Is Australian midwife Gaye Demanuele a liar or a fool?

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I’ve been told that she’s a disciple of killer midwife Lisa Barrett, who’s notched at least 5 neonatal deaths. But Gaye Demanuele has exceeded her mentor; she’s notched the ultimate obstetric disaster, a preventable maternal death.

Demanuele is taking a page out of the Lisa Barrett playbook. She is acting as if the Coroner investigating the death of Caroline Lovell is a fool by making extraordinarily implausible claims and hoping that he will believe her anyway.

I wrote yesterday about the homebirth horror that ended in Caroline Lovell’s demise. Lovell bled to death in front of not one, but two midwives who assured her she was fine even when she told them she was dying. Allegedly they never even took Lovell’s blood pressure or pulse. Apparently they “trusted birth” while birth was busily killing Caroline Lovell right before their eyes.

According to the Herald-Sun, Lovell’s mother, Jade Markiewicz, stated the obvious:

… [I]t was outrageous that her daughter was the first to notice her condition and that it took too long for an ambulance to be called.

She said two girls had been robbed of a mother and lessons must be learnt to preventing this from occurring again.

“Her death was preventable and it must not be in vain,” she said.

Demanuelle, in contrast, reeled off one whopper after another.

Senior registered midwife and nurse, Gaye Demanuele, told the court the haemorrhage was not in the medical records she was shown by Mrs Lovell and her patient did not tell her about it.

However, she did know about the uterine fibroid, a tear and two operations over suspected retained placenta after Lulu’s birth.

So Demanuele DID know that Lovell was at risk for hemorrhage.

The midwives said Mrs Lovell lost approximately 400ml of blood at home, which the midwives said was not excessive.

But they simply made up that number. Lovell was sitting in a pool of water and there is no way to accurately assess blood loss into a pool of water.

How much blood do you have to lose before succumbing to hemorrhagic shock? According to Clinical review: Hemorrhagic shock, an otherwise healthy person can lose more than 40% of blood volume before lapsing into unconsciousness. Since the average person has approximately 5000 cc of blood volume, it means that Caroline Lovell probably lost more than 2000 cc. That’s more than 2 quarts of blood.

But the biggest whopper of all is this:

[Mrs Demanuele] … denied the homebirth was a political statement in light of this situation.

That is a bizarre claim considering the paper trail left by Lovell and by Demanuele herself.

Caroline Lovell was a prominent homebirth activist who wrote a letter to the government threatening to give birth unassisted if midwives were regulated.

Within months of Lovell’s death, and facing disciplinary action, Demanuele made this flamboyant political statement:

… I choose to no longer call myself a registered midwife (which would attract a $30K fine if I did).

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…

Earlier this year, Demanuele published this manifesto, Why Birth is a Feminist Issue:

… Obstetric practice is based on risk aversion, dictated by insurance underwriters—not on good evidence of where true need exists. More women are facing legal action, accused of acting against the “rights” of their foetus. Midwives and doctors who support women’s autonomy are similarly persecuted. By putting its trust in technocracy instead of the birthing woman, the maternity care system is failing women.

Why is the culture of childbirth saturated in fear? Why not trust women to make their own informed choices about their bodies and their babies?

The answer lies in the rise of private property and the division of society into classes many millennia ago. The ruling class needed to exterminate what remained of matrilineal kinship society and subjugate its respected leaders: women. So it invented patriarchy…

And we’re supposed to believe that neither Lovell nor Demanuele viewed homebirth as a political statement?

Poor Gaye Demauele implies that she is being persecuted by the patriarchy just because the mother of two small children is dead and would be alive had Demanuele provided even the most rudimentary care. She must view the Coroner and the rest of us as gullible fools.

Demanuele is just another in a depressingly long parade of self-pitying homebirth midwifery sociopaths who leave a path of death and destruction in their wake and refuse to accept any responsibility for their own actions.

It wasn’t the patriarchy who ignored Lovell’s obstetric history; it was Gaye Demanuele.
It wasn’t the patriarchy who refused to accurately assess Lovell’s blood loss; it was Gaye Demanuele.
It wasn’t the patriarchy who couldn’t be bothered to check Lovell’s blood pressure when she complained of feeling faint; it was Gaye Demanuele.
It wasn’t the patriarchy who failed to call for an ambulance when Lovell said she was dying; it was Gaye Demanuele who assured her she was fine as her life ebbed away.
It wasn’t the patriarchy who let Caroline Lovell die an easily preventable death, leaving two small children motherless; it was Gaye Demanuele …

And for that she should be punished to the fullest extent the law allows.

  • Retired midwife.

    Nowhere in any of the reports of Carolines condition while at home is there mention of excessive blood loss, not by her husband, mother or the midwives. This case has all the hallmarks of an amniotic fluid embolism, classic sensation of impending doom, collapse and later PPH secondary to DIC. Healthy women do not arrest 1and a half hours post birth, if Caroline lost 2 litres at home there would be blood everywhere, esp when she got out of the pool. Home birth midwives are equipped to manage a PPH. I don’t believe these midwives were negligent.

    • KarenJJ

      Apart from the delay of 30 minutes in calling an ambulance when Caroline started to feel the impending doom? Someone feels like they are dying and it’s a potential symptom of something very serious and a professional midwife apparently sits on that for another 30 minutes?

      In hospital I felt like I was dying, pressed a button the nurse was there within a minute or two, tilted the head of the bed, checked blood pressure etc and adjusted whatever. She didn’t wait for me to go into cardiac arrest for example (and it turned out to be an easily managed drop in blood pressure in my case).

      • Retired midwife.

        I understood it was 15 min delay, during which time Carolines vital signs should have been taken. Hard tobelieve 2 midwives would fail to notice a deteriorating patient.

        • KarenJJ

          I’m also seeing conflicting reports.

          I wonder if some homebirth midwives have sociopathic/narcissistic tendencies. My mum is also a RN and trained in midwifery and I can’t imagine her sitting on her hands like that either. It is not logical and it is not the reasonable expectation from a health care practitioner. It is certainly not listening to what the woman wants to have her request ignored!

          It is one of the reasons that I feel very strongly that midwifery should look very hard at the standards and practises of OOH midwives. It might sound overly dramatic, but what if there really were someone like a Dr Harold Shipman amongst them? How would midwifery organisations test and screen for something like that, let alone remove them from practise?

          • Who?

            Horrible thought. And when you think how long it took to work out what Shipman was doing, and how much he got away with, it certainly isn’t impossible that there are freelancing midwives like that.

            Doubly so when they operate outside the system, control the whole show themselves and typically work with others who aren’t equipped to recognise negligence or bad practice, let alone wrongdoing.

    • Amy Tuteur, MD

      So what? They acknowledged they never even checked her blood pressure. That is criminally negligent. I cannot believe that you are defending the indefensible behavior of Demanuele.

      • Retired midwife.

        Agree Amy, they should have taken pulse & BP, preferably asap after the birth & at 15 -20 min intervals after until stable, at least for 1 hour following birth of baby.

  • Wharves of Sorrow

    “Less than 10% of women actually require obstetric services.” As a feminist I absolutely contest this. I believe obstetric care is a human right that all women deserve because birth is inherently dangerous. Making it seem as if proper medical care during childbirth is some kind of luxury or extra for most women is profoundly antifeminist.

  • jenwa

    Is anyone worried about what happened in the twelve hours that Caroline was in hospital?
    Women who have had huge blood loss (as it is alleged) surely gain expert and excellent treatment once they get to the hospital?
    Why did she die there?
    Why isn’t the hospital being asked questions?

    • Amy Tuteur, MD

      Has it occurred to you that she may have suffered severe brain damage from her cardiac arrest? Apparently not.

    • PrimaryCareDoc

      Is this a serious question? Why did she die there? She bled out, you nitwit! Do you think hospitals are some places where miracles take place?

  • Nicky

    From Gaye Demanuele’s Facebook page, posted yesterday. There are no words to describe that level of callousness.

    • anion

      I… THAT was the most awful experience of her life? Not watching a woman who was supposed to be under her care die a wholly avoidable death, but the fact that she wasn’t treated like an expert at the hospital and allowed to dictate procedures to medical professionals?

      THAT experience was awful, but being responsible for the death of a woman and leaving her children motherless was just the way it was meant to be, I guess, tra la la.

      Psst, hey Gaye…how much of a say in things did you give Ms. Lovell when she told you she thought she was dying?

      That is stunning.

  • DiomedesV

    Gaye Demanuele claims that she didn’t know about Caroline Lovell’s PPH at her first birth, although she says elsewhere that she knew Caroline had a fibroid and surgery to repair tears during her first labor. Indeed, the midwives claimed that the medical records were incomplete:

    http://www.heraldsun.com.au/news/law-order/husband-felt-helpless-when-wife-fell-gravely-ill-after-homebirth/story-fni0fee2-1226952199692

    “During Ms Lovell’s previous birth she had a tear, operation for
    retained placenta, a uterine fibroid and post-partum haemorrhage, but
    the midwives say medical records were incomplete and she had a low
    complication risk.

    Mr Lovell said his wife got medical records
    from Lulu’s birth from Barwon Health, but he was unaware if there were
    any missing, saying if there were it’s likely his wife would have been
    upset and contacted the hospital.”

    The midwives’ claims sound implausible. To me it sounds like they’re trying to say either that Caroline Lovell deliberately deceived them about her true risk, or that she simply neglected to make sure she had all her records. How likely is that?

    • Dr Jay

      Not defending the midwives here…you’d be nuts to agree to a home birth for any ONE of the problems listed here, but it is possible that the pt didn’t share this information. Pt’s do that sometimes (usually inadvertently). However, hospital notes are available to providers…if there were missing notes, then it was the midwife’s job to chase them. I’ve never heard anything so stupid in my life as “The notes were incomplete, therefore the patient must be low risk!”

      • Jessica S.

        I forgot to inform them during my son’s birth that I had been diagnosed with mild sleep apnea as a teenager. (Actually, it’s not anywhere in my medical records b/c I never thought to mention it to anyone, once I was responsible for my own health care as an adult, since I never tried to treat it.) After the c-section, when we were back in our delivery room, I was dozing off and each time I did, it would set the alarms off on the pulse oximeter thingy. After 2-3 rounds of this (and scaring my poor husband to death), I said “oh, hey! This might be helpful to know…” They gave me a little oxygen thingy (I’m so technical, I know!) for my nose and I fell asleep fast and hard. It makes me wonder if I actually *should* wear something at night to sleep. Or get retested as an adult. I’m quite off topic now. :)

        • Hooligan

          are you talking about a cpap machine? If so, yes, you should at least be seen to find out if you need one.

        • Mishimoo

          Go and get retested! I may* have had mild sleep apnea as a teen, which appears to have been stress-related because it went away as soon as I moved out of home. My dad has properly diagnosed sleep apnea, and feels so much better now that he uses a CPAP machine.

          (*I say ‘may’ because my mother insisted I had it, even though she wouldn’t take me to the doctor for it, preferring to sleep in my bed to wake me every time that I “stopped breathing”. My husband has never noticed me not breathing while asleep, so I’m not convinced that I actually had it)

      • Busbus

        I can’t see any homebirth patient not discussing their last birth with a homebirth midwife (not unless they are consciously trying to deceive them, which seems unlikely). Talking about the last birth is one of those things all those 1-hour appointments are for. After two homebirths, I should know. Can you really imagine something as significant as bad tearing and complications NOT coming up in many hours of talking about birth, your experiences, your expectations? I call BS. This is a trial, of course the midwives are trying to protect themselves.

  • Alcharisi

    Minor copy-edit: in the first line, “whose notched at least 5 neonatal deaths” should be “WHO’S notched at least 5 neonatal deaths.”

    • Amy Tuteur, MD

      Thanks!

  • Beth S

    OT would anyone be willing to sign a petition asking for uniform standards for homebirth including but not limited too increased midwife education, clear cut risk in and out criteria, clear cut transfer agreements in place with a hospital including all labs being drawn before hand, a open honest and credible peer review process and that all Midwives be required to carry Med-Mal just as doctors and CNMs working within a hospital setting have to?

    • Karen in SC

      This is great follow-up to the #NotBuriedTwice video. Thanks!

  • Guest

    I read the article. I find it ironic that the midwife claims that Lovell’s care was compromised because she withheld important medical information. Even if that is true, isn’t that straight out of the HBMW/NCB playbook? Avoid tests and ultrasounds, ignore medical history, lie to your care providers to avoid “overmedicalizing” your pregnancy, stick your fingers in your ears and hum so that you can claim that any risk factors are just a “variation of normal?” These women were waist deep in all the issues and concerns surrounding home birth, and they made a real mess for themselves. My sympathies to the family, particularly the children.

    • Beth S

      Seems to be for me. I was giving facts on the Baby Center boards and got told to shut up all they wanted to hear were positive things. Never mind this is a first time teen mother, who supposedly was told by a MFM doc that it was okay for her to give birth at home.

      • Melissa

        I suspect the conversation with the MFM doc was something like “what happens if the whole thing happens really fast and I can’t get to the hospital?”
        Doc: You’ll probably be fine.
        Turns into, Doc says it’s okay to give birth at home.

        • Beth S

          Sounds like it to me too honestly because I don’t think any MFM doc would recommend a homebirth to a first time mother.

          • Young CC Prof

            Especially not one who was seeing an MFM in the first place, though it might have been a routine consult for testing.

          • Beth S

            Seriously she just compared my PP seizure with my ODD to a car accident, walking and getting hit by a car and for some odd reason choking.

    • Susan

      What a great point. How many stories have we heard ( or have I witnessed ) of midwives deciding to lie or telling their “clients” to lie about how long membranes have been ruptured.

    • Jessica S.

      I’m pretty much convinced by now that they’ll say whatever serves them best in the moment.

      • Beth S

        Yeah because apparently midwives never recommend cinnamon candy for PPH, or garlic for GB strep or ignoring most prenatal screening tests.

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

      It really doesn’t matter whether the health care provider has a full medical/obstetrical history or not. It’s better, of course, if there is one, but a complication like hemorrhage can happen to ANYONE and the HCP [in this case, either midwife or doctor] should be prepared for the eventuality. I remember one patient in particular who nearly died from HELLP syndrome, who had asserted she was in “good health” upon admittance in early labor, whose parents, when they arrived, were shocked: “Didn’t she tell you she had serious kidney and liver problems in her high school years?” No, she hadn’t, nor had she bothered to tell her doctor. That’s rather different from hemorrhage, which should always be regarded as a possible risk.

      Women generally don’t like having someone massage their abdomens after birth; everything is sensitive, but it is essential to be sure that the uterus is well-contracted and to express clots which can interfere with contraction. I think that, along with the reluctance [or downright refusal] to do vaginal exams in labor, at least some “natural” midwives who “respect the mother’s autonomy” at all costs, this is negligent for no good, and some very bad, reasons. If no one put a hand on Mrs. Lovell’s abdomen, no one would know that it was filling up with blood. If they had, and the uterus was contracted, and she was bleeding, the next assumption would be that she had internal lacerations far in excess of what they had assumed, and for that reason alone, she needed to be transferred quickly. Just standing around and chatting simply isn’t “care”. It’s somewhere between overt, criminal malpractice, and stupidity.

      • moto_librarian

        When I was having a pph, I found uterine massage to be excruciatingly painful, and I was dreading it after my second birth. Turns out that when your uterus is contracting properly on its own, massage is uncomfortable, but hardly painful.

      • Jessica S.

        “Just standing around and chatting simply isn’t “care”. It’s somewhere between overt, criminal malpractice, and stupidity.”

        But to those midwives and likeminded souls, it’s “trusting birth”. A tragic example of why birth isn’t a thing to be trusted, and how ridiculous is that notion.

  • Beth S

    I ache for this family, for the children who now have to grow up without a mother, for the man who has to go on without his wife, and for the NCB crowd that’s going to write this off as a one time oopsy and go on with their lives. I’ve read so many of these stories and every single time I’m amazed by the idiocy that espoused by these midwives. I’m sorry but when a woman is loosing that much blood, wouldn’t the water look like a shark attack? How could they not have known.

  • Who?

    I remember this now. There was some publicity at the time I think, around Mrs Lovell’s enthusiasm for home birth. Appalling.

    It intrigues me though that she would ask for the hospital-being so opposed to the ‘interventions’. The unkind interpretation is that while risking baby’s life seems somehow ‘okay’-perhaps some ‘aren’t meant to live’-the calculation changes when it is your own life on the line. The kind interpretation is that she knew leaving her girls would be just so devastating for them. Or maybe at some point fear takes over.

    • Ob in OZ

      THis is seen again and again. The midwife or patient will request meds (oxytocin, methergine) to be available for their homebirth just in case they start bleeding, but are happy to ignore anything that may help the baby (vit K for one). It is an example of seeing is believing. Seeing yourself bleed to death is frightening. Not seeing blood pour into your baby’s skull is apparently ok.

      • Who?

        A kind of magical thinking then? There must be some formidable self talk going on and a fair few concepts not being joined up.

        I understand the attendants panicking (not that these ones did) then phoning the ambulance just as they slide out the other door. But I’m really confused by the thinking of those who allow life saving treatment for themselves-since consent is always required-where they have refused it, or allowed it too late for their baby. Apparently not the case here, thankfully, but still really interesting and particularly if, as you say, it is a common thing.

        • Melissa

          I think it comes down to the idea that they have to keep the child pure and free of contact with “toxins”. It’s fine for the adult to get treatment since they have already been exposed to toxins (i.e. they are already impure) but the baby can’t have anything introduced into their system that isn’t “natural”. Chicken pox virus is fine if its from a person but bad if it is in a vaccine. And breastmilk from an unscreened donor is fine because it is “natural”, while formula is poison.

          It’s very strange. It is sort of the idea that everyone is born good but is corrupted by society taken literally.

      • Mishimoo

        There is a small but vocal group connected with anti-vaxxers that is currently spreading the belief that Vitamin K at birth raises the risk of leukaemia. I was arguing with one recently that insists that she knows of a baby that died from the Vitamin K injection, but will not provide details.

        • Mishimoo

          I found it – apparently a neonate in Turkey died as a result of anaphylaxis after a Vitamin K injection. I can’t find anything decent other than a e-pub ahead of print abstract. Of course, the Healthy Home Economist has written an article about the dangers of Vitamin K referencing the abstract. She also claims that “Synthetic vitamins should be avoided as they can cause imbalances in the body and have unintended consequences. For example, synthetic vitamin A actually causes the type of birth defects that natural vitamin A prevents!”

          • anh

            I’m starting to truly despise the Healthy Home Economist. Her advice that people seem to follow blindly could actually kill children and she’s completely blind to it

          • Mishimoo

            I am too! It’s really frustrating, because I know someone who has a baby due in just over a month that intends to avoid the Vitamin K shot thanks to her work. If bub is okay, I’m sure she’ll claim it’s proof rather than realising that it was luck.

          • Young CC Prof

            I wonder what they’d say if someone tried applying that logic to car seats. I mean, most of these mothers are strongly in favor of infant seats and booster seats, but presumably they understand that even if you don’t use one, your child will still be OK most of the time. For example, most of our parents spent their childhoods in cars with no seatbelts at all, yet they survived!

            Going with the statistic that 1% of babies who don’t get Vit K develop HDN, that was higher than the cumulative risk from birth to age 15 of car accident death–in 1960.

          • Mishimoo

            You and I (and most people) look at the information and can make a decent risk/benefit analysis from it; she would argue about every tiny little detail in an attempt to prove that it isn’t a fair comparison.

          • Therese

            Everytime I’ve seen the stats for the occurrence of HDN it is always much lower than 1%. It’s like a fraction of 1%.

          • Hannah

            She’s a menace.

    • JC

      It’s also horribly offensive to me that those of us who choose to have babies in the hospital are “sheeple” just following the crowd and blindly believing our doctors.

      I have zero risk factors. I was GBS positive with my first but this is my third pregnancy and no GD, no high blood pressure, no excessive bleeding with either birth, no prolonged pushing or bad tears. I have easy pregnancies and births and I’m still happy to have this one in a hospital too. Not because I love hospitals or needles. But because I would do anything for this baby. And if that means some discomfort for me and the baby (shots, etc.), then so be it.

      • Who?

        Seriously, if the best someone can come up with is a second hand nickname, even they must think they don’t have substance to rely on.

        It’s like certain commentators who describe someone as a ‘socialist’, and think they’ve just trumped the argument.

        The assumption is that the expression is pejorative, that the person it’s directed at is susceptible to name calling, and that the opposite is automatically better. All anyone has learnt is that the speaker lacks originality and likely insight as well.

        BTW, agree totally re hospital. Why chance a catastrophe-birth is not a computer game that reboots when you go over the cliff.

        • Beth S

          I’ve been called a rude bitch for the ten questions for homebirth moms I wrote up on the last post. I’ve been told I’m mean and to shut up because I advocate for uniform licensing standards, informed consent, a clear cut and executable transfer plan, a credible peer review program and that HB midwives be required to carry med-mal.

          • Karen in SC

            I’m on that Rude Bitch team with you!

          • Beth S

            I am all for choice, however I also believe that if you fix the system there will be fewer deaths.

          • Who?

            Sorry to hear that-I should have also said that names can be hurtful, particularly if they are objectively pejorative (which ‘socialist’ isn’t) and clearly untrue.

            However, you’re clearly pushing some buttons, which is fantastic.

          • Beth S

            I was actually a little proud when I was told to shut up. Does that make me a bad person?

          • Jessica S.

            Not at all! It means you shut THEM up. ;) No substantial retort.

          • Beth S

            Well I did just get told OBs only average 10 patients a month.

          • araikwao

            You must be doing something right if you’re threatening people’s treasured beliefs

  • Petanque

    I think her first name is actually Gaye rather than Gail?

    • Amy Tuteur, MD

      Yes, it is. I fixed the title.

  • Guest

    You are too kind. Based on her actions and results, I would posit Gail Demanuel a sociopath – caring for no-one but her own ends.

    • Sue

      She also appears to hold any form of regulation with disdain. Her twitter profile says “(un)midwife: free of registration- handed back the piece of paper.”

      Smug and irresponsible.

      • Sue

        Today’s update from the inquest:

        “Gaye Demanuele, who identifies herself as an “(un)midwife” on her Twitter account, told the court on the third day of the inquest into the January 2012 death of Ms Lovell, that while she is in attendance to support women during home births, it is the woman herself who delivers the baby.

        “She catches her own baby in her own hands,” Ms Demanuele told the court, under cross-examination from Michael Magazanik, who is representing Ms Lovell’s mother.””

        If that’s the case, why pain this woman to attend??

        • Irène Delse

          Irresponsible through and through! So much for being there to actually help women having a baby. More like, being paid to insert herself in other people’s lives and getting as far away as possible when something goes wrong. ><

        • Young CC Prof

          I keep thinking about this horrible story I heard, about a trucker who crashed into a car and killed the family in it. It was totally not her fault, it was due to a third party’s deliberate recklessness. Nevertheless, she never drove a truck again. She couldn’t get over the horror of the accident and the family’s deaths and just shook when she tried to get behind the wheel.

          How can Demanuele just go on like nothing happened?

          • The Bofa, Being of the Sofa

            Or the short answer:
            “How can she live with herself?”

            I know how my wife gets when she even has a near-miss in her veterinarianing. She is extremely gun-shy, blaming herself all the time, even when it’s not her fault.

            How can someone be so callous about life and death?

        • Jessica S.

          What a racket. Can you imagine going to a doctor and they’re like “ok, I’m just here to observe you perform your own Pap smear.”. Moronic. Both those who pay and those who get paid.

        • sarita

          if everything is going well, there is no reason why this can’t happen in a hospital; too bad more hospital practitioners aren’t doing it

          • jenwa

            That’s what I did – a beautiful thing to catch your own child.

      • Pish

        Who are you people? I’ve never read so much malice in all my life. Do you know Gaye? Did you know Caroline? Were you the in the room when the birth took place? Nasty nasty people. Now, why don’t you get on with your own lives and keep your unkindness to your own sad little worlds.

        • Mishimoo

          We’re nasty because we hate preventable deaths?

        • Stacy48918

          Please, provide us with sources to correct the misinformation then. I guarantee you that no one here wants misinformation about this woman’s death to be repeated.

  • JC

    OT: http://community.babycenter.com/post/a50366710/i_am_12_days_past_my_due_date_and

    This my birth board on Baby Center. On page 6, a woman decides after all the amazing information she has just learned she is going to postpone her induction, which was set for 41w2d, and wait until 42 weeks.

    Me, on the other hand, have an induction scheduled for the day after my due date. Because, why takes chances? It’s disgusting to watch these women encourage each other to go to 42 weeks and beyond. The one person, a PA, who says this isn’t safe, gets tons of crap and doesn’t return.

    I truly hope all these babies are born healthy.

    • Guest

      The woo trickles in at my practice on a daily basis. Just came out of a birth plan discussion with the usual trifecta: no pain medications, no vaccines, doula. She threw me for a loop at the end of visit when her cheeks flushed and eyes got glassy saying “but please don’t let me reach 41 weeks’. Well that was refreshing. Turns out what she fears more than anything with birth is going beyond 41wks, read too many postdates stillbirth stories of parents who believed ‘babies know when to be born’. Love when I hear things are making a difference, hate that it comes at the expense of heartbroken parents and little coffins.

      • JC

        All I could think while reading this was “I hope I’m not reading a loss story on here in another week.”

        I told my OB: “I’m not comfortable going past 40 weeks.” She said: “good, I’m not either.”

        It’s awful to say, but you have these women who can’t spell or form a grammatically correct sentence, and yet the doctors are evil and their “friends” on Baby Center know all and have their best interests at heart.

        I have no medical background whatsoever but it makes me want to scream.

        • Hannah

          I have GD and am in a GD group and the number of women who go on and on about Big Obstetrics and how they’re being forced into unnecesareans and inductions by their meen, paranoid doctors is flabbergasting. Incidentally, they’re all the same women who question their diagnosis and think insulin is EBIL!

          The second I was diagnosed, I said I didn’t consent to going past 39w. By the time I did the 3hr I’d read enough to know that I didn’t want to risk it. Given that I am now insulin-dependent for fasting numbers, my OB is delivering my girl at 38+4 because there wasn’t a morning surgical slot available at 39+0 and my perinatal specialist said that there’s no way he’s risking my placenta being pushed further than 39+0.

          Every time I see another successful birth past term I breathe a sigh of relief and then want to rage when they go ‘see girls, don’t let the doctors push you around!’. Head, meet desk.

          And don’t get me started on all the poor women in Canada, Australia and the UK whose midwives will not do anything for them until at least 41w with barely an NST to tell them what’s going on.

          • araikwao

            It’s not just MWs – I did a slightly odd shared care (for the non-Aussies, a GP, usually with a diploma in obstetrics, does most of the antenatal care) arrangement but also with an obstetrician as I was planning a VBAC. I remember my last GP appt at almost 40 weeks, and I asked about what happened when I got past my due date, and the receptionist told me, “oh well, if you’re still pregnant, just give us a call next week”. I ended up seeing the obstetrician about twice a week anyhow, but that wouldn’t be typical.
            Yet the hospital where I did my O&G rotation did NST twice weekly after 40wks, but still didn’t induce until 41+3 unless there was another indication. Is there evidence for improved outcomes/less FDIU with NSTs post-term?

          • Jessica S.

            I’m so glad they are following what’s best for you! You’re right, it’s maddening and terrifying how blithely those women disregard what’s plainly indicated.

      • C T

        I’ll be making my doctor happy tomorrow then. I’m 39+2 and almost 40 years old, and at my appointment tomorrow, I’ll be energetically requesting induction on Friday since I hear it’s the day she’s on call at the hospital. I know two women who had stillbirths at full term, and I don’t want to go through their pain.

        • Mishimoo

          Hope you have a very boring induction and a healthy, happy baby. Looking forward to hearing of bub’s safe arrival.

          • C T

            I like boring. I don’t need an exciting birth story, just a healthy baby, a healthy me, and an end to being so huge!

          • Jessica S.

            I met with an OB to discuss my repeat CS and she kept looking at my belly and saying, sympathetically, “and you still have a ways to go!”. I’m 34w+5 and baby’s est. weight, as of 10 days ago, was nearly 7lbs. I appreciated her sympathy, although after a few times I wanted to say “stop bringing it up!!!” :)

        • Beth S

          Good luck and here’s hoping for a healthy baby and no complications.

        • Dr Jay

          I was delivered by my boss, thank God, at basically the same age as you were. Neither one of us had any problems with term…I was booked in for delivery at about 12 weeks (assuming I didn’t go on my own, first!). Lol.

          • araikwao

            Sorry Dr Jay, I made the totally sexist assumption that you were a guy. Oops.

          • Jessica S.

            I know, me too! ;) I think it’s innocently sexist, or inadvertently.

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

          Hope your cervix is ripe :-)

    • Beth S

      Seriously I was posting all the risks of homebirth on a couple of boards I watch and got told I was spreading hate and fear and to shut up.

      • JC

        And they’ve all just watched Business of Being Born … I always try to point out how one-sided it is and that it is not a documentary. It is most definitely an opinion piece. Oh, and I’m sure Ricki Lake had no financial incentive at all. But doctors are just greedy and heartless.

        • Beth S

          After all it didn’t put her back on the map after years of being a cancelled, washed up, second rate Jerry Springer. I mean she was still in a career wave.

        • Hannah

          Yes. If I hear one more ‘BUT INFANT MORTALITY’ from some crunchy who watched BoBB I will scream. It’s not even the right fucking stat (excuse my French)!

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

        A lot of this is connected with the fact that birth has become so safe that many, if not most, people have never actually known anyone who has had a catastrophic outcome. So much of what they hear is second or third hand, i.e. rumor, and as such is regarded automatically as “inaccurate”. [unless, of course, it confirms their previously-held views]

        • Beth S

          Yeah I’ve also been told it’s my fault I had precipitous labor and PP seizure. I guess I didn’t trust birth enough.

          • Jessica S.

            If you did, you probably wouldn’t be here chatting with us! :(

    • Jessica S.

      The ACOG actually recommends inductions at 41 wks, rather than waiting until 42 wks, as they’re discovering it actually increases the likelihood of a vaginal birth. If you wait until 42 wks, not only is baby bigger, but you’re dealing with a placenta that’s fast expiring (or expired?) and basically it’s more likely you’ll end up with a c-section. (Or heaven forbid, a still birth.) They say: “Before 41 0/7 weeks of gestation, induction of labor generally should be performed based on maternal and fetal medical indications. Inductions at 41 0/7 weeks of gestation and beyond should be performed to reduce the risk of cesarean delivery and the risk of perinatal morbidity and mortality. (1A
      Strong recommendation, high quality evidence)”

      Here’s the link to the ACOG document “Safe Prevention of the Primary Cesarean Delivery”: http://m.acog.org/Resources_And_Publications/Obstetric_Care_Consensus_Series/Safe_Prevention_of_the_Primary_Cesarean_Delivery

      Not that anyone (most of them, at least) on Baby Center will believe this or be swayed. ;)

      • Dr Jay

        And yet here in OZ, you have to fight tooth and nail to get an IOL before 40+10. I had a 42 year old primp in my clinic last week crying her eyes out because she wanted to change her EDC by 2 days…just so she could get induced 2 days earlier. She was terrified of an FDIU (she had a close friend who lost her baby to an unexplained, post dates stillbirth). FFS, why are we torturing women like this? She’s forty-freaking-two! How many babies do you actually think she’s going to have?!

        • KarenJJ

          That’s awful :( She’s not going to sleep those last two days if she’s that worried already.. My obgyn in Australia (private) offered to change my due date so that I could get an earlier c-section. I was happy to go to 39weeks (completely blissful of FDIU) and we were fine, but I’ve since found out there was probably a good reason (my immune system issue) for wanting my baby out sooner then later.

          • Jessica S.

            So I have a question, do you have private insurance that you purchase or do you just pay out of pocket for a private provider? I live in the US, so I’m clueless. :) Do you only have to pay above and beyond what your public plan would cover or do you void public coverage if you choose to go private for a particular procedure?

          • KarenJJ

            We have private insurance that we pay for (and it normally has a copay to it too). It’s a few hundred a month (we have top hospital/extras although we keep meaning to look at changing that). The government has been pushing for private health insurance and there are tax reasons for having it as well as the government paying for half of it.

            We also have the public health system and use that extensively (private health only really seems to cover everyday, routine health care – weird, rare stuff is expensive so our rare disease stuff is done via the public system). The private health insurance doesn’t get used an awful lot.

            It is kinda difficult to go without private health insurance in Australia as mental health services are difficult to access and the universal health system doesn’t cover dental. Plus the government incentives to have it.

          • Jessica S.

            Very interesting! Thanks for explaining! I find the subject fascinating, that is, how different countries manage it.

        • anion

          That poor woman. How absolutely shameful that she’s being put through that.

          I hope everything turns out okay.

        • Anne

          Just show the following RCOG guideline on advanced maternal age to the hospital’s insurers.

          http://www.rcog.org.uk/files/rcog-corp/1.2.13%20SIP34%20IOL.pdf

          My pleasure

        • Ash

          Is not allowing IOL at an earlier date specific to that particular hospital or are other hospitals in OZ held to that policy as well? I suppose one could compare it to the “39 week campaign” in the US in which some hospitals are only allowing IOL or c-section prior to 39 weeks if the woman meets criteria on a very specific list.

          • Hannah

            Based on my understanding, it usually happens in the public system with midwife-led care. Anecdotally, my friends and family have been held to this policy pretty consistently across different hospitals and states.

          • araikwao

            The obstetricians who supervised me in antenatal clinics did the same. I’ll have to check if it’s a RANZCOG thing, although I imagine Dr Jay would know

          • Dr Jay

            It’s not a RANZCOG thing, no. They don’t actually have an official g’line on the timing of induction. These are hospital protocols driven by NSW Health and the “Towards Normal Birth” policy that was put forward a few years ago. If you want a hair raising read, have a look at that. Might as well have been written in green crayon. Anyway, the NSW Health protocol states that low risk women with no medical/obstetrical risk factors are safe to go to 41+3 as the risk of SB doesn’t really start to rise exponentially until after 42 weeks (~2/1000 –> ~6/1000…and screw the 2 you lose anyway, I guess). Of course, the interpretation of this protocol can be fairly ad hoc. For example, my AMAs go post dates over my dead body (with consent, of course), but a lot of people don’t consider it a risk factor. Same with IVF. It makes sense that midwives have greater rates of post dates IOLs, because they can only see low risk women. I would say that women are roundly discouraged from IOLs for “social reasons” before 40+10 or CS for maternal choice (even though RANZCOG does have a g’line for that).

        • Hannah

          Yup. It’s disgusting that they let you go so long now.

          I have so many friends who have been 41+ in Australia. All in the midwife system. In every case, even after being induced they were sent home until they hit 4cm and 75% of them in the last year have had emergent sections. it’s appalling.

          • Young CC Prof

            And this is the biggest reason I am so bothered by the NCB agenda. The freebirthers are a tiny fringe group. I feel bad for their babies, but it’s ultimately a small problem. The cases that really bother me are the women who want good science based care and are getting ideology instead.

          • Hannah

            This is what really upsets me – women are being disempowered by this ideological agenda and their babies are being put at risk.

            I am a huge supporter of universal healthcare generally, but if I have said it once I have said it a thousand times, I would not give birth in Australia’s public system unless I literally had no other financial choice. I have just heard too many horror stories from close friends and family.

            That and a conversation with a midwife from a Sydney hospital who told me that she hates when she has to call in an OB because they ‘ruin her births’ and do lots of ‘unnecessary interventions’. These poor mothers get assigned this woman and she controls *everything* that happens to them. It’s outrageous.

          • Jessica S.

            I don’t understand why it seems sound judgement has to be sacrificed when it comes to universal healthcare. How difficult is it to build guidelines that are supported by evidence? I’m sure there has to be at least one country that has a good balance.

          • araikwao

            Conversely, as someone who has worked in the Aus health system for a long time, I refused to pay for private obstetric cover, as if either my babies or I were really unwell, I would absolutely want to be in a big teaching hospital. In general, I don’t think it’s worth paying for carpet on the floors. (although now I wonder if the MW NCB ideology is less pervasive in private hospitals..)

          • Hannah

            I don’t disagree at all. My only issue with the public system in Australia is maternity care and the fact that NCB has become so pervasive. It was literally the only reason I had health cover, as I felt care in the public system was better in every other area (e.g. when I nearly died of a weird asthma event).

          • Jessica S.

            Which is crazy, b/c emergent sections are way riskier than either a) a scheduled, pre-labor CS or b) an induction (done at that 41 wk point – or even a bit early if the cervix is favorable) that’s well managed and watched closely. The latter scenario was how my son’s birth panned out. My cervix was not favorable, but I was at my due date, with a (suspected, and as it turns out accurate) large baby and blood pressure that was climbing. It was a slow, but controlled process and in the end, I think that benefited everyone – they gave labor a shot but when it became clear it was going nowhere (I was dilated to 7cm but the bub was still high up) it wasn’t an emergency situation yet so they weren’t having to rush me into the OR with a stuck baby or whatever.

        • Jessica S.

          Oh my word, that’s awful! She’s 42?? That goes against best available evidence in my (again, uneducated) opinion. She should have been offered either an induction or a scheduled CS.

          I’m 37, in week 34 of my second pregnancy and they’re recommending a CS – which they do between 39 and 40 weeks. And this is at a major university hospital, so it’s not like they’re going rogue and doing risky things. I would be terrified in that woman’s case. And feel very undermined as a doctor for not being able to practice as you see fit.

          • Dr Jay

            Well, fortunately there’s this little thing called “maternal choice.” I educate women on the (evidence based) risks and benefits of any given procedure and I let them choose. Then if anyone tries to push them into something distressing or unsafe, I coach them to exert their rights to bodily autonomy. Just put your request on repeat and refuse consent for post dates, in this case. I figure what’s good for the goose, and all that…. At the end of the day, it is a pain to have to fight against politically motivated protocols all day, but hey, if there was ever a girl built for it, it’s me. :) In the end, if the woman gets the birth she wants (or at least a good crack at it), I’m happy. For the record, I had an elective CS (short mama, big baby, 5/5 out of the pelvis at term, cx totally unfavourable) and I had a lovely birth. I wish every woman could have as nice an experience. I’m glad you are in a centre where they take AMA seriously. :)

      • Young CC Prof

        I remember that recommendation! It was the one I saw half-quoted all over the Internet! Everyone quoted the part that said don’t induce and forgot the part that said do induce.

    • Mtbakergirl

      Again, not that these people will read an article that disagrees with them, but induction seems to show a consistent trend towards increasing the chances of achieving vaginal delivery (aka the holy grail, literally the pinnacle of achievement for any woman /sarcasm).
      There must be so much cognitive dissonance when ncb folks read these articles, the recent CMAJ article is summed up well here: http://www.cmaj.ca/content/186/9/665/reply#cmaj_el_719084.

      • Young CC Prof

        I attempted to talk to some ICAN folks about that. Yup, completely shut me down without even trying to listen.

        • Jessica S.

          Un-flipping-believable!! And yet, so so SO believable. This is information that could potentially help their PURPORTED cause, but because it involves induction, forget about it. Really exposes how they feel about “conventional” methods of childbirth. Argh. It makes me livid.

          • Young CC Prof

            Though I have managed to explain it to some less ideological laypeople with arguments like these:

            By 39-40 weeks, the baby is 100% ripe. There are only two things that can happen after 40 weeks, and neither one is good. Either the placenta starts to break down, in which case the baby gets weaker instead of stronger, or the placenta doesn’t break down, in which case the baby just keeps getting bigger and bigger. Both reduce the chances of successful vaginal birth.

          • Dr Jay

            Exactly. Don’t forget the shrinking amount of fluid allows for cord compression. There is a ton of evidence that post dates pregnancy leads to an in INCREASE in CS…not an increase in an intervention free birth. If vaginal delivery is your be-all, end-all then for God’s sake get induced when your cervix is favourable. Sheesh.

          • Jessica S.

            I’m not a doctor – or a healthcare professional of any kind – but adding to your comment about a favorable cervix, I think some women need to accept and understand that their body may not do what’s best for the baby (i.e. spontaneous labor) in the right time frame. Most women will, just like most people won’t get cancer, but when you body doesn’t do “what it’s supposed to do”, it’s not a failure as much as it’s just nature. We can be grateful for how far medical advances have progressed and that we don’t HAVE to rely on the body to do something. It’s difficult for me to understand why that is so threatening to some people.

          • Dr Jay

            Agreed. I think part of the problem is right there: “your body will do what’s right!” Um, your cervix isn’t a person. It doesn’t have a brain or a will of it’s own. Neither does “nature” for that matter….survival of the fittest doesn’t mean “I survived my birth, therefore I must be fit!” It’s more like, “Throw enough $h!t at the wall, and some of it will stick (or in this case, survive).” It’s a numbers game. In other words, you will go into labor eventually. You’re baby might be dead and you may have DIC, but hey, your cervix has got it all dialled in!

          • Jessica S.

            “There are only two things that can happen after 40 weeks, and neither one is good.”

            That’s a great way of putting it. I’m going to remember that. I met with an OB this week to discuss the repeat CS – she said they schedule them after 39 wks but not past 40. That was a relief to hear!

      • Jessica S.

        Yeah, that the gist of what I was saying below. But like you said, they won’t hear anything of it! But how many of them will try every last “natural” method of induction under the sun? Gah!

        I vowed to stay away from all pregnancy forums with this pregnancy (my second) and have done just that. It helps that I have a 3.5 year old that greatly reduces my internet time. This is the only pregnancy related site I visit!

        • Mtbakergirl

          I’m so happy to have found this site whilst googling during my pregnancy. The only problem is that I now have to bite my tongue a lot, the west coast is full of pregnancy/ child-rearing woo and if I wanted to I’m pretty sure I could get into several IRL arguments a week :)

          • Jessica S.

            Oh, I hear you! I live on the Eastside, a stone’s throw away from Seattle, so it’s all about the latest crunchy. :)

      • Mtbakergirl

        Link fail, sorry” here is the full text of the article: http://www.cmaj.ca/content/early/2014/04/28/cmaj.130925.full.pdf

    • Hannah

      You should see some of the insane birth plans I have seen in my two due date clubs. In the smaller one (20 women) someone seriously said they demanded private time to consult with their DOULA in an emergent situation, that all medical suggestions had to be discussed with her DOULA, demands to ‘inspect’ the placenta with the DOULA after birth was completed in addition to the always well-advised opting out of Vitamin K shots and ointments under the supervision of the DOULA. It was like playing NCB-obsessed, AVer bingo. Meanwhile, since when is a doula a health professional? Isn’t their *only* scope of ‘practise’ to provide emotional support?

      A doctor in the group finally said ‘why don’t you all just let your care providers do their jobs?’ in addition to telling them that 95% of their patronising instructions were things that were done in best case scenarios anyway. A girl whose husband is a pediatrician piped up and suggested the same thing and all hell broke loose because we were being meen. The crunchiest girl flounced because we weren’t all supporting her insanity. Incidentally, this woman was a ‘holistic nutritionist’.

      • Young CC Prof

        Ah, mommy holistic nutritionists. I wonder if they know that that school has a class-action lawsuit against it for discriminating against female employees on the basis of family status.

      • prolifefeminist

        Insane. There’s really no other response to this than UGH.

      • Melissa

        I love having time to talk with the Doula in an emergent situation. I suppose that if you don’t die while discussing it in private then it isn’t a real emergency and nothing needs to be done! And if you do…well then sue the hospital for not informing you of the risks!

    • Anon88

      I went 10 days overdue with my first. The midwife (CNM delivers at a hospital) would not discuss induction until 42 weeks. Didn’t explain any possible complications of waiting, just said thats when they talk inductions. I was getting tired of it and eventually got them to schedule me at 41&5. I went into labor the day before that. Baby passed mec in the womb and the nurses were like ‘that happens when babies are stressed’. I’m thinking he should’ve come out a long time ago! Thank goodness he was fine, but now that I’ve read up on going post dates, I’ve already got my doc on board with inducing me on my due date. ;)

      • Jessica S.

        Good for you! I’m glad you pushed for them to induce you earlier than their protocol dictates. I don’t know what guidelines they think they’re following but it’s not evidence based. I’m glad things turned out ok for your baby – it sounds like you’re a good advocate for yourself!

      • jenwa

        But if you “read up” on postdates, you’d know the risks associated with induction of labour…for you and for your baby.
        Go and take another look: risk of induction>risk of post-term under 42 weeks.

        • Young CC Prof

          Risks of going post-dates:

          Stillbirth.
          Increased probability of NICU admission after birth.
          Emergency c-section due to placental failure.
          Increased probability of urgent c-section due to cephalopelvic disproportion.
          Risk of maternal complications, including high blood pressure during those last unnecessary weeks of pregnancy

          Risks of induction:
          Possible urgent c-section due to failed induction. (Total probability of c-section lower than for women who wait longer.)

  • Amy M

    OT: http://www.crainsdetroit.com/article/20140611/NEWS01/140619971/babies-pay-for-detroits-fall-with-mortality-above-mexico#

    Explains one reason why neonatal, infant and maternal mortality rates in the US are not as good as they should be. And no, NCB-advocates, it has nothing to do with Csections. Those aren’t even mentioned in the article.

    • Young CC Prof

      That is a really well-thought-out article that touches on the key points.

      If you look at CDC Wonder, the maternal age groups with the lowest infant mortality are 25-29, 30-34 and 35-40. Older and younger women have worse outcomes.

      The poor outcomes for teens and women over 40 are partly due to biology, but why do the babies of women in their late 30s do better than women in their early 20s? The only possible answer is socioeconomic.

      • The Computer Ate My Nym

        Women in their late 30s are more likely to have insurance than women in their early 20s. You can see this effect in cancer survival as well: in the US, survival for patients age 18-25 with AML is actually LOWER than for patients in their mid to later 30s. This pattern is not observable in any country with universal health insurance.

        • FormerPhysicist

          And even if you have (lousy) insurance, the co-pays can be enough to put off going to the doctor. Especially in your early 20′s when you still think you might be invincible.
          My insurance is pretty good, but Dr visit is $20, specialist is $50 and hospital is $150. And that’s before any percentage of the charges.

        • KarenJJ

          Oh that’s sad..

  • Anna T

    I wonder what CAN be the maximum punishment for the midwives in attendance, under the law. I hope they both get thrown into jail for malpractice, but I fear that’s too much to hope for.

    • Young CC Prof

      Malpractice is by definition not a crime that people go to jail for. Malpractice means the provider made a serious mistake. To arrest a care provider, it’s got to go BEYOND malpractice to, for example, assault or fraud.

      • Amy M

        Would practicing medicine without a license be considered fraud? I mean, I realize this person HAD a license at the time, but I am just asking.

        Could they get thrown in jail for manslaughter?

        • Who?

          I see where you’re coming from, but wasn’t it the point that the midwives weren’t practising medicine-they were supporting wimmim through a natural and safe experience and protecting them from the patriachy. In that mindset, medicine is exactly the opposite of what Mrs Lovell was buying.

          If ever there was a case of the buyer getting exactly what she was asking for, though not in the way she anticipated, this would be it.

      • Anna T

        So what is the worst these two irresponsible “maternity care providers” can expect? A fine? A removal of their license? I’m afraid they’ll just continue practicing without it…

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

          Bankruptcy. It really depends – the widower might have a case for wrongful death, and that could attract a fairly significant amount of damages. If the midwives carried malpractice insurance, that might cover the damages awarded – if not the family might have a hard time finding a lawyer to pursue the case. It depends is the short answer (ie. whether or not the family wants to pursue the matter, and what the laws are in that jurisdiction). Public shaming might be the best that can be done in terms of justice.

  • Dr Kitty

    Ladies, if it helps visualise the amount of blood we are talking about.

    An average period involves a loss of 60-80mls TOTAL over five days. From what information we have Mrs Lovell lost about 2litres of blood, pretty quickly, and quite possibly more.

    2000mls is 25 times more than a heavy period…But lost over 1-3 hours.

    2litres is more than two and a half bottles of wine, or about the same volume as a six pack of beer.

    You have to be actively trying to ignore that type of blood loss.

    • anion

      I had abdominal surgery a couple of years ago, and about five days post-op developed a couple of huge clots/hematomas in my incision. The nurse–it was the middle of the night and there were no surgeons available save a couple of residents, who poked at the incision with Q-tips and said it would wait until the next day (no, really) when the surgeons got there–cut a couple of my staples to relieve some of the pressure, as I was already bleeding and it was excruciatingly painful even with morphine. (When one of the staples gave, a stream of blood shot three feet across the room.) She wrapped my abdomen tightly in plastic, gave me more morphine, and told me to rest.

      When the surgeons arrived six hours later and unwrapped me, there was a literal “glurp bloop,” sound as blood gushed from the incision. My stomach was a LAKE of blood; I couldn’t see my skin through it. My bed was soaked with it. SOAKED. I’d been bleeding for about eight hours total at that point.

      It ended up being about one-two bags worth of blood (after surgery to clear the clots I took four bags of blood, but I assume some was lost in surgery). I’m not sure if that’s close to two liters, but it looked like all the blood I could possibly have ever had in my body. I mean, remember how Johnny Depp died in the first Nightmare on Elm Street movie? That’s how my bed & stomach looked.

      It was terrifying, and I’m not someone who freaks out at the sight of blood, whether it’s mine or someone else’s. I can’t imagine seeing that much blood and thinking it was fine, no big deal.

      • The Computer Ate My Nym

        Each transfusion is about the equivalent of 0.5 L of donated blood, so, yeah, 4 is about 2 L that you needed altogether. Only (heh, “only”) 1 liter or so actually came out of your abdomen just then. I hope the resident who said it could wait got a SERIOUS dressing down from the surgeon.

        • anion

          Good lord. 2L is about 4 bags of blood? That’s an enormous amount to lose, how could those midwives not have noticed even in a pool? That water must have looked like cranberry sauce.

          (Thanks for the info! And no, I doubt he did–if he did I didn’t hear about it, at least.)

      • Anj Fabian

        I still can remember that scene from Nightmare. That’s a classic – and horrifying.

        I’m sorry you went through that. I hope the resident got the dressing down of a lifetime. This is one of the times that I think patients should get see a video of the event. Not for posterity, but for personal satisfaction.

  • Siri

    OT: Heather O’Brien (whose daughter Clara features in the #NotBuriedTwice video), over at Destiny Manifest, needs a bit of a helping hand. I’m sharing this because I know she’d never come over here to tell you herself, and because she is such a lovely and special person.

    • Karen in SC

      Which post? I’m over at the blog and don’t see it….

      • MLE
      • Siri

        The post dated 30 May.

        • Karen in SC

          I am very dense, I thought she was getting pushback from the video.

          • Siri

            Blame it on my communication skills, Karen! :-)

  • Anj Fabian

    Anyone checked to see if the notorious LB has been communicating?

    • Sue

      She’s re-badged as Freedom @purpleanvil on twitter – GD follows her

  • staceyjw

    She isn’t a liar or a fool- She is a MURDERESS.

  • Staceyjw (Blamer Stacey)

    I Blame the Patriarchy for all kinds of stuff!
    BUT NOT THIS.

    And birth IS a feminist issue- making sure all moms receive the highest quality care available all through their lives. Pushing NCB, and killing them? That is about anti woman as it gets.

  • auntbea

    God. I didn’t realize the daughter was there to watch her mother die. That poor, poor kid. And what about her relationship with her sister? Kids have a hard enough time accepting new siblings even when those siblings don’t result in their mother’s death.

    • Irène Delse

      That’s awful. Poor, poor kids. :-(

    • staceyjw

      And this mom knew that there was risk. She was a HB pusher. I wonder if she even considered things going wrong when she wrote that letter threatening UC and ignored the 4 GPs.

    • CognitiveDissonaceHurts

      The thing is that us homebirthers don’t consider that things could go wrong and that our children might be there to witness the tragedy. It.never.crosses.our.minds. I have since learned that my kids weren’t actually all that thrilled to watch their siblings being born. I can’t imagine the horror they would feel of birth if something had happened to me. :(

      • Stacy48918

        This is very true. When I planned and had my son at home I never really considered that he or I could die. Birth is “natural” and “safe”. The cognitive dissonance of having a plan to transfer to the nearest hospital if needed never really occurred to me. Why would we need to transfer if not for a life-threatening reason? What would happen in that life-threatening scenario if we DIDN’T transfer? Never really thought about it at all.

        I read hospital “horror stories” – i.e. “interventions”, “pit to distress”, “unnecessary C-sections”, but never homebirth “horror stories”. It wasn’t until much later that I found homebirth death stories (Hurt by Homebirth and others) and realized just how much I’d risked.

        • CognitiveDissonaceHurts

          Stacy, we are twins! Same here. I was so proud of being “educated” but I had not heard ONE homebirth horror story (other than a vague report of one local baby dying, but her midwife was a “lay” midwife and I was using nurse midwives, therefore that story didn’t count!)

          I talked recently to a mom thinking of a homebirth for next time. “The midwife said that since we’re not an hour away from the hospital we would be good candidates for a homebirth” They live about 15 -20 min away from the hospital. I can’t help but think of someone’s comment here “How long can you hold your breath? How long do you expect your baby to hold his breath while you transfer?”

          These thoughts never occurred to me before!!

      • DiomedesV

        I would suspect that most young children don’t like watching their parents in pain. Where is the evidence that, prior to moving birth to the hospital, women labored at home in front of their whole families?

        I think you have to be really out of touch with your own children–ie, thinking of primarily yourself–to believe that young children would enjoy that.

        • KarenJJ

          There are stories of children being moved out of the home to other friends/family when mum gave birth (one of the Anne of Green Gables books describes this through one of her kids’ perspectives). One of my relatives thought she was adopted for a large part of her childhood because her first memory was standing with a suitcase outside of a large brick institution in London. When she finally brought it up with her mother, it was because she had been sent there for a few nights when she gave birth and they didn’t have a relative that could take her.

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

    The odd thing is, and most folks know it, that a little blood often looks like a lot. Quite amazing how much a cut finger can bleed. An OB consultant once said to my midwifery class, after asking them how much they estimated the average menstrual flow, that it reinforced his opinion that “all nurses suffer from menorrhagia”.

    So think how much worse it looks when there really IS a hemorrhage. One homebirth I attended required immediate transfer when the mother had a partial abruption. I’ll never forget the way that bedroom looked.

    How those midwives could not see that there was a problem, I really cannot imagine.

    • Amy M

      I know right? One of my boys had a minor nosebleed last night, and managed to get blood all over himself. And I know from personal experience how messy pph is. In my blood-diminished confusion, I was very concerned about getting to the bathroom because I was making a mess all over the floor of the hospital room. In this case, you’d think the kiddie pool would have been overflowing with blood-stained water.

      • MLE

        Maybe the pool was red?

        • KarenJJ

          Maybe it was hard to see in the soft candle light… (assuming that’s what they were doing).

    • jennie

      ididn’t the article said blood clot, not hemmhorrage?

      • Amy M

        I don’t know about the wording of the article, but in PPH, the body often passes large clots.

        • attitude devant

          and sometimes a clot will block the mouth of the uterus (it’s called a lochia block) so the uterus fills with blood and does not clamp down properly. You wouldn’t know it was happening if you weren’t checking and as they’ve said themselves they weren’t checking. Un-freaking-believable

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

          Until all the fibrinogen, etc. is used up, at which point the patient gets DIC…

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

      The problem of birth in a pool of water – there really does need to be a better way of estimating blood loss….all be it, whatever that would be, they’d probably consider it “intervention” and reject it as being “unneccesary”…

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

        Well, obviously there is a fairly simple way except that it would be too much work for most people to bother with: if the pool capacity is known, then measuring the amount of liquid in the pool afterward, would mean that any additional quantity would be blood.

        I have, in my time, weighed blood-sodden sheets from the delivery table, and compared the weight to a set of dry linen. But most of the time, no one cared to go to such lengths to be exactl.

        • Sue

          Weighing? Measuring? But all that stuff interferes with the sparkles!

          • Hannah

            And the unicorn farts. Don’t forget the unicorn farts.

        • Trixie

          Except there’s also evaporation, splashing, and other bodily fluids to account for.

    • Montserrat Blanco

      Last time I saw a REAL bleeding there was a POOL of blood under the bed. We did not underestimated it though.

    • Dr Jay

      Exactly. I’m sorry, but 2 L of blood would have been enough to stain that pool bright red; and if there was a clot hidden in the uterus, it would have been up to the xiphysternum with that much concealed blood. This is particularly horrifying to me as PPH is COMMON. Seriously, you would have to be a moron to spend more than 24h on a delivery suite and not see that a person can die from PPH. There is no bleeding on Earth like obstetric bleeding. And there is no excuse for this level of mismanagement. The reason I insist on cannulas & a group/hold for anaemic women or women with risk factors for PPH (like a previous PPH and a fibroid uterus) is because THEY BLEED. This is not a secret. Roughly 25% of your blood volume is being shunted to your gravid uterus at any given time. Trust birth if you want, but unless Mother Nature has a few bags of normal saline, packed red cells, FFP, cryoprecipitate, platelets and 2 x 14g cannulas (that she actually has the skill set to place when someone is as flat as a pancake), you are going to die. Quickly.

      • Dr Jay

        And I still haven’t seen anything re: the management of the 3rd stage? Was it active or physiological? Anyone know?

        • Ash

          I would bet good money that it was not active management. The NCB movement is virulently against active management, and the deceased mother considered unassisted childbirth.

        • Young CC Prof

          If she was still in the pool, how active could it have been?

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

          What management? What third stage? Them’s medical jargon intended to interfere with “nature”, man!

          Doncha know, just let everything alone, it will be fine!

        • Aussiedoc

          I suspect physiological. So, so, so unnecessary. So risky.

          The midwives where I work are always going on about how it’s too risky to give synto while in the water. (And have yet to tell me why?)

          I give it as the risk of bleeding is higher (then get them out!!! ).

          She shouldn’t have been in the water anyway (or at home!) previous PPH and a retained placenta and anaemia – absolute contraindications to a water birth.

          But what do I know I’m just an evil doctor.

          • Dr Jay

            Right? I had a patient with a physiological 3rd stage who ended up with an inverted uterus, massive PPH, multiple transfusions and a nice long stay in ICU…at hand over she looked me dead in the face and stated that she had never heard of a physiologic 3rd stage leading to an inversion. Funny. I had.

            Still can’t get anyone to tell me what is so great about a physiological 3rd stage (for mom or baby) that is worth a 50% increase in your risk of bleeding to death. Ugh.

          • Aussiedoc

            I usually get some nonsense about natural oxytocin and bonding.

            I maintain its hard to bond/breastfeed if you’re dead/severely anaemic.

            And if its needle phobia which I suspect a great deal is – it saves you so many interventions, and having now had a kid, I have no memory of them giving it to me (nor if even delivering the placenta lol ) to busy bonding with my son.

      • KarenJJ

        One of the stupid things I picked up on a hypnobirthing course and reading about NCB was the idea that anything that reminded me of medical interventions would distract me while having a “natural” birth. I asked my obgyn about it and he rolled his eyes (wouldn’t say he had the best bedside manner but didn’t worry me – at least I knew what he was thinking!) and told me that I’m already anemic and at risk of bleeding out earlier. Thankfully the midwife running the hypnobirthing course ALSO told me not to do anything silly and take unnecessary risks. Between the reactions of both I was fine to get the cannula placed.

  • Amy M

    Was there anything in this story about retained placenta, or was Ms. Lovell said to have delivered that fairly quickly after the baby? I know I’ve read some of these homebirth stories where they don’t like to get out of the water until after/during the placenta delivery, so maybe she was waiting for that? And bleeding from it too….

    And of course midwives like these would believe in “physiological” 3rd stage, and would just wait around for however long the placenta took even if that was a week. So if it was retained, they couldn’t stop the bleeding, ’cause the placenta wasn’t available for Ms. Lovell to chew on. And they left their herbs and cinnamon candy at home, along with their brains. I think I’ve solved it.

    • Anj Fabian

      The pieces of the story I have put together go like this:
      The baby was born and had no problems.
      The mother (and baby?) stayed in the birth pool for an hour.
      At that time Caroline complained of feeling faint and was helped out of the pool.
      Caroline then fainted.
      [unclear narrative, but apparently she delivered the placenta after exiting the pool]
      Caroline was laid down on the floor.
      Caroline said she needed to go to the hospital.
      Caroline was reassured by the midwives.
      Caroline collapsed and they called for an ambulance.

    • araikwao

      We don’t have cinnamon candy in Australia. Clearly an under-resourced nation ;)

      • Dr Kitty

        You have Cherry Ripes and Tim Tams, I’m SURE they’re just as effective.

        • Mishimoo

          We have vegemite, that fixes everything!

          • Who?

            A poultice of cherry ripes, tim tams, vegemite would surely cure anything. You could then eat a crumble bar and be all set.

          • Mishimoo

            Held in place with race tape, she’ll be right.

          • Who?

            Might rip the hairs right off you though, not suitable for those who prefer to be furry…

          • Mishimoo

            Good point. I know, we’ll sell it as a post-birth cleansing ritual to reconnect with one’s innerself in order to grow more fully into a powerful mama-womyn.

          • Who?

            Damn. I can’t get my ethics chip to budge. And that is such a great idea, lost now to the world.

            Which reminds me, Samboy bbq chips, what were we thinking leaving them out.

          • Mishimoo

            BBQ involves beef, right? We’ll repackage them as super-strong homoeopathic iron wafers; perfect for post-partum haemorrhage.

          • Who?

            Now that idea has legs. So sad they are now buried in the supermarket under all those ‘designer’ ones.

          • Mishimoo

            I know, but honey soy chicken chips are sooo yummy.

          • Beth S

            I keep some Chicken in a Biscuit crackers by my bed for those middle of the night munchy cravings I have.

          • Mishimoo

            Yummy!

          • Who?

            We like barbecue shapes-is there a pattern forming?

          • Beth S

            Hey we could do beef liver jerky, perfect for the iron deficient homebirth mother who needs a little pick me up.

          • auntbea

            Given a choice between that and death I am not sure which I would choose.

          • Who?

            There, you see, that’s the trouble. No commitment. This is just the kind of thinking that identifies most of us as weak vessels, unworthy of our wimmin-ness.

            That isn’t disgust causing bile to rise that you’re feeling, it is your weakness trying to leave your body-let it go-ideally near a suitable receptacle or loo, to save your attendants having to get grotty.

        • Ob in OZ

          I think that is for the midwives. After all, they have to take care of themselves as some labors take a long time.

        • Hannah

          Oh my lord, what I wouldn’t give for a Cherry Ripe right now.

  • Mel

    “Baby Zahra was born at 8.52am on January 23 2012, she was pink and warm and breathed on her own.

    At 10.15am, Mrs Lovell asked to go to hospital and told the midwives she was “dying.””

    Was the mom who died sitting in the birthing pool for 1 hour and 23 minutes between when Zahra was born and when she said she felt like she was dying?
    That sounds like an absurdly long time to be hanging out in water even if she’s a hard-core water birth person – or a swimmer.

    I can suspend my disbelief long enough to buy that the midwives didn’t know how much she was bleeding IN the pool.

    I don’t buy that she was in the pool the whole time, so how did they miss the blood that had to be pooling up below her body?

    Two quarts is a half-gallon. Two quarts is EIGHT cups of blood. Dump a half-gallon of red Koolaid on a bed or any surface and you won’t miss it.

    Unless you’re a home birth midwife…..

    • Amy M

      Maybe she didn’t have the strength to get out of the pool and the midwives decided she was making an “empowered” decision to stay there?

    • Irène Delse

      Good point. This makes even more scary. Did the midwife just assume PPH was a variation of normal and would stop on its own, because mother nature is always beneficent? Death by ideology indeed… :-(

      It’s just horrifying. My mother started bleeding and having contractions in the middle of the night when she had her last baby. It woke her up (due date was a fortnight later, so total surprise) and she called for help. EMTs arrived in minutes, and she was promptly whisked off to the hospital, where she gave birth in the morning after an otherwise uneventful labor. Luckily for her, it was not a huge bleed, but it was scary for her and my dad! I can’t imagine blithely watching someone bleed until they’re light-headed and in shock with blood loss. Until it’s too late basically.

      • auntbea

        Some people are willing to die for their causes. I hope she felt that way about homebirth.

        • Hannah

          I am assuming if she asked to go to a hospital, she wasn’t.

        • CognitiveDissonaceHurts

          This makes me want to cry.

    • Rabbit

      I have no medical training at all, so this may be a very stupid question, but Is it possible that a clot was blocking the cervix, and holding the blood in the uterus? I’m wondering because I remember passing some fairly large clots, and having a mini-flood of free flowing blood behind them.

      • Susan

        That does happen. That’s why in hospitals it is standard to have protocols for assessing blood loss and vitals. The first two hours after birth are a high risk time and sometimes called “fourth stage”. Typically, vital signs, fundus, bleeding are assessed at a minimum every fifteen minutes for the first hour then every half hour and then start to stretch it out. And yes, a rising fundal height can mean the uterus is collecting clots and needs massaging and often that’s the first sign something is wrong. The idea is you catch these things early and prevent the problem from occurring or getting serious.

        • Susan

          Here is a link to great info re obstetric hemorrhage

          https://www.cmqcc.org/ob_hemorrhage

        • anne

          Thanks for the explanation. I was annoyed at the hospital because the nurses kept coming in after I gave birth and I just wanted to be left alone. Darn them for wanting to keep me alive!

        • NatashaO

          I work at a hospital that does waterbirth. After the baby is born, we
          help the mom out of the tub to a bed that is next to it, to deliver the
          placenta, monitor her fundus/bleeding, check a pulse and a BP every 15
          minutes for at least 2 hours, and see if she needs a repair. Baby stays skin to skin, and
          they are all covered with warm cozy blankets. Gosh, we are so mean! It is hard to assess bleeding when someone is in the tub, that is why we get them out!

          • Somewhereinthemiddle

            Yes, for my most recent birth, which occured in a hospital, in a birth tub, I was in the water less than 5 minutes after my baby was born. And that was the exactly how care was administered.

          • Aussiedoc

            She would have been risked out for water birth anyway due to previous history.

            Ugh – water birth doing it so unsafe ly. This is why it gets a bad rap.

          • sarita

            great that your hospital has a waterbirth protocol. i happen to be a land mammal, but this is an option that should be available, in a safe manner.

          • NatashaO

            There are mixed feelings about it, but better in the hospital than at home is what I think. Plus we can and do risk people out, and most understand the reasoning why, and don’t want to take any unnecessary risks. That is why they have chosen hospital waterbirth instead of homewater birth.

      • Amy M

        Sure…that’s how my pph happened, so I know it can happen that way.

    • Therese

      I stayed in the water over an hour after my water birth, so I don’t know if I find it impossible to believe. In my case the midwife didn’t show up in time (our fault, husband called 10 minutes before the birth when she lived well over an hour away) so there didn’t seem to be any point to getting out without her there to help me out and make sure I didn’t bleed all over the place. Not sure what would have happened if my midwife had been there, maybe she would have encouraged me to get out much sooner? But anyway, my point was at no point did I feel like I even wanted to get out of the pool, I was exhausted after giving birth and the warm water felt good, so I can believe a mom left to her own devices would stay in over an hour. Especially if she was losing a ton of blood then she certainly would have been weak and not feeling like jumping right out.

      • Karen in SC

        How did the water stay warm? Were you in your own tub so you could keep adding hot water? I like long baths and always have to do that.

        • Ash

          I read a HB story where the midwife apprentices basically carried water from the bathtub to the inflatable birthing tub, and then when the hot water ran out, they heated up some more on the stove. So I can see staying in the water for a while.

          • Karen in SC

            That might answer the question of what the midwives were doing during the time of the PPH.

    • The Computer Ate My Nym

      You couldn’t miss 2 liters of blood in a clean pool, but a pool filled with diarrheal poop where the water is already brownish might make the blood easier to underestimate, if not easier to miss altogether.

      • CognitiveDissonaceHurts

        Don’t forget the herbal bath that a lot of homebirth midwives use. It turns the water brownish as well. Maybe that helped to mask the bleeding?

      • Jessica S.

        Blech. Why would ANYONE want to give birth in their own filth?? It defies logic.

  • @geekpharm

    Last night I tweeted an observation that my generation had become a bunch of control freaks and hashtagged homebirth, homeschool, and helicopter parenting as examples of control freak behavior and she retweeted it. I think she thought I was somehow supporting it?

    • Amy M

      Who thought you were supporting it? And regardless, that’s nuts. Yay, let’s all be control freaks, so our children can’t do anything for themselves! (sarcasm, not support for that idea)

      • Young CC Prof

        Yup. As long as you do everything perfectly, your children will always enjoy perfect health and success, and never misbehave or do anything to upset you! So if your children ever get sick, or throw tantrums, or run off with their friends and do something stupid, it must be your fault! Yay control freak ideology. (Yes, sarcasm.)

        • Beth S

          Oh really I wish someone had told me that before I became a formula feeding, CIO, normal schooling actual mother who *gasps* lets her four year old child play out in the backyard by herself as long as I can see her.

          • The Bofa, Being of the Sofa

            In the last two days, my 5 yo has a) almost bitten his tongue (he likely bit through it) and b) got a bloody nose.

            In two separate incidents.

            Certainly a problem with our parenting.

            I did ask my wife, though, about the tongue thing: What were the boys doing wrestling at the zoo?

          • Beth S

            Boys will be boys. My daughter fell down and skinned her knee the other day trying to keep up with her much bigger brother. I am the worst mother ever.

          • Jessica S.

            No way – the more chances they get to bounce back from those things, the more risks (the good kinds!) they’ll take, the more they’ll explore and the wider their world will be. But I still find myself being overprotective. I have to mindfully will myself to let my son be – I run the same two questions through my head: “How likely is disability, dismemberment or death in this situation?” and “Would my sister-in-law let her boys do this?”. Ha! That last one is funny b/c she’s far more laid back than I am (she has three boys: 6,4,2), is a wonderful mom and none of them have had any major injuries. So I figure she’s a good gauge. ;)

      • @geekpharm

        Gaye retweeted it. Her name kinda looked familiar and then Dr. Amy tweeted this article and I laughed

  • anonymous

    “Mrs Lovell had borderline low iron stores in the lead up to her labour, but the midwives said they had managed this with diet and supplements.”
    Bullshit. Show me where they were monitoring her iron levels. Show me the WoW blood tests where they claim that her iron levels were normalized.

    • Karen in SC

      My sister was anemic a few years ago and went all out for beef and leafy greens. She still required a transfusion and then got serious about taking a supplement. Still the level was low enough to spur her to get a uterine ablation to solve her problem.

    • Ash

      Ah-ha, notice how the midwives said they had “managed” it, though. Also means that even if they were doing labs, every time they got an abnormal result, they would just say “keep taking spirulina and your mother’s intuition will improve your iron stores”

      • Irène Delse

        They “managed” it. So they knew about it. And it shows just how efficient these alternative ways of managing anemia are. Infuriating.

    • KarenJJ

      It was how my anemia was found to be mostly unresponsive to iron tablets. It had been found previously and I’d been told to take iron tablets. During pregnancy I had a followup blood test that showed the iron tablets were only having a marginal difference to my iron levels and my anemia. It still took a while to work out what was actually going on (another year) but it was anemia of chronic disease and was due to an underlying inflammatory issue and it was never going to resolve on iron tablets alone.

      So I agree, there is no way they were managing her anemia by telling her to just take iron supplements. They probably also were recommending piss-weak “natural” iron supplements and recommending spinach – not the big gun high-dose things my obgyn had me on as well as reinforcing the need for regular red meat.

      • The Computer Ate My Nym

        Ouch! Hematologists world wide wince at histories like this one. I’m being somewhat unfair because anemia of chronic inflammation and iron deficiency anemia look a lot alike on labs and presentation, but I do wish OBs would refer sooner. Could have saved you some time and unnecessary GI distress.
        Iron is not the only issue that causes anemia. There are multiple reasons for anemia, some of which iron can actually make worse. This assumption that it’s always iron is downright dangerous. (Wanders off grumbling.)

  • Young CC Prof

    NCB ideologues ARE the handmaidens of the patriarchy.

    1) They trivialize the pain of childbirth and claim that pain relief is unnecessary or even morally wrong.

    2) They discourage and deny access to the best medical care on the most dangerous day most women have experienced since they day of their own birth.

    3) They listen only to women who say what they want to hear, and deny the validity of experiences that do not fit their narrative.

    4) They judge women by their fertility and other biological functions rather than by the work of their hands and minds.

    What is remotely feminist in any of that?

    • Staceyjw

      If I could up vote this x1000 I would.

      • Hannah

        Ditto. This articulates exactly why fighting against the NCB movement (and it creeping into medical policy) is the true feminist issue.

  • Outraged OB (aka attitude d)

    Has anyone asked what the other “more pressing matters ” were that kept them from assessing their patient?

    • Sullivan ThePoop

      You mean that kept them from doing the job they were paid to do. I bet she would have lived if she would stick with her threat to have an unassisted birth.

      • LovleAnjel

        No doubt, the minute she felt like she was in trouble she would have called 911.

        • madwife

          Or possibly Called 000 *Australian emergency phone number

          • Mishimoo

            I’ve never tried it, but apparently 911 now diverts to 000 just because so many people have dialled it for help.

          • The Computer Ate My Nym

            That’s a good idea. I wish the US would reciprocate–and add 110/2 and any other major numbers as well. In short, let’s make it as easy as possible for panicked people to dial the right number the first time.

      • Sue

        Yet another example that freebirthing is likely to be safer than renegade-HBMW birth – at least there is nobody to stop you calling an ambulance.

        All that guff about having to support people birthing at home no matter what because they would otherwise go underground (so to speak – sorry) is nonsense – let them birth unassisted (which they do with lay MW anyway) and call for help when worried.

        • Sullivan ThePoop

          I do think they would be better freebirthing. Often these women call for an ambulance saying they cannot do it anymore and the midwife talks them out of it.

          • jennie

            except thats not what the statistic say. trained care provider always better than not.

          • Jessica S.

            “Trained” being the operative word there. In a situation where the care provided is negligent, where they may prevent you from getting help when you need it, then unassisted would be one notch better.

          • Sullivan ThePoop

            Actually the statistics say that UC has better outcomes than birth with a CPM.

    • MLE

      Packing up their stuff so they could GTFOT and deny any responsibility?

      • The Bofa, Being of the Sofa

        Amazingly, I figured out what GTFOT means (although I think it’s missing an O)

        • MLE

          The O stands for “outta.” Normally it’s GTFOH, the H being “here.”

      • pinkyrn

        GTFOT? Can you give me a definition for this one?

        • Gene

          Get The F@ck Out of Town

    • Ash

      Oh, so many possibilities:
      1) baby wasn’t actually doing very well
      2) preparing for placenta encapsulation and art
      3) “holding the space”
      4) going back in their handwritten charts and adding false entries. Better get ready with that pen and paper…

      • MLE

        Don’t forget the knitting.

      • Mel

        5) Writing a blog post about the lovely healing water birth at home.

        6) Playing games on FB.

      • Amy M

        Eating the fabulous the spread the mother laid out while she was in early labor, like that Martha Stewart-wannabe. They were in the kitchen, so no blood pressure taking from there.

      • MLE

        Omg I forgot
        -getting the breast feeding relationship started
        -removing any hats from the vicinity

      • anion

        Advising other clueless fools on Facebook that they just delivered an anemic mother with previous blood-loss issues and she was “just fine,” so it’s not risky at all.

    • Amy M

      Maybe they were rummaging around looking for the pitocin they should have been carrying. Or the cinnamon candy at least.

    • Amy M

      Maybe the were trying to figure out just where on the spectrum of red that water was. Who said it yesterday, I don’t remember? The spectrum of Kool-Aid to Claret.

      • AmyP

        That was me.

        Watermelon Koolaid: OK

        Claret: BAD

    • Karen in SC

      That may be revealed in later testimony. I wonder how the bereaved husband is feeling and what he witnessed.