UK midwives treat a loss father with contempt

Joshua Titcombe

I am humbled by the profound love that James Titcombe has shown for his son Joshua.

James and his wife Hoa lost their son to midwifery incompetence (Joshua’s easily preventable, tragic hospital birth death). According to an National Health Service investigation quoted by The Independent:

Joshua died in November 2008, nine days after being born at the Furness General Hospital, part of the University Hospitals of Morecambe Bay NHS Foundation Trust. An inquest in 2011 said that staff at the hospital failed to spot a common infection, and that he would have stood an 80 per cent chance of survival if antibiotics had been delivered in the hours after his delivery.

The pain and frustration that James Titcombe deals with must be immense. The NHS initially refused to investigate, but James continued to advocate for Joshua. When he decided to take a break from his years of pressing for an investigation, he was treated with unspeakable contempt. According to The Independent:

The family were left deeply hurt on two occasions after seeing internal email exchanges between Trust staff. One followed an email from Mr Titcombe in June 2010 saying he would be stepping back from his inquiries after “becoming extremely distressed and anxious” about the investigations progress.

Informing the Trust’s head of midwifery of the email, the Trust’s customer care manager wrote: ‘Good news to pass on re [Mr D]’, and received the reply: ‘Has [Mr D] moved to Thailand? What is the good news?’

In another email from August 2009, later seen by Mr Titcombe, a discussion of a midwife’s statement to the Nursing and Midwifery Council (NMC) concerning the circumstances of Joshua’s death was subject lined: “NMC shit”.

But James did not give up. He fought on for Joshua and ultimately he and Hoa received an apology from NHS for not investigating Joshua’s death back in 2010, and an apology for the inappropriate emails.

James has continue to advocate on behalf of other babies, so no parent will have to endure the preventable death of a baby, a refusal to investigate it, and the contemptuous treatment that followed it.

UK midwife Sheena Byrom and her colleagues are familiar with James’ efforts and apparently consider him ever so tiresome.

Byrom and colleagues were having a public Twitter confab on the use of social media during and after birth (just like nature intended, no doubt). Byrom tweeted that hospital policies appeared to be dictated by risk and “all this talk about risk. Not comfortable with it.”

James entered the Twitter stream to point out that childbirth is indeed quite dangerous. He should know. His son died as a result of an infection acquired during birth.

A chilling response from Byrom and colleagues follows:

Sheena Byrom 1

Highlights include:

oh James-don’t let’s get on that roll again …

and:

getting out of bed in the morning has risks http://homebirth.org.nz/magazine/article/climbing-trees/

Yes, James, how could you be so tiresome, always going on about the risks of childbirth and the babies who die as a result? Sheena is so over that.

Sheena ought to be ashamed of herself for the chilling way that she dismissed the father of a baby who died as a result of midwifery incompetence. But that would involve insight, compassion and a sense of responsibility, something in woefully short supply among UK midwives.

How can women trust “professionals” who dismiss a dead baby as a troublesome distraction from the agenda of promoting midwifery?

And how can women trust “professionals” who are aggressively close minded. When I posted a link to my piece debunking the article that Sheena cited, she responded thus:

don’t read your foolish, dangerous blogs, you are blocked.

and:

Sheena Byrom 2

It’s almost as if Sheena and colleagues fear that by reading my blog, they might learn something they did not want to know. And that could be “toxic and dangerous” to them (who cares about babies and women who might be saved?).

Byrom’s contemptuous dismissal of James Titcombe, a father whose son died of midwifery incompetence, who was forced to endure a refusal to investigate his son’s death, and subject to chilling emails that treated his dead son as an inconvenience, is both outrageous and disgusting.

Her refusal to read my blog is indicative of the close mindedness of UK midwives who prize validation above scientific evidence, process above outcomes, and midwifery income above the lives of babies and mothers.

Sheena Byrom, have you no shame?

Oh, wait, you’re a UK midwifery leader, so of course you don’t.

Joshua and Hoa

  • Anna Dorman

    Funny that they accuse you of being too mean and callous to pay attention to– while, of course, disregarding grieving parents.

  • toni

    It’s as if she is trying to make Mr Titcombe feel he’s making a big deal out of nothing. out of losing his son to incompetence and apathy! The inevitable result of an attitude that hey ho life is risky why worry about prolonged rupture of membrames and an unstable temperature since it’s usually nothing to worry about right? I read the coroner’s report.. very obvious they tried to cover up their mistakes and it beggars belief that Joshua wasn’t examined by a doctor until he started to seriously deteriorate

  • Deena Chamlee

    Ok I am beginning to think all leaders in midwifery are pathologically narcissistic. Here we see the classic display of projection. Ms. Byrom must feel that she herself is toxic and dangerous, and since her fragile ego cannot handle these feelings she projects it onto SOB.

  • Heather Dalgety

    IMHO Sheena BYrom should be reported to the UK MIdwives COuncil over the inappropriateness , heartlessness, and rudeness of her very public comments , in a case where the findings against the midwives involved were upheld .

  • Hannah

    On a side note, the other week I posted about a woman who had a caesarean ordered by the Court of Protection. She’s now been ordered to have a Depo Provera injection while they’re at it and there’ll be a further assessment of her capacity wrt contraception:

    http://www.bailii.org/ew/cases/EWCOP/2014/13.html

    • Who?

      There are no good outcomes or perfectly right answers here. The whole situation is so sad. Let’s hope the outcome of all this is that the baby is okay and she can be helped to a healthier and safer future for herself.

  • Hannah

    You might be interested in this report that James Titcombe tweeted:

    https://www.uk-sands.org/sites/default/files/PREVENTING_BABIES_DEATHS_REPORT_2012LR02.pdf

    The infiltration of woo into some parts of British midwifery is a worry, and some of the tweets leading up to the ones you highlighted offer some particularly scary examples but I think it is fair to say that there are thousands of midwives up and down the country doing their jobs to the best of their ability and not being idiots on Twitter.

  • The Bofa, Being of the Sofa

    WAY OT: But instead of digging up an old Ina May thread, I thought I’d mention it here.

    I was watching “Sex in the Wild” on PBS last night, and the topic was elephant reproduction. Lots of funny stuff (they were trying to collect a semen sample from an elephant; hilarity ensues), but they also followed a pregnant female through her pregnancy, birth, and beyond. Oh it was wonderful, we got to see her go through labor and deliver. Baby elephants are just the cutest things (I love baby elephant trunks; even the guy in the documentary says, “On a cuteness scale of 1 – 10, this is an 11, at least’). Then they showed the great family approach that elephants use for raising and protecting their young, and a great scene were the baby was stuck in the mud and the whole family came to help her get out.

    And then came the end. Unfortunately, when the baby was 6 weeks old, the mother had to be put down, because she had suffered a herniated intestine during childbirth, and never recovered from it.

    Wait a minute! I thought that animal births were all so wonderful? Although it wasn’t completely a wild birth (she was in a boma on the reserve), it was completely unaided. Elephants trust birth, right? And, sadly, some of them die. And it’s not like they chose this story because she died at the end, this was a random elephant birth that they chose to document.

    Actually, elephants not only trust birth, they even learn about birth beforehand from watching their mothers, sisters and aunts. Birthing is a family event (as is mating, but that’s a different story). Moreover, this was actually her second baby, so she was even experienced. Seriously, if she were a human, she’d be claiming that she was educated and had a proven pelvis, so she was low risk.

    • sdsures

      I’m going to watch this program right now!

  • KarenJj

    I don’t use Twitter but I just scrolled through the link on Sheena Dysom’s website (took a while – she has a LOT) – has she deleted the tweets she sent? I didn’t see them.

  • RNMomma

    At the children’s hospital where I used to work, like many hospitals, we had a rapid response team ( < ten minute response time) in addition to the code team ( < 2 minute response time). Upon admission to the hospital, every parent is supposed to be oriented to some standard policies. One is that as the parent, they have the right to call for the rapid response team if they feel their child is not doing well and they are not feeling that they are receiving adequate feedback/attention from the primary team. I would tell them it's the parent's in-house 911, and their rightful second opinion from an ICU resident. I never had a parent use this resource (though I and my coworkers had on a semi regular basis). I wish this is something that could be implemented in all hospitals. Then again, it's a nice resource that might not help so much… as patients, we should be able to trust our providers assessments and explanations and so we typically do. It's rare to see a patient/parents who doesn't frequent the hospital regularly that know what their rights are and how to insist upon them.

    This case is just heartbreaking. Please know I'm not at all placing any blame on the parents with my comment. Having those resources and being able to demand and receive your rights as a patient should be safety nets only. The burden of proper care is always on the provider. These providers were negligent and failed tremendously.

    • RNMomma

      What just happened to my post? Okay… editing.

  • yentavegan

    I have not read through all the posts, so forgive me if this has already been asked in answered. Here in the USA isn’t it standard procedure that if a mother’s water ruptures prematurely she is admitted to the hospital? Why is that not the standard of care in the UK?

    • Joy

      In the UK, I was told that you go in and you can wait up to 24 hours after your water breaks. If you agree/want to you can monitor your own temperature for up to 3 days (although some places it is 2) at home.

  • Smoochagator

    God bless James for continuing to advocate for his son and other babies, in spite of the cost to his own reputation and emotional well-being.

  • Wendy Wilkinson

    I am appalled at the lack of professionalism on display in those email excerpts. Is there not a Code of Conduct for the NHS that covers electronic communications?

    As for the midwives… what is it that makes it all about them, and not their patients (clients, whatever the current terminology is). As a nurse who works in Quality and Safety I am continually disappointed, and increasingly appalled by this trend in health care professionals, and some specialties more than others, to think it’s all about them – their shift, their workload (which is acceptable to a point), how a patient’s needs and care impacts on the HCP.
    What happened to patient focussed care? And that includes the baby and the family/carers.

    These particular midwifery leaders are unwittingly (I hope) doing the exact same thing they accuse the ’empirical medical model’ of Obstetric services of doing – stating what should/shouldn’t be happening to the people in their care, actively advocating for their model of care being the superior way to do things, and increasing poor outcomes through inaction rather than action.

    It’s not about them. Health care is not an ‘us v/ them’ game, it’s about teamwork. Nursing is not about self-gratification. It’s about caring for others, respecting their rights and intervening with the right procedures/processes when things turn bad.

  • Anna T

    I can’t believe the callousness of this midwife on Twitter. Can it be she didn’t know she was speaking to a loss father?

    I’m so sorry for this family, for any family that lost a child. The pain never heals. My mother’s twin was lost at birth (it was 1949, the USSR; no ultrasounds, nothing of what we take for granted today), and though perhaps my Grandmother had the small comfort of at least coming home with one baby rather than with empty arms, she never forgot. She lived to be 97, had children, grand-children and great-grandchildren, she took part in many of the most stirring and terrible events of the 20-th century, she survived several operations for colon cancer at the age of 75… and yet sometimes she would speak to me of this little boy, and there were always tears in her eyes when she did. “Do you remember your mother had a twin?” she would remind me. “It runs in the family. Perhaps you will have twins too, some day.”

    A family’s whole life is forever changed by the loss. It doesn’t matter how long they live or how many other children they have. Should the worst happen, the pain will never heal. This is something to always, always keep in mind while making decisions.

    • KarenJJ

      It is possible she didn’t know – if so she hasn’t kept up with midwifery in the news very well – or has forgotten it. Her comment “don’t let’s get on that roll again” makes me think that she did indeed know, has discussed this previously with him and has found his efforts to bring midwifery to accountability to really really annoy her for some reason….

      • Anna T

        Karen, I got the same impression from her comment, but perhaps it’s possible they had a general discussion without him mentioning the loss of his baby, and her being unaware of it? Still, however you slice it, her comments are rude, unprofessional, and show an irresponsible attitude. “Getting out of bed in the morning has risks” indeed!

        • KarenJJ

          That’s possible. I wonder how she would explain her comments?

          • KarenJJ

            Reading the comments more closely now – did she really call herself “Sagefemme”? These midwives certainly do think a lot of themselves, don’t they?

            Dr Amy’s “ATuteur” is rather sedate for the angst she causes these midwives online. A handle “ScalpelWieldingOverlord” might be more in becoming with reputation “Toxic and dangerous”.

          • Louise

            You do know Sagefemme is the French term for a midwife?

          • KarenJJ

            Is it? Well there you go, I just learnt something new 🙂

          • Anna T

            So that would be literally “wise woman”? Very fitting (in most cases).

          • KarenJJ

            That’s what I thought it was – I thought she was just being wanky by sticking those two words together, but if it’s really the term for ‘midwife’ in France then I stand corrected.

        • KarenJJ

          She knew exactly who she was talking to and that he is a Dad who lost his child due to midwifery incompetence. Look at the screen grabs below on here where Sheena Byrom mentions speaking to CQC.

          James Titcombe is listed as an advisor to CQC and it mentions on his (short and very easy to read) profile that he is passionate about patient care after losing his son.
          http://www.cqc.org.uk/content/james-titcombe

          • KarenJJ

            He seems like a sensible and compassionate person:

            “In my last blog, I mentioned the importance of listening to and accepting challenges from others, even if such conversations were difficult or uncomfortable”

            http://www.cqc.org.uk/content/conversation-whistleblowers

            Now there’s a challenge for the midwifery community. Are they able to listen to these uncomfortable conversations without making the conversation all about themselves? Judging the culture surrounding birth blogs and deleting/banning different opinions, the silencing of dissent as being “unsupportive” and the vilification of anyone that is whistle-blowing poor practices (eg Dr Amy being “toxic and dangerous”) I suspect they aren’t.

          • KarenJJ

            I promise I’ll stop talking to myself now. My time zone is awkward…

          • The Computer Ate My Nym

            Hi there. (Just so you know that there are others in this time zone…well, in a compatible time zone anyway.)

          • anion

            Lol, me too.

          • KarenJJ

            Actually seeing the concept of loss mums and dads and others like Dr Amy as whistle-blowers makes their vilification understandable – and it doesn’t reflect well on the midwifery community.

          • The Bofa, Being of the Sofa

            I agree. I’d call it “true colors.”

            The next time Dr Amy gets jumped on with the “how dare you post this person’s story! You are heartless!”, you will know that is only diversion. That’s not their real objection, and we know it’s not, because we have seen the response when someone posts their OWN story. Then the real heartlessness shows up.

          • Anna T

            In that case, her attitude isn’t just flippant and irresponsible… it is despicable. Go tell parents who lost a child that birth and the first few days after it are “safe”. It’s like spitting in their face.

  • auntbea

    Ugh. It is just so IRRITATING when people keeping bringing up that time you killed a baby.

  • Beth S

    So basically midwives are trying to tell me that it’s okay to dismiss a Father’s search for answers and justice in order to further their cause. That just boggles my mind. A parent’s right to speak on behalf of their child is one of the most fundamental rights we have as parents especially of babies, yet this man can’t speak because he what…harshes their mellow?

    • Jessica S.

      He must be an outlier in their minds, thus they can dismiss him b/c he doesn’t fit within their worldview. Pitiful.

      • Beth S

        Within the homebirth industry father’s are often marginalized to begin with. I hate seeing it because a father is just as important as a mother in the long run.

  • KarenJJ

    Midwives: You have become the bullying and paternalistic “Dr knows best” of past times. Congratulations.

  • anion

    Sheena Byrom’s blog post about how Twitter is so great for education and “connectivity that crosses hierarchies” is pretty amazing to read in light of this.

    http://sheenabyrom.com/2014/04/19/help-to-connect-more-midwives-around-the-world-and-be-a-twitter-buddy/

    • Young CC Prof

      She definitely needs to read her own advice chart, starting with “everything is public, don’t be stupid.”

      I’m a little disturbed by her suggestion to use Twitter instead of reading actual journals, however. Twitter might be a good place to find out that an interesting article was published, but it’s no substitute for actually reading said article.

      • Beth S

        Especially when you add in the word limitations, I’m too long winded for twitter.

  • the wingless one

    I just looked at Mr. Titcombe’s presentation about the events leading to his son’s death and I feel sick to my stomach. The Titcombe’s did EVERYTHING they could to get their son the care he needed and it seemed like the midwives were determined to let him die. Why? I just can’t understand. It makes no sense to me how anyone can defend people like this. They murdered that baby with their inaction, there’s no denying that.

  • Mishimoo

    My heart goes out to Hoa, James and their family. I am so very sorry for your loss; it is infuriating that it was preventable.The reactions from those midwives are beyond disgusting.

  • anne

    Every now and then I read this blog and think Dr. Amy is wrong about midwives’ craving for publicity and stunts. It comes off as over the top. Then she posts an exchange like this and I’m just boggled. I’m trying to imagine a situation where neurosurgeons would get together to talk about the use of social media during operations.

    The lack of self awareness and professionalism stuns me.

    • the wingless one

      I think this is what the people who complain about Dr. Amy’s “tone” are missing. Dr. Amy’s tone is 100% appropriate if you look at the type of lunacy she is trying to combat.

      • Smoochagator

        There are times when I’m not a fan of the good doctor’s tone, but I am always a fan of the work she’s doing.

  • araikwao

    I don’t have anything new to contribute, but just want to add my outrage and sadness to the appalling way the Titcombe family have been treated in the face of losing their sweet little boy. Keep pushing for accountability, Mr Titcombe.

  • Anonymous

    Just a minor update Dr. Tuteur, according to the Daily Mail he had a 90 percent chance of survival not eighty percent:

    http://www.dailymail.co.uk/news/article-2521685/Furness-General-Hospital-midwives-blamed-deaths-3-babies-mother.html

    Another sad, sad, preventable death at the hand of incompetent midwives.

    • Amazed

      The picture is heartwrenching. How convenient that Byrom, Warwick. Tritten, Collins and the likes lack the organ to be wrenched.

      This poor, poor baby with his excellent chances and terrible choice his providers made.

  • Amazed

    Hey, I am short of money. Someone willing to bet that they’ll delete the exchange in no time at all and keep preaching love, support and being with women?

    Come on, people. Have hearts. You know I’m going to win.

  • Amazed

    Stacey! Stacey, where are you? YOUR TURF IS BEING ENDANGERED, GIRL! Soon, people will decide that they don’t need a vet to treat their female dogs. They’ll just turn to the dogs’ sisters – bitches, like Sheena Byrom. She’s quite the animal if you ask me.

    Quick! Summon the Trust Vets Consensus Summit. Or you’ll find yourself out of employment soon. Sheena and her likes can hardly grab the obstetricians’ business but my, they might have greater success with vets’.

    Don’t you feel it, Stacey? Aren’t you shaking in your boots?

    *Sarcastic hat off* These women are unbelievable.

    • Mishimoo

      Actually, there are some breeders and animal fanciers purporting to know more than vets (and it annoys me). Vets Behaving Badly had some interesting posts about it.

      • Stacy48918

        Vets Behaving Badly is a great guilty pleasure read. 🙂

        • Mishimoo

          “They can’t catch heartworm, their skin is an inch thick which means that mosquitoes can’t bite through it.” (paraphrased) still makes me giggle every time I think of it.

        • Guesteleh

          I was enjoying it until I got to the post that referred Obamacare as an abortion. :/

          • Stacy48918

            I haven’t read the whole site. Like SOB and really everywhere I read, I doubt I would agree with every single thing written. Doesn’t mean the nonsense about clients isn’t spot on! 🙂

      • The Bofa, Being of the Sofa

        Actually, there are some breeders and animal fanciers purporting to know more than vets

        The group that really knows more than vets (just ask them) are the horse folks.

        They are the major acupuncture drivers, too.

        Granted, they’ll do anything to try to prevent/solve laminitis, which is pretty random on the whole, but the combination of the two (desperation with randomness) makes it easy to fall into the woo.

        • Stacy48918

          Oh the many reasons I don’t treat horses…all the nutso people that come with them!

          • The Bofa, Being of the Sofa

            You ain’t lyin…

          • Amy M

            Hahaha! I’m not a vet, but I was a Vet/AnSci major in college, and we called them “HORSE people” (you have to say it right, and look down your nose while you do.) ‘Course, they called themselves that…..

            I remember one class, we were doing a section on dairy cattle, and the professor asked a girl a question, and her answer was : “I don’t know, I’m a HORSE person!”
            Sigh. The horses themselves now…beautiful animals.

          • Dr Kitty

            As the granddaughter of a racehorse owner…yup.
            Horsey folk are bonkers.

        • Mishimoo

          Especially racehorse trainers! One of my friends is a Master Farrier* and is regularly irritated with some of the nonsense from them.

          (*Like midwifery in the US, there is a problem over here with what could be called Direct Entry Farriers, who have no formal training, undercut the professionals prices, and risk injury to animal and rider by not really knowing what they’re doing or how to do it properly. Being a Master Farrier requires completion of a 4 year apprenticeship combined with 2.5 years of tech school.)

    • Stacy48918

      Actually this is already the truth. People trust the high school kid at petco for food allergy recommendations, their groomer for ear infection treatments and their breeder for vaccine schedules. I get a lot less of this nonsense though working ER. When it’s 3am and your dog is puking it’s guts out – all you got is me. Take MY advice or leave it.

      • Guestll

        We are looking for a Golden breeder and I’ve eliminated anyone with stupid assvice on their website (delayed/non-vaxxing, other forms of dog woo, etc.) As a sidenote, we’ve stopped vaxxing our 13 year old GSD for anything other than rabies (mandatory) because we titre with approval from our vet.

        I really hate dog woo…

        • Stacy48918

          “titre with approval from our vet”
          Eh, save your money or just vax. That I’m aware of there are no studies that demonstrate any particular level of titer as actually being effective.

          There was a theriogenology resident at my vet school when I was a 4th year that bred BEAUTIFUL Goldens…top in the country 2010: https://www.facebook.com/pages/Blue-The-Golden-Retriever/186374188049447
          Dr. Leeah Chew. Don’t know if she’s still breeding but I think her kennel name was “My Buddy”.

          • Guestll

            There’s so much conflicting information out there about titres. Our last vet was all for them. Our current vet will do them but doesn’t recommend, per se. Our dog is 13, is never boarded, has zero contact with other dogs/cats, and is essentially a 75 lbs happy GS couch potato at this stage of her life. She was vaxxed until age 10 and we still do rabies. I just don’t think the other shots are worth it in her case at this point in her life.

            Thanks for the breeder recommendation — we’re in Canada and I think we’ve actually found one we really like who does all of the clearances and produces some truly amazing dogs. We’re on a lonnnnng waiting list for a pup as they breed quite selectively. Nothing like watching your 3 year old frolic in a field surrounded by five Goldens. 🙂

        • Carrie Looney

          Oh, god, dog woo. Homeopathic shite in mainstream pet stores. The Dog Whisperer going on about how acupuncture is great for dogs. I found someone online who was arguing that you shouldn’t give your dog the rabies shot. RABIES.

          (We have two rescue mutts, sweet bitches, that are fully vaccinated, and we only take health advice from the local vet. Who happens to be wonderful.)

          • Stacy48918

            ” I found someone online who was arguing that you shouldn’t give your dog the rabies shot. RABIES.”
            This is more and more common. Thankfully telling them that the health department is more likely to make them EUTH their dog if it bites someone and is unvaxxed makes a lot of folks decide that one shot isn’t so bad. In my state you have to have an internal medicine specialist sign off on non-vaccinators for rabies. So the couple times I had people call/ask about it/decline rabies I just told them I’d be happy to arrange their referral to the specialist so they could get their certificate. No one ever took me up on the offer.

          • Carrie Looney

            I mean, even if you don’t give a shit about other people – how could you wish even the chance of a disease like that on your dog? I don’t get it. (But I don’t get a lot of anti-vax stances, so what do you do.)

          • Guestll

            Rabies frightens the living shit out of me, I witnessed it from a distance in a dog in Tanzania and it’s truly awful.

  • lilin

    Here is a brilliant take on UK midwifery by a UK comedian. It starts at 47:00, and goes through a guy and his wife at a class listening to a midwife offer homeopathy kits (water) for pain relief, and say things like, “Don’t let the doctors near you! With their knives!”

    https://www.youtube.com/watch?v=c2IqI7gOE54

  • Amy Tuteur, MD

    Perhaps people should let Sheena Byrom know how we feel about the way that she has treated James. Maybe that might cause her to think twice before she contemptuously dismisses him in the future:

    • Guesteleh

      I didn’t think anything could shock me anymore after being on this site for awhile, but this did it. Heartless and stupid, what a great combo.

      • Amazed

        Waiting to see just how many homebirthers will run to support this one. Because you know, the fact that you had the birthing constitution of a cow (one that successfully brought her calf into the world because even cow births end deadly sometimes. Wonder whether bitches know it) makes you an expert in normal birth and obliged to stare adoringly at the “midwife” who held he space. You know, with cowlike adoration.

    • Amy M

      What is CQC?

    • anion

      “I didn’t refuse, I chose not to?” So not only is she ignorant about childbirth, she’s ignorant about what words mean.

      • KarenJJ

        Can she get anymore patronising?

    • Guestll

      Wow. Just wow. Revolting, shameful, stupid people. Mr. Titcombe, your dignity and grace are admirable.

    • Jessica S.

      What a wretched, sorry excuse for a person. And who is this Robert Bird person? Have these people no shame, to speak to a parent who has lost a baby within the context of said lost baby? Where’s their sense of humanity?

    • Beth S

      Good God that’s disgusting. Seriously someone needs to slap Robert Bird and Sheena for the way they were talking to Mr. Titcombe.

  • June bug

    I really want to support “real” midwives, but the way they often close ranks around these losers is just so unacceptable.

    I hired a hospital CNM to be my “backup” in case something went wrong at my homebirth. She was happy to take my money and never bother mentioning that if I transferred I’d really need an OB during an emergency.

    When I did transfer to the hospital during labor she refused to come in and claimed to the hospital nurses I had transferred care and wasn’t her problem. I’d seen her a few days prior and everything was normal.

    Hearing stories from friends that work in L&D has further degraded my opinion.

    I wish they’d get it together, formally denounce CPMs, drop the ideology, and stick to the science.

    • Deena Chamlee

      Now I understand your anger. I am sorry for the abuse you endured through exploitation.

    • Medwife

      It is horrendous that a CNM would offer herself as backup for a CPM. I am so sorry.

  • Young CC Prof

    Some kind of bingo here.

    These people refuse to accept that not only were mistakes made, but that clear signs of trouble were repeatedly ignored by multiple staff members.

    And of course, “getting out of bed in the morning has risks” which is classic dodging. Yes, everything theoretically has risks, but reasonable human beings comprehend that some of these risks are large enough to worry about and some are not. Birth, big enough risks to worry about. Walking to the store, not big enough to worry about. Common sense, people!

    • lilin

      I would propose a game for people who say, “Getting out of bed in the morning has risks.”

      Every morning, when you get out of bed, take a tablet that has the same odds of being an overdose as the odds of death in whatever you’re dismissing. I’m betting if you risked death getting out of bed the same way the people you’re scoffing at risked death, you’d go ahead and decide to either take the safest possible option, or not get out of bed as much.

    • Cobalt

      I wonder if people who dismiss these tragedies with “getting out of bed in the morning has risks” bother to wear seatbelts, or look before crossing the street, or reading dose instructions on their meds.

      • junebug

        I eat all my chicken raw, because YOLO or something.

        • Beth S

          HA! I eat all of my pork products raw! YOLO.

        • Mishimoo

          I once heard someone say that they regularly eat chicken sashimi. I’m still not sure if they were serious, or merely confused sushi with sashimi.

          • junebug

            You can pry my chicken tartare from my cold dead hands.

          • Mishimoo

            Nope…you’re most welcome to keep it!

          • Forgetful Guest

            No, it’s really a thing, apparently. Of course they’d use super fresh chicken to minimise the risk, same as with regular sashimi. At least there’s some kind of genuine acknowledgement of risk in making sure it’s as fresh as can be, unlike that stupid line about getting out of bed having risks while ignoring real risks, if you know what I mean.

          • Mishimoo

            O.o how is that a thing? Ew! But yes, there is definitely a difference between minimizing risk and denying the existence of risk.

            (It was in a rat owners group, I take everything there with buckets of salt)

          • Forgetful Guest

            I actually see new potential for sushi chefs there. They should be more like “trust food!” Got food poisoning? You didn’t trust your food enough. 😉

  • Guest

    I just read the post about Joshua’s death – absolutely heart breaking. Sheena Byrom must not have a heart.

  • Deena Chamlee

    It is difficult for me to wrap my head around Ms. Byrom’s lack of consciousness. Dismissive of a grieving father’s struggle to accept the loss of his son. I would hope there is some government agency in England that has backbone and a conscious and addresses such abuse from a professional. I swear I may not always comment here daily but I do read this blog daily. The more I read, the more I see, the more I feel hopeless for the profession.
    But I continue to love midwifery and hope that one day things will change for us all.

    • cant quit

      Why would you hope the same for England when there is no agency here in the US (where you claim to practice) that investigates at all! Perhaps if you truly “love midwifery”, you should become involved in seeking justice for the babies who met untimely ends due to midwifery care? Perhaps you should advocate for agencies to investigate those deaths here in the US? How can you possibly claim to care about your patients and NOT offer them this service?

      • Deena Chamlee

        lol you have no idea what work I have done and continue to do. You have no idea the price I have paid in my attempt at driving change. In fact you know not what you are speaking of, therefore, I will let your angry comments slide off my back.

        • Siri

          Good for you, Deena! Not sure what you’ve done to deserve that person’s ire…

          • Deena Chamlee

            and it isn’t any of your business what I have done. Just because I don’t blog away about what awful abuse I have endured because of standing up and what small progress I have made doesn’t mean it doesn’t exist. Your anger is definitely misplaced on this girl.

          • cant quit

            Likewise Deena, you don’t know the loss I’ve suffered because of incompetent CNM care.

            And you still haven’t answered my question – how can love “love midwifery” but deny your patients access to basic services like investigations of dead babies when CNM goes awry? Don’t you think that birth mothers deserve that protection? Or will your love of practicing essentially unregulated medicine that does not comply to medical guidelines be enough to protect them (and yes, I know the difference between a CNM and CPM and in my state, CNM’s operate in midwife groups that routinely defy medical guidelines such as routinely ignoring requests to induce labor – they won’t induce here until 43 weeks).

            There is no anger in my question – just an honest-to-God question. In my profession, my services are highly regulated and any sniff of malpractice and I would be thouroughly investigated by my liscencing agency. It does not seem to be the case in your profession – at least, not in my experience of your profession in my state (WA).

          • Deena Chamlee

            I cannot answer your question. I cannot defend the profession and all I can say is I don’t practice in such fashions.

          • Bombshellrisa

            I too am in WA state and time again I have been shocked at how deeply into the woo CNMs are. Even ones who strictly deliver at hospitals. I had an experience with the midwives at Valley Medical, where they told my sister in law that she should do things “all naturally” when she showed up at 41w3d in labor that was not progressing. One midwife kept saying she gave birth at home almost four weeks after her due date. I can say that with beliefs, there seems to be very little difference between a nurse-midwife and a CPM in WA state. I read your story, I am appalled this happened to you. I do hope you will continue reading here, there have been posts from many CNMs who do practice ethically and without the ideology that is so dangerous.

          • Jenny_from_da_Bloc

            I can’t believe that! They should be reported to the board or nursing or whoever licenses in WA! Don’t the CNM have to work an OB? I know they do in Ohioans

          • Bombshellrisa

            They are ARNPs also in this state, and able to work alone (although unless something has changed, they are supposed to refer out to an OB for a consult at 41w). At any rate, we were in triage when this happened and I demanded they send in an OB. Turns out the OB wasn’t nearly as interested in natural anything and admitted my sister in law and good thing. My nephew needed to be delivered via C-section and was a whopping 10 pounds.

          • Siri

            I’m not angry, Deena! I was supporting you. 🙂

          • Deena Chamlee

            Thanks Siri I think her anger may have bothered me a tad bit. But I understand because we have all been harmed in one way or another.

      • Jenny_from_da_Bloc

        Like any good medical professional she hopes for change and accountability in all countries, not just the U.S. and U.K. Midwives who don’t follow protocol, dismiss their patients concerns and practice such recklessness with other people’s lives need to be held accountable for their actions or better yet, their inaction. Bottom line is that these midwives are responsible for these women and their babies and if the patient asks for a doctor, you go get the doctor! You don’t tell them.they don’t need a doctor ever! Midwives who act so dangerously whether it be a hospital or home birth should publicly shamed especially if they refuse to acknowledge their lack of responsibility in the deaths of children like Joshua.

    • Busbus

      I think it’s wonderful if midwives who are aware of the risks advocate for safer practices and accountability, as I assume you do. Fight on!

  • Comrade X

    If you’re “not comfortable” talking about risk, maybe taking care of medically vulnerable people ain’t your calling. Just saying. Get a pet rock and a job where nobody can get hurt and you don’t have to think about risk.

    • Tsabhira

      No kidding. I’m myself not comfortable with being treated by doctors who don’t want to discuss the risks associated with my treatment. Oh right, these aren’t actual doctors, so why would anyone listen to them anyway.

  • Jenny_from_da_Bloc

    Absolutely heartbreaking! Sheena Byron should be ashamed of herself and kudos for the Titcombes for not letting their son’s preventable death be swept under the rug.

  • GiddyUpGo123

    Those photos of Hoa holding her son are heartbreaking. I don’t understand the callousness of the people involved in this. I don’t understand how you can look at those photos and just shrug your shoulders and wish that those irritating parents would go away. Those people don’t have hearts or souls. My four year old has more empathy than they do.

    • AmyH

      That pic brought tears to my eyes. It didn’t need a caption.

    • wookie130

      The photo rips me apart for Hoa. Sheena…what happened to her humanity?

  • Mel

    Dr. Amy’s blog is more “toxic and dangerous” than failure of a group of midwives to identify a common infection with lots of warning signs that the Titcombes frantically tried to get the midwives to pay attention to?

    More toxic and dangerous than rank medical incompetence in midwives that lead to a baby bleeding to death on ECMO?

    More toxic and dangerous than a toxic culture on a ward that lead to several neonatal and maternal deaths of women who just happened to be minorities?

    If you want to be delivered by Sheena Byrom et al, remember that letting a baby die is less of a problem than reading a blog.

    • wookie130

      Dr. Tuteur’s blog never killed anyone. Just sayin’.

    • KarenJJ

      When people come here complaining of “tone” why do they not understand these points? It is the sum of what is wrong with midwifery – focussing on process over outcomes, on “tone” over facts, on “support” rather than continuous improvement of a profession that’s main priority should be the health and wel-being of the women and children it serves.

  • Amazed

    Is this Jan Tritten’s twin sister? Midwife, editor, undergone a surgery that left her with a heart replacement?

    • Amy M

      Reverse tin man.

      • Amazed

        Thanks for clarifying. I didn’t know what a tin man was but my, your comparison is very apt indeed.

  • Deena Chamlee

    I am lost for words. James and Hoa I am an american certified nurse midwife who deeply feels compassion, grief and empathy for you, your wife and your son. It seems the inital investigator who expressed “extremely distressed and anxious”, thus, he was stepping back might have encountered bullying from others. It is these types of occurances that are occuring globally in the profession that angers me beyond words. The bully is actually a coward who gets their needs met at others expense without a shread of guilt or remorse.

    I dont have any answers except this type of behavior is anything except professional.

    • cant quit

      Shame on you Deena! I’m so sorry that the hospital investigator (whose job it is to investigate!) may have encountered “bullying” from others! I would suggest he look for an alternative career choice! His actions are inexcusable and your excuses for him are inexcusable! His job is to investigate. He did not fulfill his job – plain and simple.

      Other people’s bad behavior does not give anyone the right to abandon their job – I don’t know of any profession when you can just walk away with no recourse from your duties when the going gets tough…except for midwives who can pass the consequences of their disastrous actions on to doctors!!

      • Deena Chamlee

        Well do you feel better? I did not say he is without fault. I stated fact and a conclusion based on a possibility why he felt anxious and extremely distressed.
        If you have not experienced mobbing by others, which I have to an awful extreme because of standing up against such abuse, you possibly cannot feel empathy for the investigator.
        I did not say he is not negligent also for not seeking assistance with the investigation in order to expose truth, I merely implied I empathize with his anxiety and extreme distress when dealing with midwives who possibly have mental disorders.

      • Siri

        It was Mr Titcombe who stepped back due to becoming distressed and anxious. Why are you so cross with Deena?

        • Deena Chamlee

          Geeze I misread. Still no reason to displace anger on a CNM who has taken a stand against abuse in my profession.

          • Siri

            Yo Deena, again, I’m on your side! Peace, girl! 🙂

          • Amy M

            Was there a disqus issue there, this conversation is very confusing?

          • Siri

            No, I think we’re good! Couple of crossed wires. 🙂

          • Deena Chamlee

            I know I was referring to cant quit. The anger messed with me a bit, so I went into total defense mode sorry Siri.

          • Siri

            No worries, happens to all of us at times! I have nothing but respect for you.

      • anion

        Shouldn’t we also have some anger for the people who bullied the investigator? Yes, that he stepped aside/gave up is wrong, and he should be held accountable, no question. He did that. But the people who bullied him into it also deserve a share of the blame; they’re the disgusting individuals whose goal was to cover up the death of this precious baby. Unless you’ve been the target of an organized hate campaign, you can’t imagine what it feels like–again, does not excuse him, not one bit, but makes what he did slightly more understandable, especially when you factor in that not only was he apparently getting bullied by those vicious sociopaths, but his own employer (and the government, by extension) didn’t really want him to look into it either. Not everyone can be Norma Rae.

        With all due respect… I am sorry for the awful experience you’ve had and your anger is absolutely justified, but Deena didn’t personally do that to you (unless it was her, in which case that should be known).

        I’ve had disagreements with Deena here myself, but I have never doubted her integrity or that she genuinely cares; the fact that she’s here, publicly exposing herself to the ire of other midwives, should tell you something. The fact that she loves midwifery doesn’t mean she thinks abuse by midwives is cool because it’s all about her baby-junkie high, and I’ve never seen an indication from her that she feels that way. She is standing up and trying to change things; she is your ally, hard as that may be to see.

  • anne

    I’m sad to see that James Titcombe has to continue fighting for his son almost six years after Joshua’s death. His love is amazing.

    The twitter eyeroll from Sheena is disgusting, immature and cruel.

  • Amy M

    And an evidently stunning lack of understanding of how the internet works in terms of privacy, and lingering evidence. This sort of thing really doesn’t jive with that whole “personal, loving care” thing that homebirth midwives are trying to sell.

  • fiftyfifty1

    Beautiful baby. Senseless loss.

  • moto_librarian

    Few things that midwives do shock me anymore, but this managed to stun me. The complete lack of empathy, the adherence to NCB drivel from the mouths of supposedly “good” midwives? It is outrageous. I hope that the NHS looks into this latest incident of unprofessional behavior and does something about it.

    James and Hoa, you and your family are in my thoughts. I am so sorry for the loss of Joshua.