Homebirth horror: mother bled to death while clueless Australian midwives assured her she was fine

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The story was horrifying even before we knew the details.

Maternal deaths in the hospital are unusual; perinatal deaths are 100 times more common. There are so few maternal deaths in the developed world that they are measured per 100,000 and most of the women who die have serious medical complications like cardiac disease or pre-existing medical conditions. Death from a routine childbirth complication like bleeding is almost unheard of in an age of blood transfusions and surgical repair … but not in an age of homebirth.

Caroline Lovell was an Australian homebirth activist.

She wrote the following in response to midwifery legislation under consideration:

On a personal note, I am quite shocked and ashamed that homebirth will no longer be a woman’s free choice in low-risk pregnancies… I feel the decision to outlaw homebirth’s is contrary to women’s rights … Please find a solution for women and babies who homebirth after this date as their lives will be in threat without proper midwifery assisstance. And as a homebirthing mother I will have no choice but to have an unassisted birth at home as this is the place I want to birth my children.

Yours sincerely,
Caroline Flammea, Nick Lovell and daughter Lulu Lovell.

She never acted on her dare, but perhaps she would be alive if she did. According to a tribute published at the time:

Caroline Emily (Flammea) Lovell

LOVELL (nee Flammea). – Caroline Emily 15.07.1975 – 24.01.2012 Passed away suddenly after giving birth to a beautiful baby girl. Beloved daughter of Jadzia (Jade), loving wife of Nick and exceptional mother of Lulu and Zahra. You taught us how to love Always in our hearts

Instead, Lovell told her midwives that she was dying, and they, with stupidity that borders on the criminal, never even examined her.

“A mother told her midwives she was dying and needed to go to hospital in the moments after she gave birth to her second daughter in her Melbourne home, the Victorian Coroners Court was told on Tuesday…

But just over an hour after the “overjoyed” couple greeted their daughter in their Watsonia home, the court heard Ms Lovell told her midwives she needed to go to hospital. Ms Lovell, 36, died later that night in the Austin Hospital.

And so Caroline Lovell bled to death … slowly, preventably … because the midwives she depended on were too ignorant, or too ideologically brainwashed, to perform even the most basic midwifery tasks. Instead, as reported by midwife Melody Bourne:

Just over an hour after Zahra was born in a birth pool, Ms Bourne said Ms Lovell was light-headed and hyperventilating, telling her midwives she was dying and needed to go to hospital.

“Gaye [Demanuele, the second midwife] then questioned Caroline as to what she was feeling, in this conversation Caroline did not identify any physical symptoms,” Ms Bourne said.

“Gaye and I also made efforts to calm and reassure Caroline.”

Five minutes later, Ms Lovell became pale, cold and unresponsive and an ambulance was called. Examination by hospital clinicians revealed Ms Lovell had suffered two tears and a blood clot.

Any real healthcare provider will tell you that the most chilling words you can hear from a patient are: “I think I’m dying.” That’s because they probably are dying and it is up to you as the provider to undertake whatever examinations and tests are necessary to prove that they are not.

It would have been laughably simple for the midwives to have assessed Lovell BEFORE they reassured her. Her life threatening blood loss would have been easily diagnosed by taking her blood pressure or checking her pulse. Nothing sophisticated was required, merely the most basic of clinical skills.

Instead:

Under questioning by Tania Cristiano, the counsel assisting coroner Peter White, Ms Bourne said this could have been identified if the midwives had examined Ms Lovell.

“There were more pressing events and there didn’t appear to be any excessive blood loss,” Ms Bourne said,

More pressing events? What could me more pressing than checking blood pressure and pulse to see if their patient was dying?

And that wasn’t the only basic task the midwives ignored. They never checked her past obstetrical history to learn that Lovell was at increased risk of bleeding to death:

Ms Bourne, who said she has since “distanced” herself from midwifery, said she was not aware of Ms Lovell suffering a postpartum haemorrhage in the hospital birth of her first daughter, Lulu.

Ms. Lovell had been warned:

Ms Lovell saw three general practitioners from the same clinic during her pregnancy, where she was warned about the risks of home births on four occasions and underwent blood tests, which revealed she was anaemic.

Dr Daniel Bevz had told the court earlier Ms Lovell was steadfast in her decision to have a “natural” birth.

“She indicated she had discussed that with previous doctors at length and did not want to enter into further discussions,” Dr Bevz said.

Had Ms. Lovell given birth unassisted, she might be alive today. When she told her husband she was dying, he may have called an ambulance to summon real medical professionals.

Instead, Ms. Lovell trusted homebirth midwives and they “reassured” her she was fine even as her life ebbed away.

Ms. Lovell trusted birth and birth killed her.

A fitting memorial to Ms. Lovell would be very strict regulation of Australian homebirth midwifery, so that no other woman or baby dies while ignorant, brain washed, negligent midwives stand by and watch.

But I predict that Australian midwives will fight that tooth and nail. Indeed, I can’t wait to see how midwifery spokesperson Hannah Dahlen tries to spin a mother’s easily preventable death at the hands of homebirth midwives who couldn’t even be bothered to check a pulse.

  • Godzilla

    Didn’t the coroner state that her death was either the result of Haemorrhoagic shock, Pulmonary Embolis or an Amniotic Fluid Embolus? Where is the evidence that she did in fact bleed to death? I’d love to find out so please share the conclusive evidence with your readers.

    • Young CC Prof

      Hemorrhagic shock is caused by (surprise!) hemorrhage. It’s a fancy name for bleeding to death.

      Amniotic fluid embolus is extremely rare, pulmonary embolism in a woman with no history of clotting disorder is fairly rare. Post-partum hemorrhage is distressingly common.

      • Karen in SC

        All three of those are best treated at the hospital. AFE is 100% fatal at home.

        • Godzilla

          Yes best treated in hospital BUT where is the stated evidence that she bled to death?

      • Godzilla

        Where is the evidence that she did bleed to death to keep it simple for you! AFI is rare indeed and often fatal regardless of birth place. PE is less rare than AFI and can indeed be fatal regardless of birth place BUT where does it say conclusively that she died from a PPH?

        • Young CC Prof

          Let me put it this way. Out of the three possible causes listed, PPH is orders of magnitude more common. About 1 woman in 6 suffers severe bleeding if nothing is done to prevent it, and this woman’s risk was actually even higher since she was anemic and had a prior history of PPH. She had no particular risk factors for PE, so her risk was about 1 in 10,000. The incidence of AFI is about 1 in 50,000.

          So, the probability that she had PPH is well over 99%.

          • Godzilla

            So you are saying she probably died from PPH now. I suppose it’s for the coroner to decide not blog writers. Was an autopsy conducted? What is the woman’s chance of dying in childbirth in Australia? Do you know the stats?

          • Young CC Prof

            It is remotely possible that she died of something other than PPH, but it’s extremely unlikely.

            I’m not sure why you’re arguing about this, are you trying to claim her death wasn’t the midwives’ fault and she would have died in the hospital, too?

            And the maternal death rate in Australia is 8 per 100,000, although deaths actually caused by the birth itself account for only about 2 per 100,000.

          • Godzilla

            Im not arguing about it except to say that the title of this post states that she bled to death, so I wanted to know where the evidence came from. To me from what I have read she sounded panicky and anxious and breathless and they can be symptoms of PE and AFI also. If there was any evidence that she did have an AFI then she would have likely died in hospital too.

            No I have actually heard some horror stories about Gaye Demanuele. I have had clients claim she had them push in second stage for 6 hours, one client’s mother asker her to leave after the birth and she took her daughter to hospital after a haemorrhage at home. gaye wouldn’t take her into hospital and the woman awoke from her unconsciousness with the taste of honey in her mouth. The woman ended up with x2 units of blood.

  • Maria Miller

    This story haunts me! I am the same age as Ms. Lovell and I was pregnant at the same time. I am happily now enjoying my 2 year old and am expecting again. My heart aches for her kids!! I will be forever grateful to my hospital birth team and my very careful common sense OB!

  • Ash
  • Guest

    I lost 1000mL after my csection and distinctly recall feeling like I was dying and that my life force was rushing out of me. Awful awful situation

  • Whimsy

    This is the most skewed and poorly written article I have ever had the misfortune to read. The author needs to return to primary school for some basic lessons in grammar, syntax and fact checking.

    • Stacy48918

      So…any examples??? Care to correct the “facts”? Anything substantive at all?

      Or just a parachute in “I-know-better-than-you-do” nah-nah-nah-nah?

      • Karen in SC

        Maybe Whimsy doesn’t like the one sentence paragraphs. I’m not an English teacher but since this is a blog post, I think it reads very well that way: more emphasis to important points.

    • Bombshellrisa

      Dr T doesn’t mind it when we point out any errors in grammar or syntax-just point them out and she will correct them. As for fact checking, she has only directly quoted the midwife here.

      • AustralianMidwife

        “she has only directly quoted the midwife here”…
        Actually, most of the quotes are from a mainstream Australian newspaper article by Tammy Mills – complete with an emotive, journalistic edge.

        An example of the skewed nature of the writing would be: “while ignorant, brain washed, negligent midwives stand by and watch”. The question about the clinical competency of the midwives is a separate idea to the wild assumption that they are “brain washed”. People have a wide variety of opinions on this matter, as with many others. It demonstrates underwhelming intelligence to claim that anyone who sees things from a contrary standpoint is brain washed.

    • areawomanpdx

      This is the most skewed and poorly written comment I have ever had the misfortune to read. The author needs to return to college for some basic lessons in critical thinking and logic. I might suggest starting with straw man and personal attacks. Perhaps backing up an argument with examples and evidence would be appropriate as well.

  • Hannah

    This just gave me goosebumps. These midwives should be in jail.

  • Jennie

    article doesn’t state she had PPH, its a bit vague; it says two tears and a blood clot. that could mean hemmhorraging from the tears but more likely an embolism. where is the information that says she had PPH?
    Article also says that she died later that night in the hospital. How critical was the 5 minutes delay in calling the ambulance (assuming that was truthfully reported)?
    (certainly, had she been in the hospital already, there would have been no travel time)

    • Young CC Prof

      That 5-minute delay, probably not much difference. But it appears that no one noticed anything was wrong until she was close to unconscious from blood loss. If they’d been monitoring her more closely, they probably would have realized that she was bleeding too much well before it reached that point.

      • jennie

        thats assuming that the problem was hemmhorrage, which the article doesn’t say. the post title says so, but where is it in the article?

  • Beth S

    OT: I’m trying to list things that could go wrong with homebirth in an email to a friend of mine, so far I have Macrosomia, Shoulder Dystocia, Breech, PPH, Nucal Cord and retained placenta. I know there’s more but I’m drawing a blank here. I know I’m going to link to Hurt by Homebirth. HELP!

    • The Computer Ate My Nym

      Pulmonary embolus, HELLP, malposition of the fetus, transverse lie, hemolytic disease of the newborn, cardiac malformations that need immediate treatment, immune thrombocytopenia purpura, infection, eclampsia, undiagnosed bleeding disorder contributing to PPH. Will that do for a start? It’s by no means a comprehensive list.

      • Beth S

        Thanks: Here’s the list of 10 questions that I think every mother considering homebirth should be asked:

        Here are some of the questions I have and please don’t take it the wrong way when I ask these questions I ask out of concern for both you and your child:

        1: Is this your first baby? If it is, you really should have been risked out of homebirth. It’s not for women with unproven pelvises as there are so many things that can go wrong.

        2: If it’s not your first baby do you have a history of GD, Pre-eclampsia, PPH, macrosomia, shoulder dystocia? If you do, then you should’ve been risked out immediately.

        3: You say a high risk OB/GYN is going to help with the delivery? By help do you mean act as a doula or act as a doctor because those are two differant things.

        4: You say the hospital is three minutes away, have you made transfer arrangments if nessicary? Will you have labs on file? Does the MFM doctor have privaleges at this hospital? Is the ambulance reponse time in your area quick? Is the hospital in your area equiped with a OR, 24 hour anastesiologist, NICU, do they even do births outside of the rare emergancy there?

        5: Have you read this site? http://hurtbyhomebirth.blogspot.com/

        6: Did you know that CPMs only have to have a high school diploma 50 births, 110 prenatal visits 40 new born exams and 50 post partum visits to be liscensed? And they’re not required to be nurses which CNMs are.

        7: Are you going to vaccinate your child? CPMs are not allowed to dispense vaccines or the Vitaman K shot babies generally need. Have you been tested for Group B strep or will you get tested? CPMs are not allowed to dispense the anti-biotics to keep your baby from getting sick either.

        8: Have you talked to the hospital you say they have too many rules and regulations, but most of the time if you want a natural, unmedicated birth without CEFM, IVs, Heplock, or C-section unless absolutely nessicary they’ll let you go that route. You can also turn down antibiotic eye goop, vitamen K shots and heel sticks for the baby. And no matter what others tell you Doctors cannot do anything without your permission.

        9: Do you have someone around to do the post-natal clean up? That is not part of a CPM’s duties and do you really want to have to clean up all that mess?

        10: Have you read this site? http://www.skepticalob.com I know in a lot of circles Dr. Teutuer is villified, but she makes a lot of sense, and there are a lot of CNMs, GPs and OBGYNs who comment on her site.

        I have to ask that you consider these questions for the safety of yourself and your child.

        • KarenJJ

          That’s a great list!

          The only thing that struck me is that some people think that seeing 50 births, or 100 births or 1000 births is a lot of experience. It takes a CPM how long? To get the sort of experience that an ob gets in a week or so?

          • Beth S

            Yeah now she keeps telling me her midwife went to college and they have master’s degrees. I think all HB moms should have to read the list.

          • Mishimoo

            Can she independently verify that they have master’s and in what field? How much experience do they have? (I recently discovered that the CNM that told me I was a good candidate for homebirth had only been registered for less than a year when she recommended it!)

            I think the list should be made into post or series of posts for homebirth mums, as a reminder of risks, if possible.

          • ki sarita

            This information can be easily found on state registries, they list all licensed professionals and the date of licensure.

          • Mishimoo

            Not all homebirth midwives are licensed professionals, they also (for the most part) don’t carry insurance.

          • Karen in SC

            Safer Midwifery for Michigan and What Ifs & Fears both did similar posts, very well written and researched. You might print them out and attach to your letter to your friend.

          • Bombshellrisa

            A masters in midwifery from a school like Bastyr? Their degree is specific to that school, the credits earned there don’t transfer to an actual college or university.

          • Irène Delse

            Ah, yes, naturopathic and assorted alt-med schools…

            “I have a degree in homeopathy!”
            “You have a degree in baloney!”

          • Jessica S.

            Best. Quote. Ever.

            I could watch that clip over and over. (Heck, I watch the shows over and over, thank you Netflix!)

          • RNMomma

            Masters in what though? A masters in English doesn’t help you deliver babies.

        • areawomanpdx

          Just a note… CPMs only need to have 20 births, not 50.

        • guest

          My friend delivered at home with no risk factors and several births behind her. She used a very experienced CNM with decades of experience. The baby is dead because she did not initiate appropriate NRP despite having taken the class (many times). She did not call an ambulance in a timely manner. There is no going back.

      • The Computer Ate My Nym

        Oh, amniotic fluid embolus. Rare but 100% fatal outside the hospital, 50% fatal in the hospital. And uterine rupture. Yes, it can happen spontaneously. And placenta previa or acreta, ditto.

      • The Computer Ate My Nym

        Heart failure. And I’m not talking about “heart failed due to lack of blood”, but actual cardiac issues, which are exacerbated by pregnancy. Sickle cell crises that can range from inconvenient to deadly (presumably anyone with sickle would know it already by childbearing age, but you never know who a CPM will take as a home birth client.) Asthma exacerbations (came disturbingly close to killing a relative).

        • Beth S

          This is a first time mother, she never should’ve been accepted in the first place hence the ridiculously long list of questions I sent her.

    • Mishimoo

      Cord prolapse and other cord accidents.

    • The Computer Ate My Nym

      Stroke. Malignant hypertension. Sepsis.
      Sorry, I keep coming up with more.

    • ki sarita

      i would suggest you get someone with some medical knowledge, as well as knowledge of homebirth laws in your state, to do this for you. if you don’t know what you are discussing you’re not going to be a very effective advocate.

      • Jessica S.

        I see where you’re coming from, but this is a friend of hers, so there’s already a connection and also, someone who is interested in/planning a homebirth is not necessarily going to take a medical professional at their word. Depends on the person, but especially when you’re dealing with an ideology, appeals to authority (especially from the “other” side) can backfire.

        Plus, Beth knows her stuff – at least I’ve always found her comments to be informative and substantive!

    • yentavegan

      infant inhaled meconium

    • Jessica S.

      Someone might force feed you your placenta?

      (Kidding. Everyone else in weighing in with helpful additions, I thought I’d bring the humor. ;))

    • MaineJen

      Undiagnosed GBS infection.

    • Helen

      did anyone say uterine inversion yet? My sister had that, normal pregnancy, normal birth and complete surprise: uterine inversion. Apparently she was rushed to the OR, lucky that they saved her uterus, lost several pints of blood and had to have blood transfusions. Doctors said if she’d been at home, she would be dead (but I’m sure NCB advocates would say “well they would say that, wouldn’t they?”)

    • Lisa from NY

      See page 5 of this Midwife consent form.

      http://dyekorasumda.com/Docs/Informed%20DisclosureFpub.pdf

  • Beth S

    Didn’t she know to blow cinnamon on the hemorrhage I thought that was always supposed to work. /sarcasm I don’t get it, I really don’t. These warrior women these HB midwives speak of would have killed to have the kind of medical interventions we have today. I remember Little House on the Prairie where Ma and Pa lost their only son, or one of the last books I think it was The First Four Years, but don’t quote me on it, where Laura was talking about losing her own son, and

    • The Computer Ate My Nym

      Really? I thought Henry the 7th didn’t even like Elizabeth of York and only married her for dynastic reasons. I guess, assuming my information is correct, that the pathos of losing someone in childbirth–with your child–is so extreme that it doesn’t even matter whether you loved them or not.

      • Beth S

        He married her for dynastic reasons however according to everything I’ve read (and I’m not including Phillipa Gregory) they did fall deeply in love. Henry 7th never really stopped mourning her, it’s said to be the reason he never remarried and he outlived her by 6 years so it was quite unusual for the time. He was also faithful to his wife from everything that’s known and when you consider in the 13th and 14th century this was unheard of for kings, it paints a picture of man who deeply loved his wife.
        Sorry for the long screed but history is kind of my thing. I love reading about it.

        • The Computer Ate My Nym

          Hmm…perhaps I should stop getting my history from Ricardian sources.

          • Beth S

            I have no dog in the fight when it comes to Ricardians V Tudors, but I kinda fell in love with Elizabeth of York for her name and so my reading tended to rely on sources about her.

          • anion

            Nonsense. Ricardian all the way!! :-)

          • The Computer Ate My Nym

            Uh-oh, now I’ve started it!

          • anion

            DOWN WITH THE TUDOR USURPERS!

            :-)

        • toni

          Henry VII was fifteenth/sixteenth century.
          I think Edward I was another king famously devoted to his wife

    • NoLongerCrunching

      Laura’s daughter Rose lost her baby boy too.

      • The Computer Ate My Nym

        Meaning that Charles and Caroline Ingalls had zero biological great-grandchildren that survived to adulthood (Mary and Grace never married, Carrie married and adopted 2 children but had none of her own.) Also of note: at least 3 out of the 4 girls in the Little House books died of diabetes, probably brought on by the stress of near starvation in the Long Winter (though that’s speculation on my part.) Ah, the good old days when all food was organic, no one was obese, and birth proceeded as nature intended.

        • NoLongerCrunching

          And of course Mary’s blindness from a vaccine-preventable illness (bacterial meningitis). Oh, and Almanzo being crippled from diphtheria. Good times.

          • Karen in SC

            Oh my god – I was even a regular watcher of the television show and didn’t remember about the cause of Mary’s blindness.

          • The Bofa, Being of the Sofa

            It has always been generally accepted that her blindness was caused by scarlet fever, but recent re-evaluation suggests it was most like BM

        • MaineJen

          And all food was locally sourced! Don’t forget that one. Even when there was no local food to source.

          • Trixie

            Not true! Pa used to hike through blizzards to bring back refined sugar and oyster crackers.

    • Sue

      A report from the inquest says that the midwives “helped the couple prepare for the birth” for SIX MONTHS – and yet they didn;t get an obstetric history? The more junior MW claims she didn’t know about the previous PPH.

      What were they doing over those six months? Choosing knitting patterns?

    • attitude devant

      And Jane Seymour?

    • Susan

      One thing that someone once pointed out, there is are people who seem to believe that death was somehow more palatable back then, or people loved their children less, or that women in other cultures are somehow accept that death is a part of nature… circle of life and Kumbaya. But really, where you read biographies the sense I get is that it made people batshit crazy to be faced with the capricious nature of birth and death, and it still does, in the third world, and often in our first world. It’s that “what doesn’t kill us makes us stronger” well no, we are scarred and wounded often and sometimes less able to cope than when we were more naïve.

  • fiftyfifty1

    Back in the 1970s when homebirth went through its first trendy phase it was different. At that time it seemed to target only low risk, healthy women. I remember my mother saying that since she had already had 3 easy births without needing the doctor at all, she might as well do the next one at home with a midwife.

    But now the philosophy has shifted. Natural used to be seen as best as long as everything was normal. Now it is seen as the CURE for situations that are already abnormal. This mom should never have been a candidate for homebirth. She had a PPH with her first and was anemic with her second. But because of NCB’s new screwed up philosophy, I’m sure she was told that home was the ideal location for her. Her soothing homebirth/waterbirth would prevent another episode of the PPH that I’ll bet was blamed on the hospital.

    • MLE

      That’s the best description of the problem I think I’ve ever seen – natural as the CURE as opposed to a silver lining, as long as everything fell into place perfectly.

      • http://www.antigonos.blogspot.com/ Antigonos CNM

        How often does one hear/read about the “healing” properties of a homebirth following the trauma of a hospital birth/ C/S?

        Precisely why one needs to be healed from a birth where the mother and baby are healthy at discharge is unclear to me, but there it is.

        • The Bofa, Being of the Sofa

          Precisely why one needs to be healed from a birth where the mother and baby are healthy at discharge is unclear to me

          Because they’ve come to the conclusion that they have “failed” and that their body is a “lemon.”

          Of course, that only begs the question of who taught them that? Homebirth midwives, of course.

        • Somewhereinthemiddle

          Well, I can answer this from my own personal perspective. My first birth was indeed rather traumatizing and I did need to heal from it. We both left the hospital healthy.

          I had an uneventful pregnancy during which no issues were detected. During labor was another story. I ended up having an abruption and a cesarean, neither of which were expected. So, while I am eternally grateful that the problem was detected and solved, it was a jarring experience. I was very, very shaken and fearful and had postpartum depression for a good long while.

          Again, that isn’t to say I’m not grateful for the medical expertise, but I think a situation like this is a prime example of how someone *can* walk away healthy but still need some healing.

          • Young CC Prof

            And it is perfectly reasonable to feel emotional trauma or distress after unexpected and scary complications crop up during birth. What’s weird is the people who decide that doctors CAUSED the feelings of distress, or that the only way to heal is to have a natural birth that goes “right.”

          • Somewhereinthemiddle

            Right, that part makes no sense to me at all either.

          • Carrie Looney

            I can totally see that. Emergencies and unplanned surgeries can indeed be highly traumatic, and IMO there should be mental health freely available for women who go through them, to help them heal.
            But then NCB/HB advocates prey on that trauma, convincing women that it was all the fault of the evil OB and hospital that saved them, not the birth itself and the blunt fact that nature can be a bitch sometimes. And that is what makes me mad. Having someone trust a process that tried to kill them and reject the people and processes that saved them is not a healing outcome, IMO.

          • Somewhereinthemiddle

            “Having someone trust a process that tried to kill them and reject the people and processes that saved them is not a healing outcome, IMO.”

            So very, very true. While I chose a different OB the second time, it was because the practice I saw during my first pregnancy attended maaaaybe 2-3 vbacs total per year collectively. I chose an OB that was waaaaay more experienced than that with vbacs, but obviously didn’t choose to walk away from the hospital entirely. Although I admit that it was my first knee jerk reaction to want to never set for in a hospital again.

        • sarita

          if you are still caring for women, maybe you’d like to find out then?

  • Captain Obvious

    I remember all the crunchy comments posted trying to crunchy rationalize how this wasn’t homebirth’s fault or the midwife’s fault…

    Jenn, Issaquah, Washington, 2 years ago
    There is no guarante that this woman would have survived in hospital. It appears that her heart condition was undiagnosed. Sad, but there it is.

    • Captain Obvious

      Judith Castro, Eugene, Oregon, 2 years ago
      My condolences for the family and friends of Caroline Lovell who passed away after giving birth to her second daughter. It is easy to be defensive and judge the choices of people who make decisions that break with convention, and who have the integrity to live be their values and good solid sensible research. I originated from a belief system that accepted hospital birth as a norm. After extensive and critical medical and alternative research my conclusion is that home births are best for low risk cases. One cannot foresee what else is going on in the body. It is unkind and unfair to assume that the hospital may have saved Caroline’s life. They may have induced the condition sooner with unnecessary medical interventions that frequently occur at hospital births. I hold her in the highest respect for living her life with integrity, courage, and grace. In some cultures she would be considered a warrior who died in battle, a warrior that helps other warrior women live with honor.

      • realitycheque

        “In some cultures she would be considered a warrior who died in battle, a warrior that helps other warrior women live with honor.”

        Something about these words is particularly unsettling for me. The woman died a preventable death and yet HBers find a way to spin it so that she lost her life FOR the cause. Her children are without a mother, her husband without a wife, yet she’s a warrior who bravely sacrificed her life in the war against “the man”.

        • Susan

          My first thought… the JW’s who hold up a woman who left a family motherless as a heroine.

        • Bombshellrisa

          What cultures are these that she is talking about?

          • realitycheque

            I’m betting that she has a stereotyped image of the idealised “tribal warrior woman” in mind.

          • KarenJJ

            Maybe she’s been reading The Red Tent?

          • The Computer Ate My Nym

            Aztec’s the only one I can think of that even vaguely fits. And it’s not, how shall I put this, not a culture I really feel we should emulate in detail.

          • Mishimoo

            Vikings as well, I think. Weren’t women who died in childbirth allowed entry into Valhalla as well?

          • Karen in SC

            Possibly she’s thinking of Klingons.

          • PrimaryCareDoc

            *snort*

          • Poogles

            “What cultures are these that she is talking about?”

            First thing that comes to mind is ancient Sparta – the only people who received gravestones were warriors/soldiers who died in battle and women who died in childbirth – both were seen as having given their lives for the state, and thus were honored after death.

        • anion

          In other words, if you go to the hospital to have your baby, you’re a lesser woman, dishonorable and not a “warrior,” and thus not worthy of any sort of respect.

        • Maria

          I was about to comment about this as well. I just don’t get it at all. She rails against “medicalizing” birth, but then turns around and compares it to war? I can guarantee in most cultures she would simply be mourned by her husband, children and family, not held up as some warrior who sacrificed herself on the “battlefield” of birth. Makes me sick.

      • Young CC Prof

        Yep, some cultures respected the risks and sacrifices that women made in bearing children by honoring the memory of those who died in childbirth. Our culture respects those risks and sacrifices by devoting an entire branch of medicine and wing of most hospitals to preventing those deaths.

      • Pilo

        Why is it unkind and unfair to assume that a hospital may have saved her life? I’m quite interested to know your rationale behind that statement.
        Hospitals have trained medical professionals from many disciplines (nurses, doctors, pharmacists, respiratory therapists, etc.); access to anesthesia, oxygen, medications, blood banks, and operating rooms; and experience in dealing with life-threatening emergencies. NO homebirth midwife has that. There’s nothing unkind about being equipped to save someone’s life. There are plenty of unkind things about watching her bleed to death while attending to ‘more pressing matters’ though.

        • Amazed

          Pilo, Captain Obvious in an OB. He’s simply citing homebirth advocates’ pathetic attempts to shift blame.

        • MLE

          Polo, Captain was quoting some NCB folks who commented on this topic when Dr Amy first blogged about it, before the facts were known.

      • Montserrat Blanco

        “One cannot foresee what else is going on in the body. It is unkind and
        unfair to assume that the hospital may have saved Caroline’s life.”

        Well, actually, yes you can assume that. BECAUSE IT IS PERFORMED ROUTINELY AT A MILLION HOSPITALS IN THE WORLD EVERY SINGLE DAY. We have all saved bleeding to death patients. We have all diagnosed properly severe bleeding patients. This is why it is so shocking that someone did not picked that up. We diagnose that because we are trained and because we know what to look for. And yes, she would have been saved at the hospital. It is not unkind to assume that and it is not unfair, especially if you have saved similar people before.

        The only patients that I recall bleeding to death are cancer patients when an artery is infiltrated by the cancer AND they do not respond to previous treatment like radiotherapy AND it is not possible to get a surgical treatment/endovascular treatment due to various reasons. People do not routinely bleed to death in hospitals. They might bleed to death in the street but not inside a fully staffed hospital with a blood bank.

        I am not going to comment on “she is a warrior” as I find that profoundly disrepectful regarding her and her family.

        • The Computer Ate My Nym

          I saw someone bleed to death or rather suffocate from slowly progressive anemia in the hospital once. JW, refused blood, very nasty renal/inflammatory anemia on top of a couple of other assorted problems with the marrow. It was ugly. Other than that…can’t think of any cases, not even the guy with 10 alloantibodies.

          • Dr Kitty

            I watched a man bleed to death when his massive mediastinal tumour suddenly eroded into his aorta.
            Unfortunately we just didn’t have time to save him.
            Thankfully he was unconscious in seconds, and died very quickly afterwards, despite our best efforts.
            It was the single most upsetting thing I think I’ve ever seen at work, and the only time I’ve had to shower after a resuscitation before I could talk to the family.

            The worst part, he’d been coughing up blood for months but hadn’t seen anyone about it, and had only been diagnosed earlier that day after being dragged to A&E by his family, so a) it was a terrible shock for them and b) it was hard to convince them we hadn’t killed him.

          • The Computer Ate My Nym

            That’s a nasty one. It’s hard for people not to feel that if they take someone to the doctor and they die the next day it was somehow the doctor’s fault, even if the person was obviously desperately ill.
            Heck, the other day one of the fellows asked me to guess what the bone marrow biopsy on a patient showed. I said the first horrible thing that popped into my head, which happened to be “severe MDS transforming into leukemia”. She said, “How did you KNOW?” My first, irrational response was to wish I’d said, “low grade lymphoma”. I know I didn’t cause his MDS, but somehow it still feels like I gave it to him by making a flip remark about what he might have. (Actually, it’s worse than that because I had brought up MDS as a possibility a few days before and everyone else had said, “nah, not that because x, y, z.” X, y, and z were all good reasons why it was probably something else, but…they were wrong. This time it was the zebra. So I felt doubly like I was responsible…despite knowing better.)

          • Mishimoo

            That would have felt terrible!

            I once listed off all the reasons why my brother-in-law should go to the doctor for his gut issues and keep going until he got a diagnosis, culminating in an explicit explanation of how much Crohn’s Disease sucks and why he needs to rule it out. The conversation when he told me went something like this:
            “Guess what I have!”
            “Oh shit.”
            “Exactly. Turns out it was Crohn’s.”

          • UsernameError

            My husband has seen it in newborns – once. They did a heel stick, covered the baby to keep warm, and when they pulled the blanket back, the heel never stopped bleeding. But this baby had liver failure, and so no ability to clot, from a rare congenital issue that I will never remember the name of. I think they got the baby back just enough to transfer to a higher level NICU, where they withdrew care. But in 16 years, it’s the first time he’s seen it.

          • Jessica S.

            Scary!!

        • theadequatemother

          pts I’ve seen bleed to death: polytrauma with DIC, PPH with DIC, erosion of tumors into the pulmonary artery with massive hemoptysis, bleeding from esophageal varices in end stage liver disease, bleeding into the gut in a very sick ICU patient with subsequent abdominal compartment syndrome. I think I could think of more if I tried.

          Women do die of PPH even in the first world and even in the hospital – generally when they develop DIC. But I don’t think that Caroline Lovell would have been one of them. She was symptomatic for more than an hour before she died. That doesn’t sound like a rip roaring PPH.

          It sounds like a “run of the mill” PPH that could have been treated with some IV fluids, uterotonics and possible manual removal of uterine clots/ placental fragments.

      • Jessica S.

        “After extensive and critical medical and alternative research…”

        AKA Univ. of Google.

        “…my conclusion is that home births are best for low risk cases.”

        In which she disproves this conclusion in the very next sentence:

        “One cannot foresee what else is going on in the body.”

        Right. Which is why, REGARDLESS OF RISK FACTOR, the hospital will always be the BEST case scenario.

        Just because she can string sentences together and make them sound smart, does not make them so.

    • MLE

      “Heart condition” being a heart that can’t function without blood? Yeah it’s good to know ahead of time if you have one of those.

    • The Computer Ate My Nym

      Heart condition? If you call having no blood available for the heart to pump a “heart condition” then, yeah, I guess she had one.

      • The Computer Ate My Nym

        Drat! MLE said it first and better. That’s what I get for not reading the full thread before commenting.

        • MLE

          Hahaha I’ve done that so many times. I need to remember to sign in so I can hide the evidence.

    • Bombshellrisa

      Issaquah-very upper middle class area. Gorgeous. A lot of wealth. They also have an extremely beautiful hospital that looks like a cross between a spa and a ski lodge. The area has a free standing birth center and so many herbalists, massage therapists and naturopathic doctors. I wonder if Jenn would choose to go to one of them instead of the hospital if she felt like she was going to die.

    • Beth S

      How can someone diagnose PPH as a heart condition? Is this woman stoned or does her reading comprehension just suck that badly? That’s like saying my history of PP seizures is a cardiac condition rather than a neurological one.

    • Dr Kitty

      I was thinking exactly the same thing.
      All the comments at the time who were sure there was an underlying but undiagnosed heart condition, or AFE, or some other completely unpredictable and incurable COD.

      Nope.
      Straight forward old fashioned PPH that wasn’t diagnosed or treated in a timely and effective manner.

      Here’s the thing I find so alarming.
      The midwives took a history but didn’t examine.

      If you’ve just delivered a woman’s baby “I think I’m dying” IS the history, you should already know everything about her medical history and her L&D. You skip straight to vital signs, checking for tears, tone and retained tissue while taking steps to prevent PPH.

      And if your hands are too full doing other, more pressing things it is time to call an ambulance, because you no longer have the manpower to manage the situation safely.

  • prolifefeminist

    This is mind boggling. This happened in 2012, for Christ’s sake! Not in some rural poor country with no medical care to speak of…this happened in a developed nation with lifesaving intervention at the ready! People have simply forgotten what it was like when home birth was the norm…back when birth was viewed with a healthy fear, because everyone knew that, left to run its natural course, birth has the power to kill. Even today, with the best medical care available, birth still has the power to kill. The general public has all but forgotten that.

    I was talking to my neighbor the other day, a woman in her 60′s who grew up in a rural European town. Her mother died in childbirth and her father was killed in an accident soon after. From the age of eight, she grew up an orphan. She sadness in her voice and the tears she tried to choke back as she spoke of her beloved mother left me with tears in my own eyes. Fifty-two years later, this woman – now a grandmother – still grieves deeply for the mother she lost so long ago. I can’t imagine that she “trusts birth.” How foolish these women are (and I was once one of them) to risk an entire lifetime for a fleeting experience.

    My heart goes out to this woman’s children and family. This is a loss that they will carry their entire lives.

    • Busbus

      What a sad story – this one, and your neighbor’s, also.

      I have started to read the European fairy tales to my daughter, and I am stunned by how many women die in them. It occurred to me just a few days ago that the reason there are so many “evil stepmothers” in these fairy tales surely was that there were lots and lots of motherless kids around (whose fathers may or may not have remarried later on). There are also several stories in our book that start with a baby being born, “but a few days later, the young queen died.” (That particular quote is from the German version of Snow White.)

      Modern medical care has really enabled us to forget about the dangers of child birth. But the modern homebirth movement is bringing them back.

      • Young CC Prof

        And that’s probably one reason why the original NCB folks in the 1970s weren’t nearly so extreme. Deaths in childbirth were much closer to living memory for them. My mother’s grandmother, for example, would talk about her friends who’d died in childbirth. So, while my mother wanted as natural as was feasible, she never made the mistake of assuming that everything would be fine.

        • http://www.antigonos.blogspot.com/ Antigonos CNM

          Once again, it’s worth remembering that the origins of the NCB movement were VERY different from now. Prior to the development of the epidural, the ONLY really effective form of analgesia in labor was IV or IM medication, which depressed the baby’s respirations. NCB, mainly using some form of breathing techniques a la Lamaze, was intended to be a substitute method. THAT WAS IT. Nothing about homebirth, or promoting the “experience”, just a way of making the birth SAFER for the baby, not a means of worshipping at the shrine of “nature”.

          The emphasis shifted BECAUSE, IMO, the advent of epidurals removed the need to avoid analgesia.

      • Bombshellrisa

        I was thinking that the current NCB culture and their obsession the ideal birth experience has much in common with the craze about fairy tale princesses. The European version of fairy tales was gritty: the little mermaid felt like she trod on knives as she walked and she ended up dying in the end, Cinderella’s story included women cutting off parts of their feet to attempt to fit into the glass slipper, the pied piper led children into a river and drown. The stories were grim and had some sad endings. But who remembers those stories I their original form? Most people have only been exposed to the Disney version, so they are focused on the happy ending. Same with homebirth, Few of the privileged, white women who are homebirth advocates have seen the grim reality of what can happen without access to medical care. They didn’t talk to their great grandmothers who birthed at home and didn’t have pain medicine and who lived with the aftermath of birth injuries that were never repaired. They have watched “The Business of being born” but not “A Walk to Beautiful”.

        • KarenJJ

          For every person that watched The Business of Being Born, I would like them to also watch A Walk to Beautiful. Perhaps it should be a facebook challenge?

          • Beth S

            I just want to slap the people who made The Business of Being Born. I watched it for ten minutes or so, then shut it off because it is oddly hypnotizing. I want the people who watched it to read things like the Little House books where Laura talks about losing her younger brother and her own son (they can watch the show if they don’t want to read, it was hokey but the way they dealt with these two issues was beautiful.) Read some of the Orphan Train stories, or even Oliver Twist, then tell me that people in the past didn’t fear childbirth.

          • Bombshellrisa

            Anne of Green Gables-Anne was an orphan because both her parents died of something we have a vaccine for now and she lost a baby soon after birth. Reading those books, you would never hear homebirth being gloried, it was where babies were born, and a lot of them didn’t make it (and some of their mothers didn’t make it either). When they said “wasn’t meant to live”, they were saying it to try and make some sense of their grief.

          • Medwife

            In the Little House books, no mention is ever made of the Ingalls’ son who died. It must have been horrifically traumatic.

      • Irène Delse

        Indeed. Snow White’s mother dies shortly after giving birth, so does Cinderella’s, and Beauty’s from “Beauty and the Beast”. It was a known danger, and very much part of life, even though not much could be done about it. In Catholic countries, people hoped to find protection in invocations of saints, in relics, etc. Medals of Saint Margarita were a frequent gift to pregnant women. Blessing medals was a source of revenue for priests, and midwives also sold them as a side business. People felt the need for as much help as was available, both natural and supernatural.

  • QZ_101214

    It occurred to me that the MWs were busy because the baby came out less healthy than claimed.

    • Mac Sherbert

      I was wondering about that. The only thing I could see that would be more important than mom or keeping them busy might have been a baby in trouble. ???

      • MLE

        Or maybe the knitting came unraveled? The space they were holding got away from them for a second?

  • realitycheque

    Unfortunately, this response to this poor woman’s fears doesn’t surprise me in the slightest. GD was my homebirth midwife and she is very extreme in her views, and very anti-medicine. I know she has done homebirths with twins before, and referred to breech as “a variation of normal”.

    I fear this won’t be the last preventable death we hear of under her care.

    • jenna

      So SO worried for two women i know whose births she will be doing this year and next

      • realitycheque

        Woah… it is my understanding that she has handed in her license, and I can’t find her registered on any websites… although I’m not very savvy with that sort of thing, so may be looking in the wrong places.

        I have heard speculation that she de-registered so that she could attend high-risk births under the radar (a’la Lisa Barrett, who – as I understand it – is a friend, or at least acquaintance of hers), and I know that after she decided to hand in her registration, she stated publicly to the effect that she was relinquishing the “title” of midwife, but “they cannot take away my midwife hands, or my midwife heart” (quoting verbatim there).

        If she has truly handed in her registration, there is no way she should be attending births.

        • jenna

          She is definitely still attending births! Maybe as a ‘doula’ and had publicly said she is not a MW anymore on twitter but it is untrue…

        • Sue

          Thankfully, the actions of LB have resulted in national changes, originating in South Australia, to ban any unregistered ”birth attendant” participating in a birth in any active way. Any unregistered birth attendant who leads the birth care team is liable for a $30,000 fine or up to 12 months imprisonment.

          • KarenJJ

            Are they national now? My memory was that the SA coroner wanted the laws to be national but they weren’t able to get national laws in place within good time to stop LB and had to settle for just getting them into SA for now. Hopefully they are national – last thing you want is LB shuffling over the border to wreak havoc in another part of Aus.

          • Sue

            You are right, Karen, it’s only South Australia so far.

          • realitycheque

            If she got caught attending births unlawfully, surely she would have difficulty claiming that she wasn’t there as a HCP… I suppose she could claim to have been attending as a doula/”support person”, but unless she was being paid in cash, there would surely be financial records. With that said, I have to wonder what the deal is with declaring tax if someone is receiving income for a job they’re not legally supposed to have.

            It’s concerning, as you can imagine there would be considerable motivation to avoid transferring to hospital, or accompanying your client to the hospital during a transfer if you know you’re doing something that could potentially get you into a lot of trouble.

      • realitycheque

        This was the post made about handing in her registration:

        (Dated June 4, 2012)
        “To all the wonderful women who have shared the birth circle with me, those giving birth and those supporting, I wish to share with you that I have returned my midwifery registration to AHPRA. I choose to no longer call myself a registered midwife (which would attract a $30K fine if I did).
        Of course, no one can take away my midwife heart, hands and soul and I will continue to physically and emotionally support birthing women as I can.

        I’ve decided to make public a copy of the letter that I wrote to AHPRA.

        To whom it may concern,

        I choose to terminate my midwifery registration NMB0001113105 and my nursing registration NMB0001113104, effective from the 31st May 2012.

        I choose to not collude with a maternity care system that does not respect the rights of birthing women and their midwives.

        A maternity care system:
        • That restricts women’s birthing choices; that coerces some women into medical treatment that places them at a 1 in 3 risk of surgical birth with it’s associated complications. (Less than 10% of women actually require obstetric services.)
        • That restricts the ability of midwives to care for women in a woman centred and holistic, primary health model.
        • Where the human experience of birth is given little recognition or importance.
        • Where many midwives are reduced to the role of subservient obstetric nurses rather than their rightful role as autonomous health professionals working in partnership with women.
        • Where some registered private midwives deny choice to women through fear of being reported to AHPRA should they support a woman’s choice that is not in compliance with imposed and non-consultative obstetric guidelines dictated by insurance policy underwriters.
        • Where too many women and their babies suffer the effects of frequently unnecessary procedures that result in physical and psychological birth trauma.
        • Where some of my peers feel compelled to make malicious and vexatious complaints based on gossip and hearsay to AHPRA in the name of mandatory reporting.

        • That forces some women into the position of choosing unassisted birth where their choice would have been to have a midwife attend her in labour at home had one been available. A system that then blames and penalises women in this position.She posted this “They didn’t have a license when they first began, as far back as I can remember. I didn’t know of ‘em havin’ t’have ‘em until up later years. Then thet got t’where if they delivered babies, they had t’have a license. And then they were finally just completely cut out of th’job at all. Weren’t allowed to’do th’ job at all. Cox, “Midwives and Granny Women,” 286.””

  • Forgetful Guest

    I remember reading about her death, and wondering what had happened.

    I suffered a PPH after the birth of my first child. I don’t think I would have been able to “identify any physical symptoms” or even speak because you know, I was too busy slipping in and out of consciousness. Luckily I was in a hospital with competent staff that took immediate action.

    Poor woman. And poor kidlet, growing up without a mother and the additional burden of knowing that she died after giving birth to her.

    • realitycheque

      Not being able to identify symptoms doesn’t mean there are no symptoms present. I would think a lack of lucidity would be a pretty common symptom of PPH… how could they hear her say, “I think I’m dying” and go… “Well, she can’t describe her symptoms to us, so she must just be imagining things!” surely you would at least take the woman’s blood pressure/pulse??

      Given the fact that these women consider themselves “feminists”, you would think they would listen to a woman’s concerns and not blow her off as being hysterical.

      • Forgetful Guest

        So true. I guess these symptoms didn’t fit the midwives’ agenda and would have inconvenienced them. If the symptom is incompatible with the pursuit of a perfect homebirth, well then it’s just hysterics. It really seems to be like that.

  • Young CC Prof

    OT: For those of you in the USA, the deadline to submit comments on provider non-discrimination is tonight, midnight eastern time! Let’s keep Medicaid and private insurers from being forced to pay for CPM care, or treat naturopaths as primary care doctors!

    http://www.regulations.gov/#!docketDetail;D=CMS-2014-0033

    • Busbus

      This is really important! I had no idea this was going on. The vast majority of comments on midwives are from homebirth supporters. If you live in the US, take a few minutes to fill it out! You can even leave your comment anonymously, if that is what you prefer.

    • Trixie

      I’m happy to comment, but is there a quick copy and paste script I could use?

      • Young CC Prof

        Um, something like:

        The only properly qualified midwives are nurse-midwives with graduate degrees. Some states have recognized lesser licenses such as Certified Professional Midwife or Licensed Direct Entry Midwife.

        These minimally-trained practitioners are not eligible for hospital privileges and usually deliver babies in birthing centers or at home, with dreadful results.

        Death rates are at least three times higher for the babies they deliver than for comparable babies delivered by certified nurse midwives in hospitals. They also have high rates of permanently injured babies and serious maternal complications, frequently requiring hospital transfer and very costly additional care.

      • Stacy48918

        I commented. Also uploaded 12 research articles on the risks of homebirth, all just in the last 2 years.

      • Melissa

        It’s an administrative ruling so copy and paste comments don’t matter. Agencies only look at comments that are relevant to the specific rules, and form comments get filtered out. (The agencies aren’t elected so popularity of an idea is generally not something they can use as a factor in rulemaking). At some point I’m going to write up a guide on how to comment on a rulemaking (since between this and the net neutrality thing it is becoming more common.

    • Busbus

      I just submitted this comment:

      While I do believe that homebirth should be a viable option for women, I don’t believe that Medicare or Medicaid funds should be used to fund homebirth (non-nurse) midwives in the US today.

      There are several reasons for that.

      1) US homebirth midwives are unqualified to attend to mothers and babies in childbirth:

      Nurse midwives (CNMs) are well educated and full members of the medical community and frequently work together with other health care providers within and outside of hospitals. Other types of midwives, however, may have little to no actual medical education. Even today, this fact is not obvious to many parents who choose homebirth. It certainly wasn’t obvious to me when I chose to have a homebirth in 2013.

      Non-nurse midwives can be licensed in certain states (as CMs, LMs, etc.) and the requirements differ from state to state. The CPM (“certified professional midwife”) credential is licensed through a private organisation (NARM). It is probably the best-known credential for homebirth midwives, but its requirements were only recently tightened (!) to include a high school degree. Even today, it is possible to fulfill the CPM requirements by an unsupervised apprenticeship only or by attending one of several practically unregulated midwifery schools, some of which you can attend online(!). This is then followed by a short test. That cannot be considered adequate education for someone who wants to take on the sole responsibility for the health and safety of mothers and babies during child birth. In addition, many homebirth midwives continue to practice without any license or standardized education at all.

      These non-nurse midwives would not be eligible for licensing in ANY other first-world country—and for good reason: They don’t have the necessary education to be medical providers in a potentially life-threatening situation (which every birth can turn into in a heartbeat).

      There is no other medical field where providers without a university degree can attend patients without supervision and be refunded by Medicaid/Medicare. We should value mothers and babies enough to not accept sub-standard care for them, either.

      2) Homebirth with a non-nurse midwife in the US leads to significantly more infants dying preventable deaths, as statistics have shown in every state where the outcomes of homebirths with licensed (non-nurse) midwives were officially collected (Oregon, Colorado, etc.)

      3) Most homebirth midwives do not carry malpractice insurance—which is a family’s safety net if something goes wrong. The tremendous costs of treating birth-related injuries (such as brain damage in a baby due to asphyxia, a complication that is significantly more likely at a homebirth due to less fetal monitoring at home) therefore has to be born by the individual families alone and/or by their health insurance (possibly Medicaid/Medicare), if they are lucky enough to be covered.

      4) Homebirth is not a good use of funds. Whatever cost savings there may be when comparing the cost of a homebirth to the cost of a hospital birth must be weighed against the risks of an adverse outcome. Even one catastrophic birth injury will negate the “savings” made on hundreds of homebirths, if not more. As homebirth becomes more common, the numbers of dead and injured babies will go up.

      If homebirth midwives want to be integrated into the medical system and refunded as part of Medicare/Medicaid, they need to live up to the standards of medical professionals. That would include the following requirements:

      A) Have a university degree on par with nurse midwives (CNMs), which includes clinical experience inside (and possibly outside of) a hospital

      B) Follow evidence-based, clear rules that establish the conditions under which a patient can be accepted for homebirth and the conditions that necessitate a transfer of care to a physician (such as twin pregnancies, breech babies and VBAC attempts, which are currently taken on by many homebirth midwives and account for a large number of homebirth deaths)

      C) Carry malpractice insurance, just like every other medical provider

      I had my baby at home and can certainly understand the allure that homebirth has for a certain group of women. However, bad outcomes of homebirth are generally not talked about by midwives or the homebirth community at large, and I believe that I took on a risk that was far higher than I understood at the time.

      I also believe that it is important to understand that the vast majority of women is not interested in homebirth—they want to give birth in a hospital, with safe providers and access to pain relief and emergency care. That is certainly what I would choose if I was pregnant today.

      The road to better choices for pregnant women is not to accept the dismal state of homebirth midwifery in the US as it is today, but to demand nothing less than truly safe and educated providers, at home and in the hospital, with Medicaid/Medicare funding, and accessible to all

      • Young CC Prof

        Well said! I was looking at the pro- lay midwife comments, and none are remotely as well-researched or well-written as this.

      • KarenJJ

        Awesome comment!

      • ki sarita

        since CNM’s also attend homebirths (and an occasional MD now and then) your comment is not clear as to whether it refers to CPM’s only, or to ANY homebirth.

        • ki sarita

          in your opinion, should medicair reimburse a CNM or MD who attends a homebirth?

  • Captain Obvious
  • Mishimoo

    This is the story that began my questioning the safety of homebirth. After our second bub, one of the home visiting midwifes asked why I’d had babies in hospital as I’m kinda hippy-ish and “a good candidate for homebirth” despite my OP babies, anaemia, nuchal hands/arms/cord, and light meconium staining. (No surprises, she does/did homebirths but as far as I know, does not do deliveries in hospital). I did think about it for a bit, but then this happened to that poor family and I couldn’t take the same risk.

  • Aussiedoc

    This makes me so angry.

    In PPH seconds count – they get a mother who’s already CRITICAL and what do they do – fiddle around for an hour before transporting. If it wasnt already too late it would have been by then.

    A woman with a previous PPH is not a candidate for either homebirth or water birth – bet she was told neither by her midwives.

    The midwives at work tell me over and over again I am reactionary and part of the problem that homebirth can be done safely that women deserve a choice and that if people like me support it it will be safer – show me the evidence?

    All I see is ideology, unsafe practice, women being lied to about risk and preventable death and disability. I won’t support that.

    Those poor kids. That poor man. All for an “experience” all for a “choice” an “ideology”. Worth it?

    • prolifefeminist

      “All I see is ideology, unsafe practice, women being lied to about risk and preventable death and disability. I won’t support that.”

      THANK YOU for being one of the doctors who will stand up and tell women the truth about home birth. Done with kindness, I think quite a few women can be talked out of unsafe birth plans. I’d like to think that if the backup OB for my home birth attempt had taken the time to go over the real risks and alternatives with me, I would have been swayed. He didn’t agree with HB but was agreeing to serve as a backup physician for patients attempting it, on the basis that women deserve a choice. Well yes, but they should be fully informed – and I guarantee you that my CPM didn’t do that!

      • Busbus

        I completely agree. I have also since thought about my back-up OB and about the fact that, while he made me sign a medical waiver (since he knew I was going to have a homebirth), he never questioned my choice or even commented when I did stupid things such as declining the GD test. Especially with the GD test, I am certain I would have had it done if he had told me that he thought it was really important.

      • Stacy48918

        A hospital based CNM referred me to a homebirth CNM for my first birth. While I’m glad she referred me to the only homebirth CNM in the area and not to any of the CPMs I still desperately wish she would have talked to us about risks. It was just “We’re thinking about homebirth” “Oh, you need to talk to so-and-so then”.

    • Beth S

      I wonder when the midwives decided to call EMS or the Australian version, was it when the floor looked like they’d just gutted a rabbit? Or was it when the floor started looking like they gutted a cow?

  • DoulaGuest

    One of the things I hear about most in NCB is “always listen to what the mother tells you”. This is most often said in reference to mothers who insist that “baby is coming”, and it falls on deaf ears and then baby comes too quickly for the doc/midwife/nurse to catch the baby. Then, everyone stands around and marvels and sighs at how providers don’t listen to patients. Beyond feelings of deep sadness and horror, it leaves me incredulous that this most basic principal was not followed by the very culture that seems to chant “listen to the mother” from the rooftops. Chilling indeed. My heart breaks for this family.

    What educational background do Australian midwives have? I really believe a bachelor’s (or equivalent) are not enough to be a primary care provider.

    • Mishimoo

      I’m not sure about homebirth midwives, I’d have to look it up. The CNMs that delivered my babies in hospital were all Masters of Midwifery from reputable universities, with several years of experience. (Which is as should be expected for midwife-led care)

    • Klain

      This is from the Australian College of Midwives for my state.

      “To become a midwife you need to complete either a Bachelor of Midwifery
      degree (direct entry) or a postgraduate program if you are already a
      registered nurse. A University Admission Index (UAI) is required for
      acceptance into a midwifery course at universities in NSW.

      Postgraduate midwifery programs are one year full time.”

      I checked some of the universities offering the direct entry path and students needed to get a score above 90 ie have higher marks than 90% of students in their major high school exams (HSC) at the end of Year 12.

      • Sue

        Australian midwives are almost all registered nurses with post-grad midwifery training, though there is now a direct entry stream.

        In a sense, though, it doesn’t matter how skilled a single provider is in the OOH environment. Trauma patients who hemorrhage aren’t managed in the field – they are stabilised and taken to hospital.

        The home environment just can’t substitute for an institution with resuscitation teams and equipment, blood bank and operating theater – no matter how skilled the provider is.

  • EM

    I was admitted to ICU several days after my son was born with kidney failure, pneumonia and a whole list of other fun things. At some point I actually did feel myself losing my grip on life. I didn’t even have to utter the words… I had several people surrounding my bedside within minutes because the monitors showed them I was in danger. For that reason, no matter how intensely traumatic that whole experience was, I would give birth in a hospital again without a doubt.

    • Therese

      What did it feel like to lose your grip on life? I am really curious about this. How does one distinguish between feeling really crappy and actually dying? I can’t even imagine what it must feel like.

      • EM

        For me… One moment I was completely aware of my body and what was happening to me. The next I found myself almost disconnected from my body, standing outside myself just watching the chaos unfolding… no pain, no discomfort, a moment suspended in time. I can’t even call what I did at that moment praying, I simply asked to come a chance to raise the child I had waited so many years for. I wish I could fully explain it to you, but I can’t. When it was all over my OB referred me to a psychologist.

  • Dr Kitty

    A sense of impending doom IS a symptom…
    One that is fairly commonly associated with Pulmonary Embolus and hypovolaemic shock.
    Two potentially life threatening conditions a woman who has just given birth is at high risk of suffering from.

    Grey, sweaty people who tell you they think they are going to die are terrifying, usually because you know they might be right (as a GP they’re usually having heart attacks though, not bleeding out).

    Best case scenario as the midwife, you’ve overreacted, aggressively fluid resuscitated and transported a new mother with a panic attack, and everyone gets to go home after an hour in the ER.

    Worst case…the above happens and you have to explain why you sat on your hands to a coroner, widower and motherless child.

    I send people to the ER all the time to rule out serious things if I can’t rule it out myself.
    I tell them it may be inconvenient, but it’s safe, and almost all of them prefer that to convenient but reckless.

    • Montserrat Blanco

      It ALWAYS throws an electric feeling down my spine when I hear: I am dying. I ALWAYS get anxious. I am a medical oncologist, so there are lot of times I know that I will not be able to do much more than prescribing morphine. Even within that setting it ALWAYS feels like a rush. Whenever a patient says something like that I start a physical exam and the nurse takes all the vital signs: blood pressure, cardiac frequency, temperature, breath frequency, oxygen saturation, blood glucose and an EKG. That is normal care at a hospital. I do ask for symptoms but we ALWAYS perform a physical exam and take all vital signs whenever someone does not feel OK. It sounds like a lot of things to do but for us it is really a five minute assesment. After that you have pretty much an idea of what is the problem and what steps are needed. Never in my career I have not had an idea of what to do next. Unfortunately sometimes we can’t do very much (remember I usually treat very sick people) but I have ALWAYS had an idea of what was going on.

      As I said I work with very sick patients, this happening to a healthy young woman is simply UNBELIEVABLE. It is really poor care. I would be surprised if they are not found guilty of gross negligence or whatever the charges are. Not taking vital signs is more dangerous than driving without lights, without seatbelts, inside a snow storm and with ten vodka shots in your belly.

      It gives you an idea of the knowledge and education they have when they are not able to do something that we all learnt at our first day as students on a medical ward.

      • CrownedMedwife

        Decades later I can still hear hear the voice and see the fear in the eyes of the first mother who said such words to me. As a new grad in a rural hospital at 2 am with a fully staffed night shift which included 4 RN’s to cover LD, PP and SCN without in house OB or Anesthesia and a very limited blood bank, I gained more respect for PPH than I ever could have from a book or class.

        Details I remember, 42 year old preeclamptic primip, forceps delivery with 4th degree laceration of a macrosomic infant after a prolonged labor freshly out of 2 hour recovery period. Words I’ll never forget “Am I going to die?”. How does one respond to that when the words thundering in your head are shouting “I don’t know. I really just don’t know”. I learned much that night about managing PPH, but more than anything I learned respect for the process, the expedience of interventions, the isolation of a low resource institution. Hours later intubated in the ICU, she opened her eyes again and I was finally able to answer her question “No, you’re going to live.”.

        It’s moments like those that stole away any naivete I could have had about romanticizing birth in my early years and no wonder why decades later I could still never imagine attending births anywhere outside a hospital. There have been countless PPH in years since, but hers was the first lesson I had in why births happen in hospitals and not at home.

        I still get goosebumps retelling the story. Her son is in college now and she chose never to risk getting pregnant again. I still see her in the community every few years. When we see each other, I still see the same look she gave me when she asked that question 20 years ago. Bystanders would never notice, but when our eyes meet we both know just how close it was.

        • Lombardi

          Incredible story I get goosebumps reading it!

        • Susan

          Applause for this post. Have had similar experiences and reckonings that made me question the homebirth rhetoric.

          • CrownedMedwife

            Makes me wish I could drag a HB midwife into the hospital setting to shadow for a day (as if near misses could be planned) and watch a shoulder dystocia, eclamptic seizure, cord prolapse or hemorrhage in the hospital setting. I can imagine myself in each teachable moment, but then I also imagine I’d turn to her with a maniacal look in my eyes and shout “…and at home, AT HOME THESE MOTHERS AND BABIES WOULD HAVE DIED”. Maybe it doesn’t conform to principles for the adult learner, but it would make ME feel a hell of a lot better and maybe scare her out of HB. Wishful thinking.

          • KarenJJ

            What I find scary is that there are some midwives that do have at least rudimentary experience of these things in hospital. And then decide “meh, I’ll chance it and hope my patients get lucky”.

            I really really really don’t think that people who think like that should be midwives. I wish there was a good way to tell the difference.

          • The Computer Ate My Nym

            Heh. Except that they’d blame all the problems on the hospital: If the mother were at home where she could relax properly and give birth “naturally” it would never have happened…at least that’s the claim.

          • Guest

            Funny you should mention that. Just had a conversation with a HB doula/patient who is seriously traumatized from a recent birth with a massive PPH at a homebirth requiring transfer. She saw ‘the look’ and I am pretty sure she is seriously considering whether she can continue to attend future HB as a doula.

        • Karen in SC

          This should be the featured post.

        • Montserrat Blanco

          Words I hate to hear at 3 am: We have x units of … (write your needed blood product here) left in house. How much will you need? As someone that has finished a blood bank supply twice for her patients, those words are chilling. I remember a particular shift when the only available surgeon was busy at the OR with another patient and my patient was on the ward bleeding. I recall something like 10 blood units used. At some point I was waiting for that call. Fortunately the patient made it to surgery and was able to be discharged home. I did not sleep a single hour that night. Almost ten years later I still remember that night with chills.

          Funny enough the patient only felt he was in danger when he saw me on the ward at 3 am. The seriousness of the situation was picked up by the nurses before he felt anything was seriously wrong. He said: I must be very sick when you are here at this hour of the night.

          I still remember the feeling of relief when the surgeon walked in the ward to get the patient to the OR.

          • Sue

            My equivalent in ED is the asthmatic who feels they are going to die and then vomits – it’s time to get ready to intubate and ventilate.

          • Guest

            Isn’t it amazing how real healthcare professionals acknowledge, integrated into practice and don’t forget the impacts of past experiences? On the other hand, HB midwives seem to ignore its existence or refuse to acknowledge their role in it.

    • Young CC Prof

      Are there ANY conditions other than anxiety attack that would cause a typical reasonable person to believe he or she is dying when in fact no serious condition exists?

      • Siri

        Sudden drop in blood pressure? Mind you, there is a difference between an impending sense of doom and feeling as if you’re going to faint. Recently my hearing and vision went strange, and I had to sit down before I fell down; I didn’t think I was dying though.

        • Therese

          Yeah, I’ve fainted and come really close to fainting numerous times and it never occurred to me that I would die.

      • Guestll

        Thyroid attack (hyperthyroid) in my case. Thought I was having a heart attack and was convinced I was going to die.

        • Sullivan ThePoop

          Like a thyroid storm? That can kill you.

          • Guestll

            No, not as severe as a thyroid storm, but a thyroid attack, with racing heart heartbeat.

          • Sue

            Overactive thyroid symptoms are often initially mistaken for anxiety – with racing heart, sweating, feeling uneasy.

      • Montserrat Blanco

        Quite a few. With a physical exam and vital signs checked you can rule most of them out. Sometimes you do not know exactly what is going on and you perform more tests. The point is not to make a perfect diagnosis from the start but to rule out the really important things that can lead to death in minutes. Once you have done that you get a couple of hours to run some tests, make a diagnosis and make a clinical care plan.

        Most of the times a serious condition does exist. Typically something that could lead to death in a couple of days if left untreated.

        • Siri

          I read a really scary newspaper story of a young woman who ate a tuna steak and then felt an immediate sense of impending doom; her boyfriend was persuaded at long last to take her to A&E, where she collapsed from anaphylactic shock and was worked on for five hours before being stable enough to go to ITU. Her only sign was slightly blue lips; her only symptom was a conviction that she was dying.

      • Gene

        POTS: postural orthostatic tachycardia syndrome

        Syncope (fainting)

        Seizure?

        Various phobias

        Vasovagal syncope (esp when someone sees blood, etc)

        I mean, serious condition is a bit in the eye of the beholder. Even panic attacks can be debilitating.

        • Who?

          My friend has POTS and it is horrible. She’s a bouncy, full of energy person normally and has been floored by it. I saw her one day as she had an episode it was very distressing for her and the other people around.

          • Gene

            In retrospect, I likely had POTS when I was a teenager. It’s most common amongst teen girls. It can be scary, but won’t, in theory, kill you.

      • Medwife

        Actually, right before I pushed my son out, I yelled that I was going to die. I was not actually in danger of dying right then- I had a very normal, actually easy birth (for a primip). But I was unmedicated and it hurt so bad, and giving birth seemed totally impossible all of a sudden, that yup, I was convinced I was dying.

        • KarenJJ

          I’ve had a couple of friends say the same of their midwife-led unmedicated vaginal births. I imagine it can be a little different if they are being monitored by competent midwives and they are saying it during transition, as opposed to after the birth.

      • Sue

        There certainly could be if the person was not in a dangerous situation – people having panic attacks often feel they are going to die.

        But context is everything – a person feeling they are going to die while giving birth is not having a panic attack until proven otherwise.

      • Beth S

        Unmedicated childbirth and a seizure, of course by the end I was groaning I wish I’d died, but that’s a different story.

    • Siri

      If ever I find myself grey and sweating I’m coming to see you, Dr Kitty! :-) Hope that’s ok.

      • Mac Sherbert

        She will just send you to the ER because she will believe you! ;)

        • Siri

          Lol, that’s true! Any excuse to see Dr Kitty though; she seems so lovely.

          • Mac Sherbert

            I love the signs in our Family doctor’s waiting room. It lists several things like if you are in labor, think you are having a heart attack, etc…GO TO THE EMERGENCY ROOM!
            Dr. Kitty does sound nice.

          • Dr Kitty

            Thanks!

    • Gene

      I tell people all the time: “I’d rather see you too soon than too late.”

      • The Computer Ate My Nym

        I tell people that the ideal patient is a very mild hypochondriac: If I occasionally see you when nothing’s wrong I’m happier than if I never see you until it’s very late in the game (maybe too late).

    • Mishimoo

      I had a strong sense of impending doom with the last bub, which I’m always hesitant to mention as it feeds the idea ‘mama intuition’. While pushing, I had this gut feeling that something was very wrong and I needed him out asap. I pushed as hard as I could, his head came out and the midwife unwrapped his cord. Then they dealt with his shoulder dystocia. Once we were all snuggled up and he was feeding, my midwife said “He had some late decels, but before I could say anything, you’d gone to work and got his head out so I could deal with his cord. It was amazing.”

    • Beth S

      I know this is weird, but after 30 years of dealing with epilepsy I can tell when I’m going to have a seizure. I just feel…I guess off is the word I want to use here. I’m pretty well controlled with medication, but sometimes it happens like when I was suffering from the worlds worst morning sickness and throwing up my seizure meds. So I get what you’re saying about the impending feeling of doom.

    • sapphiremind

      this is very true. I’ve experienced it as a patient myself (my patients can’t verbalize anything) but I was at home, having been nauseated for about a week with epigastric pain (same symptoms of my mother’s gallbladder issues) I had a PCP appt the next day, I was watching for signs of jaundice or infection (which would indicate more immediate help needed) As I was resting at home, I got that feeling of doom and the feeling that I had to *do* something, even though I was tachypneic and tired. It’s hard to describe the feeling, but your body does know when things are seriously wrong and it tries to tell you. Ended up going to an ER and finding out I was in fulminate liver failure with a bicarb of 15, secondary to an idiosyncratic drug reaction to green tea extract and was lucky to survive with my life and my original liver.

      People really need to believe that feeling you get from acidosis or hypoxia. And medical professionals should know to take it seriously. There was no other possible pressing matter that could have taken precedence, because if the baby needed resuscitation, there should be someone who is there just dedicated to the baby.

      • Dr Kitty

        Recently I had an ovarian cyst rupture on me, dumping 200mls of fluid in my abdomen, probably after torting. It very successfully mimicked appendicitis in the process, so that was super fun.

        I know from experience that I am REALLY sick right about the point I start telling everyone I’m perfectly OK and start cracking inappropriate jokes.

        Like when I had vomited more than 100 times over five days and hadn’t passed urine for 16 hours (hyperemesis: DO NOT RECOMMEND) and this last time with the cyst when I had a pulse of 145 and a systolic BP of about 80 by the time I got to A&E, but you know, still wisecracking.

        If I ever get to the point where I’m actually telling people I feel like I’m dying there should probably be an ICU bed waiting.

    • ki sarita

      my l&d nurse didn’t listen to me either when i was feeling unwell. she told me my pulse was skyrocketing because of all the excitement. really she was at the end of her shift and all she wanted to was to get me out and over to the postpartum unit. she refused to even restart my IV which had come out, said the postpartum nurse would do it. luckily, my symptoms were transient.

  • renee

    I remembered this case, but this is so much worse.
    Can you imagine that you KNOW you are dying, and no one is doing a thing to help you? Its a nightmare.
    Glad the one MW has distanced herself from MWery, too bad it took an egregious death to make it happen.

  • Trixie

    Semi-OT: did you know that MANA has reviews enabled on their Facebook page? Consider letting them know how you feel: https://m.facebook.com/MidwivesAlliance?_rdr

  • yentavegan

    You people don’t seem to get it. Some mothers aren’t meant to live. It was this mother’s right to die after childbirth. Just like Jacob’s beloved wife Rachel who bled to death after giving birth to Benjamin. This brave mother and her supportive midwifes chose to cast their lot into the abyss of the unknown natural ebb and flow of the universe. Those of you who trust science to answer all your life’s questions are delusional.

    • RebeccainCanada

      Ugh! Got so spitting mad from your first two sentences! Then I read your name, cuz I was thinking “What kind of idiot….?” Yeah, Yentavegan, this just drives me as nuts as it obviously does you too.

      • Allie P

        The sad part is, it’s practically impossible to tell the difference between people who are being sarcastic and those who aren’t on this matter. Those who shrug and say “some babies aren’t meant to live” actually think it’s a comfort.

        • yentavegan

          Right. Because it is this kinda of moral relativism that fuels the homebirth community!

          • Jessica S.

            It’s got to be a coping mechanism, to deal with the unwarranted risks they take. Kind of like, this is nature and it’s what happens when you are one with nature or something. But you have to wonder what percentage of them have a check in their gut that tells them otherwise.

        • Amazed

          Yeah, I recently had a new commenter asking me whether I was being sarcastic. The very fact that people need to ask is very troubling indeed.

          This poor woman. I can’t believe they didn’t examine her. Then once again, my mother almost bled to death a few hours after her second delivery. It all happened in a minutes. If a cleaning lady hadn’t peeked into the hospital room to find her… presumably like Caroline Lovell was around the time they called an ambulance, I wouldn’t have had a mother today. Someone didn’t do their job with her. But thanks to happy chance and the fact that she was in the hospital, they thankfully managed to fix it… barely.

          Caroline Lovell never had a chance, I think. But the fact they didn’t take her seriously is beyond words.

      • MLE

        I have done this to myself by failing to note the sarcasm and received quite a tongue lashing from the netizens here, lol!

    • The Computer Ate My Nym

      I’ve heard this sentiment expressed by NCB advocates, actually. Usually as “if a mother dies that’s evolution in action and if we don’t allow that to happen the species will get weak” or something similar rather than with the religious imagery per se, but yes overtly advocating allowing women to die if they can’t survive a pregnancy without help.

  • Ash

    A USA CPM’s response to “If I were at home, I would have died” question after a woman was prosecuted for practicing midwifery without a license:

    http://www.holisticwithhumor.com/if-i-were-at-home-i-would-have-died-or-the-midwives-battle/

    • FormerPhysicist

      Argh. Somebody tie the fool up in an old graveyard. Or just an old library with census type records.

    • The Computer Ate My Nym

      I wonder how she explains outcomes like this one to herself?

    • Amy M

      I can’t seem to get that load correctly/at all, but I’ve read that sort of thing from the NCB crowd before. I don’t know if this is the same essay I’ve seen or a new one. I HATE this. They are so smug, and convinced that the doctors and interventions CAUSED the problem that they then had to scramble to solve. Of course we know that’s crap. And this is a perfect example of how crap it is.

      Of course we only exist in one timeline and can never know how something would have happened if we’d made different choices. But, we can certainly say that “IF the same thing that happened to me in the hospital happened at home, the baby and/or I would have died.” Sure, maybe it wouldn’t have happened…there are no guarantees. But, it DID happen…and thank goodness the mother was in the hospital at the time.

      If I’d have tried to give birth at home and refused to go to the hospital? I suspect my babies would have died. Most likely of an infection that never happened in real life, because 1)at the hospital I got abx and 2)they gave me pitocin to move things along when they weren’t moving along on their own. How long could labor have gone on without that pitocin? Days?

      And let’s say I managed to get the babies out of my body eventually, alive or dead. After days of ineffective labor and months of carrying twins, the odds of PPH would have been insanely high. As it was, I had a pph in the hospital, where it was addressed quickly and I was still left anemic for months. At home? I would have bled out before I could have gotten to the hospital. These people have no respect at all.

      • Karen in SC

        The MANA study contained its share of PPHs with no interventions. How is that explained?

        • Melissa

          Not enough placenta eating. Or maybe someone put a hat on the newborn.

          • Young CC Prof

            Normal physiologic blood loss needs to be redefined up to a liter or more. One of them actually claimed something like that.

          • Trixie

            Well, that probably used to be normal — that’s why they didn’t let them sit up or get out of bed for weeks after birth, back in the day.

    • moto_librarian

      I replied to a post that was similar to that (may have even been the same one) several years ago. I had one midwife tell me that my pph caused by a cervical laceration could have been stopped by eating some of my placenta, another who claimed I would have been risked out of homebirth because I lived more than 10 minutes away from a hospital (I think we all know that is pretty much bullshit). The most thoughtful answer came from a new CPM who claimed that she had seen such complication, her preceptor had clamped the laceration, and mom lived thanks to LifeFlight. When I pointed out that the majority of CPMs don’t seem to be capable of evaluating vaginal tears appropriately and I sincerely doubted that most of them would be capable of identifying this complication, she got huffy and told me not to paint all midwives with the same brush. In other words, typical.

      • S

        Maybe the placenta prevents exsanguination by causing you to choke to death first?

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

    Oh my god. That poor family. It never ceases to amaze me, the horrors that these birth hobbyists cause, oversee and allow.

  • Susan

    “Any real healthcare provider will tell you that the most chilling words you can hear from a patient are: “I think I’m dying.”: — yep!

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

    I’m sure Mrs. Lovell assumed that her care providers would still provide competent care – it’s a reasonable assumption, provided there are stringent regulations and avenues for recourse in the event of malpractice. Too bad the state of midwifery in her case was such that her assumption was wrong and it killed her.

  • The Computer Ate My Nym

    Of course, even if they’d been completely on the ball and diagnosed the hemorrhage early, what are they going to do besides call 911? Death from hemorrhage can happen quickly. It can only be averted by a rapid response including IV fluids wide open (preferably by two large bore IVs) and blood products, including not only PRBCs but factor and platelets as quickly as possible. In short, things that are only available in the hospital and only if one is prepared. For example, has a hep lock IV set at the start of labor and a type and screen already done, in case this very problem occurs.

    • Amy M

      And there is info in the article indicating she had known risk factors for hemorrhage, and obviously should have been in the hospital. Wonder how the husband feels about hospital birth now.

    • Therese

      What about administer pitocin or cytotec while waiting for the ambulance? Not sure if Australian midwives are authorized to carry those drugs but where I live it is legal for midwives to carry them.

      • The Computer Ate My Nym

        Not to mention being ready for the worst case scenario of needing a stat hysterectomy before the DIC sets in. Speaking of things you can’t do at home.

    • moto_librarian

      I wonder what type of tears she had, and how those contributed to this tragedy. If she had a lacerated cervix or uterine artery, that can cause you to bleed out very quickly. Pitocin and cytotec wouldn’t have done much unless the source of the bleeding was closed off.

      • Trixie

        Isn’t that what happened to NGM’s daughter?

        • moto_librarian

          NgM’s daughter had an arterial bleed after a c-section. NgM stated that she was extremely swollen after pushing for three hours prior to the section, and the speculation is that a suture slipped as the swelling went down. She required 11 units, and nearly went into DIC.

    • Young CC Prof

      It sounds like they started transport an hour after she first asked for help, and was still alive when they reached the hospital, though too far gone to save. Which leads me to suspect that she’d have survived if they’d call for an ambulance immediately rather that wasting that hour doing who-knows-what-but-not-their-job.

      • Bombshellrisa

        Oh probably doing what midwives do after a homebirth: laundry, make tea, drain the birth pool. You know, no real patient care.

        • Trixie

          And Facebooking about how empowering the birth was.

      • The Computer Ate My Nym

        I agree, she likely could have been saved if they’d done vital signs and known what the results meant (and responded appropriately). Even if they took VS, I can also see them blowing off her tachycardia as “excitement” and attributing the decrease in BP to no longer being in pain.

    • Montserrat Blanco

      Well, probably do not taking vital signs and reassuring her everything was fine instead of getting transport as soon as you can did not help either. I am pretty sure they take your vitals at some point after a normal low risk uncomplicated vaginal birth at the hospital.

  • attitude devant

    I just can’t even find words.

  • auntbea

    Did she die of blood loss? Or a clot?

  • poop on dr bitch amy

    birth didnt kill her. incompetent midwives did.

    • auntbea

      What a charming handle. You must be fun at parties.

      • attitude devant

        I was hoping it was ironic?

        • Poopity poop poop Siri

          No, I’m afraid poop on dr bitch amy is deadly serious. Our only recourse would seem to be merciless mocking.

          • auntbea

            Do you think maybe she has herself confused with a puppet of a rottweiler?

          • renee

            Bwahaha
            I wonder if anyone else caught the joke?

          • auntbea

            Of course. My joke was excellent. For ME TO POOP ON.

    • KarenJj

      A little from column A, a liitle from column B. Do you always think in such black and white, or can you deal with a little more complexity?

    • Amy M

      How do you distinguish though? She would not have bled out if she hadn’t given birth. Of course, competent midwives would have caught the problem and dealt with it quickly and could have saved her life, sure. But the problem (hemorrhage) was directly related to birth.

      • KarenJJ

        And if they are incompetent, what does poop on dr bitch amy suggest for better regulation of midwives that work with homebirths? Risking out of mothers with previous history of hemmorrhage? Clamping down on homebirths without back-up and introducing requirements for transfer?

        • Amy M

          Included in the regulations for the homebirth midwives should be 1)understanding of how to manage the 3rd stage of labor and 2)what to do in the event of pph. For real, none of this herb and placenta bullshit.

        • Amy M

          Of course, if the woman is truly determined to use an underground/under-trained midwife, or go it alone, then she is risking her life as well as her baby’s. Hopefully she knows that, but some people are convinced of their own invincibility I guess.

          • KarenJJ

            If she was alone, the woman might have transferred as soon as she said that she felt like she was dying. So they might be determined enough and have a death wish, but at least they won’t be reassured by people who’s medical opinion they trust.

          • Amy M

            True. Assuming the emergency responders could get there fast enough and get her to the hospital fast enough.

    • Amy Tuteur, MD

      No, birth killed her. Incompetent midwives failed to save her.

    • Trixie

      You know what’s interesting? A person can make up an inflammatory name like yours, and Dr. Amy will let your moronic comments stand for all to see.
      A homebirth loss mother comments about her experience on any number of NCB/homebirth pages, and she’s mocked, ridiculed, deleted and banned.
      Who has something to hide here?

      • Jessica S.

        Bingo! Maddening!!

    • RebeccainCanada

      Did a ten year old bad-ass help you think up that name? It’s so intelligent and catchy! Really gets your point across!

      Birth was killing her, they failed to even do the basics an ER nurse would have no problem recognizing and acting upon, and hey, ER nurses aren’t experts in “normal” birth! ;) They are supposed to be experts aren’t they? Then they must know sometimes nature is a bitch and frequently kills? If they were really experts at normal birth they wouldn’t have been so completely incompetent and let nature take it’s course.

      I know that feeling she describes, the can’t breath/tunnel vision/can’t weight bear/can’t see/can’t hear. Except when this happened to me, I was in an ER with an iv in place, a nurse at my side, trained professionals around helping me back to bed. Blood products available, an OR suite available with a cool OB/GYN….. All the difference in the world.

    • Jessica S.

      Seriously, I can’t understand why you bother commenting with a screen name like that. Why bother if you know you won’t be taken seriously, regardless of the content of your comment?

      • Mishimoo

        She’s being a wonderful ambassador for her beliefs.

        • Jessica S.

          ;) I guess so!!

    • Sue

      Some people get caught taking a sarcastic comment seriously. I did the opposite – I assumed this post was ironic.

  • KarenJJ

    It’s interesting that one of the midwives has “distanced herself from midwifery”. So the ones that have been shocked at their incompetence and lose faith in the “trust birth” narrative leave quietly without rocking the boat (note that I am making assumptions there) and the blowhard dunderheads like Hannah Dahlen carry on in midwifery still trying to push their “Towards Normal Birth” policy in NSW.

    • no longer drinking the koolaid

      Something like 90 % of people who are incompetent do not recognize that they are incompetent. The 10 % who do realize they are lacking skills or judgement will do something about it. If you are surrounded by people who also lack that skills and judegement then it is much to difficult to recognize what is lacking.

  • UsernameError

    I had very low blood pressure during labor one time. My pressure was 60/20, and although I don’t remember much, I do remember them asking me a lot how I felt, before I couldn’t respond anymore. Feeling tired, light headed, and unable to move, while not physical symptoms like you would have if you have a broken bone, are still very telling, and my doctors took those feelings very seriously. I seem to remember I had about 10 people in the room all staring at me and hoping the meds they gave me worked. They didn’t, I needed a second dose, but in the end, it was reassuring that so many people were there for me, instead of just patting me on the head, telling me that I’m fine and walking away while I died.

    When I went on to deliver again, they had all of this noted in their chart, and they took my blood pressure every 5 minutes during labor and for 2 hours after, just to be safe.

    • Young CC Prof

      Actually, my friend bottomed out from the spinal right before her emergency c-section. She felt like she was dying and called out for help. Fortunately for her, the anesthesiologist was doing his job, right next to her, watching, listening and monitoring her vitals, and he brought her back up fast. THEN they got the baby out. Exciting day, but all ended well.

      • Amy M

        That just happened to a friend of mine as well, last month. Same deal—she was fine in minutes, and is fine now. So’s her baby.

      • moto_librarian

        And that’s one of the things that they warn you about prior to inserting an epidural or spinal. I know that the anesthesiologist watched carefully for several minutes after starting mine to be sure that I didn’t have a BP drop. I have no doubt that it’s scary as hell when it happens, but the NCBers love to play up this complication, despite the fact that it is usually reversed very quickly.

      • Wren

        I had a very similar experience with my spinal and c-section. Scary for me, but the expert way the anaesthetist handled it was totally reassuring. It had a second minor drop but that was handled pretty much immediately and led to him discussing cats of all things with me. Looking back, I’m sure that was to keep me talking and make sure I was ok. At the time, it was just a lovely conversation about our respective cats while the surgeon was getting my baby out

      • sleuther

        Similar experience here. Felt like I was passing out. Remember my BP being called out as something-over-40. It’s not a good place. They pushed epinephrine into my IV and my bp went back up. They were very attentive… I could tell that it was not a good situation. However, they reacted in a very well practiced way. There was no panic, although they moved quickly.

        • Dr Kitty

          I got the weird head spins when they were pulling my ovaries out of my CS incision to have a look at them after the baby was out, but I literally just had time to say “I feel a bit weird” before it was fixed.

  • Karen in SC

    It seems like Australian coroners are not reluctant to examine the performance of midwives. Good.

    • Sue

      Yep – ironically spurred on by the actions of LB.

  • lawyer jane

    Very sad. Poor motherless children and widow.

    One thing you rarely see discussed about homebirth is weighing the risk of motherless children. I can’t fathom why a mother would risk leaving her children alone? But I guess if she’s willing to risk their lives, then she’s not seeing things the same way I am anyway.

    • MLE

      Yes. Now that I have one kid, for my next birth we ALL must survive.

      • Mac Sherbert

        Yes. I remember my first pregnancy I was worried about the baby surviving. I really didn’t think about me not surviving. I just wanted the baby to live even after I knew I had to have a C-section I was only thinking about the baby. 2nd pregnancy I worried about me and the baby because I just could not imagine my 1st child losing his mommy or having to tell him “his baby” didn’t make it.
        I feel so much for this family.

    • Michele

      Exactly. If I wrote a birth plan for my current pregnancy “live mother” would be the first thing on the list, the only thing above “live baby.” I have a duty to my older child and my husband, not just myself and the baby.

    • Busbus

      People don’t believe what they don’t want to believe. I’m sure, prior to the birth, this mother was convinced that she would be perfectly safe – despite the doctors’ warnings.

    • Beth

      not only does her family have to go on without her, but now her husband has to live every day in the place where his wife bled to death.

  • Amy M

    I am not a medical professional in the slightest, but even I know that losing consciousness is symptom of too much blood loss. How did these midwives not recognize that? And don’t we often see in homebirth circles: “What about excessive bleeding?” While the answer is often “Use herbs! and Eat placenta!” at least they acknowledge it can be a problem and they attempt to address it. These brainiacs didn’t even seem to consider that she might have been bleeding. Why hire a midwife if she’s just going to watch you die? The father, beyond dialing 911 of course, should have been demanding herbs or something…isn’t that what they were paying those women for? Are those midwives being charged with anything?

    • Elizabeth A

      Losing conciousness is a pretty late symptom of too much blood loss, and the midwives seem to have missed the earlier symptom – the patient feeling lightheaded and hyperventilating, and TELLING THEM SHE NEEDED TO GO TO THE HOSPITAL. Sorry to yell, but that last is a pretty large red flag.

      • Medwife

        In a postpartum woman, even lightheadedness and hyperventilating are very late symptoms of hemorrhage. They can just dump blood and not notice a thing until all of a sudden they’ve got a bp of 80/40 and pass out. You have to be friggin on the ball in the third stage.

        • PrimaryCareDoc

          Which is why is a damn stupid idea to give birth in a tub of water.

          • Carrie Looney

            I was wondering about that. Is it easier to see that a woman is dumping blood if she’s not in a big tub that dilutes it all out? Not that I needed another reason to look at Birth In A Tub and wonder WTF.

          • Young CC Prof

            I was thinking the same thing, that the tub probably kept them from being able to see how hard she was bleeding, much less being able to actually measure the blood loss.

          • Trixie

            That’s weird. According to Public Health Scholar #1, homebirth midwives know exactly how to measure blood loss in a pool.

          • Karen in SC

            That still cracks me up! What an idiotic!

          • AmyP

            Watermelon Koolaid is OK. Claret is BAD.

          • Medwife

            It’s really hard to tell if the baby is followed by a massive gush from a partially detached placenta, I bet. How would they know if they needed to go straight in with an emergent manual removal? And immediately give pit? And oh yeah, call someone who can actually get them to the surgeon and OR they desperately need.

            And without a quick EBL, how can you estimate total blood loss if she trickle-bleeds within the first few hours?

            These stories are hard to read!

          • Sue

            “Medwife” – when you read this stuff, do you feel that your professional organisation should do more to outlaw these renegades?

            It seems to me that people like this case a bad shadow on your professional group, but we don’t seem to see the legitimate midwifery organisations and standards-setters cracking down – or even speaking out.

            Any thoughts?

          • Medwife

            Well, this particular case happened in Australia, and I’m in the US. I applaud Australia for making it more difficult for “midwives” like these to ply their trade. I know there are American cpms who are just as dangerous, and I have come to the conclusion that ACNM needs to back away from them and push much more aggressively for them to get the proper education and training, or get out of the business.

            The study showing resistance against reasonable standard setting among cnms attending home births does not make me feel optimistic.

        • Guestll

          Mine was 83/38 upon waking in the morning about 6 hours after my daughter was born. The nurse came into the room, looked at the sleeping baby, looked at me, said, “Are you always this pale?” (I am super-white) and immediately took my BP. I’m usually 100/55 normally but yeah, 83/38 made her busy, busy, busy.

      • Amy M

        Oh yeah, of course—as “medical professionals” they totally should have picked up on that. I’m just saying, as a complete lay-person, reading an article, I could diagnose a hemorrhage problem. If I can do that, a real medical professional would have stepped in long before, therefore, they are not real medical professionals.

      • The Computer Ate My Nym

        Why did it even get to the point of being symptomatic? Shouldn’t they have been aware of things like her pre-labor hematocrit, her blood loss during labor, and changes in her blood pressure and pulse after labor? Maybe even checked a quick H/H after labor (though that can be deceptive in someone who is volume depleted)? Any of those would have given a clue that there was too much blood loss going on long before she even felt much more than a bit tired.

        • Elizabeth A

          It got to that point because they were, at best, negligent. This story is an ample demonstration that they had no idea what they were doing. The family would have been better off hiring a cab driver to attend, because the midwives seem to have believed that a cab driver’s tools (minus the driving) would get everyone through.

          If you believe that birth will never really end badly, and that the entire medical eatablishment of OB is nothing but scare tactics, why would you check anything? That belief makes outcomes like this inevitable.

          • Young CC Prof

            One OB here had a story about some birthing center midwives who called to ask him about a PPH and told him a current hemocrit number, he asked for the one from before the birth so he could estimate how much she’d actually lost, and the midwives said something like, “We don’t do those, it’s not a positive affirmation.”

          • Trixie

            What does that even mean?

          • http://www.antigonos.blogspot.com/ Antigonos CNM

            You see, that calls for a certain level of education. But you don’t have to have been taught normal lab values (and, as noted Hgb/Hct during active bleeding usually does not indicate the actual amount of blood loss). Look at the conjunctiva, the nail beds, take the pulse, respirations, and BP. Anyone who isn’t officially retarded can do that ( my husband can’t change a light bulb, but he’s capable of putting on the BP cuff and pressing the button — he takes meds for his BP), and compare observations with a healthy person’s vital signs, if you don’t know the normals.

          • Trixie

            No, I mean the “positive affirmation” part.

          • Irène Delse

            My guess: it means the midwife doesn’t want her clients to worry their pretty little heads about possible negative outcomes? As in, if you don’t know about it, it won’t happen… Head in sand midwifery at its best (and worse).

          • Montserrat Blanco

            NOTHING. Well, actually it means they have no clue about what they are doing. It is not the same having an hemoglobin of 9 grams when the day before it was 8.5 than having it when the day before it was 15. On the first situation the patient is improving and in the second one they are likely pretty sick.

          • Sue

            Means they don’t understand that a pre-natal work-up is not ”unnecessary intervention” – it has a specific purpose.

          • moto_librarian

            Jesus. I can’t even wrap my head around that. I know that my hematocrit was higher than average for a pregnant woman (thank you, red meat cravings!), and that plus prompt care were what kept me from needing a transfusion.

          • Amy M

            I don’t know what mine was during pregnancy, but it was 26 after the bleeding, which isn’t good under any circumstances.

          • Jessica S.

            W. T. F.

          • Busbus

            What makes this story really horrible to me is that the midwife learned NOTHING. How can you be responsible for another person’s death and just go on spouting drivel about the oppression of homebirth midwives? How can you go on attending women in labor? How is it possible that after being responsible for a mother dying, two kids growing up without their mother, she does not experience a shred of doubt in her abilities? What kind of person do you have to be to be so cold???

        • Ash

          Does any HB midwife draw labs shortly after giving birth? They would have to get a courier to pick up the labs and then get the results called in.

          I think even if a non-hospital affiliated freestanding birth center had a lab next door, they wouldn’t do it. The HB/NCB philosophy places priority of leaving the family alone after birth because it’s critical for bonding (not my thoughts, BTW!)

          Speaking of labs, I googled the HB midwives in my area to see what they said on their website about labs. Only 1 encouraged pre-registering at a hospital and having lab results available there, as well as meeting with a hospital/clinic affiliated physician or CNM at least 1x during pregnancy.

          I found a different HB midwife’s website that said you can do the newborn screen for women who can afford it. Website also said that in some women, VBACs, multiple gestation, and breech was as safe as hospital birth for some women. :(

        • Montserrat Blanco

          If you are loosing blood quickly the first signs are usually elevated heart rate and an increase in breath rate. Then blood pressure drops. That is why you have to monitor all vital signs. I learnt that when I was in 4th year at medical school, three years prior to be allowed to look after patients with supervision. But, you know, I am just an evil doctor. So, to answer your question there was no reason at all it was not picked up.

      • renee

        THIS is why I think UC is safer than HB with bad MWs- the UCer will call for help and won’t have anyone to stop her. I can think of two other tragedies that ensued because mom was ignored: the deaths of Aquila Paparella, and Shahzad Sheik.

  • MLE

    Just another example of an “empowering” birth experience in which the midwife tells you what you are and aren’t feeling.

  • LisaL

    So.. even though she was warned over and over and over.. oh and over again, she still chose to homebirth w/ a couple of idiots. I don’t understand women that take these risks. Unfortunately she paid the price and now her family has to deal with the aftermath :(

  • Adelaide GP

    South Australia now has legislation in place ( post Lisa Barrett disasters) that says it is an offence for an unregistered health care practitioner to attend home births. There are also clinical practice guidelines around planned home births:

    http://www.sahealth.sa.gov.au/wps/wcm/connect/76aaf1004f3219c488eefd080fa6802e/Planned+Home+Birth+Policy+and+brochure-13082013.pdf?MOD=AJPERES&CACHEID=76aaf1004f3219c488eefd080fa6802e

    …….however, if the clinical skills are at such a level that basic obs are not even taken , it doesn’t bode well for preventing such disasters. Just give birth in the hospital people!! It really is that simple.

  • Mel

    “Ms Bourne said Ms Lovell was light-headed and hyperventilating, telling her midwives she was dying and needed to go to hospital.

    “Gaye then questioned Caroline as to what she was feeling, in this conversation Caroline did not identify any physical symptoms,” Ms Bourne said.”

    Three symptoms: Light-headed, hyperventilation, feelings of panic.

    Oh, plus the bleeding from two tears and a (retained?) blood clot.

    Make that four symptoms, you freaking idiots.

    • Dr Kitty

      Hyperventilating AKA tachypnoea AKA raised respiratory rate.
      The first and most sensitive sign of shock.
      RR increases even before pulse elevates and BP drops.

      Srsly…what are they teaching midwives about basic recognition of the sick patient?

      If a BP and pulse check is too complicated, they could also check capillary refill.
      Press your finger to their sternum and count to 5, lift your finger off. Count how long it takes for the little pale circle left by your finger to match the colour of the rest of the chest. More than 2seconds =possible shock. No special equipment, takes 7seconds and you can do it while having a chat, so “I didn’t have time” isn’t an excuse, because everyone has ten seconds.

      • Mel

        What terrifies me about this situation is that I AM NOT a doctor, nurse, midwife or anyone with specialized medical training and I would have called 911 immediately.

        I’m a teacher who has a Biology degree and took as many ecology / botanical or zoological courses as I could.
        I’ve taken Red Cross First Aid classes….but those are available to EVERYONE.

        Let’s say she was ‘just’ having a panic attack. You can still go to the ER for a panic attack because they suck.

        This whole situation makes me feel sick.

        • KarenJJ

          I occasionally volunteer as a test patient for medical students at the local university and one of the scenarios I had was someone that was having a panic attack and a history of heart disease in the family presenting to the ER. The students had to take a history from me to work out what was going on and pick up on the life stresses that were happening (part of the scenario was history of depression and money troubles and a child that had died in a car accident a few years ago).

  • wookie130

    One of the most chilling aspects of this incident to me, is how one of the major selling-points of NCB/home birth midwifery is that a woman will be “listened to” and that the mother is essentially in control of everything during the delivery process. Well, this demonstrates that when the shit hits the fan during a home birth, and she outright tells her lay-midwife that she believes she is dying, that she’ll be disregarded, that there are other matters that are more important than her, and her needs will NOT be met in any way, shape, or form. Oh, the irony. Tell me again why having a home birth is better for women than hospital births?

    • Lena

      All the “listened to” nonsense means is that the midwife will keep you out of the hospital. How many birth stories have we heard where mother says she was screaming and begging for an epidural, but the wise midwife ignored her and she was able to have the natural birth she wanted? Mom is only listened to during the pregnancy when she tells her midwife she wants a peaceful homebirth–anything she may want during labor doesn’t count if it means transferring. If the midwives have listened and taken Lovell to the hospital, we would be reading a birth story that includes everything the midwives should have done to avoid the “unnecessary” transfer.

      • araikwao

        Unfortunately the wise midwives in the hospital will also deny or delay women’s requests for epidurals..

  • Lena

    “Ms Lovell saw three general practitioners from the same clinic during
    her pregnancy, where she was warned about the risks of home births on
    four occasions and underwent blood tests, which revealed she was
    anaemic.”

    And that, right there, is the real danger of woo midwifery. Not only are they so incompetent that it doesn’t even occur to them to check a pulse, but they have lay people so convinced of their bullshit that even four doctors and anemia can’t convince a woman to change course.

  • Pilo

    If a patient says they are dying, especially in a situation where they could actually BE dying, there is nothing more pressing than attending to them and doing everything in your power to figure out what is going on. Even a random bystander on the street with no medical training or relationship with the person would do as much.
    It takes a pretty cruel dis-interested person to say, “You think you’re dying? Well, I have more pressing things to attend to right now. I’m sure you’re fine.” The idea that the cruel dis-interested person was actually hired for PRECISIELY THIS PURPOSE makes it sickening beyond belief.

    • Medwife

      When a patient tells you they are dying, BELIEVE THEM. Fundamental.

    • Busbus

      That’s the problem when you believe every complication is made up to scare women, and your prime job is to reassure them instead of providing medical care.

  • Mel

    As Young CC Prof said brilliantly (as best I remember) “HB mothers rarely die because a deathly ill woman looks critically ill to everyone around her.”

    How the FUCK do you miss a woman bleeding to death in front of you?

    We had a worker crush and partially amputate a finger last year. There was blood everywhere. Cleaning up all the blood was hard enough when we knew the worker was safe and recovering well in the hospital. Cleaning up the blood when you know the woman died needlessly…….

    He’s alive and well today because the other milkers called 911 first, started first aid and called us. Basic FUCKING common sense.

  • CanDoc

    Speechless.
    Okay, a whole bunch of unprofessional expletives, and THEN speechless.
    No. Not even speechless, actually, because I just keep thinking this:
    How hard is it to check a pulse? A blood pressure? An obstetrical history?
    I mean seriously, WHAT THE F*@% ELSE DO THEY DO DURING ALL THOSE HOUR-LONG SPECIAL SNOWFLAKE “THEY WERE REALLY INTERESTED IN ME AS A PERSON, NOT JUST A NUMBER” MIDWIFERY APPOINTMENTS???
    A horrible, needless, and tragically ironic loss.

    • moto_librarian

      I don’t understand this need for hour long appointments. I saw CNMs, and mine rarely lasted more than 15 minutes. If I had a specific question, she would stay as long as needed to explain, but then again, we were addressing my health and that of my unborn child, not trying to become BFFs.

      • Lena

        People really want to be BFFs with their health care providers, and maybe it’s because I’m not particularly sociable, but I do not get it. My only requirements outside of professional competence is “don’t be a raging asshole.” I don’t need charm or friendliness, just do your job, answer any questions and concerns I might have, and let me get to rest of my day so you can get to the rest of your patients.

        • Ob in OZ

          I wish I had more patients like you

        • Kira

          I’m an outgoing extrovert and I don’t understand it. When my oldest needed a hemangioma excision and we were looking for a specialist, people would ask me if the doctor we were seeing was nice. My reply every time: “I don’t care.” I could not have cared less if the surgeon was a child-hating litterbug, as long as he or she was the most skilled. Why anyone would want the nicest doctor, instead of the best, is baffling to me.

          • Young CC Prof

            Well, there’s different meanings of nice. One doctor I switched from because practically every time I told him something, I got the impression that he didn’t believe me, or thought I was exaggerating, and from there the appointment would become adversarial rather than constructive. There’s a good chance it was just me, and his other patients thought nothing of the sort! Still, my point is that being able to communicate effectively with your doctor IS important, whether you want to have a beer with him is irrelevant.

          • Amy M

            Yes..I’ve been seeing a specialist for migraines. He’s very personable, and I respect him as a doctor. However, he’s come across as patronizing to me at times…I could overlook that but also in a year of seeing him, there’s been no progress on the migraine front. That last bit is what prompted me to seek a second opinion. I’m sure he knows what he’s about, but for me personally it’s not working, regardless of how I feel about him as a person.

      • Medwife

        Most return OB appointments can be done in 10-15. If I can do it in 10 I really try to. That way when a patient needs more like 45 minutes, _maybe_ I won’t get killed the rest of my schedule. I won’t short anybody who is in real need of my time but I do not have the flexibility to shoot the shit with the worried well.

  • Young CC Prof

    The absolute worst outcome in obstetrical care is the death of the mother, and for it to happen to a perfectly healthy young woman in such a preventable fashion…

    And by the way, if the baby is out and doing well, what could the midwives POSSIBLY be doing a few minutes after the birth that’s more important than attending to the third stage of labor and monitoring bleeding? Whether the mother claimed to be in distress or not!

    • Ellen Mary

      IDK: I think the absolute worst outcome is a too late Cesarean, because if I lost my baby that way I would still have to attempt to go on living. :( I suppose academically the worst outcome could be losing both . . .

      It is pretty shocking how quickly Maternal Mortality can skyrocket when you take away western medical care.

      • Trixie

        Except, no. She had another child who is now motherless. You keep living for the sake of your other child.

    • MLE

      Right?!?! Aren’t they normally ignoring the blue/grey/white baby and snapping pics of skin to skin moments?!?

    • http://www.antigonos.blogspot.com/ Antigonos CNM

      Putting the kettle on for a cuppa?

    • Irène Delse

      Absolute worse outcome: wouldn’t that be the death of mother and baby? :-(

      • Young CC Prof

        Yes, I suppose so.

  • Somewhereinthemiddle

    That poor family. Her partner is left to raise two children on his own and their children are without a mother needlessly. Those fucking incompetent fools killed her.

  • moto_librarian

    This hits very close to home for me. I have no words.

  • Lana

    My friends MW. Very scared for her :(

    • wookie130

      After reading this, I can hardly blame you.

    • Carolina

      Share this with her. As gently as you can. She needs to know.

    • moto_librarian

      Ms. Bourne claims to have “distanced herself from midwifery.” But she is clearly still delivering babies. Can you report her to the authorities?

      • lana

        I think they will just claim to be Doulas.

        Actually, i KNOW they will claim that. “assisting as a friend”

    • LisaL

      Share this story with her. She needs to know that this woman is an idiot and she and her baby’s life deserve better.

      • lana

        She wouldn’t listen – she knows of this site i think and makes fun of it. Would think it was all concocted by the patriarchy and medicine to make the MW look bad and take away women’s ‘choices’

        • Young CC Prof

          Share the news article, then.

    • Amy M

      Can your friend ask the midwife what would be done in case of excessive bleeding?

    • KarenJJ

      Oh wait. By “distance herself from midwifery” does that mean she’s become a “doula” or a “traditional birth attendant” or some such nuttery? Along the lines of Lisa Barrett’s weasel words. Bugger.

      • lana

        Yes – practicing unregistered now, because otherwise would have to pay for insurance

        • KarenJJ

          I hope she gets the book thrown at her, to put it politely.

  • Linda Tock

    That is absolutely horrifying.