The moral rot at the heart of homebirth midwifery

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Homebirth midwives have come up with a new way to bury babies twice, first in a coffin in the ground, and then by erasing their lives and deaths so that pregnant women will have no way to assess the dangers of homebirth.

It’s hardly news that homebirth midwives (CPMs, LMs, and lay midwives) are dangerous. They are lay people who awarded themselves a made up “credential” in order to trick the public into believing that they are real midwives. They’re not. They lack the education and training required of real midwives in EVERY industrialized country.

Not surprisingly, their death rates are hideous. In Oregon, the state with the highest rate of homebirth, and most comprehensive statistics, LICENSED homebirth midwives have a perinatal death rate 9X higher than comparable risk hospital birth. But their ignorance and dangerous is not the worst thing about them. The worst thing is the moral rot at the heart of homebirth midwifery.

It’s hard to blame them for being stunningly ignorant, when their “training” is based on nonsense. It’s hard to blame them for the many deaths at their hands when their own certifying agencies have LITERALLY no safety standards. But no matter how ignorant they are or how clueless they are about their own deadly mistakes, there is one thing for which they bear complete moral responsibility. I’m talking about the practice of homebirth midwives changing their names in the wake of a baby’s death in order to trick both the authorities and American women.

Consider this case from Hoboken, New Jersey:

On Sept. 18, 2012, Olivia Kimball, a 31-year-old resident of Great Meadows in Warren County, assisted in the delivery of a baby in a home on Garden Street. At 6:30 p.m. that day, the baby was pronounced dead at Hoboken University Medical Center, Hudson County Assistant Prosecutor Michael D’Andrea told the media at the time.

The state medical examiner later determined that the baby had been stillborn due to an infection, according to Rubino…

Kimball was arrested on Sept. 21 and charged in a Hudson County court with unlicensed practice of medicine. The crime is a 3rd degree indictable offense, the state equivalent of a felony.

How many, many times have we heard the same story: a baby dropped dead into the hands of a clueless midwife who had no idea that the baby was in distress, let alone dead.

Since then:

… Kimball appears to have moved to the southern United States and adopted a new working last name. A professional website lists a person with the new name as director of site development for an international pro-midwifery non-governmental organization, the same position Kimball was credited as holding in a February 2012 profile in the Warren Reporter.

According to the website, she is “currently relocating to” the area and offers services as a doula, a non-medical companion who supports pregnant women during the birthing process. The website does not advertise midwifery services. (my emphasis)

This is not the first time that Kimball has attempted to trick regulators and pregnant women:

Kimball first received a license to practice midwifery in New Jersey in August 2005. Sometime between then and 2007, the Midwifery Liaison Committee of the State Board of Medical Examiners opened an investigation into her practice after learning that she had allegedly assisted in a vaginal birth for a woman who had previously received a cesarean section—also known as a VBAC—in a home setting, according to a consent order issued by a New Jersey attorney general…

In February 2007, Kimball testified before the Midwifery Liaison Committee that her patient had not informed her of her previous C-section, and that she did not perform a physical examination at the patient’s request.

Ultimately, Kimball “decided to discontinue her practice of midwifery in New Jersey and…sought permission from the board to surrender her license,” according to the consent order.

On March 19, 2007, Kimball was granted leave to surrender her license “with prejudice to any future reapplication.” According to the deputy attorney general that represents the Midwifery Liaison Committee, Kimball is not barred from reapplying, but any reapplication would require a review of the terms of her consent order.

But she didn’t stop practicing midwifery. She just continued practicing without a license or professional oversight.

This is not the first time that a homebirth midwife who has surrendered her license has continued to practice. This is not the first time a homebirth midwife has changed name in the wake of a preventable death at her hands. And it’s not the first time that a homebirth midwife, having been prosecuted in one state for a preventable death, moves to another and implies that she has a clean record. Each and every time it happens, it demonstrates the moral rot at the heart of homebirth midwifery. These actions represent both a consciousness of guilt, and an effort to preserve income by hiding their practice history. And it is emblematic of the central reality about homebirth midwives: they place making money and satisfying their desire to attend births ahead of the lives of babies and mothers.

Most states now publish the malpractice history of doctors and nurses, so patients will have access to a provider’s practice history before choosing him or her. When doctors attempt to practice without a license, the punishment is severe. When doctors lie about their malpractice history, their licenses may be revoked. And when a doctor moves and changes his name in order to hide his malpractice history, we all recognize it for the morally bankrupt, illegal action that it is.

It is no different when homebirth midwives attempt to do the same thing.

Some women do not care if their midwife has presided over previous deaths, but most do. By simultaneously exhorting women to “educate” themselves about homebirth while directly interfering with their ability to educatd themselves about practitioners, homebirth midwives demonstrate the deadly selfishness and moral rot at the heart of their “profession.”

  • CNM

    The ultimate midwife ‘name changing’ is the case of ‘Midwife International’ -which you wrote about last year Dr. Amy, as a community of folks called them out for unethical training overseas and a variety of other unethical practices around training ‘midwives’. In any case, they never apologized, and instead of dealing with the fallout from the media attention in an ethical manner, they just… you guessed it… changed their name! They are now ‘The Birth Institute’. http://www.birth-institute.com/. Same staff. Same everything. Midwife International still ‘exists’ but they simply refer people on over to their new school The Birth Institute, which not only offers extremely expensive options to travel to another country to watch brown women give birth, but ALSO online midwifery education. So disgusting. Please write about this Dr. Amy. Please oh please.

  • April

    So I work for a CNM that practices out of hospital birth. Not all CNM’s deliver in hospital…

    • Stacy48918

      Does she assist CPMs with prescriptions, referrals, etc? The 2 OOH CNMs I know both did. They had an “in” because they are CNMs and would cover for CPMs lack of a real medical degree all the time. If so she is aiding their substandard care and is a part of the problem.

      Even if she doesn’t you are still aware that OOH with a CNM is still more dangerous than hospital birth with a CNM? Are you ok with that increased risk of a baby dying while you’re there?

  • Still tired

    I had to change my name too, in order to get a job as a midwife. I had to do it to cover up the fact I went to med school. As a just married at the time, I took my hubby’s name so it worked out perfectly timing wise. Yep. True story.

    • fiftyfifty1

      why?

      • Still tired

        I was told my background made me a ‘bad match’, ideologically speaking. Got hired after I changed my name and purged my CV of every MD reference. Still keeping it a secret. I think some practices wouldn’t care but the ones I applied to were turned off by my background.

        • The Bofa, Being of the Sofa

          I know it is easy for me to say (you need a job, of course) but I have think any place that would act like that would NOT be the type of place where you would want to work

          • Still tired

            That’s exactly why I’ve started studying for the medical boards. Shame, because I love my current job, sans the BS. Now, if I can’t get a job as a doctor because of my midwifery past, that’s going to be something.

          • The Bofa, Being of the Sofa

            I wouldn’t be surprised if it didn’t help you get a job, but I would think that mwery experience would look really good on a med-school application.

          • fiftyfifty1

            Having an MD by itself without passing the boards or doing a residency is actually a LIABILITY. And not because of any ideological “bad match”. It’s that is is extremely uncommon for someone to finish medical school but not have finished Boards. There are 3 from my medical school class who have an MD but are not licensed doctors: one could never pass Step 3 (there is a limit on the number of times they will let you try), another had a psychotic break shortly after getting her MD and had to leave residency a few weeks into it. The 3rd was found to be molesting one of the boyscouts in his troop and this sort of crime makes you permanently ineligible for licensure and unable to practice (but doesn’t negate the fact that you have an MD).

            Having an MD but nothing else is weird. Definitely needs an explanation.

          • Still tired

            Not at all weird if you consider that you can become an MD anywhere in the world. Heck, here in Canada we have MDs everywhere – pizza delivery, construction, coffee shops, cab drivers. Many have passed all of their board exams, both US and Canadian yet cannot find a residency spot. Simply because there aren’t enough spots to accommodate all foreign med school graduates as we match via a separate stream. Many move to the States to match there, some keep trying their luck in Canada. So…lots of reasons why you can have an MD and nothing else, most of them being rather trivial – not enough money to finish the licensing process, not enough residency spots, lack of exposure to the local healthcare system.

          • fiftyfifty1

            My apologies Still Tired. I totally agree. Domestic medical grad MD without a license = Big Red Flag but Foreign medical grad MD without a license = totally understandable.

            When I was a senior resident, my intern was the former Chief of Surgery at her hospital in Russia. She came to the United States, worked for 5 years manning a hospital autoclave, and then was forced to join a Family Medicine residency (since FM always has extra slots) and start all over at age 50. It kills me to think of all those surgical skills that have gone to waste, and she is one of the lucky ones who at least is able to work here.

          • Still tired

            No worries :) I think I’ll try what the Russian lady did. I’m not desperate to work as an MD given that I have an ok paying job that I love (as long as I can filter out the bullshit) but I’m starting to feel…well…tired. Every time I turn on my Kaplan lectures, I find that they entertain me way more than anything Ina May has ever said.

          • The Bofa, Being of the Sofa

            “The answer is -8πα”
            “What are you doing?”
            “Answering question, winning Physics Bowl”
            “But you are a janitor!”
            “In Russia, I was physicist. Here, I am janitor.”

          • Still tired

            Hahaha, I remember that one :-D

          • The Computer Ate My Nym

            Still tired, how willing to live in the armpit of the universe are you? Because there are places in the US where they’re short of residents but they tend to be places that are short of residents for a reason. Like, you have to live in Middle of Nowhere, TX for 3 years. Still, if you need to, you could look into them.

          • Still tired

            Lol, Ontario isn’t exactly heaven on earth either. I’d do it. If it means I’ll be spared from placenta eating mamas, I’ll do it :-)

          • yarnbarf

            Ask Aviva Romm!

          • fiftyfifty1

            No, Aviva is different. She may be a quack but she at least is a licensed MD who has completed all her MD boards, her family medicine residency and is specialty certified. This is totally different from somebody, for instance, who finished medical school, but never passed Step 2 or Step 3 and is thus not eligible for even a basic license much less specialty boarding.

          • fiftyfifty1

            “That’s exactly why I’ve started studying for the medical boards. ”

            Which medical boards!? Do you mean to say that you finished medical school but never went on to get licensed or do a residency, or are you saying that you are licensed and completed a residency but have yet to take your *specialty* boards? Because obviously the first scenario is legally problematic. Having that MD but not having a license IS a major problem if you are working as a healthcare provider. If you call yourself “Jane Doe MD” and provide obstetrical services (for instance as a CPM) you could easily be held liable for practicing medicine without a license. Even if you are a MD who later went on to get your CNM, it could be false advertising if you lead patients to believe that a doctor is providing their care when in reality you have an MD but not an MD medical licence. You are leaving out vital details here!!

          • Still tired

            I graduated from a med school in Europe. Didn’t do residency as my immigration visa would have expired so I was in a rush to leave. Therefore, I’m not licensed to practice medicine in either my home country or Canada. However, I went on to get my midwifery degree in Canada and I’m licensed and working as a registered midwife. I have been sorta disheartened lately…for reasons we all know and understand. Hence, I’m starting to look elsewhere…Canadian licensing exams. Possibly USMLEs as well.

            As far as disclosing that I have a degree in medicine to clients, I do it sometimes if they ask about my background but I don’t see a problem with this as long as I make it clear that I’m providing services as a midwife. Gosh, I would have never touched or given medical advice to a patient in my ‘MD’ alter ego mind frame. I’m very humble about how little I actually know.

          • fiftyfifty1

            Thanks for the details. This is seriously disturbing that you had to take your MD off your CV in order to be hired as a Canadian registered midwife. I fully understand a hiring group asking you, for liability reasons not to tell your patients that you are an MD since you can’t legally work as an MD, but it sounds like that was not their concern at all. This is nuts that they hold 4 years of EXTRA medical training against you. Are you in an especially woo-ish area of Canada?

          • Still tired

            I wouldn’t call Ontario especially woo-ish. Not after I’ve visited the West Coast, anyway :)

          • Still tired

            Not an issue, fiftyfifty1. I’m glad we had it clarified.

  • Serenity

    Don’t forget Brenda Shea AKA Victoria Johnson AKA Victoria Konradson, the midwife who spread the flesh-eating bacteria to her client’s vagina: http://oregonmidwifeinfo.com/midwife-neglects-to-wear-gloves-mother-contracts-flesh-eating-bacteria-in-her-vagina/.

    • Mishimoo

      That makes me clench every time I read about it. That’s just terrible!!

  • Amy Tuteur, MD

    OT: I’ve just added visual archives to the sidebar, allowing people to browse posts in a unique way. It takes awhile to load, though, because it is graphic intensive.

    Check it out and let me know what you think.

    • guest

      I like it! It’s much easier and faster navigating through older posts..

    • Mishimoo

      It’s pretty cool, I like it too.

    • guest

      It’s great! I have been reading old articles during the many hours of nursing a newborn, and this will make it a lot easier. (I love this site!)

  • Therese

    So are they just using a different name or are they legally changing their names? Because if it is the latter it seems really wrong a judge would approve such a name change when a simple Google search should reveal their ulterior motives.

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

    By changing their name in the wake of tragedy, they escape the only accountability that remains for their malpractice as most do not carry malpractice insurance making formal recourse difficult if not impossible for most of their victims.

  • Trixie

    I wonder when Christy Collins will move and change her name.

    • Elizabeth A

      It’s tough to sell a house in Nevada – they were one of the “sand states” hit really badly by the mortgage crisis – but I’m sure as soon as she finds a way to get it off her hands, she’ll be on the road.

    • areawomanpdx

      She already moved once, didn’t she? Away from California and problems with the law there?

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

    *coughcough*Darby Partner*coughcough*

    • attitude devant

      who now practices on the Big Island as “Kavita Amrita.” If I didn’t detest her so thoroughly I would find her FB page, full of underwater photos and belly checks in bikinis, hilarious self-parody. As it is, she killed the precious son of a dear friend, so all I do is a slow burn.

      • Karen in SC

        I thought she changed it to Blessed Whapio, or is that someone else.

        • attitude devant

          There is a Waipio Canyon there, but her FB is all Kavita. Go look.

          • The Bofa, Being of the Sofa

            Waipio Valley is AMAZING! We did a horseback ride through there once.

          • attitude devant

            It is. I hiked down in and out. There’s an old ‘city of refuge’ there—where tabu-breakers could get cleansed by the priests and return to their homes

          • The Bofa, Being of the Sofa

            We didn’t have to hike down, nor drive. The trail-ride guys gave us a ride. Handy, too, because we had to drive through streams. There was a car that tried it on their own and didn’t make it.

            Turned out to be a great trail ride. A group of 12 cancelled at the last minute, so there were only 4 of us along with the guide.

            We have a couple of pictures from that outing that hang on our wall. Wapio Valley was probably my favorite place we visited in Hawaii.

            The other pictures on the wall were ones we took from a beach north of Kona (Sunset Beach, I think). A beautiful sunset, of course, with the silhouette of a sailboat that you can see, but the best part is the second picture we took, by turning around and facing east, with the full moon sitting right at the top of the volcano. Unfortunately, it was to a large extent that lunar optical illusion, so the moon looked massive, just kissing the volcano. Absolutely stunning.

            Even the locals were like, “Did you see the moon tonight?”

            We love that pair of pictures, taken at the same time, one facing west and one facing east.

        • areawomanpdx

          No, Whapio is the founder of the Matrona School of Quantum Midwifery. Check out her website sometime if you have an hour or five to waste in astonishment. http://www.thematrona.com/

  • Box of Salt

    I didn’t change my name when I got married. But I’m also proud of what I accomplished under my original (and only) name.

  • Ash

    Is she on Sisters in Chains yet?

    • Smoochagator

      She’s been on there for more than a year, apparently.

  • anonymous

    A little bit of Internet searching and it looks like Olivia Kimball is now Olivia Augusta. Didn’t even bother changing her appearance.

    • PrimaryCareDoc

      Here’s her website. It’s excellent. Let’s see, she does doula work for $750 a pop. Not bad.

      http://www.oliviaaugusta.com/

      She also does a “Mother Blessing” ceremony, Henna, a medicine sweat lodge, Sacred Movement classes, chakra balancing, aura clearing, and placenta encapsulation.

      Is there anything this woman can’t do (or culture she can’t appropriate)?!

      • Amy

        It’s because she tapped into her “feminine wisdom.”

      • Amy M

        Did you read about how she prepares placentas?
        1)Drying and encapsulation (we’ve heard about this sort of thing, and frequently discussed the possibility that its not placenta in those capsules.

        2)Tincture. She soaks the placenta in alcohol (ETOH, not isopropyl), for 6-8wks, and all the “healing placenta medicine” somehow ends up in the alcohol, and then you can bury your (pickled) placenta.

        OMG. She must have some really gullible clients. I can’t believe that many people fall for this crap. I imagine if they think the tincture is helping them in any way, it must be placebo. (Placenta Placebo! For all your postpartum needs!)

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

          Does soaking raw meat in alcohol preserve it properly? And don’t they have to ingest placenta sooner than 8 weeks (by the laws of fairies or whatever?)

          • Amy M

            Well they don’t eat the alcohol soaked placenta, they drink the magic tincture it was sitting in. Can’t make a tincture with water, it’ll get all contaminated with bacteria. I guess the placenta would be at least somewhat preserved, because the alcohol will dry it out.

            This charlatan has an answer to your 8wk question. She says if you want some placenta immediately (but the rest made into a tincture), she can hack off a lump and make a homeopathic remedy much more quickly. It doesn’t say how she does that…maybe holds the placenta near the bottle of water she is going to sell the gullible?

          • Medwife

            Oh ew. Picturing drinking a shot of placenta infused vodka. Cannot unsee!

          • Amy M

            Maybe tequila, only a big ol’placenta instead of a little worm?

          • MLE

            They are working on some kind of placenta tiramisu.

          • Mishimoo

            Layer all of them together and let them infuse for maximum magical sparkles through the power of womyn combined. Wait, that sounds more like Captain Placenta, not placenta tiramisu. Better throw that lot out…I mean, bury them for nature and stuff, and start over with a new recipe.

          • MLE

            Omg I’m imagining Captain Placenta now, glooping through towns trying to help. Stop Captain, you just crushed the mayor!

          • Mishimoo

            Next question: Does Captain Placenta suck up pollution like a sponge or are they boldly going where no placenta has gone before?

          • KarenJJ

            To go with the Plasagna I imagine.

            Two course dinner, including alcohol. Someone should open a restaurant….

        • Rachele Willoughby

          Vodka? No honey, it’s just my *hic* herbal placenta infusion.

      • guest

        Quote from her website: “specializes in births with alternative positions, such as Breech and Twin Birth” Scary! It truly is difficult to believe women actually fall for this snake-oil sales-woman…

      • Captain Obvious

        “She has attended thousands of women in countries around the world,” ugh, THOUSANDS?!

      • Dr Kitty

        Hoping the sweat lodge is not for pregnant women…because adding hyperthermia, hyponatraemia and dehydration to pregnancy is NOT a good plan.

      • AgentOrange5

        I can’t imagine being so hard up for friends that I would pay anyone $750 to my “doula” (don’t they basically just sit with you like a friend would?) If I wanted a fake friend, I could go to a chat site using the hospital’s Wi-Fi and find a friend for free.

        • Elizabeth A

          I thought about it, and I can see why women do it.

          My husband sucks at medical stuff. Seriously, from the moment we got the first whiff of hospital, he was white-knuckled. My friends are awesome – but they have jobs and kids and stuff of their own. They can’t necessarily drop everything to come sit with me for as long as labor might take. My sisters are out of town. My mother tends to take over pretty hard-core, and it can be great, but in a situation where I want quality nursing and OB care, I don’t necessarily want every professional in the room to be flashing their credentials at my mom.

          People on the internet include people like Feminist Breeder, who admits to tweeting anti-cesearean crap at expectant fathers who say that their wives are being prepped for c/s. I don’t want to risk getting that kind of blowback when I’m in labor.

          All the doulas I could find seemed to be one kind or another of problematic crazy, but the idea that you have someone experienced come sit with you, help you with non-medical pain management techniques, and reassure you about how this is going/supposed to go – it’s a real service.

      • respectlife

        YES, I think she can not find common sense and use some common sense!!

    • Smoochagator

      Ugh, and it appears she had the gall to post something on “ethical midwifery.” I just want to scream.

      • guest

        How ironic.. “ethical midwifery”..that concept doesn’t seem to exist for most midwives!

  • Pixie Miss-Pranksterpixie

    I would hazard that one of the primary issues here, is not that these women are involved in home birthing or that women/babies are not safe in their presence… but in the lack of government regulation of the USA’s medical professions. There is no standardisation, no government oversight, there is no secretary of state for healthcare upon whom these deaths would be the fundamental responsibility.

    If this was made the government’s responsibility, with legal recourse to sue the government if it was found a midwife was unqualified, then there would be a greater standardisation and requirement for medical practitioner qualifications and oversight of service provision.

    Say what you want about the lay midwives, but women are going to have home births anyway. And if you are a medical doctor whining about the lack of experience, ethics or training of those who would assist a woman to birth as the mom feels is best, then you are compounding the problem, not helping it… If you want this changed, start a midwifery school which teaches nursing, as well as the ability to assist in home births. If you want this changed, push for your government to give universal healthcare. If you want this changed, push for your government to give full medicinal training to would-be-midwives (and all other medical professionals) with federal accountability and licencing, competence standards, and everything else which universal systems ensure.

    … the rest of the world may see a decrease in quackery pushed upon us from USA sources if you actually standardised and ensured your medical professionals (including doctors) acted according to professional ethics, guidelines and accountability.

    • Elizabeth A

      Most medical professionals in the USA *are* highly regulated, under standards that are more or less uniform from state to state, including Certified Nurse Midwives, who are qualified to deliver babies in hospital and in homes (but often cannot get malpractice insurance to practice out of hospitals).

      Lay midwives, including CPMs and people who advocate for them, have strongly resisted calls for professional training, professional standards, professional licensure, and professional accountability, and have thus far been successful in avoiding all of those things. The federal government considers this a state issue, and state legislatures have taken a variety of tacks, with varying degrees of success. In some states, midwifery is highly regulated. In others, midwifery is alegal – simply not covered in state regulations.

      I’m amused that you think naming a “secretary of state for healthcare” would result in some official being made responsible for maternal and infant deaths. Has that worked in other countries?

    • Ash

      This blog makes it quite clear that in the US, only CNMs or physicians should be allowed to attend homebirths and they should be required to carry malpractice insurance. See Safer Midwifery for Michigan’s page for a more comprehensive overview of what is necessary to ensure higher standards for midwives.

      http://safermidwiferyformichigan.blogspot.com/2014/08/midwifery-laws-state-by-state.html

    • moto_librarian

      You don’t seem to comprehend the problem here. Certified nurse midwives are legal in all fifty states. They must fulfill rigorous educational and clinical requirements to obtain this designation. They are indeed held accountable to state nursing boards. While there are certainly some CNMs who are into woo, overall, this system works quite well.

      The women who become CPMs and DEMs find it too “hard” to become CNMs. So they have set up a niche credential for themselves, complete with “review” boards that do pretty much nothing and advocacy groups.

      BTW, I wouldn’t be so quick to claim that the U.S. is the prevailing source for quackery. The NHS funds homeopathy, correct? There is a Canadian midwife who comments on this blog who recently completed her education, and she is appalled by the amount of woo that she encountered in her program.

      • The Bofa, Being of the Sofa

        The women who become CPMs and DEMs find it too “hard” to become CNMs. So they have set up a niche credential for themselves, complete with “review” boards that do pretty much nothing and advocacy groups.

        And it’s not like the medical establishment, for the most part, recognizes them. I’ve complained that the ACNM doesn’t do enough to oppose them, but CPMs aren’t getting hospital privileges, for example.

        The only thing they can do is homebirths and outside of hospital “birthing centers.”

        • Squillo

          Which also makes training a CPM less cost-effective than training a nurse-midwife. CPMs can only serve the 2% of American women who want and are able to achieve OOH birth, and only during the childbearing period.

      • Still tired

        Yep, I’m the midwife. I’m continuously appalled. Listen to this, our minister of state for science and technology – Gary Goodyear – doesn’t believe in evolution and was trained as a chiropractor. Take that, USA!

        • moto_librarian

          Headdesk.

    • Anonymous

      We have this already. Doctors are licensed, and are subject to review, periodic testing, and carry insurance. As are nurses. Once they lose their license, they are not longer to practice medicine, and cannot prescribe drugs. This is why practicing medicine without a license is a crime in the US. The crux of what Dr. Tuteur is talking about are unlicensed, underground, and undertrained “lay midwives” that make up their own certification to make themselves look like some form of professional.

      Doctors and nurses are bound professionally and ethically to conform to a set of standards, hence “standard of care.” When they don’t conform to this, sanctions can range from fines, to loss of license, and in extreme cases, jail. Most of the quackery that comes out of the US is not coming from doctors but lay people. Those doctors that are pushing quackery are mostly doctors that have lost their license(Biter) or someone that has received their license from some diploma mill for the sole purpose of having PhD after their names. In the US there is a very, very big difference between a medical doctor, and a doctor of philosophy. Dr. Amy Tuteur is a medical doctor of obstetrics, and is qualified to speak about obstetrics. Having a PhD in botany on the other hand, does not.

      Please do some research into how medicine is practiced in the US before posting something like this. There are several medical professionals that routinely post here. Please show references to how doctors and nurses are unlicensed unless you want to look silly.

    • auntbea

      Secretary of State for Healthcare? You mean like Secretary of Health and Human Services? Who is currently this woman: http://www.hhs.gov/secretary/about/?

      • Liz Leyden

        We also have a Surgeon General, though their focus is on public health, not regulating medical practice.

        • auntbea

          Yeah. He’s under HHS.

    • guest

      You obviously know very little about the US healthcare system, yet you have the gall to criticize it? I totally agree with auntbea. Clean your own house first.

    • PrimaryCareDoc

      As an actual physician in the USA, I have regulations coming out of my ass. I have a medical license and a DEA license. Those are from the state and federal government, respectively. I am certified by my national specialty board. My license has to be renewed every 2 years. My board certification every 10, with proof of CME on a yearly basis.

      In addition to this, my billing is standardized by the federal government (Center for Medicare Services). My record keeping is mandated by the government.

      I could go on and on…but Trixie, for you to say that all medical professionals don’t have federal accountability and licensing is insane.

      • Amy M

        That’s not Trixie, that’s Pixie. I don’t think Trixie would say that. (probably discus error)

        • PrimaryCareDoc

          No, my error! I edited!

      • Squillo

        Moreover, to practice in hospitals, you need valid med-mal coverage, and are subject to the oversight of various medical practice and quality assurance committees.

    • MLE

      #SwingAnaMiss

    • Who?

      Why should people who are already offering a high, safe and accountable standard of care do any damn thing at all to support lower, less safe and non-accountable alternatives.

      Actual medical practitioners are controlled from all directions and insurance companies (who can recognise and quantify a risk when they see it) give them insurance cover in return for money. A lot of money, admittedly, but that’s just how risky birth is. The charlatans have no insurance and usually not enough assets to make suing them worthwhile.

      Life is really easy in the cheap seats-no education expenses, a few ‘tools of the trade’ no insurance. No chance for the babies unfortunate enough to have mothers who had too much of the koolaid.

    • MaineJen

      Um. Actual medical professionals ARE subject to country-wide standards of practice. No government oversight? Have you ever heard of HIPAA? The only “health care providers” I can think of who don’t have to follow a single safety standard or regulation are…homebirth midwives. Because…why again? They just don’t feel like it?

    • areawomanpdx

      There are PLENTY of midwifery schools that require a nursing degree first, and bestow degrees which allow their graduates to practice homebirth midwifery. These CNMs have government oversight and standards of practice. These idiots just can’t hack it, so they make up their own certification.

  • The Bofa, Being of the Sofa

    In February 2007, Kimball testified before the Midwifery Liaison Committee that her patient had not informed her of her previous C-section, and that she did not perform a physical examination at the patient’s request.

    I don’t know what I find worse, that she would admit to doing such thing, or that she thought that this would actually be a defense of her actions.

    • PrimaryCareDoc

      How do you care for a pregnant woman and not perform a physical exam?

      That’s a trick question, in case anyone missed it.

      • The Bofa, Being of the Sofa

        Hey, the patient didn’t want one.

      • Mariana Baca

        With cardboard cutouts with fetuses the appropriate size, and holding it up to the mother. Isn’t that what they use instead of ultrasounds? http://wisewomanwayofbirth.com/low-tech-non-invasive-ultrasound-alternative/

        • guest

          How pathetic! Ironic too, that she had a posting about a lawsuit in which the parents were awarded $70 million for their son who supposedly sustained brain damage from a cytotec/pitocin induction. Yet parents can’t even recover a penny from a midwife for a dead baby.. so wrong on so many levels..

          • Who?

            Unless the damages are punitive, you’d expect to get less for a dead baby-who, by definition, needs no future care-than a damaged one who has exceptional care needs for their projected lifetime.

        • Still tired

          Oh god. Why did I even look?..

      • The Bofa, Being of the Sofa

        What would be the point of an exam? The only thing you could learn is that all is not perfect, so if you want to avoid learning anything is not right, you shouldn’t look.

        • Liz Leyden

          Then you can say the baby died because “some babies just aren’t meant to live.”

    • MLE

      Shocking that she missed (wink) the c-section scar, given that they are so traumatic and basically mutilate a woman’s body!

      • The Bofa, Being of the Sofa

        No, you are interpreting this under the pretense that she carried out a physical exam. If she never did a physical exam, she would have not had any chance to see anything until delivery time.

        • Smoochagator

          IF Kimball’s story is true, I find it equally disturbing that her client hid her previous C-section from her midwife. I know that I as I prepared for a homebirth, my MW asked (as an OB would) how many previous pregnancies I had, how many live births/stillbirths/miscarriages, and for each live birth whether it was vaginal or C-section. Let’s assume that Kimball did not ask these questions – bad on her (obvi). But if she did and the client LIED, that’s another can of worms entirely, and not out of the realm of possibility, considering that the desire for VBAC is so intense within certain groups that they advocate “showing up pushing” or even birthing unassisted. The fact that some women are so brainwashed into thinking that C-sections are grossly overused/mostly unnecessary and VBACs are without significant risk that they engage insuch risky behavior chills me to the core.

          • PrimaryCareDoc

            She’s full of shit. There is NO WAY she cared for a pregnant woman and never looked at her belly. That would mean that she never auscultated fetal heart tones.

          • MLE

            Pin the wand on the belly?

          • The Bofa, Being of the Sofa

            There is NO WAY she cared for a pregnant woman and never looked at her belly.

            By definition, I’d say.

            But you are making the assumption that she actually “cared for” the patient. I wouldn’t put it past any clown like this to have done nothing the entire pregnancy that would have required seeing her belly. Fundal height? Why bother?

          • Melissa

            But why would the expectant Mother pay for a midwife and not give them any details? Might as well just freebirth if you aren’t going to allow any examinations.

            I think it’s more likely that Mom told her the details but they both agreed to pretend that nobody knew anything so that she could get her healing HBAC.

          • The Bofa, Being of the Sofa

            But why would the expectant Mother pay for a midwife and not give them
            any details? Might as well just freebirth if you aren’t going to allow
            any examinations.

            I don’t know and I don’t care.

            It is the midwife’s responsibility to do proper care. Not doing any physical exams, as she claimed, is incompetence, regardless of what she claims the patient requested.

          • Still tired

            Agreed. How did she do her Leopold’s maneuvers? How did she feel the presenting part? Through layers of clothing?

          • CNM

            It’s possible the mother told her the scar was from something else? Hard to believe, but possible.

          • fiftyfifty1

            No, she said she never looked.

          • The Bofa, Being of the Sofa

            IF Kimball’s story is true, I find it equally disturbing that her client hid her previous C-section from her midwife.

            While it’s possible for a client to try to hide her c-section, given Kimball’s history, I wouldn’t believe a single thing from her mouth.

          • Deborah

            Oh, we’ve had VBAC patients lie and say the scar was from an ovarian cyst removal, for example.

          • The Bofa, Being of the Sofa

            Yeah, but as medical professionals, you are smart enough not to fall for it.

          • MLE

            Amazing!!!

          • Medwife

            Anyone attending a VBAC should review the surgical report to check for themselves what kind of incision was made and if there were complications. We are going back to basics here.

          • Liz Leyden

            Unless the patient refuses to release a copy of her medical records. In that case, the midwife can either refuse to take the patient or assume there was a previous C-Section.

          • The Bofa, Being of the Sofa

            Unless the patient refuses to release a copy of her medical records. In
            that case, the midwife can either refuse to take the patient

            What kind of healthcare provider would accept a patient who “refuses” to release a copy of her records?

            Why in the world would any legitimate provider accept such a patient, a patient who is actively hiding information to you?

            (that’s a trick question, of course)

          • Liz Leyden

            At my first pregnant OB appointment, the NP asked who I’d seen for GYN care before, then gave me a form to sign so they could get a copy of my records. It would be easy enough for a patient to lie and say they had no previous GYN care, though it would be hard to believe if it’s not your first baby.

          • Montserrat Blanco

            Nobody on real world. I had exactly that case today. A patient wanted a second opinion and I said I could not give one unless I had his previous medical records. He understood and we made another appointment for me to review them. If he would have denied I would have refused to give a second opinion and document that in my records.

            It is simply imposible to look after someone you have no idea of the previous medical history.

        • MLE

          False – I am interpreting this under the assumption that mama labored nearly nude and that the midwife would have seen it then, unless she was keeping her eyes above the neck to avoid seeing anything that could lead to an intervention.

          • The Bofa, Being of the Sofa

            Yeah, but as I said, by that point, the baby was dead.

          • CNM

            That baby did not die, Ms. Kimball turned in her license after being brought to the medical board for doing the VBAC in the first place… but the outcome was fine on that one. The baby that died of GBS was several years later and because she had no license, she was charged with practicing medicine without a license. Not that these facts make any of this better, just trying to follow what happened.

      • attitude devant

        Oh come on! Of COURSE she knew!! This falls under the heading of plausible deniability.

        • The Bofa, Being of the Sofa

          But how is “plausible deniabilty” redeeming? “It’s not my fault, I’m an irresponsible provider”?

          As I said, it’s not even that she admits to doing this, it’s that she thinks this excuses anything.

          • attitude devant

            It’s NOT redeeming. Bofa, don’t you get it at all? It’s all about getting away with whatever based on having some story. Sheesh! You act like these people have some ethics! Get a clue!

          • The Bofa, Being of the Sofa

            It’s NOT redeeming. Bofa,

            Then why do you keep calling it “plausible deniability”?

            It’s irrelevant deniability.

            None of it is plausible.

          • fiftyfifty1

            I think she calls it plausible deniability because that was Kimballs plan: to claim she didn’t know and hope that the authorities would find that excuse plausible. Or at least plausible enough. Sounds like it worked, eh?

            Obviously it’s a load of shit. And a board of medicine wouldn’t have accepted it for a minute. As a REAL medical provider it is your job to know, no excuses accepted. But homebirth midwives don’t have a board they report to. The authorities are nothing compared to a board of medicine, since they lack a scientific/medical background they are more easily hoodwinked.

          • attitude devant

            You seem to expect these clowns to conduct themselves like professionals or even to reason like adults. Whence cometh these ridiculous expectations?

          • fiftyfifty1

            She doesn’t think it excuses anything. She doesn’t care about “redemption”. And she sure as heck doesn’t care whether Bofa on the Sofa respects her. The only thing she cares about is avoiding legal trouble. Looks like it worked.

          • The Bofa, Being of the Sofa

            She doesn’t think it excuses anything.

            The only thing she cares about is avoiding legal trouble.

            If it avoids legal problems, apparently, it DOES excuse it. You even said below that it is an “excuse”

        • MLE

          That’s where the wink comes in. She knew exactly what was going on, and she will lie as many times as necessary until the lie becomes true.

    • Liz Leyden

      If the patient refused a physical exam, doing one anyway would be battery.

      • PrimaryCareDoc

        And that’s where a responsible provider says, “I’m sorry, but I can’t provide care for you under these conditions.”

        • The Bofa, Being of the Sofa

          Exactly. The response to “You can’t examine me” is not, “OK, we’ll do it anyway,” it’s “I’m sorry, as a responsible health care provider, that is unacceptable. Either I will examine you, or you will find someone else to take you.”

    • attitude devant

      See below. This is plausible deniability at its finest.

    • MaineJen

      I don’t believe for one second that she didn’t know her client was a VBAC. I do believe that she is lying. Isn’t that chapter 1 in the midwife-in-legal-trouble handbook? Lie. Pretend you didn’t know. Don’t write it down in the “chart.” Disgusting.

      • The Bofa, Being of the Sofa

        I don’t believe for one second that she didn’t know her client was a VBAC.

        And I don’t care for one second either way. It doesn’t matter.

        Does it really make it any better if she DIDN’T know? That would be incompetence just as would knowing it and not doing anything about it.

  • Amy M

    I always feel bad for the women who are duped by these “midwives.” The woman will say “But my midwife never lost a baby! And she only has a 3% transfer rate!.” And how do you know that? “She told me! She said that some women give up when it gets too painful and transfer for an epidural.”

    The part about the 3% transfer rate might be true, but the lower the transfer rate, the more likely there have been deaths and/or injuries at the hands of the midwife. Sadly, the women are led to believe that 97% of the births this midwife attended went swimmingly, and probably even that those that were transferred had no further complications.

    • MLE

      Yeah having never lost a baby sets the bar low at “alive” and glosses over the “healthy” aspect.

      • KarenJJ

        It also leaves open the “I’ve never lost a baby”… but leaving out that some of those “transfers” were losses that “happened in hospital” weasel reply.

  • lawyer jane

    So by the timeline here, it seems that she got her midwifery license at 22 years old, and two years later at 24 years old was attending an HBAC? Yikes. so inexperienced, so little training. You’d think that even diehard NCB advocates could see that point.

    • Smoochagator

      Yet, if my Google-fu is working, she claims to have assisted in 1000 births around the world through the organization she founded. Yikes.

      • Amy M

        Well maybe she went to Africa to practice on the poor, brown people. Those mothers already expect a higher mortality rate (for themselves and their babies), so they might not even realize how bad the midwife is.

        • The Bofa, Being of the Sofa

          What the expect or not is one thing, but I don’t think it is unreasonable to think that the midwives themselves can try to use the high baseline of problems to cover their own ineptitude.

          • Amazed

            … and it isn’t as if the midwives would give those women’s addresses to their future clients. And it isn’t as if those mothers can realistically pursue a charge. So see? Nothing happened!

        • Smoochagator

          I keep trying to come up with a snarky reply but honestly I’m just so astounded by the selfishness and foolishness of middle-class American white women. Turning up our noses at the sort of medical care women in developing countries would be overjoyed to have access to and/or be able to afford, as if we’re too good for it.

          • guest

            So, so true! I see it everyday, and it’s just unbelievable..

    • Therese

      I’m not sure why a midwife would need more experience and training to attend an HBAC than just a normal homebirth. It’s not like there is anything she can do if the patient starts rupturing other than transfer as quickly as possible so how are extra years of experience going to make her any safer when it comes to HBACs?