Does homebirth midwifery have more than its share of sociopaths?


I’ve been writing about homebirth for nearly two decades, so you’d think that I’d be used to not merely the appalling stories of neonatal and maternal death, but also the bizarre behavior of homebirth midwives in response to those deaths. But I still am startled every time I encounter another homebirth midwife (or physician) who, in the wake of a death, exhibits no remorse, views any attempt to hold her accountable as “persecution,” and learns nothing from the experience even if she is condemned, sued or arrested.

I’ve begun to wonder whether homebirth midwifery (particularly as practice in the US) has more than its share of sociopaths.

What is a sociopath?

WikiHow has an illustrated guide to spotting a sociopath. It’s a bit tongue in cheek, but the basic characteristics are all there.

1. Someone is dead or severely injured and the homebirth midwife has no remorse.

Look for a lack of shame. Most sociopaths can commit vile actions and not feel the least bit of remorse… If the person is a true sociopath, then he or she will feel no remorse about hurting others …

Most obstetricians, midwives and obstetric nurses are devastated by an obstetric death. There is tremendous grief, anxiety and soul searching. Could we have saved that baby or mother if we had done something different? Did we make a mistake? Providers may give up obstetrics in the wake of a death. If they feel they are responsible, some will go so far as to commit suicide.

Many homebirth midwives respond in the exact opposite way. They can give a long exposition about their legal woes without once mentioning the fact that a baby is dead, let alone mentioning the name of the baby or the circumstances of the death.

There is no soul-searching, no root-cause analysis. The death is dismissed with a callous, “Some babies are meant to die.” or “Babies die in the hospital, too.”

I’ve never seen a clearer expression of homebirth midwives’ bone chilling lack of concern for dead babies than this quote from Geradine Simkins, former President of the Midwives Alliance of North America (MANA), the organization that represents homebirth midwives, in From Calling to Courtroom; A Survival Guide for Midwives:

You know, babies die; it’s part of life. And only those entrenched in the bio-technical model think that that it doesn’t, or shouldn’t happen. I have traveled extensively in other countries, mostly developing nations, and people understand this reality elsewhere. I once arrived at the house of a midwife in another country the morning a baby had died in a homebirth. I found that the family had embraced the midwife and was so grateful to her—because the mother did not die. They were understandably sad about the baby, but families expect that a baby might die. A mother dying is considered beyond tragic. It’s a matter of perspective.

2. The homebirth midwife refuses to accept any blame and lashes out at any attempt to hold her responsible.

According to WikiHow:

When a sociopath does something wrong, he or she is likely to accept none of the blame and to blame others instead.

Or worse, she is likely to cry “persecution,” setting up Facebook pages and fundraising campaigns to solicit support and money.

Want to get money from other homebirth advocates? Just let a baby die!

A homebirth midwife who is alleged to have presided over the death of a very premature baby after insisting that homebirth would be fine, interfered with an ambulance crew trying to rescue a hemorrhaging mother, lied on medical records, and MAY HAVE MULTIPLE DEAD BABIES BURIED ON HER PROPERTY, is the beneficiary of a fundraising campaign.

An unlicensed homebirth midwife who was arrested for presiding over a homebirth death AND prostitution received enough donations to “free” her that she could make bail, and then violated the terms.

There appears to be no death so appalling and no circumstance so egregious that homebirth advocates will not rally to support the midwife … not the parents.

3. Homebirth midwives do not learn from their mistakes.

According to WikiHow:

Sociopaths do not learn from their mistakes and repeat the same ones again and again.

Homebirth midwives learn nothing from a disaster or death, refuse to accept any blame and lash out at any attempt to hold them responsible. Inevitably, some will go on to preside over additional deaths. The average obstetrician may lose 1 or 2 term babies in a 40 year career encompassing thousands of births. There are quite a few homebirth midwives who have lost 2 or 3 babies in less than a decade, encompassing 100 or 200 births, if that.

Professional homebirth midwifery organizations have LITERALLY no safety standards, so there is no teaching about safety. There’s no reason to have safety standards when safety is not important.

4. Homebirth midwives have no compunction about lying to protect themselves.

From WikiHow:

Sociopaths are perfectly comfortable going through their lives telling a series of lies. In fact, true sociopaths are uncomfortable when they are telling the truth. If they are finally caught in a lie, then they will continue to lie and backpedal to cover up the lies.

Indeed From Calling to Courtroom includes advice on lying in specific situation.

In the future my motto is, “No witnesses”. If I ever have to cut an episiotomy to save a baby’s life, I would ask everyone to turn their backs and turn off all video cameras. I would say to the mother, “I’m sorry, I had to TEAR you to deliver your baby quickly” (ok, so you tore her with scissors). I do not carry Pitocin anymore. For those midwives who do carry Pitocin, I would advise them to never admit it to anyone who has the ability to testify (that is, anyone except your husband). If a midwife ever feels the need to inject Pitocin or administer any kind of drug, such as Methergine, she should refer to such substances as “minerals.”

5. Homebirth midwives are emotionally manipulative.

According to WikiHow:

Sociopaths understand human weakness and exploit it maximally. Once determined, they can manipulate individuals to do just about anything. Sociopaths prey on weak people and often stay away from equally strong people; they look for people who are sad, insecure, or looking for a meaning in life because they know that these people are soft targets.

What tactics do homebirth midwives use to emotionally manipulate clients?

They ignore professional boundaries, encouraging clients to think of them as close personal friend. They encourage distrust of and lying to other medical providers, family and friends. They try to isolate clients from anyone who might question the midwife’s skill, competence or risk taking. They hold clients in psychological thrall having them look to her and only her for praise, affirmation and advice.

There are just the highlights of sociopathy, but even a quick perusal suggests that homebirth midwifery (and doctors who support homebirth midwifery) has more than its share of sociopaths. These are people who preside over deaths and serious injuries of babies and mothers, but express no remorse, refuse to accept any responsibility, consider efforts to hold them accountable to be “persecution,” lie repeatedly to protect themselves, emotionally manipulate clients and refuse to learn from their deadly mistakes.

Many aren’t just medically incompetent; they’re criminally negligent. And until homebirth midwifery organizations institute safety standards and stop pretending that babies who die were “meant to die,” they will continue wreaking havoc, leaving countless tiny bodies and broken, grieving parents in their wake.