Update 2 to the #notburiedtwice campaign

notburiedtwice red

We continue to add signatures to the Change.org petition expressing revulsion at the behavior of Midwifery Today Editor Jan Tritten in connection with the death of a baby. As of this moment, 439 people have signed.

If you haven’t signed yet, I urge you to do so. In addition, the comments left at the bottom of the petition are worth reading. Some are very moving.

It was only a matter of time before homebirth midwives began leaking details of the case, and making manifest what I had only suspected. Many homebirth midwives, in addition to Jan Tritten, are aware of what happened in this case. Their highest priority is to make sure that the midwife or midwives responsible are never held to account.

Christy Collins, a Las Vegas Midwife, shared quite a bit on Facebook (since deleted):

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The story strains credulity to say the least. Suddenly there is a physician involved. Jan Tritten didn’t mention a physician, and specifically stated that the midwife did NOT have to transfer care to any physician. But in Christy’s version, it is the physician who is caring for the patient, the midwife is an innocent bystander, and it is the midwife who recognizes that the baby is having a bradycardia, not the obstetrician or the radiologist doing the scan. Really? And if that isn’t enough, Christy insists that the doctor announced that the baby had been doomed from the previous day and could not have been saved under any circumstances, raising the question of why the obstetrician was ordering tests on a baby he knew could not survive.

Christy was not the only one sharing. Laura Hopper, a Utah homebirth midwife (who was coincidentally as a neonatal resuscitation workshop in Las Vegas last weekend) weighed in, too.

I asked Christy on her own Facebook page whether she was the primary midwife in the case. She responded by deleting my question, deleting the entire area on her Facebook page where people can ask questions, and she sent me a Facebook message:

No, I’m not, but enough details had been passed around to select midwives to realize it was not what got created on Jan’s page, and it was NOT Jan. Someone needed to say something…

Good to know, Christy. So tell us who is the midwife.

I’m sorry, you know I can’t do that. Coming to the defense of others is something I will do if I feel that their actions were defensible. With what I have heard, and with what others posted, they were. It was presented by the midwife poorly, but the actions taken up to that point and past appear to have been within OB protocol…

So Christy has considered the situation, absolved the midwife and is moving on. But that’s not how it works, Christy. Impartial medical personnel should be evaluating the care that the patient received, not the friends of the midwife. And as long as we are discussing principles, Christy, you have nothing to be proud of. “Coming to the defense” of a midwife involved in a fatality by hiding the identity of that midwife is not ethical behavior. It’s the exact opposite.

I conveyed that to Christy, and she revealed her knowledge of the law to be as deficient as her knowledge of ethics:

… If I see my name associated with her situation per your doing again though, I will take legal action.

Ummm, Christy? YOU associated your name with the baby’s death on a public Facebook page. YOU have no basis to take legal action against anyone.

Where does that leave us?

We now know that quite a few midwives are aware of this debacle because the primary midwife shared the details. They have deliberately chosen to maintain a conspiracy of silence to protect the homebirth midwife from accountability.

Jan Tritten has disappeared, supposedly to be with her family. Rather ironic considering that what she is hiding from is the destruction of someone else’s family. Midwifery Today is refusing to make any statement of any kind. The Midwives Alliance of North America is utterly silent (of course, they are currently having bigger problems; the integrity of their study claiming that homebirth is safe has been demolished by Brooke Orosz, PhD). Melissa Cheyney, Head of the Board of Direct Entry Midwifery in Oregon has ignored the dead baby entirely.

They don’t seem to realize that their efforts to obliterate the life and death of this baby confirms so much of what I have been writing about them over the years.

I’d like to end this update with a shout out to my new best buddy, homebirth midwife Marlene Waechter. Marlene posted the following on Jan Tritten’s Facebook page:

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Why is Marlene my new best buddy?

I spend my days trying to alert American women to the dangers of homebirth midwives and the horrific deaths at their hands. I can tell women that they are uneducated, untrained and unacceptable in any other country. I can tell women that they aren’t midwives, but lay “birth junkies” who care more about their experience than whether a baby lives of dies. I can tell women that there are no safety standards in homebirth midwifery and no accountability. But I can’t do it alone. People like Marlene, demonstrating a stomach turning contempt for the death of this baby, whining that being held to account is being “picked on,” and offering support to the midwife involved in a baby’s death instead of to the family of the dead baby, make my job so much easier.

American women need to ask themselves: do you really want to be attended at birth by women like these, who won’t care if your baby lives of dies, and will protect themselves and each other from any accountability?

It’s time to abolish the CPM credential. It is nothing more than a public relations ploy that allows homebirth midwives to prey on unsuspecting women and their babies.

  • Amy Tuteur, MD

    The disgust with Jan Tritten extends to Croatia!

    • The Bofa on the Sofa

      BURN!!!!!!!!!!!!!!!!!!!!

    • Trixie

      Truly brilliant.

    • Guesteleh

      OH SNAP.

    • prolifefeminist

      OMG I love it

  • Ash

    Whoa, y’all. Just found this article attributed to Midwifery Today. Remember how Jan Tritten was talking about that “bathtub” comparison?
    http://birthaction.org/tools-for-mothers-2/all-those-tests/suspect-diagnoses-come-with-biophysical-profiling/

    “This diagnosis of low amniotic fluid frightens the parents-to-be into
    acquiescing to an induction of labour. Even though the official BPP
    guidelines do not require immediate induction for a finding of low
    amniotic fluid, in practise, the parents are pressured to induce.”

    “Be warned that this latest suspect diagnosis using ultrasound is
    increasing in frequency and causing increased harm to mothers and unborn
    babies through aggressive use of induction.”

    • Squillo

      Can someone post this to the Midwifery Today Facebook page? (I avoid posting on Facebook these days.)

      • guestguest

        Probably no one from around here can since they are blocking people left and right. I just left a nasty tone-inappropriate comment on a (seemingly) totally unrelated subject on one of their fb pages. I think nothing will sum up the ignorance better than a screenshot timeline comparison of before and after of how they posted, deleted, then posted again, then deleted again…Actually while I was typing this and tried to quote someone from the comments, the most recent version of the same disclaimer post on Jan’s page got deleted. Again.
        Point proven.

    • MaineJen

      That says “Low fluid.” Not “No fluid.”

  • The Computer Ate My Nym

    Do CPMs undergo any training on how to perform and interpret BPP as part of their certification? Are they required to undergo any kind of retesting or competence hours to maintain their certification? In short, do they know what they’re talking about when they declare that a fetus looks good on a BPP or are they mistaking, for example, seizures for movement?

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

      I went through the course catalog of a MEAC approved midwifery school for my blog, and there were zero courses about ultrasounds or interpreting them. You can take homeopathy or reflexology as an elective though!

      • The Computer Ate My Nym

        So, how can they even say whether the BPP was normal or abnormal? I suppose it’s possible that they referred the patient to a doctor to have the BPP and interpret the results, but I find that unlikely in context.

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

          Yeah I find it unlikely too. MWs practice outside their scope all the damn time, they just look stuff up or ask another midwife and go with whatever they find out.

    • LMS1953

      I imagine they have a sympathetic USG tech at one of those strip mall 3-D Memorabilia Ultrasound boutiques next to a Chinese Buffet Restaurant/Tae Kwan Do studio/ Fabric Shop/Sally Beauty Supply (I think those malls are pre-fab’ed somewhere in Indiana next to The World’s Biggest Fireworks Warehouse).

      Please click on images to see a strip mall boutique (3-D Baby Kisses) in North Las Vegas which is 11 minutes from a CPM office. Note: I am not implicating either establishment, I am just showing how such an arrangement is very feasible.

      • Mer

        Heh heh, turkey lane, how appropriate!

    • manabanana

      No. They are not required to have any training on BPP. They just learn that ultrasound causes hearing loss, autism, hives, hammer toes, allergies, syphilis, chronic fatigue syndrome and celiac disease. (I’m paraphrasing, because I can’t remember all what terrible things ultrasound causes.)

      But anyway – THAT’S what CPMs learn about BPP. Basically. But it’s not required.

      • The Computer Ate My Nym

        Syphilis? Well, why not. Makes as much sense as sound waves beyond the range that people can detect causing hearing damage.

  • ngozi

    I have a hard time believing that these parents were “urged” by midwives (or midwife) and truly given the risks and the parents were the ones who decided nothing should be done. I could be wrong, but I find this unbelievable.

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

    I just wonder how many other crowd sourcing idiocy posts from CPMs on facebook ended in death, but the midwife did not update it to tell everyone like Jan Tritten did on this post. This can’t be the first time (or the last).

    • Jocelyn

      Such a good point.

    • CognitiveDissonaceHurts

      I had a friend who had a homebirth go south and I later saw the midwife crowdsourcing on a midwifery page, but it was immediately after the fact, not during the decision to transfer. It was only because I knew the details of the botched homebirth that I recognized that it was my friend’s situation that was being discussed. It was kinda creepy, nonetheless, because my friend almost died.

      • Anj Fabian

        Was there a consensus?

        The midwife could have had a chat with the OB who took over the care. I’m sure the good doctor had some ideas as to what she should have done.

        • CognitiveDissonaceHurts

          Nope, there was not a consensus. No one bothered to note that had the mw been CHARTING, this situation would have been detected before it became life and death for the mom. And in the end it was the mom who insisted on the transfer…I shudder to think what would have happened otherwise. The hospital staff were extremely upset when the transfer came in and rightly so.

      • manabanana

        I’ve had CPMs call me and ask me advice regarding a laboring mom. (I’m still in their clique – but moving away).

        They generally stop calling me after I’ve told them once: “It sounds like you have a labor that is not progressing normally, and it sounds like you need some medical help. I think you need to go to the hospital.”

        This is not the advice they want. They want magic fairy-dust, everything-will-be-OK advice. I get called less and less.

        So maybe that is why they go to Facebook: the wingnuts will always post their advice – and they’re free to take it – and they’re free from any sort of professional consult situation where they would have to defend NOT taking a physician’s professional advice.

        Patients should never be discussed with any detail on social media. And I’ve seen it FAR too often. Mainly by midwives.

  • LMS1953

    One national news reporter who might be interested in doing an exposée on the issue of CPMs obfuscating their hideous neonatal death rate is John Stossel. I’m pretty sure I have seen him take on charlatans and medical consumer fraud before.

    • Zornorph

      It would be much better to get a woman reporter, though.

      • NoLongerCrunching

        Disagree. Having men involved communicates that this is not just a “women’s issue.”

        • Zornorph

          It’s just I figured he would be attacked because he’s ‘never given birth’ and ‘couldn’t understand’, blah, blah, blah.

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

            All will be condemned for stupid reasons. I wish it weren’t so, but I agree a man would be taken more seriously. Patriarchy sucks, but we have to work within it until/while it changes.

    • guest

      I don’t think anybody takes Stossel seriously as an objective reporter anymore. He’s veered into opinion and his schtick as a conservative contrarian. Also, the audience for his broadcasts has aged well past childbearing. If you want a large audience of men and women who are tempted by NCB well, if this were 15 years ago I’d try for NPR for broadcast and possibly the New York Times Magazine for print, as well as Mother Jones, the Atlantic, and maybe even Rolling Stone. I’d get Hanna Rosin. But you’ll be hard pressed to find a young audience for anything like that these days. And even if you could, I’m still not sure you could reach people who are in it. A lot of these things (vaccines, raw milk, homebirth) involve submersing yourself among like-thinkers and ignoring things you don’t want to hear. Get all your news straight from Mothering.

      • LMS1953

        I think HB crunchies are beyond hope. The target audience for Stossel would be state representatives who have voted to license CPMs. I would love to see him interview a crunchy representative from Vermont or Oregon and watch ‘em squirm and dissemble when he confronts them with the hideous statistics and asks them why they abrogated their duty to protect the public safety.

  • Tiff

    What a nightmare. Rest in peace, little one. Signed the petition and will definitely hold my c-sectioned baby even closer tonight.

  • prolifefeminist

    Ok, now hold on just one hot second. Let’s go over a couple of things midwife Christy said:

    1) “before leaving the last BPP where there was still zero fluid, but baby and placenta scored well, the midwife caught fhb’s dropping…”

    Any medical professional who declares that a baby and placenta “scored well” on a BPP without any fluid whatsoever is a negligent moron, am I right? Doubly so if they also failed to notice the dropping fetal heart rate. THANK GOD that midwife was there to catch that, eh?? What a friggin hero. /sarcasm Thank you, Christy, for rewriting history for us to try to make the incompetent midwife who kept saying that this “baby and placenta look great!” sound like the hero.

    2) The supposed OB said that the “first BPP they had done 24 hours prior was likely already too late and his induction would surely have caused the same result.”

    Oh, so the supposed OB involved saw that the baby was dying, and since he didn’t think this little boy would survive an induction, he…didn’t urge the mom to undergo an emergency cesarean?? Nowhere have I read anyone say that he did, which is the only damn recommendation that would make sense if you think a baby is actively dying and labor will finish the job. Maybe the midwives defending the negligence that lead to this little boy’s death (I see Christy referred to the baby as a he) should get their stories straight. The story gets more embellished, it seems, as we move along and as more questions are asked.

    A beautiful, innocent little boy will never grow up to be a young man who enjoys and experiences his life and brings joy and love to his family…a loss that is just beyond comprehension to me. And yet, all these HB advocates talk of nothing but how the midwife is completely, automatically innocent of all wrongdoing – not a word of sorrow over the death of this little baby, a question of whether the midwife made a mistake, or a desire to know how it all went so horribly wrong.

    How can anyone – especially anyone who witnesses the miracle of new life being brought into the world – care so little about making sure this never, ever happens again. Have they no heart??

    • LMS1953

      My take is that whoever did the first BPP tried to console mom by saying that *in retrospect* the first BPP showed no fluid and that the meconium aspiration had already occurred and the die were already cast. So, don’t feel guilty, mom. There was nothing you could have done. Some babies just aren’t meant to live.

      Ironically, this is one of those cases where if some bastard OB was going on vacation and scheduled her for an induction at 38w 0d and then did a C-section at 4PM because he wanted to make tee time at 1700 to get in a quick round on the back nine before heading home to pack – this baby would have been born just fine.

    • The Computer Ate My Nym

      Hang on a sec…

      A nonstress test (part of the BPP) involves evaluating the fetal heart rate and fetal movement. How could the fetus have been “perfect” on a NST if the midwife picked up a low heart tone a few minutes after the test was completed? I suppose there could have been an acute change that just happened to occur then, but if so then the die was NOT cast at the time of the first BPP and delivering then could have saved the baby.

      What is this bit about the placenta being “perfect” on the BPP? I can’t find anything referring to the placenta in the BPP. As far as I can tell, the components of a BPP are the NST, fetal movement, fetal breathing, amniotic fluid volume, and fetal tone. I’m not an OB and maybe the descriptions I’m reading are leaving something out, but…the more I hear about this story the less sense it makes. I wonder if they really did a BPP at all or just ran an ultrasound over the poor woman and declared it all good…

      • ngozi

        A NST test is what saved my baby, after he had just had a ultrasound that looked “good.” He had a horrible NST that lead to an emergency c-section.

      • prolifefeminist

        “How could the fetus have been “perfect” on a NST if the midwife picked up a low heart tone a few minutes after the test was completed?”

        EXACTLY!!!

      • manabanana

        Often the first part of a BPP is done without the NST. (movement, breathing, fluid volume, tone). If there’s a score lower than 6/8 on those aspects of the BPP, then then NST is performed.

    • Squillo

      Collins also says that they were “at a hospital with those 3 BPP’s, so wenr [sic] promptly into an emergency c-section”

      However, Tritten, quoting the midwife, says: “We came in, chose a c-section, and they worked on the baby for 47 minutes.”

      Were they at the hospital or not?

      Not that it mattered to the outcome, of course, but it certainly seems as if folks can’t quite keep their stories straight.

  • LMS1953

    So, it appears as if the tragedy occurred in Nevada and we have the date of birth within a day or two. The baby was delivered by C-section so the birth certificate will be signed by the obstetrician. The baby died at 2 or 3 days of age so the death certificate will be signed by the neonatologist. I don’t think the actual birth and death certificates are discoverable by non-relatives. I would imagine there would be a funeral notice in mom’s local paper, but it would be unethical and crass to track her down and harass her. But, given the city in Nevada, we could probably narrow it down to 2 or 3 CPMs.

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

      Where are you getting 2 or 3 days of age? They worked on the baby for 47 minutes before calling it.

      • LMS1953

        I am sorry. I got it confused with a New Zealand case that was posted a couple of days ago. With so many dead newborns, it is sometimes hard to keep their tragic stories distinct in the fog of Woo.

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

          Agreed. Thanks for clarifying. Poor babies.

  • Zornorph

    I would love for some reporter to start ambushing these women and shoving a microphone in their face on camera and nailing them with rapid-fire questions. Shoot, let’s see if we can fund somebody like they do in political campaigns to do it. Could make for some good footage on YouTube.

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

      I’d chip into that Kick Starter project. OR for a documentary that shows the dangerous side of homebirth.

  • Trixie

    Posters pointed out yesterday that Christy had the balls to post a poem about how babies don’t expire when they go past their due dates on her page.

    And that she was convicted of practicing medicine without a licensed in CA in 2011. So she moved to Nevada and kept practicing.

    • MLE

      Yeah she is a shady one, it seems.

  • CanDoc

    Yes. Yes. And Yes. Thank you, again, for shining the bright light of scrutiny on this whole appalling situation. And for always, always thinking of the precious babies who deserve the best chance we can give them at a healthy beginning. Thank you.

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

    This business with Laura Hopper and Christy Collins playing “I know a secret” with the mid wife’s name is particularly enlightning about the maturity of these babyslaughterers. I can’t believe they can still shock me this much STILL.

    • Trixie

      I have a strong feeling that Christy knows the midwife very, very well.

    • MLE

      Thankfully it is only a matter of time before someone blows the whole thing wide open. What’s the big deal anyway? The midwife depends one night in jail and you bail her out. Piece of cake.

  • desiree

    So according to Christy, this mother had 3 BPPs in the span of 24 hours? How could that possibly happen without an actual MD involved in the care? Would an MD be ok with waiting on a patient concerning enough to need a BPP every 12 hours? She’s got to be lying about 3 in 24 hours…

    • areawomanpdx

      You don’t have to have an MD to do a BPP. If she had an ultrasound, the midwife could be doing them herself. Or going to a naturopath or chiro that does them on the side…

      • Trulyunbelievable2020

        I think the following scenario is more likely:

        They did go to the MD for the BPP. The doctor told them that the baby was in grave danger, but the midwife and the mother suspected that he or she was just “fearmongering” by “playing the dead baby card.”

        In order to confirm her opinion and get the perspective of her fellow midwives, she then contacted Tritten. Tritten not only failed to tell her to get the woman to the hospital immediately, but also reposted her question. Then a bunch of other midwives told her exactly what she wanted to hear. Only when an indicator that she viewed as reliable– decelerations– appeared did the midwife do what she should have done in the first place: play the “dead baby card” herself.

        That’s just a guess, of course.

        • Danielle

          This seems like a fairly good guess. At least, it would explain why apologists are now saying, “a doctor was involved” — and yet was not able to convince the mother to act on the information from the first BPP. It seems reasonable to imagine that an OB was consulted at some point, but I have a very hard time imagining that a physician was in charge of the case from the start or was the primary source of information.

          It seems awfully convenient to say, “the baby had no chance of survival, even at the time of the first BPP.” But even if true, that does not justify the actions of whoever advised the mother–or enabled her in maintaining–that she ought to wait things out.

        • anion

          Christy pretty much said this outright in another of her comments in the same thread: that the perinatalogist was waving the “dead-baby flag,” and she contacted Jan to see what “other professionals” would say. So yeah, they had a doc there to do the test, but then totally disregarded his opinion. (Also, I still think that if the doc did say “This would have happened yesterday, too,” it was not at all a sign of approval of the midwife’s actions, but an indictment of the fact that she let this mother go so far postdates. And perhaps an attempt at kindness to the mother.)

          I ranted about it in comments to Amy’s post about Christy’s story, and quoted it there. Unfortunately I’m not sure how to link to a comment here and since I’m not logged in we can’t just click my name to find it.

  • guestguest

    Your correspondence with Christy M Collins proves that this was NOT a hypothetical let’s-all-chirp-in case study (she confirmed it was not Jan, thus confirming another midwife was involved indeed). This was a real life emergency that unfolded while the midwife sent out emails to figure out what she was dealing with and looked up medical advice on fb. It just crashed me, this new knowledge that this whole thing was real. Somewhere deep down I was hoping that it was not, and that a baby did not die in such a manner that all of us witnessed it.

    My condolences to the family, I do not know these people personally, but the way it was happening while we all watched I feel immense guilt over just being there on the internet, reading that post and the comments as they were so needlessly losing their child.

    I cannot even begin to imagine the pain or the humiliation if the family ever finds out what the person they trusted with the life of their baby was doing while their baby was dying, or how repulsively the midwifery community reacted to protect its interests.

    • Danielle

      I would like to believe that actually, more physician involvement was evident than it initially seemed (as they are now claiming), and that the mom was informed of all risks and did what she wanted to do, etc. However, the fact that they a first tried to claim this was only a “case study” shows that their first instinct was to obfuscate. That casts a lot of doubt on the claims made on Midwifery Today’s pages, as well as the information Christy is releasing through “back channels.”

      If the brief post on Jan Tritten’s page had been followed up immediately with more details to assuage fears and directly answered concerns, I’d be more willing to give the benefit of a doubt.

      • Young CC Prof

        The worst thing you can do in a public scandal is provide repeated contradictory “explanations.” Apologize up front, refuse to discuss the matter, make a brief statement and refuse to discuss it further, none of these would look as bad as backpedaling and forthpedaling and backpedaling.

        • prolifefeminist

          Yup. Because now they’ve shown everyone that they lied. And lied again. And continue to lie. It’s one thing to suspect someone of lying – quite another see it in print and know for sure.

          CPMs around the country regard Jan Tritten and Midwifery Today as the leaders of the HB movement. Anyone contemplating a HB ought to think twice about trusting anyone who follows these liars.

  • Ra

    I recently went on a family vacation with my sibling who is a healthcare provider (one of the “ebil” ones with actual training). We were in a place where there is legitimately NO internet or phone access. To get internet or phone reception you have to make quite a journey to a main road, and then wander around until you find the exact spot where you can sort of get a bit of a signal. It’s highly inconvinent and takes a good chunk of time away from the usual vacation/family activities.
    Anyway, prior to our departure, sibling had a patient with unanticipated complications. The complications were not life-threatening (probably a 4 on a 0-10 scale of complication severity) and care had been appropriately handed off to another competent provider while we were away. We STILL made the trek out to the main road at least once a day so that sibling could check up on the patient–both with the temporary care provider and the patient herself.
    Here’s another thing that legitimate healthcare providers do, but midwives can’t seem to manage: follow-up with patients, even when negative events happen. I’m surprised how many patients transfer to the hospital and then the midwife suddenly checks out of the picture and claims ignorance about the situation.

  • Sarah

    I can’t believe they’re trying to shift the blame on the parents. I can only speak for myself but if someone told me ‘we need to go to the hospital RIGHT NOW because of XYZ’ I would go in a heartbeat. These poor parents.

  • Karma Kidney Stone

    It seems like this is making the rounds, I saw someone posted about it on a Disney forum I frequent, of all places. Let’s hope it goes viral, that is the only way that there may be some changes. Maybe.

  • anh

    OT: I just moved to the UK where they apparently can show much more on tv. I just saw a commercial for Save the Children. It showed a young African girl giving birth. The baby comes out blue and the girl lies on her side and cries silently. Some text appears that says something like “For one million babies a year their first day is their last”. For a few more seconds you watch the midwife rubbing the baby who finally starts to cry. I don’t think my husband or I took a breath during the duration of the video.

    I felt such a rush of gratitude for the “cascade of interventions” that used to make me feel salty but which led to my beautiful daughter’s safe birth. Why the crap did I ever feel guilty for pitocin and monitoring and epidurals? What on earth was wrong with me? I didn’t have one freaking second in labor where I was worried for my daughter’s life. How can people not see what an enormous privilege that is? why do people want to condemn that which has made it possible for us to go into labor and have every reasonable expectation we will have a child at the end of it.

    Do these women not understand that their houses may be clean and nice and their candles might smell freaking great, but in terms of equipment they aren’t that much less primitive than hospitals in rural parts of the world where 1 in a hundred babies die at birth?

    • anion

      Completely agree. It takes quite a bit of privilege to turn one’s nose up at a lifesaving system that millions of less fortunate women would kill for–and die because they don’t have it.

      And I’m an American in the UK, so welcome to the club (you may be Canadian, of course, or someone from a non-English-speaking country who just types/speaks in perfect idiomatic English. Welcome to the club no matter where you’re from. :-) And get used to those commercials; wait until you see the NSPCC ones. Or the Dogs Trust ones, or the numerous other Africa charities ones, or the ones for every other charity.)

      • Dr Kitty

        Just be grateful you don’t have the Northern Irish road safety adverts.
        Graphic car crashes, blood, screaming, tiny coffins, the works.
        Instant dive for the off switch on the remote in our house.

        • Jessica S.

          Good Lord! I wonder if it makes an impact. (Yikes – I’m sure there’s a better word.)

        • anion

          I’ve heard about those. My goodness.

      • Joyous76

        I’m also an American in the UK. The adverts get worse at Christmas. Be prepared.

        • anion

          Oh, yeah, they really do, don’t they?

          I’m ashamed to admit we fast-forward over those ads (we do make monthly donations to the NSPCC and Save the Children). They upset our own kids quite a bit, so we avoid them when possible.

          (Lovely to “meet” another expat!)

      • anh

        yup! American. It’s been great thus far, although some things drive me nuts.

        • anion

          Oh, I hear you. I so, SO hear you. It’s quite an adjustment–and funnily enough I think it’s usually the little things that are the hardest to deal with. Cracked.com did an article a while back about five things that happen to you when you become an expat, and they were pretty accurate (and funny, of course), if you ever feel like Googling it.

          If you ever need to commiserate or ask questions or whatever, feel free to email me; I’ve lived here about five years total. Anion73 AT hotmail.

      • Comrade X

        Wait….you guys don’t have horrific tv adverts for charities featuring graphic footage of dying children? We have to switch the channel over every time one of those comes on, because my mother-in-law and I get so fucking upset every single time. Sometimes nearly to the point of being physically sick.

  • The Computer Ate My Nym

    Also, shall we start addressing you as Dr. Satan now?

    • Amy Tuteur, MD

      I’ve spoken at a number of conferences where I’ve introduced myself as Satan. Always gets a big laugh.

      • NoLongerCrunching

        I like it when they call you “She Who Must Not Be Named.” As if saying your name will cause you to appear in a puff of smoke and start lecturing them.

        • Young CC Prof

          But in the era of the Internet, naming someone actually CAN draw her eye.

          I’m just sayin.

          • MLE

            That’s because there is a Taboo curse on her name.

        • Karma Kidney Stone

          Beetlejuice, Beetlejuice, Beetlejuice!

        • Squillo

          Dr. Tuteurmort.

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

            Teteurmada? (Like Torquemada.)

            The inquisition! Let’s begin!
            The inquisition! Look out, sin!
            We’re on a mission!
            To make you tell the truth
            (Truth truth truth truth, truth truth truth)

            Not my best parody, but not bad for not having had coffee yet.

      • Trulyunbelievable2020

        Does Marlene Waechter live in a gingerbread house?

      • Medwife

        I’ll be honest, you rubbed me the wrong way for quite a while, but I refuse to call someone who’s never killed a baby or mom as “Satan”.

        • OBPI Mama

          I only call Satan “Satan”. I must be boring like that. Words to describe Satan, I will use. And oddly enough many of those descriptions apply to many homebirth midwives… deceitful, cunning, liar, killer, thief, destroyer (of families), jealous of God (thus hungry for power and more… which is funny because they claim doctors have a “God complex”)… Sigh

          • Zornorph

            All I can hear is the voice of the Church Lady. Could it be…SATAN????

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

            Zornoph, I spent a half hour yesterday arguing with cheezeburger mobile to make a church lady meme, and I never did win. Argh, I hoped I’d get it posted before another geek went Dana Carvey! Lol

    • anion

      Don’t you mean “Doctor” Satan?

  • The Computer Ate My Nym

    This sort of thing is exactly why there need to be standards for CPMs if they want to continue. No organization is capable of policing itself. It doesn’t work for doctors. It doesn’t work for drug companies. It doesn’t work for CNMs. It doesn’t work for CPMs. There MUST be guidelines, standards, and independent agencies overseeing quality of care. Or this will keep happening. Because there may be very good CPM practitioners, maybe even very good home birth practitioners, but there are always going to be bad ones too. And if you just let them go on without oversight, people will die.

    • jetset

      I think the bigger concern is location. Even though the bulk of the CPMs posting on Midwifery Today were absolutely moronic in their comments, the problem is home birth. CNM attending home births had worse outcomes than CNM attended hospital birth.

      • The Computer Ate My Nym

        I agree that location is a major problem: very few people have an OR and a NICU in their houses and it’s just never going to be as safe. But CPMs are acting dangerously even above and beyond the issue of home birth: prescribing potentially dangerous “natural” treatments, completely ignoring standard of care, blaming the parents when a baby dies…if they want to be considered professionals they need to start acting like professionals and establish some minimum educational and behavioral standards.

  • Dr N

    From Sermo.com

    1. I just read this post on Sermo: https://app.sermo.com/posts/posts/209480. I’m still seething over the incredible stupidity of this midwife. If this family sues her – and I sure hope that they do – is she at least going to be held to the same standard as an obstetrician would be, since she she thought that she did not need to get a doctor’s help?

    No.

    In fact, she is not even going to be held to the standard of a nurse-midwife, who is already a nurse and then takes at least two years of additional training in hospitals.

    She will be held to the standard of her “specialty”, a Certified Professional Midwife, a category of direct-entry midwife, a group that does not require any prior medical/nursing-related education and can become credentialed through self-study or by apprenticeship or at a midwifery school. CPM’s generally only handle home births and usually have no supervision by/association with an obstetrician or affiliation with a hospital.

    Their standards are those set by the North American Registry of Midwives and the Midwives Model of Care.

    This principle of non-physician practitioners being evaluated under a separate standard of care was dealt with in a 2002 case in Connecticut (in which it actually appears that the nurse-midwife was not fault).

    A patient being followed by a nurse-midwife (provided by her HMO) began to have a thick, milky vaginal discharge 18 days after an uncomplicated amniocentesis. The nurse-midwife diagnosed leukorrhea of pregnancy and advised her that she should just rest and that she did not need to come to the hospital. The patient began to bleed 12 days later and was referred to a physician who told her to come into the hospital. PROM was diagnosed and labor was induced but the baby was stillborn at 21 weeks.

    The parents sued and lost.

    They then appealed, claiming that the jury instruction on the applicable standard of care was incorrect and that the jury should have been told to assess the conduct of the nurse-midwife according to the standard that would apply to a physician practicing obstetrics.

    The appellate court upheld the trial court, making a distinction between “advanced nursing practice” and the practice of medicine. The court held that the nurse-midwife was “held to the prevailing standard of care that is recognized as acceptable and appropriate for a reasonably prudent nurse-midwife engaged in the practice of obstetrics and gynecology. A nurse-midwife is not judged by the standard of care for ob/gyn physicians.”

    It is important to note that the appellate court made a very important distinction from a non-physician provider who is under the supervision of a physician who is their employer. In that situation, the physician standard would apply to the supervised non-physician.

    In the case of a CPM, who is extremely unlikely to work with a physician, that would not apply.

    This case has some fairly egregious elements, such as the Facebooking while a critical condition progressed, that may therefore fall below even CPM standards – including at what point there should be involvement of a physician – but it is those standards that will be applied in determining if she committed malpractice as a CPM.

    • PrimaryCareDoc

      Gah. I know nothing on the internet if private, but Sermo is supposed to be a private group and pasting posts is a violation of their TOS.

      • anion

        Those of us without Disqus accounts can’t edit our posted comments, so perhaps flag it?

        • PrimaryCareDoc

          Ok, I flagged it.

    • sermo-police

      I agree with PrimaryCare Doc. Not a good idea to re-post Sermo content that is intended to be private.

  • Cathbetty

    Well said Dr. Amy.

  • MLE

    Talk about stomach turning. Didn’t Christy say that the mother was avoiding a c-section/transfer because she instinctively knew there was nothing that could be done for the baby and so she “wanted more time” with the baby before it was born and taken away? I can’t believe how easy they find it to sentimentalize negligence!

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

      Just like babies that could have been saved were ‘born sleeping’ or ‘didn’t want to come Earthside’. As though the baby just made a decision to die as opposed to be killed by willful ignorance and gross incompetence.

      • MLE

        Which is basically their way of recognizing that the baby has more control over the situation than they do (position, oxygen needs, etc) but that they aren’t going to do a damn thing about it.