.

  10. Amy Tuteur, MD
    February 25, 2014 at 8:44 am #

    Here’s a screencap:

    • lizzo
      February 25, 2014 at 9:13 am #

      I know that this isn’t the point, but the misunderstanding of what trolling is — it’s making me crazy.

      • Anj Fabian
        February 25, 2014 at 9:28 am #

        Actual trolls are never subtle, very easy to pick out. Experienced people will ignore them, and offer the “Don’t feed the troll.” advice to the less experienced.

        I’ve seen that link posted multiple times and each time, it was used as an implicit ad hom against a poster.

      • Jocelyn
        February 25, 2014 at 10:50 am #

        I keep hearing Inigo Montoya in my head: “You keep using that word. I do not think it means what you think it means.”

      • Jessica S.
        February 25, 2014 at 10:52 am #

        Liz Powers Moore finds (supposed) trolling more despicable than a baby’s preventable death. Factoring in your accurate assessment of her confusion over the term “troll”, what she really finds more unacceptable than a baby’s preventable death is dissent.

        • Dr Kitty
          February 25, 2014 at 3:53 pm #

          Look at this site.
          Dissenters parachute in to old (really, really old) posts, hoping to have the last word.
          Posters here will counter with evidence and try to have an actual discussion.
          Mostly the dissenters don’t come back.

          NCB…dissenters are deleted or banned so they can’t respond.

          Seriously, us raptors are more open minded and tolerant of dissenting opinions, we just us stronger language and tolerate less BS when we defend our position.

          • The Bofa on the Sofa
            February 25, 2014 at 4:01 pm #

            Pretty much the only time you will hear the description of “troll” here is in reference to tone trolls, and, in those cases, it’s pretty clearcut.

            Moreover, even when we get those, the response is not “go away” but “say something useful”

          • Jessica S.
            February 25, 2014 at 4:10 pm #

            IMO, it’s the difference between feeling secure in your argument b/c it’s based on evidence and feeling defensive of your ideology b/c it’s based on dogma. They have to keep out those who would cause others to start asking questions. But the majority of us came to accept facts based on the questions we asked. And we continue to question, changing beliefs based on evidence. At least, that’s the way it should be. Lord knows it’s not easy; it’s must easier to memorize the narrative and never have to think for yourself, but it’s ultimately futile.

      • Coraline
        February 25, 2014 at 12:29 pm #

        It’s driving me nuts, too!! When they get backed into a corner, just scream, “TROLL!!!!” It’s immature and harms their credibility.

    • Amazed
      February 25, 2014 at 9:18 am #

      I don’t see anything.

      • Karen in SC
        February 25, 2014 at 9:23 am #

        Refresh the page, that works for me.

        • Amazed
          February 25, 2014 at 9:26 am #

          Thanks. My, isn’t he pissed! And Jesse Stavis is great three times over. I saw her other comments and she’s spot on.

          • auntbea
            February 25, 2014 at 9:46 am #

            I think Jesse’s a he.

          • Amazed
            February 25, 2014 at 9:51 am #

            Probably. With all those women there, I didn’t spare much time to think of the men, bar Evil Dr Amos. Sorry!

  11. Ennis Demeter
    February 25, 2014 at 8:08 am #

    There is a woman on Jan Tritten´s page who is defending J.T. Her name is Melanie. She says that her baby died at 42 weeks + 5 days from placenta failure. She’s trying to make a point about not having tests unless you can act on them and that tests are inaccurate anyway because she had lots of lfuid when they said she didn’t. She says she had an ultrasound only after she felt her baby pass away. I think she’s unwittlingly revealing that she refused tests that could have saved her child, right? Placenta failed because she waited too long? Can someone smarter than me explain to a non-medical person if I am right about this?

    • Karen in SC
      February 25, 2014 at 8:26 am #

      But she got her “Waiting it Out” badge!

    • Rochester mama
      February 25, 2014 at 8:47 am #

      I just don’t get it and it makes me furious. So many women I know have problems conceiving or are plagued with recurrent miscarriage and these bozos get to term and let the baby die to avoid a CS. I just don’t get it.

      • ngozi
        February 25, 2014 at 9:26 am #

        I wish those women knew that THEIR c-sections doesn’t have to be that bad. Just because someone else has a horrible time with their c-section doesn’t mean they will.

        • ngozi
          February 25, 2014 at 9:26 am #

          sorry for the grammar errors. I am always in a hurry.

          • Dr Kitty
            February 25, 2014 at 4:21 pm #

            I anticipate any future CS recovery will be much improved by my recent discovery that I don’t metabolise codeine and can ask for an alternative.I have idiosyncratic reactions to drugs. I need child sized doses of propofol and Midazolam and elephant sized amounts of morphine. Anaesthetists find me a source of endless amusement.

        • fiftyfifty1
          February 25, 2014 at 9:38 am #

          And testing doesn’t even mean they will need a c-section. If you induce by 41 weeks you DECREASE your chance of a c-section, even if you induce with a totally “unripe” cervix. The reason is because pregnancies that go too long cause 2 very important problems both of which lead to c-sections in themselves:
          1. potentially oversized babies that can’t come down (your body CAN make a baby too big for you to birth, especially if your body does not kick into labor when it should)
          2. A placenta with decreased oxygen carrying capacity just at the time (labor) when a baby needs all the oxygen it can get.

          • Young CC Prof
            February 25, 2014 at 9:41 am #

            #2 is the reason I’m kind of glad my baby was breech. When he was delivered, we were much closer to complete placental failure than even the doctors realized, and I doubt he would have tolerated labor. Going straight to the c-section rather than screwing around with induction first made it easier on both of us.

          • fiftyfifty1
            February 25, 2014 at 9:45 am #

            Yes, of all the reasons not to “trust birth” my greatest reason is because I don’t trust placentas. My second was born at 38 +4. She was borderline growth restricted with the “lollipop” look (normal size head but seriously scary skinny body). The placenta was found to be calcified. I had NO risk factors for this beyond being 36 years old at the time of the birth. My first baby had had a nice fat juicy placenta just a couple of years prior.

          • auntbea
            February 25, 2014 at 9:48 am #

            Jesus. Did they realize something was wrong and induce, or was it just lucky she got out in time?

          • rh1985
            February 25, 2014 at 11:16 am #

            My baby was still growing fine but I am glad I went straight to CS as well. Induction just would have exhausted me and made recovery worse since it would have ended in a really emergency CS, nothing was favorable for induction at all. Mine was technically emergency but didn’t feel that way since I wasn’t in labor.

          • ngozi
            February 25, 2014 at 12:31 pm #

            Just wanted to let you know that my c-section was an emergency and I feel I recovered well. I think it would have gone much better had I of known my full bowels was what was causing about 50% of my pain. I wish their was an educational campaign about c-sections like there is about out other health issues. C-sections are still a major surgery, but not the automatic nightmare that many people try to make them out to be.

          • Jessica S.
            February 25, 2014 at 12:26 pm #

            Great points!! I’m telling you all, we should write our own “Past 41 weeks? Let’s Go Already!” campaign! 🙂

      • rh1985
        February 25, 2014 at 11:04 am #

        I had a CS last week, it wasn’t fun but it wasn’t traumatic either. Still some pain but first baby so nothing to compare to. I don’t get the CS hate at all…

        • Rochester mama
          February 25, 2014 at 11:07 am #

          Congratulations!

          • rh1985
            February 25, 2014 at 12:19 pm #

            Thanks. I am holding her now and listening to her make little noises and I can’t imagine not having her here for such an utterly stupid reason….

        • Jessica S.
          February 25, 2014 at 12:23 pm #

          Congrats! I had a CS with my first, and didn’t find much to fuss over. A friend has had three vaginal deliveries over the last four years and she said “trust me, there’s pain and downsides here, too!”. I’m pretty sure I’ll be having a schedule CS with this pregnancy, too. I’ve been told it’s much easier when it’s planned, as opposed to the end of a long labor (at least mine was uneventful and not an emergency. I was just wiped from all the waiting and not sleeping.)

        • Maria
          February 25, 2014 at 4:55 pm #

          Congratulations! I had a c-section 11 days ago too and I agree, it was odd and wonderful at the same time during the surgery, and the pain after was more acute than with my vaginal delivery 2 years ago, but I am feeling better on day 11 now than I did the first go around. I was so happy to get my little breech baby out safely and hold her in my arms. Nothing would have convinced me I should wait or try to deliver vaginally.

    • fiftyfifty1
      February 25, 2014 at 9:31 am #

      The risk of stillbirth is very, very high after 42 weeks. The placenta fails and the baby is smothered.

      • Karen in SC
        February 25, 2014 at 9:33 am #

        March of Dimes needs to get right on that. I’m serious! If they can have billboards with the 39 week rule, they can cover the other end, too.

        • Young CC Prof
          February 25, 2014 at 9:36 am #

          That’s what I said! Why don’t we have a “41 weeks or fewer” campaign too, since postmaturity, unlike prematurity, is always preventable and never medically advisable as long as the due date is reasonably precise.

          • Jessica S.
            February 25, 2014 at 12:18 pm #

            Excellent point, about prevention. You guys should write a pitch!

          • AllieFoyle
            February 25, 2014 at 12:30 pm #

            That’s a great idea! I’d love to see March of Dimes do it, though I wonder if they are too invested in the NCB POV to consider it.

          • Coraline
            February 25, 2014 at 12:40 pm #

            Seriously, this is a good idea. I wish this would catch on somehow.

          • Justsayin
            February 26, 2014 at 2:22 pm #

            ACOGs latest white paper endorses 41wk induction along with several tacit nods to the NCB community lengthening accepted labor times.

        • Jessica S.
          February 25, 2014 at 12:16 pm #

          Absolutely!

    • Anj Fabian
      February 25, 2014 at 9:33 am #

      She goes through her entire pregnancy refusing ultrasounds and it isn’t until she hasn’t felt the baby move that she gets an ultrasound, which confirms the fetal demise.

      I don’t know why she bothered. It’s like having a blood pressure cuff and not taking a reading until after the patient has had a stroke.

  12. Trixie
    February 25, 2014 at 7:49 am #

    Holy crap, there’s a lady on Jan Tritten’s thread whose baby died of the exact same thing, she was 42+5 with no fluid, and she’s still defending Jan and Midwifery Today. She says her baby died “for no reason anyone could find.”
    This really is an awful cult.

    • PrimaryCareDoc
      February 25, 2014 at 7:58 am #

      Whoa.

    • Ennis Demeter
      February 25, 2014 at 8:09 am #

      I just posted about this! She’s trying to make a point about how tests are wrong, because they were wrong about her fluid. But she refused the test until it was too late to save her baby. I think.

      • Trixie
        February 25, 2014 at 8:11 am #

        The line about how she proved the doctors wrong about the fluid (as they delivered her dead baby) was what really got to me. Awful.

        • Ennis Demeter
          February 25, 2014 at 8:15 am #

          I don’t dare tell a loss mom that maybe that test she refused until she was willing to act on them would have saved her child.

          • Karen in SC
            February 25, 2014 at 8:50 am #

            Why not? What if the woman conceives again? Couldn’t you say something like “I’m sorry you felt that a NST and BPP testing was unnecessary after your due date. The reason we recommend those tests is X, Y and Z, which tragically occurred in this situation. Again, I’m very sorry for your loss.”

          • Trixie
            February 25, 2014 at 8:54 am #

            I think she means she doesn’t dare write that in a FB thread.

          • Karen in SC
            February 25, 2014 at 8:54 am #

            Ah, I see. Good to know.

          • Rochester mama
            February 25, 2014 at 8:57 am #

            Jan didn’t have any hesitation telling a SIDS mom it was her fault for vaccinating.
            http://www.whale.to/vaccine/my_antivaccine_passion.html

          • Ennis Demeter
            February 25, 2014 at 9:22 am #

            Santa Mierda! I read your link. I think she made a special trip over to that woman’s house to blame the SIDS death on vaccination. What a shitty person.

          • Jessica S.
            February 25, 2014 at 12:34 pm #

            This is worth copying/pasting in its entirety:
            ——
            “My Anti-Vaccine Passion

            Vaccines are my pet peeve in life. The only “SIDS” case I have had in my practise (20 yrs, 800 births) was a little boy named Sam. His Mom had him in hospital with no meds and no intervention. She was someone I judged to be “too conservative” for me to mention the risks of vaccines.

            Her baby had thrush at six weeks, so she took him to the doctor and he received an antifungal treatment for the thrush, then she drove to the public health clinic and he was given oral Polio and DPT shot. He never woke up for his 3:00 am feed . . . . . I’ll never forget getting the news he was dead. I told his Mom about my judgement of her and my cowardice to tell her about vaccine risks, and she slammed her fist into the kitchen wall. I promised her I would do everything I could to stop this health holocaust and to never let another client vaccinate without information about the risks.

            This is what drives my passion.
            Jan Tritten, editor
            Midwifery Today Magazine
            (Ed. note: Jan Tritton is a friend of mine. Visit her website:
            http://efn.org/~djz/birth/MT/mtmag.html)”
            ——-

            WHAT. A. MONSTER.

          • ngozi
            February 25, 2014 at 12:43 pm #

            Who determined that it was the vaccine that killed the child? Does this woman remember what happened to children who lived before the time of vaccines (or before the time of medicaid and other social programs to pay for them)?

          • Jessica S.
            February 25, 2014 at 4:17 pm #

            I know, it’s disturbing. I’m not even sure I understand what kind of web page, or the purpose of the webpage, that statement was on (I didn’t provide the link originally) but I know I’ve read the name of that site – “whale (dot) to”? I think? – on other skeptic topic blogs, usually when someone’s referencing ridiculous medical advice they’ve come across.

            Edited to remove link – I don’t like to link to sites with which I’m unfamiliar!

          • Amazed
            February 25, 2014 at 12:43 pm #

            That’s it. End of swearing. I’ll now say what I’ve been itching to say since Jan’s name first came around this week.

            What. A Fucking. Pig. Of. Woman. This. Bitch. Is.

            So we shouldn’t “judge” homebirth loss moms since it hurts them but it’s OK for the pig to judge other loss moms and say so? Classssy (imagine a snake hissing this.)

            I don’t care whether I sound childish. I don’t care that I’m demeaning myself. I’ll say it again: what a fucking pig of woman this bitch is.

            20 years, 800 births? Just enough for their bunch of dumb pigs to think the bitch is sooooo experienced.

          • AllieFoyle
            February 25, 2014 at 12:50 pm #

            So she basically told a woman who had just lost her baby that it was her own fault and that she would have told her the lifesaving woo truth if she hadn’t appeared too “conservative”–whatever the hell that means in this context.

            What a vile person.

          • Dr Kitty
            February 25, 2014 at 4:06 pm #

            We have legitimate HCPs who, even when it is clear that the HB train wreck in front of them would not have happened if the parents had chosen hospital birth, will say “oh no, there is nothing you could have done, don’t blame yourselves!”because they don’t want to cause more guilt and trauma.

            Yet Jan, without any evidence of causation, drives over to a grieving mother’s house just to tell her that Jan thinks her choice to vaccinate her son killed him.

            Wow.
            NCB get upset about OBs playing the “dead baby card”, and one of their leaders pulls THAT STUNT.

            Jan Tritten is the worst sort of person.
            Emotionally tone deaf, lacking in empathy, sure of her righteousness and willing to run roughshod over anyone who stands in the way of her ideology.

            *I managed to write that without using a swear word. Can I have a prize please.

          • Jessica S.
            February 25, 2014 at 4:12 pm #

            First Place award in Restraint goes to Dr. Kitty!! *crowd cheers*

          • anion
            February 26, 2014 at 5:08 am #

            That is seriously one of the worst things I’ve ever heard in my life. What an absolutely vile and disgusting thing to do.

            Personally, if I were that mom it wouldn’t have been the wall I was punching.

          • February 26, 2014 at 1:08 pm #

            Yeah. I’d have been punching her right in the face.

          • expat
            February 26, 2014 at 5:39 am #

            She walked right up to that mom and told her that she thought that it was her fault that her baby died of sids because she vaccinated him? Jan Tritten is a horrible, horrible person.

          • Anj Fabian
            February 26, 2014 at 9:11 am #

            Post that link on Age of Autism.
            They’d welcome Tritten with open arms.

          • February 26, 2014 at 1:07 pm #

            Ugh, what an awful woman.

          • Ennis Demeter
            February 25, 2014 at 9:13 am #

            Yes, you are right. I’m not medically trained, so my approach has to be more curious sounding, but that woman should be questioned. She is presenting her choice not to test as defensible because she wasn’t prepared to act on the results, meaning, I think, no abortion and no “unnecessary” c-section. And she uses her example to point out the test she finally had after her baby died at nearly 43 weeks was wrong about the amount of fluid. But she has this huge blind spot: her decision to forego the “unnecessary” test killed her baby. I think, because it’s not clear if she had an earlier test or not, but I guess it’s pretty clear that she waited too long, no matter what.

  13. Meredith
    February 25, 2014 at 7:26 am #

    I just posted a comment on Midwifery Today’s FB page. We’ll see how long it’s allowed to stay up.

    I also tweeted MANA and Jan Tritten with the #notburiedtwice tag — and that one they can’t delete.

    • Meredith
      February 25, 2014 at 9:42 am #

      Aaaand, it looks like my FB comment was deleted. It’s good to know Midwifery Today is so committed to transparency and open discussion when their editor-in-chief does something unethical.

  14. LMS1953
    February 25, 2014 at 6:43 am #

    I think it would be beneficial to forward the screen capture Dr Amy provided to an Oregon state representative on the maternal health committee. It is my understanding that Oregon passed law that went into effect on 01/01/2014 that defined CPM scope of practice and what constitutes “high risk”. Going past 42 weeks is considered high risk. It is unclear in which state this deplorable tragedy occurred but it was described as one that gives CPMs “full autonomy”. Does anyone know which states those are? Send it to them too. Also there was a CPM in Virginia who implied that she attended to 42+ week home births which is against the law in Virginia. She later backtracked, but it would be appropriate to forward it there as well. It is very important for state legislatures know how they are abrogating their duty to protect the public safety. They are being barraged with lobbying efforts by MANA in states like Arizona and Hawaii to preserve and expand CPM scope of practice under the guise of maternal autonomy. Another favorite argument of theirs is: “Evidence based studies show that home birth has as good or better outcomes as in hospital births in *low risk women*. Then they play the maternal autonomy and *variation of normal* meld to deflect bad outcomes in what is being legislated as *high risk* – post dates, breech, multiple gestation, VBAC and medical conditions – for which transfer is mandated.

    • Karen in SC
      February 25, 2014 at 8:07 am #

      Along the same lines, are legislators in Oregon on Twitter? Attorneys General in the states where CPMs are trying to expand their scope of incompetence?

      • Karen in SC
        February 25, 2014 at 8:19 am #

        @GosiaWozniacka – OR reporter that covers health care

        • Irène Delse
          February 25, 2014 at 8:50 am #

          Speaking of Oregon, how about the blog Science-Based Medicine? Dr. Mark Crislip, himself based in Portland, has already posted and podcasted at length about the woo that infects his home state. He’s also a co-founder of the Society for Science-Based Medicine, with Jann Bellamy, who is a lawyer specialised in healthcare legislation. And she too posts at SBM. I remember Dr. Steve Novella, president of SBM, doing recently a good post about the awful MANA stats and the intrinsic risk of HB. Maybe they can help boost the signal here too.

          • Karen in SC
            February 25, 2014 at 8:55 am #

            Done, good idea!

  15. OBPI Mama
    February 25, 2014 at 6:25 am #

    As far as Jan saying this lady was not her client… as I scrolled down Midwifery Today’s facebook page, I noticed that all her other posts that listed questions from other midwives were titled “from anonymous”, “From so-and-so” and then went on to ask the questions. Of course, she didn’t include that in her crowdsource about the dead baby… This woman makes me so mad!

    I remember my wonderful OB telling me that the mistakes a doctor makes always sticks with them and they remember it forever. He shared he had an emergency c-section for a surprise breech baby (as a very young physician) and, because of how hurried it all had to be, he accidentally cut something in the mom that he had to go in and fix a day later (can’t remember what). He said he just felt so guilty. All was well, nothing crazy life-threatening and surgery corrected it. BUT, he said, he saw that lady and her child 9 YEARS later and that guilty feeling just grabbed him and it was the first thing he remembered when he saw her. She, on the other hand, was perfectly happy with her healthy son and thankful for his birth. So if he felt that after a small mistake….

    It makes me think these midwives who kill baby after baby or injure baby after baby have something SERIOUSLY wrong with them, that they can continue to live life normally, have no guilt (because if they felt guilt they would HUMBLY ask forgiveness, learn from mistakes, get a real education so their choices wouldn’t harm more families, etc).They are so warped.

    All this and 2 friends getting ready to have homebirths this year with my former midwife… Sigh.

    • OBPI Mama
      February 25, 2014 at 6:31 am #

      Wish I could edit my above post… shoot, maybe my old doc did say the mistake he made was serious… but because he caught it though, it didn’t up being serious for the patient. My point was though, he felt awful and it never happened again!

      • Dr Kitty
        February 25, 2014 at 6:54 am #

        I know an OB who was climbing one of our local tiny mountains and stopped at the view point where he saw a lady who he vaguely remembered.
        He smiled and asked how she had enjoyed the walk.
        When he got back to the bottom he remembered that she was familiar because she has come in with a IUFD at 37 weeks and he had told her that the baby had died and been there when she delivered her stillborn baby…four years before.
        Weeks later he was still feeling guilty that he hadn’t remembered at the top when he could have said something nicer.
        Real professionals remember the hard cases, because it makes them better.

    • LMS1953
      February 25, 2014 at 7:06 am #

      They always assuage their guilt by saying “babies die in hospitals too” or “some babies just aren’t meant to live” or “death is an opportunity for personal growth by learning to *let go*”.

      Would a woman in labor – especially in a long, painful, protracted one – be allowed to sign a contract to buy a house? I don’t think it would be legally binding and whoever got her to sign it would be sanctioned and disciplined for having her sign it, especially if the terms were not in the best interest of a *reasonable* person. Several of the crunchies said that they have heard moms say that that they would rather their baby die than to deliver by C-section. No judge or jury would consider that a decision that a *reasonable person* would make. Hence, a CPM should be mandated to call for transfer when the situation exceeds her scope of practice. If the laboring mom refuses transfer, then the EMT should be mandated to call for police to place the woman in protective custody and take her away, kicking and screaming if need be. If these mandates are not followed, then it will be contributory evidence for charges of manslaughter or negligent homicide for all parties involved, most especially the CPM and even the mother. No right is absolute, even medical autonomy.

      • ngozi
        February 25, 2014 at 9:20 am #

        I completely understand women who are terrified of c-sections. I used to cry and stay up at night worrying if or not I would be required to have one. The fear of a c-section used to make me almost vomit (yeah, I know, pregnancy hormones). Also, I didn’t have anyone at home to help me, so that was a big concern too.

        Finally after 5 vaginal births, I had a c-section for very emergency reasons with my sixth delivery. After it was certainly determined that my child was DYING all my fear about the c-section was gone. I stayed in the NICU with my baby so I didn’t have to worry about childcare, cooking or cleaning for about a week. My incision healed great, and the only problem I had was constipation that aggravated my c-section pain (had I known from the beginning what was causing that pain, I would have asked for an ENEMA!).

        In short, there were a lot of horror stories on the internet and NCB woo (some from people who are doctors) that had me terrified of something that was not that bad (for me). Maybe that is what has happened to some of these ladies that would rather have a dead child than a c-section. I am sure some people’s c-sections turn out badly. Instead of trying to scare everyone out of c-sections, maybe some of these people who are so against them need to educate themselves and others about the FACTS about c-sections.

        • Karen in SC
          February 25, 2014 at 9:28 am #

          You are totally right. Having facts and demystifying the c-section experience would be great. Maybe more pregnant women need to watch that TLC show – IIRC there are many sections done. There is also a great series of Youtube videos filming a c-section. I

          I think it might be that these are mostly younger women with no surgical history. I had two surgeries before getting pregnant so I had experienced all those kinda scary and painful things already. So the only reason I was scared of a c-section was if I had one that meant something wasn’t right!

        • Meredith
          February 25, 2014 at 9:48 am #

          I had a c-section and was surprised at how well it went. I described the pain as “the worst pulled muscle pain of my life, but not the worst pain, ever, of my life.” I took nothing but Demerol, and then ibuprofen when I got home. A coworker of my husband said, “Within a week of the c-section, your wife will feel much better. Within two weeks, she’ll be back to normal.” She was right!

        • rh1985
          February 25, 2014 at 11:27 am #

          I initially was terrified of a CS because I hated the idea of being awake for surgery. I even had general anesthesia for my wisdom teeth! But later in pregnancy I ended up deciding on elective CS because I developed a fear of labor being unable to progress and needing a CS in the end anyway. It was all moot since I ended up needing one for medical reasons one day before I was scheduled for my elective CS.

      • me
        February 25, 2014 at 9:45 am #

        IDK. At the risk of being flamed here, it seems a slippery slope to say laboring women refusing transfers should be arrested, carted off, and forced to undergo surgery against their screaming protests. What about women refusing certain screening tests or interventions? Should they be physically held down and forced, and later charged as well? What about pregnant women who drink an occasional glass of wine? Should they be carted off and jailed so they can be supervised the duration of their pregnancy? What about pregnant women who eat cold cuts, or take Tylenol in the second and third trimester (there is a recent study suggesting a correlation between acetaminophen use and ADHD), or change the cat box? Should they be similarly jailed and charged if anything happens to their child? What about women with pre-existing medical conditions that make them more likely to have pregnancy complications? Should they be forcibly sterilized?

        Yes, what happened is a terrible tragedy. Maybe, just maybe, had this mother been accurately informed of the risks of postdates pregnancy, especially with low fluid, she would have taken herself to the hospital, midwife be damned, and her baby might be alive. But the idea of arresting laboring women, forcing them to undergo surgery, and charging them if the outcome is bad… yikes. Do we really want to go down that path?

        • NoLongerCrunching
          February 25, 2014 at 9:48 am #

          No way. I think LMS1953 is in the minority. Most of us believe that if mothers were accurately informed of the risks, only a vanishingly small number would have to be forced to do what’s best for her baby.

        • Young CC Prof
          February 25, 2014 at 9:48 am #

          I agree. If a woman is able to demonstrate that she knows what’s going on, and still refuses care, we should not force her. Ever. Once the child is outside her body, the child’s right to live overrides the parent’s right to make choices for him, but while it’s inside her, her bodily autonomy is more important even than another person’s right to live.

        • Karen in SC
          February 25, 2014 at 9:54 am #

          Dr Amy wrote a post in which she described a similar situation where she wrote up a short note along the lines of “I understand by refusing ______, there is a good chance my baby will die.” She and other caregivers were charting of course, but she felt something more was needed.

          The parents looked at it, an “actual dead baby card”, and changed their minds. Maybe seeing the words printed out and holding the pen opened their minds too.

          • me
            February 25, 2014 at 10:17 am #

            Exactly. Yes, I too have that visceral reaction of Jesus, why didn’t someone cart this woman off and MAKE her go to the hospital?!! OTOH, I see the mother as almost as much a victim here as that poor baby. Seems to me, she agreed to a BPP (tho it’s not clear where that was done or by whom), she agree to transfer when the baby’s heart rate looked bad, she agree to a c-section at the hospital…. had she not had some midtwit whispering in her ear telling her to ignore the post dates, to ignore the low fluid, that everything would be okay and babies know when to be born, I firmly believe she would have made a very different decision. And had her midtwit acted responsibly, and transferred her care no later than 42 weeks, and certainly as soon as they discovered low fluid, I believe this woman would ave complied. And her baby would be alive, and she wouldn’t be following a tiny coffin with empty arms.

            Yes, she needed a firm wake up call. She trusted this person who promoted herself as an “expert” and a “health care provider” to give her guidance and tell her when and if transfer was needed, and she was lied to. The “midwife” should be prosecuted to the fullest extent possible (and laws need to be changed to make sure that midwives are held fully accountable in cases like these). But the mother? She strikes me as a victim in all of this too.

        • Medwife
          February 26, 2014 at 2:28 pm #

          Well I sure as fuck will not be going down that path. A person has the right to refuse medical treatment and being in labor or just having a fetus within does not preclude that right.

        • Guesteleh
          February 26, 2014 at 2:46 pm #

          I 100% agree with you.

    • Young CC Prof
      February 25, 2014 at 9:34 am #

      Prior to this whole incident, I thought most of them were just kind of dumb. Now I realize they aren’t HCPs at all. They have no investment in outcomes, no drive to improve them. It’s some kind of weird religious thing, they like watching and having a hand in life and death.

      Their sister midwives 300 years ago may have enjoyed the respect of the community, but they were out to save lives as well as they could.

      • Anj Fabian
        February 26, 2014 at 8:23 am #

        At least some lay midwives cater specifically to religious groups.

        Judy Jones (currently charged with manslaughter) is one of those.

  16. anion
    February 25, 2014 at 5:40 am #

    1. Trying to shift the blame to some mystery “doctor” is pretty much a tacit admission that there is blame to be shifted, isn’t it? So much for “Oh, the baby aspirated mecomium a long time ago, nothing could have been done differently, nobody’s fault, nothing to see here, everything is under control!” (Aside from the fact that it’s clearly bullshit anyway; there wouldn’t have been that line about transfer of care if an OB was already involved.)

    2. I bet by the end of the day that FB page will be filled with pictures of babies and moms in birthing pools from the last three years.

    3. I have a big old crush on Dr. Grunebaum.

    • Dr Kitty
      February 25, 2014 at 6:56 am #

      IF THERE WAS AN OB INVOLVED (which I don’t think is true) and they didn’t advise immediate delivery then their practice needs to be investigated, and the MW involved has a duty to report concerns about their practice…no?

      • LMS1953
        February 25, 2014 at 7:27 am #

        I am not sure if an OB was involved. However, at least TWO BPPs were done. If somehow the CPM owned an ultrasound and did the BPP, then that is clearly practicing medicine without a license which is against the law. If a radiology tech did it, then s/he has to practice under the supervision of a physician (typically a radiologist but it could be an appropriately credentialed OB. Either or both of them could have legal liability – especially if they reported a BPP as *normal* with an AFI of 0 at 42+ weeks. I would really like to know how CPMs have access to ultrasounds and fetal monitors as these have stickers on the back saying they must be used under the supervision of a physician. If the CPM does not have such a supervising physician, then she should be convicted of practicing medicine without a license. If she does, then the physician should be sued out of practice for the CPMs negligence and malpractice. That would put an end to that crap.

  17. MrG
    February 25, 2014 at 2:16 am #

    As seen on the MT Facebook page for a second until it got deleted:
    5 Stages of Death by Kubler-Ross:
    1.Denial (the midwife didn’t do anything wrong)
    2.Anger (you accuse a midwife of not knowing her job? Shame on you!)
    3.Bargaining (there was a physician involved, this was a theoretical case with a real woman, Jan is no midwife but teaches it to others)
    4.Depression (Oh sh%^& that midwife killed a baby and it could have been prevented in the hospital)
    5.Acceptance (CPM midwives doing homebirths are undertrained, overconfident, have an increased neonatal death rate at homebirths. Let’s stop them from killing more babies)

    • Guestll
      February 25, 2014 at 2:23 am #

      I saw it.

      They can delete all they want. They can censor and manage and they can try to shove this under the rug, but people aren’t shutting up, they’re outraged and this isn’t going away.

      What I want to know is who manages their communications/crisis management strategy. What a disaster.

      • Anj Fabian
        February 25, 2014 at 7:55 am #

        Their PR person is probably arranging a group meditation to send healing energy into the internet.

    • Trixie
      February 25, 2014 at 6:44 am #

      I can still see that one.

  18. Stacy21629
    February 25, 2014 at 1:03 am #

    Random question…just listened to the Point of Inquiry piece (I know there’s another post on this, but didn’t think anyone would reply since it’s “old”). If an unintended OOH birth occurs (car on side of highway for example) who DOES sign that birth certificate? The hospital doc that intakes?

  19. attitude devant
    February 25, 2014 at 1:00 am #

    FWIW, the MIdwifery Today thread is the currently the best show in town. Donna has tried to deflect by claiming a physician was the caregiver in the case, and all the commenters are running with that idea:”That’s great! Since it was a doctor, he has malpractice insurance, so now you can sue!” I am DYING!

  20. Zornorph
    February 24, 2014 at 11:35 pm #

    Well, I tweeted Jan and posted on the FB page of Midwifery Today. I’m sure that won’t be up very long, but it felt good to post it.

  21. MLE
    February 24, 2014 at 10:39 pm #

    While putting the heat on Midwifery Today, I saw that someone asked on 2/11 whether she should become a CPM or a CNM. Of course there are many hilariously awful answers, including that CNMs have to go to school, learn something, etc, whereas with CPMs there are “many paths to knowledge” and there’s no danger of being “brought down by the medical approach.”

    In addition to those gems, someone did come up with a plus side to becoming a CNM: “But it also means I will have experience and access to dealing with higher risk women, thereby increasing my knowledge base for home deliveries.”

    • Young CC Prof
      February 25, 2014 at 9:43 am #

      Because going to school couldn’t possibly increase your knowledge base, right? School will just mess up your purity.

      • Amazed
        February 25, 2014 at 1:36 pm #

        … and priorities. God forbid you start caring more about saving life and health than keeping birth safe.

  22. Guesteleh
    February 24, 2014 at 9:44 pm #

    Amos Grunebaum Hold on please. If she is the editor of this journal then she is pretty active. She does a lot of conferences. Pretty active. If she is still a midwife then she should have known right from wrong. Or are you saying she is not a midwife anymore?
    about an hour ago · Like · 13

    • Amazed
      February 24, 2014 at 10:04 pm #

      I saw only one post of his there – the one you copied. And he sounds quite pissed off. I can’t believe this was his only comment. Are they deleting him?

      I imagine he’ll think about this fiasco next time he conducts a study proving that the whackos kill babies. Of course, whackos will scramble to discredit him. Otherwise, they wouldn’t be whackos.

      • DaisyGrrl
        February 24, 2014 at 10:13 pm #

        Trixie has a screencap of another one of his comments that they deleted. He’s pissed.

        I think that CPMs are starting to see the backlash against their rising popularity. As more disasters like this happen, the angrier OBs will get. After all, they’re the ones that get sued when a transfer doesn’t end well and Junior needs life-long care.

        • Amazed
          February 24, 2014 at 10:16 pm #

          But… but OBs don’t want to be backups! That’s why homebirth has such terrible rates! If only they were ready to shoulder the disaster, there’d be no disasters at all!

          Think there’s a big chance Dr Grunebaum would see the light and agrees to become a backup OB for the midwife from the case we’re discussing? Or the big majority of the midwives dispersing their pearls of wisdom?

          • DaisyGrrl
            February 24, 2014 at 10:19 pm #

            I know, right? He should be kneeling at the altar of their womanly wisdom, desperately hoping that they will deign to bestow even some crumbs of knowledge upon his humble person.

            Or, you know, he could just become one of the most outspoken critics of American midwifery out there. Yeah, I think he’ll do that instead.

          • Amazed
            February 24, 2014 at 10:26 pm #

            Oh yes. He’s a Man, after all. Hence, he’s all for persecuting women. Oh, and he’s an OB. Hence, he’s all for persecuting venerable midwives, lest they push him out of business.

          • attitude devant
            February 25, 2014 at 12:55 am #

            Yes, they only like men like Michel Odent and Michael Klein.

          • Amazed
            February 25, 2014 at 7:56 am #

            Addi, Addi, being a traitor to wombyn, you really aren’t the one to talk. Real women don’t become obs. They rely on their guts (what was this syndrom of their bowel disease again?) and become Midwives (I insist on keeping the capital letter.)

          • Young CC Prof
            February 25, 2014 at 9:51 am #

            I think that was Compliant Bowel Disease. Your gut tells you everything is A-OK.

          • Amazed
            February 25, 2014 at 1:22 pm #

            Yes! That was it. Thanks.

      • Guesteleh
        February 24, 2014 at 10:17 pm #

        They’ve deleted at least one of his comments.

        • February 24, 2014 at 10:19 pm #

          they have decided grounds for deletion are ‘further questions’ or ‘nastiness’, so basically anything that doesn’t support their view point. what a joke.

          • Medwife
            February 26, 2014 at 3:18 pm #

            I can’t post anymore. I wear my block as a badge of honor!

      • Danielle D.
        February 25, 2014 at 7:25 am #

        It makes a fair amount of sense that they’d delete Dr. Amy Tetuer and the deluge of non-friendly posters as “haters” who are transgressing into their “safe space”. It’s more notable that they have temerity to delete Dr. Amos Grunebaum, who is a major name in current, published, peer-reviewed research on mortality rates associated hospital/birth center/home birth. It’s like they don’t realize or won’t recognize how important he is and that he is someone to whom they actually have to respond.

        • Amazed
          February 25, 2014 at 7:57 am #

          I was actually surprised as well, more fool I.

  23. MLE
    February 24, 2014 at 9:39 pm #

    Sara Allsopp Lander if you’re reading here, thank you for the “peace and love.” You can always tell when they are up against the ropes when the faux blessings be comin’ around.

    • Trulyunbelievable2020
      February 24, 2014 at 9:49 pm #

      Namaste!

    • MLE
      February 24, 2014 at 10:32 pm #

      Um and just to be clear I was thanking Sara for the laugh for mocking the blessed “midwives.”

  24. sleuther
    February 24, 2014 at 8:58 pm #

    The correct twitter handle for MANA is @MANACommunity – not @MidwivesCommunity FYI. Thanks.

  25. moto_librarian
    February 24, 2014 at 8:58 pm #

    If you can, go to Jan Tritten’s FB page. She deleted all of the comments on her post in which she said that all questions were sent anonymously (i.e., her covering my ass post that followed deleting the conversation about the dead baby). People have noticed what she did, and she is being called to task.

  26. February 24, 2014 at 8:55 pm #

    God, I am getting more and more angry as I think about their response. http://exhomebirthers.wordpress.com/2014/02/24/the-first-rule-of-midwifery-is-you-do-not-ask-questions/

    from my post:

    “What I don’t understand is that if a physician was attending to this matter why on earth would the midwife be crowdsourcing the problem in the first place? She already had access to someone with much more training and experience than she did in the matter, who she could (presumably) talk to on the phone or in person to get in depth answers about her concerns. Why would she turn to a bunch of strangers on the internet to get suggestions?”

    Its just BS, pure and simple.

    • Squillo
      February 24, 2014 at 9:19 pm #

      Quite simple. Even if there was a physician involved, the midwife was looking for ways to “support” the mother in waiting. The physician was not “making the final decisions,” he or she was advising (any guesses as to what he or she advised?); the midwife was looking for advice that lined up with exactly what she wanted the client to do.

      • February 24, 2014 at 9:50 pm #

        ….”support” them by putting the primary physician’s license in jeopardy by sharing patient information on a public facebook page?
        The point is that nothing about this story makes sense. The narrative is all over the place.

        • Squillo
          February 24, 2014 at 10:53 pm #

          Sure. What the hell do they care? And you’re right; very little makes sense. They’re just throwing shit at the wall to see what will stick.

  27. Trixie
    February 24, 2014 at 8:37 pm #

    Did you see the latest post on Midwifery Today from Donna Zelzer?
    Begin quote:

    For those of you who have been posting on this page with your questions about something Jan posted on her private profile, Jan has mostly been away from the internet since Friday afternoon. I just talked to her on the phone and she told me:
    1. this was NOT her case. She has not been an active midwife for 20 years or so.
    2. the midwife who wrote to her privately was working with a physician on the case and the physician was the primary caregiver. The midwife was looking for additional information but was not the one making the final decisions. (I realize this was not clear in the original post. However, a number of people were and are jumping to huge conclusions without knowing anything about what was actually going on.)

    I am now going to delete all the questions on this matter that were posted and will delete any new ones. I will also delete any nasty comments on this thread.

    Donna Zelzer

    • almostfearless
      February 24, 2014 at 8:39 pm #

      Great, who was the physician who thought zero amniotic fluid was okay? Name the doctor.

      • Young CC Prof
        February 24, 2014 at 8:40 pm #

        The one who was wondering, “Where did it go.”

        • February 24, 2014 at 8:41 pm #

          their response is causing more questions than it answers. I don’t for a second believe a doctor was involved in this.

          • Young CC Prof
            February 24, 2014 at 8:44 pm #

            It’s pretty unlikely. Certainly not a “real” doctor. Maybe remotely an MD who went to the woo and gave up hospital privileges and insurance arrangements, but I doubt it. Actual doctors gone to the woo tend to confine themselves to safe cases and quickly shove off medical emergencies.

          • Trixie
            February 24, 2014 at 8:45 pm #

            Maybe “working with a physician” means posting on Joe Mercola’s FB or something.

          • Jessica S.
            February 24, 2014 at 8:52 pm #

            Ha!

          • Amy Tuteur, MD
            February 24, 2014 at 8:58 pm #

            They are simply trying to change the focus of the discussion. Let’s not let them do it. It makes no difference even if a hundred extra providers were involved. Jan Tritten crowd sourced a life or death decision on Facebook and a baby died. That’s the only relevant issue.

      • Trixie
        February 24, 2014 at 8:42 pm #

        It took them days and days to think up that excuse.

      • MrG
        February 24, 2014 at 8:56 pm #

        Dr.Stuart Fishbein, convicted sex abuser and home birth supporter?

    • Young CC Prof
      February 24, 2014 at 8:39 pm #

      a) Raise your hand if you think there was actually a physician involved.

      b) Even if there was, the fact that most midwives provided the wrong answer, and those who got it right offered the wrong reasoning, on a clear-cut emergency, is still alarming.

      • R T
        February 24, 2014 at 11:20 pm #

        If there was a physician involved, they were probably begging the woman to induce or have a csection. When my friend decided to go to 42.3 days the doctor she was transferred to, from her homebirth midwife, was very firmly telling her it was dire she delivered her baby, but she was still getting advice from the woo crowd to hold out. I doubt there was a doctor somewhere with a smile on their face telling the mom she was doing the right thing! Instead, the mom was probably under a great deal of pressure from the doctor to deliver and that’s one of the reason’s the midwife reached out in desperation for support from people on that page.

    • Karen in SC
      February 24, 2014 at 8:39 pm #

      I don’t believe that about “working with a physician” !!

      • Awesomemom
        February 24, 2014 at 8:44 pm #

        Yeah I am calling a major BS on that one. A Doc would have played the dead baby card and maybe gotten through to the mom about the seriousness of the situation.

        • KarenJJ
          February 24, 2014 at 8:48 pm #

          It also doesn’t excuse the inane responses of the “midwives” in that facebook thread who didn’t recognise an emergency and gave such moronic advice.

          • Dr Kitty
            February 25, 2014 at 9:43 am #

            It’s like playing a game of “telephone”
            I imagine the scenario could go something like this:
            MW to Dr: “Everything is fine, baby looks great on BPP, but the fluid is perhaps a little low”
            Dr to MW: “We should induce for low fluid, get her to come in”.
            MW to client:”The OB thinks you should think about inducing for low fluid, but baby looks great and many women with low fluid post term have wonderful homebirths. I have spoken to my MW colleagues who have lots of experience with this. Do you really want to lose your birth experience over such a small thing? Scans can underestimate fluid levels very easily.”
            MW to OB: “After being fully informed of the risks of going post dates with low AFI, client prefers to wait and see. We’ll repeat the BPP in a few days”.

        • R T
          February 24, 2014 at 11:24 pm #

          Like I said, the doctor may very well have done just that, but it doesn’t mean the mother or midwife believed him or her. I have sat in a room with a client when she signed out AMA for borderline preeclampsia, after two doctors had been in the room playing “good cop, bad cop” trying anything to get her to consent to an induction! She did not care what they said and wanted to go home and wait it out to see if it got worse. Thankfully it did not!

        • Danielle D
          February 24, 2014 at 11:35 pm #

          If a doctor was consulted and the doctor was not a doctor of some alternative medicine, there is a good chance that she/he did not talk to the mother. Probably the midwife had the conversation and then relayed her conclusions.

          Obviously I have no way of knowing that, it is true conjecture, but my natural childbirth/home birth friends have generally relayed to me that they understand one of the midwife’s main purposes to be keeping the doctors at bay, communicating with the doctor for the patient, and letting the patient know what is really going on. The implication is that the doctors are going foist things on you given half a chance, so you need someone to get them out of the room and somehow protect them. I don’t have any idea what that is supposed to look like in practice; at least in the hospital, I should think doctors would not be deterred from walking straight past the midwife and talking directly to the patient. However, with a home birth ….

    • Trixie
      February 24, 2014 at 8:40 pm #

      In reply to this post (sorry, I posted them in reverse order)

      • Trixie
        February 24, 2014 at 8:44 pm #

        And they’re deleting Dr. Grunebaum faster than I can screenshot now.

      • moto_librarian
        February 24, 2014 at 9:04 pm #

        Of course they have no sense of decency!

    • Klarastan
      February 24, 2014 at 8:52 pm #

      How incredibly cowardly.

    • Amy Tuteur, MD
      February 24, 2014 at 8:53 pm #

      They don’t even bother to pay lip service to the dead baby. Their only concern is to avoid accountability for grossly unethical, unprofessional behavior.

    • auntbea
      February 24, 2014 at 9:10 pm #

      I hate it when people comment on my private page which I have made public for anyone to comment on!

      • MLE
        February 24, 2014 at 9:29 pm #

        You must have been hacked! (Actual assumption by Elder Midwives)

    • DaisyGrrl
      February 24, 2014 at 9:10 pm #

      If the physician was primary, then why did Jan’s post say “We’re in a state with full autonomy for midwives and no transfer of care regulations past 42 weeks.”

      I don’t care whose case it was. It should never have been posted!

      • Squillo
        February 24, 2014 at 9:21 pm #

        A guess? Because the physician advised induction (or c-section) and the midwife wanted to be able to present the client with stories that conflicted with that advice. “Nyah, nyah, nyah. I don’t wanna, I don’t hafta!”

        • DaisyGrrl
          February 24, 2014 at 9:25 pm #

          Yeah, I’m not buying the physician story at all.

          • AmyP
            February 24, 2014 at 9:46 pm #

            Unless it was not an MD, but some other type of “doctor.” (Somebody upthread thought it might be a naturopath or something like that, which I think is a very good guess.)

          • anion
            February 25, 2014 at 5:33 am #

            Chiropractor, maybe? :rolleyes

    • Squillo
      February 24, 2014 at 9:13 pm #

      I hope that physician has really good med-mal coverage. (Was it a “naturopathic physician” by any chance?)

      Whether or not there was a physician involved, it is quite clear that the midwife was looking for support for the idea of waiting it out. But I suspect the physician story is a lie.

      • Karen in SC
        February 24, 2014 at 9:19 pm #

        “waiting it out” is one of the homebirth badges!!

      • Medwife
        February 24, 2014 at 9:23 pm #

        I bet it’s news to the doc s/he was the primary.

        • Squillo
          February 24, 2014 at 9:24 pm #

          How often have we heard that story?

          Midwife: “Oh, yes. I have a backup OB.”

          OB: “Huh?”

          • Young CC Prof
            February 24, 2014 at 9:25 pm #

            I found her number in the yellow pages. It’s in my phone and everything!

          • CanDoc
            February 24, 2014 at 10:18 pm #

            Welcome to my former life.

    • Young CC Prof
      February 24, 2014 at 9:17 pm #

      And still no apology or regret for the death. Unpreventable, right?

    • Medwife
      February 24, 2014 at 9:22 pm #

      Oh bullshit.

    • Squillo
      February 24, 2014 at 9:23 pm #

      Once again, way to own the outcome.

      No matter what, a bad outcome is ALWAYS someone else’s fault–the mother (she wanted to stay home), the baby (who didn’t want to come earthside), or the mystery physician (who apparently saw the 0 fluid and said, “meh.” Go ahead and have a homebirth.”)

    • Julia
      February 24, 2014 at 9:34 pm #

      Sure. There was a physician. The midwife was just there to do the web searches for him. Dr. Nick Riviera from the Simpsons maybe?
      Oh, and my question on Midwifery Today regarding this mess has been deleted.

      • PrimaryCareDoc
        February 24, 2014 at 9:37 pm #

        It might have been Dr. Drake Ramorey. (the character Joey played on Friends).

        • Durango
          February 24, 2014 at 11:39 pm #

          Or Dr Spaceman ( from 30 Rock)!

          • Jessica S.
            February 25, 2014 at 4:27 pm #

            OMG – I forgot about him! He was hysterical. I love the scene where he was trying to tell someone they have diabetes and he was like “I don’t know how to say this. No seriously, I don’t know this word: DEE-ay-BEH-TEES?” Or something like that.

          • Dr Kitty
            February 25, 2014 at 4:34 pm #

            As long as it isn’t Dr Krieger from Archer…

      • Jessica S.
        February 24, 2014 at 9:42 pm #

        “Hi, everybody!”

        • Trulyunbelievable2020
          February 24, 2014 at 9:48 pm #

          “Did you go to the Hollywood Upstairs medical school too?”

          • February 24, 2014 at 10:13 pm #

            wowww didn’t think you all were as big of simpsons fans as I am, but here we are. <3 you all.

          • Jessica S.
            February 24, 2014 at 10:26 pm #

            I’m a Simpsons nut!

          • Trixie
            February 24, 2014 at 10:28 pm #

            Pretty sure based on last week’s Weird Al discussion that this was a foregone conclusion.

          • Mishimoo
            February 25, 2014 at 5:43 am #

            And just like that, I have ‘Alberquerque’ stuck in my head again.

      • February 24, 2014 at 9:50 pm #

        HI EVERYBODY!!!! “inflammable” means “flammable”? WHAT A COUNTRY!

      • Trixie
        February 24, 2014 at 9:50 pm #

        The knee bone’s connected to the…something. The something’s connected to the red thing.

      • MLE
        February 24, 2014 at 10:40 pm #

        The coroner? UGH, I am so SICK of that guy!

  28. February 24, 2014 at 8:25 pm #

    OOOH responded (sort of):

    • Amy Tuteur, MD
      February 24, 2014 at 8:45 pm #

      Excellent. It already bothers them. Let’s keep it up.

      Also, the person who responded seems to have missed the main point. It DOESN’T MATTER if Jan wasn’t the primary midwife. She was the one who crowd sourced a life and death decision among her Facebook friends. That is both unprofessional and unethical.

      • Young CC Prof
        February 24, 2014 at 8:47 pm #

        1) Jan did not immediately tell the hypothetical other midwife to send the woman directly to the hospital for immediate delivery.

        2) She violated privacy by sharing the story in an open space.

        3) All the other midwives provided insane answers.

        • KarenJJ
          February 24, 2014 at 8:50 pm #

          In my work I need to report accidents as well as “near misses”. Near misses are taken JUST as seriously as accidents, because often the difference between a near miss and accident is purely luck/timing. The failures that led up to the near miss or accident are virtually the same (carelessness, negligence, lack of training etc).

          It doesn’t matter if this was a real death (which I believe it was), the actions of the midwives are still unconscionable.

          • Sue
            February 25, 2014 at 10:02 pm #

            Right, Karen. That’s how responsible professionals work. IN the health industry, it’s called Clinical Governance. Audit and review are a core part of business amongst actual health care professionals.

          • Chi-Town_MotorCity
            February 28, 2014 at 12:26 am #

            KarenJJ I might have accidentally flagged your comment. I’m on an iPad and it does odd things. I trust that the moderator will ignore my accidental flagging.

          • KarenJJ
            February 28, 2014 at 11:47 pm #

            Well I just learnt something. I didn’t realise that posts could be flagged!

    • PrimaryCareDoc
      February 24, 2014 at 9:03 pm #

      Bull. Shit. No way a physician was involved in this.

  29. Karen in SC
    February 24, 2014 at 7:51 pm #

    I just got a Twitter account, what do I do? (sorry Luddite)

    • Karen in SC
      February 24, 2014 at 8:07 pm #

      Okay I think I’ve got it! LOL

  30. Amy Tuteur, MD
    February 24, 2014 at 7:45 pm #

    In the Fed Up with NCB Facebook group someone had the fabulous suggestion of #notburiedtwice as the hashtag for our tweets.

    • February 24, 2014 at 8:23 pm #

      come on people there aren’t many tweets w/the tag yet! if you cant think of something to say retweet people who said something

      • Klarastan
        February 24, 2014 at 9:13 pm #

        Posting with gusto.

      • Karen in SC
        February 24, 2014 at 9:27 pm #

        Just tweeted Dr. Sanjay Gupta. Somebody else tweet him and add link, I ran out of characters!

    • auntbea
      February 25, 2014 at 10:31 am #

      Just a reminder to everyone: if you want your tweets to show up on a public page (e.g. MANAcommunity), you have to have your twitter feed set to public. Otherwise, only those who already follow you can see them. There are a lot of posts on the #notburiedtwice list that are not showing up on actual feeds.

  31. almostfearless
    February 24, 2014 at 7:17 pm #

    I just sent an email to 7 of my favorite publications, giving them a quick break down of this emerging story and attached the original FB thread. If you can think of a publication you like, or a writer you respect, email them a very short email about this, maybe “Midwife crowd sources life or death decision on FB, baby dies” might be a good subject line. Links to source material helps. At a minimum most publications have a “tips” or “scoops” email address.

    • Christina Channell
      February 24, 2014 at 7:24 pm #

      My local pro-CPM group had a status asking if anyone had reporter sources or “ins” with news outlets to promote their cause. They had several responses including email addresses. I contacted each one personally and offered to provide “the other side of the story” to make their article more interesting. We’ll see!

      • Karen in SC
        February 24, 2014 at 7:45 pm #

        Christina and Almostfearless – you are both awesome!

  32. Dr Kitty
    February 24, 2014 at 6:35 pm #

    Anyone think the ACNM might want to be made aware of what their “sisters” are up to?

    • Amy Tuteur, MD
      February 24, 2014 at 6:39 pm #

      They know what they are up to and it is to the everlasting shame of the ACNM that they don’t put a stop to it.

  33. Paula
    February 24, 2014 at 6:20 pm #

    Here is what I posted on the Midwifery Today FB page: I am
    curious about what will be done in response to Jan Tritten’s
    crowdsourcing treatment of the baby who died recently. I am sure that as
    a reputable source of information you will be as eager as I to denounce
    her handling of that situation (which, as we know, resulted in the
    baby’s death). And of course, since she is the owner of Midwifery Today,
    I am sure that if she wants to preserve any bit of credibility she will
    remove herself, correct?

    It was deleted within about 90 seconds.

    • Dr Kitty
      February 24, 2014 at 6:34 pm #

      I can still see it in “recent comments”.

      • Paula
        February 24, 2014 at 6:53 pm #

        I see it now! I don’t know if there is a way to edit my comment here, but it hasn’t been deleted–I totally missed it.

  34. DaisyGrrl
    February 24, 2014 at 6:09 pm #

    How do you take a screencap? Dr. Grunebaum just posted to the Midwifery Today facebook page!

    • anion
      February 24, 2014 at 6:25 pm #

      Mac or PC? What browser are you using?

      Don’t refresh until you have the cap!

      • DaisyGrrl
        February 24, 2014 at 6:31 pm #

        Okay, I’m on PC, Chrome. I got it and put it in Paint. How do I share it here?

        • DaisyGrrl
          February 24, 2014 at 6:39 pm #

          Trying now…

          • Guesteleh
            February 24, 2014 at 7:21 pm #

            Ice. Cold. Burn. He’s pissed. And he’s not the only one. The page is filling up with people asking for an investigation into Tritten’s actions.

          • Trixie
            February 24, 2014 at 8:30 pm #

            Dr. Awesome!

          • Ash
            February 24, 2014 at 10:28 pm #

            Dr Grunebaum is PISSED (as we all are). But of course, this is some Mysterious Hypothetical Midwife working with a Mysterious Hypothetical Physician.

            The truth will not come to light unless the family of the dead child finds this stuff on the Internet 🙁 No CPMs are demanding accountability, we don’t know where this event occurred. Tritten sure isn’t going to tell the truth. No CPMs are working for justice for this family.

        • anion
          February 24, 2014 at 6:41 pm #

          Load it into imgur (save to your hard drive first) and share the link? Or click that little photo icon in the lower left of the comment box. I’ve never loaded an image into a Disqus comment, sorry.

          • DaisyGrrl
            February 24, 2014 at 6:44 pm #

            So I tried it with the little picture icon. Looks easy to do, but I clearly need to work on my cropping abilities. It’s tiny, but you can click to embiggen.

      • Dr Kitty
        February 24, 2014 at 6:33 pm #

        Oh…loving that page…

    • Young CC Prof
      February 24, 2014 at 6:33 pm #

      ctrl-p, then look for “print pdf”. Or just ctrl-s.

  35. Amy Tuteur, MD
    February 24, 2014 at 5:57 pm #

    Found this being shared on the MANA Facebook page:

    • Young CC Prof
      February 24, 2014 at 5:59 pm #

      Right. No standing on the shoulders of giants, no learning from those who came before, everyone relies exclusively on her own research and experience. Is that what they’re saying?

      • Dr Kitty
        February 24, 2014 at 6:08 pm #

        If you aren’t super nice even in the face of extreme idiocy, women will know you won’t support them if their situation becomes too hazardous to safely manage at home and they might decide to save their money and just go to the hospital.

        So…Unconditional support and validation is better than safety!

        • anion
          February 24, 2014 at 6:29 pm #

          Exactly. If you dare criticize another midwife or even disagree with her publicly, you’re a meanie poopiehead! You should support other midwives no matter how reckless and irresponsible they are, or how many babies they kill, because all that matters is Being Nice.

          • Amy Tuteur, MD
            February 24, 2014 at 6:34 pm #

            English to English translation:

            If we don’t protect Jan Tritten from accountability when a baby dies, who will protect us from accountability when we let babies die?

          • Jessica S.
            February 24, 2014 at 6:35 pm #

            / THIS!! /

    • DaisyGrrl
      February 24, 2014 at 6:08 pm #

      The stupid, it burns.

    • AlisonCummins
      February 24, 2014 at 6:36 pm #

      I wonder if she knows what “vantage point” means.

    • fiftyfifty1
      February 24, 2014 at 7:46 pm #

      This is a cult, pure and simple, isn’t it?

    • realitycheque
      February 24, 2014 at 7:48 pm #

      God, these women act like a bunch of preteen girls.

      These are supposed to be adults, “healthcare providers” by their own accord. When will they realise that this isn’t some Traveling Sisterhood of the Ya-Ya Pants, or some other such crap… this isn’t a pinkie promise made at a sleepover party to be bestest friends forever; these are lives they’re playing with. Do they not look at their own children – do they not see the joy of every milestone, the laughter, the cuddles, the bedtime stories and the future that is filled with opportunity and realise that these babies will never experience that? That many of them will never even have the opportunity to consciously experience the warmth of their mother’s arms? And for what? A birth experience?

      That there would be one person who thought the way that they do would be unthinkable, but we’re talking about hundreds, possibly even thousands of midwives and “birth workers” who rally behind this crap. I can’t even comprehend how such evil can be so routine for them.

    • Danielle D.
      February 24, 2014 at 8:11 pm #

      They want to imagine a bold, new community of sisterly support that will be a model to all women?

      Here’s a start: let’s have a healthy community where criticism and discussion is possible.

      What good is a community that sits in a circle and goes “la la la?” And why, pray tell, shall I accept that as a standard for feminine community, let alone a professional one. Can you imagine a group of scholars not reviewing another’s work so that the analysis gets sharper over time through dialectic and new evidence? Can you imagine a group of doctors saying, the important thing is not to improve our outcomes or serve our clients by rigorous standards, our goal is to make certain that every MD feels supported in her work?

  36. February 24, 2014 at 5:56 pm #

    Deleted. From MANA and Midwifery today. I think if I wake up at an odd hour I’ll try again then.

  37. Dr Kitty
    February 24, 2014 at 5:53 pm #

    You can tweet Midwifery Today.

    I re-phrased slightly, asking what they were planning to do about a baby that died because a midwife didn’t know what to do about post dates anhydramnios.

    An obvious educational deficit needs addressed, rather than a personal attack.

    If even THAT is too much…

  38. Amy Tuteur, MD
    February 24, 2014 at 5:25 pm #

    From the Midwifery Today Facebook page:

    • Christina Channell
      February 24, 2014 at 6:40 pm #

      Woot! That was me.

      • moto_librarian
        February 24, 2014 at 8:17 pm #

        And I just noted that most people in the real world would view being the owner AND editor as a glaring conflict of interest.

  39. Amy Tuteur, MD
    February 24, 2014 at 5:09 pm #

    I posted the question on the Midwifery Today Facebook page. Already deleted!

    Even if they delete the Facebook posts, they’re still valuable. They’re public and they will be seen, if only for a little while.

  40. almostfearless
    February 24, 2014 at 4:57 pm #

    Yes, this. I’ve been commenting over the weekend on this thread: https://www.facebook.com/jan.tritten/posts/10152606010653696?stream_ref=10 which is the only thing left after Jan deleted the original post. No insults, no trolling, just asking over and over again, “what will be done to prevent this in the future?”

    • Anj Fabian
      February 24, 2014 at 5:01 pm #

      A simpler question:

      What happens when a baby dies under the care of a midwife?

  41. February 24, 2014 at 4:56 pm #

    NM please ignore

    • Ash
      February 24, 2014 at 5:39 pm #

      FYI Shameon, I uploaded a cached copy of the “shannah’s quick vbac breech waterbirth” story since it was conveniently removed from Hypnobirthing http://i.imgur.com/xFu09a1.jpg

      • February 24, 2014 at 5:51 pm #

        THANK YOU! I didn’t notice it was removed. I added your link to my post. You all are the best, seriously.

      • Dr Kitty
        February 24, 2014 at 6:14 pm #

        The trifecta of unnecessary risks to take!

        Because an entrapped head is SO much easier to manage underwater, and blood loss is so easy to estimate in a kiddie pool.

        I’m glad they were lucky, but oh, I wish they really appreciated it!

        • February 24, 2014 at 8:11 pm #

          I just can’t believe how much more interested the licensed midwife was in covering her own legal bases than providing appropriate care and real information about the risks. saying “do you understand the risks” and the mom going “yeah” (bc she read stuff on the internet about it) is so, so far from sufficient.

  42. Mel
    February 24, 2014 at 4:35 pm #

    Let’s bring it.

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