Does homebirth midwifery have more than its share of sociopaths?

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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.

  • Spiffy Marie

    I have had two home births and two different midwives. I had excellent care with both of them. There are good midwives and there are bad midwives. Just like there are good doctors and there are bad doctors. Not all midwives act like this. The midwives I had were at least RN’s before they became a midwife. Vanderbilt offers a midwifery program, which is where I plan to attend to earn my degree in midwifery.

  • Rosalind Dalefield

    I would say that midwifery as a profession has its share of sociopaths and narcissists, who relish having power over a woman made too helpless by pain to fight back, and that homebirth is a particularly attractive option for such midwives because they don’t have any other medical professionals to answer to. However I am firmly convinced that the midwife who took care of me during my first labour was personality-disordered, mostly narcissistic but with more than a streak of sociopathy as well, and she worked in a hospital. However my OBGYN had gone home to bed thinking that I was in early labour and would not enter active labour until morning, so when I promptly entered active labour the midwife had free rein and nearly killed my baby before finally calling for assistance.

    • AmyP

      With regards to “rare,” I think I’d be tempted to say, “You keep using that word. I don’t think you know what it means.”

      And honestly, homebirth midwives don’t seem to understand that a condition that affects 2-8% of pregnant women is not rare. (I pulled the number from Wikipedia–not sure if it’s reliable.)

  • OttawaAlison

    My daughter died from what we can tell was a stillbirth with no known cause (my daughter died in utero at 37 weeks, I was under obgyn care, I went to the hospital one morning after not feeling her kick that morning and discovered she had died). Perhaps in future years there will be a way to prevent such deaths of seemingly healthy babies that just die (either in utero or due to SIDS).

    I had a reasonable expectation of a live baby, and i’ve been grieving my baby girls death and it is tge worst thing that has ever happened to me. My obgyn, nurses and other staff had tears in their eyes, they treated it for what it was, an awful tragedy, not a dismissive “oh babies just die”. Some of those midwives are just so callous.

    • Dr Kitty

      I’m so sorry for your loss.
      Some of the things here can be triggering, or rage inducing at the best of times.
      You take care of yourself.

    • Mishimoo

      I am so very sorry for the loss of your beautiful daughter, it would be absolutely heartbreaking.

    • Amazed

      So sorry for your loss. It might be painful and infuriating to see there are people who just brush it away with “some babies just die”. Don’t forget, they are a very fringe part of woo. Most of us do recognize tragedy when we see it.

    • Kq

      I am so sorry for your loss! Might I recommend the website (no longer updated) knocked up knocked down? I found it helpful. As much as anything can be 🙁 🙁 🙁

      • sdsures

        There must be a new website somewhere.

        • Kq

          Sure. Probably plenty. This is the one I’m recommending, because the memoir was very helpful. The author eventually moved on once she had a living child, but the writings she did over the years and the three losses she went through, including a near term stillbirth haven’t lost any power with time. She also published a book, same title.

          • sdsures

            “After the Darkest Hour” by Elizabeth Mehren is another book.

    • Bombshellrisa

      I am so sorry for your loss.
      The book “An exact replica of a figment of my imagination” was a book that has been helpful to my friends who have experienced stillbirths.

    • yentavegan

      I am so sorry for the loss of your beloved daughter,

    • Sue

      SO sorry for your loss. It must be devastating.

    • momofone

      I am so sorry for the loss of your daughter. I am glad you were treated with kindness.

    • OttawaAlison

      Thanks, it’s only been about 7 weeks. i have been reading this blog for years and I was always disturbed by the “some babies just die” mentality, but now it is beyond painful to see a baby’s term death being dismissed with it.

      • yugaya

        I am so so sorry for what happened to you. When you can please think of joining groups and pages set up by Gavin Michael’s mom over on facebook: https://www.facebook.com/groups/1606850182868715/ . My heart aches for how reading “some babies just die” garbage hurts you right now.

        • OttawaAlison

          Thanks, I have joined her groups. I was alway saddened by what happened to Daniel and Gavin Michael.

      • Amazed

        I thought it must be a recent tragedy but I had no idea it was this recent. So sorry.

      • Box of Salt

        I am sorry for your loss.

      • Guesty

        I’m so sorry. There is no worse pain than the loss of a child. When I miscarried, I was shocked at how visceral the pain was. I’d have done anything to save her, and I was only 12 weeks pregnant when it happened. You poor thing. My love and prayers to you and yours.

      • mythsayer

        A girl I used to work with had basically the same thing happen. She felt the baby kick on Friday or Saturday, but then felt nothing on Sunday and she waited until Monday to go in. She was 38 weeks and the baby was gone by Monday. I couldn’t believe it… nothing wrong at all… she was just…. gone. I can’t even imagine the pain of that. I’m so sorry.

    • just me

      Oh I am so sorry.

    • Medwife

      I’m very, very sorry for your loss. How terribly unfair. If you are looking for others who can relate, the blog “expecting the unexpected”, by a nurse midwife who lost her baby just after birth to congenital abnormalities, is somewhere to start. Of course there are also commenters on this blog who have lost babies.

    • MLE

      Very sorry to hear that.

    • freya

      I’m sorry your daughter died. I’m sorry your arms ache with yearning for your girl.
      Glow in the woods is a place that I’ve found refuge and understanding.
      Be good to yourself x

    • Trixie

      I’m so very sorry.

    • Empliau

      I am so sorry for your loss. It is truly our worst fear while pregnant. We grieve with you for your daughter. I teach Latin, and have always liked the words: Requiem aeternam dona ei, et lux perpetua luceat ei. Grant her eternal rest, and may light perpetual shine upon her (my prayer at the graves of those I have loved.)

    • moto_librarian

      I am so very sorry for your loss. I think of situations like yours, and it simply breaks my heart. That any midwife could be so dismissive simply enrages me.

    • Guesteleh

      I’m so sorry you lost your precious daughter. Everyone here grieves with you.

    • demodocus’ spouse

      So sorry for your loss. And so recently too. My parents lost their first daughter that late in pregnancy as well.

    • wookie130

      I really can’t even begin to imagine the pain you and your family have suffered…I’m so sorry for your loss.

    • FEDUP MD

      I am so sorry.

    • just asking

      I’m sorry but what exactly does your baby’s death have to do with midwives? How can you call midwives callous if they were not the one managing your pregnancy? I’m sorry for your loss but perhaps it might be more worthwhile to seek out a support group rather than blaming people who had nothing to do with your situation.

      • Amy Tuteur, MD

        Where did she say it had anything to do with midwives? Nowhere, so why are you asking?

      • OttawaAlison

        It had nothing to do with midwives. Just about the sentence “sometimes babies just die”, I have an issue with the attitude exhibited by some midwives. I’m hoping research prevents baby’s deaths like the one I experienced. Scientists and researchers don’t just accept “some babies just die”., they look into further finding ways to prevent deaths.

        I have also been reading/posting here for 6 years and I just don’t understand the attitude. of ” some babies just die ” never have. I also wasn’t here looking for support quite frankly, but lovingly received it anyway which is really sweet. I was just sharing my perspective on why that attitude is utterly hurtful to women who have experienced loss. I’ve accepted my beautiful baby is dead and am receiving support, I don’t blame midwives and hope one day through research there will be less deaths like the one my daughter experienced.

    • Rosalind Dalefield

      So sorry for your loss Alison. That must be devastating. I can identify with your comment about callous midwives because I was distraught when my baby, as a result of being delivered by emergency forceps rotation and traction, had huge bruises all over his head and one bony plate of his skull almost overlapping another, but when I expressed my horror to the midwives and other staff in the postnatal ward they just shrugged and said dismissively ‘Babies are tough’. I told my next OBGYN ‘Your experience may be that babies are tough, but I expect you to treat mine as fragile and precious’ and he said ‘I treat all babies as fragile and precious’ I knew I had found a good OBGYN. He made sure I had a midwife I could trust during my next labour, too.

    • Ardent

      I am so sorry, Allison.

  • attitude devant

    Odd…..Katie hasn’t posted on this one…..

    • Amazed

      Missing her much, Addie?

      • attitude devant

        LOL, no. She actually doesn’t reply to me at all.

        • Stacy48918

          Lucky you. She’s apparently FB stalked me to find my real first name. Crazy lady.

          • Samantha06

            Damn! That’s sick..

          • attitude devant

            She also went after Bombshellrisa.

          • Samantha06

            I’m not very good with FB or any of that stuff.. how can she find out personal info?

          • attitude devant

            some people’s profiles are linked to FB

          • Samantha06

            OK, that makes sense..

          • sdsures

            FB rules mandate using your real name. I am not sure what other things might be relevant.

          • The Bofa on the Sofa

            I break that rule.

          • sdsures

            A sensible option. But I know people who use very obviously fictional names (example: Christine Daae), and their accounts remain online.

          • Siri

            That’s not obviously fictional. It’s a normal Norwegian name. The whole world isn’t English-speaking, and the US is not the only, or even most important, country. And some American names look ‘obviously fictional’ to the rest of the world.

          • demodocus’ spouse

            True, but I suspect my bro’s friend Miss Juggalotus probably does not have a really obscure Greek surname.

          • sdsures

            Yes, Swedish in fact, My point is that the character of that name is fictional.

          • attitude devant

            My sister’s a Silicon Valley exec. She swears up and down that Zuckerberg will never get her real name or her birth date. So she has the most ridiculous name you could ever imagine on FB. And her dog’s birthday.

          • sdsures

            Rumplestiltskin?

          • Cobalt

            I do too, if only because I don’t think FB deserves it.

          • Bombshellrisa

            It’s ok, I prefer to call you Bofa

          • The Bofa on the Sofa

            That’s not there, either.

            Actually, my FB account name is descriptiive, and people who know me know who it is with no problems, based mostly on my wife. However, I don’t use FB for much, and not at all outside of family, so I want to avoid random people seeking me out there.

          • Stacy48918

            Is Fed Up with Natural Childbirth a public group? It wouldn’t be too hard to figure out from comments as I’m the only vet from NH.

          • sdsures

            It is.

          • Bombshellrisa

            My email is on my disqus profile and she probably just typed it into search on Facebook.

          • Stacy48918

            My discus is linked to nothing. Took a bit more effort on her part. Determined crazy lady.

          • Samantha06

            That’s what scares me about social media… so many crazy people out there.. you never know..

          • Stacy48918

            I prefer to worry about the close crazies in my life – my ex and pissed off clients. My personal FB is all private though so she can’t see where I work or stuff like that. ETA I guess she could just Google my name and veterinarian. Eh, whatever. Like I said, I’m not the one trying to hide a felony conviction. Ill worry about the things close to me and leave her to her nuttiness.

          • Samantha06

            Mine is too.. I am not linked to anything though…

          • Kq

            Sure. Half of digital footprinting is educated guesses and research. Look at past comments, plug usernames into other forums, find a state and start narrowing it down… pretty shockingly easy even if you aren’t “connected”

          • Samantha06

            Wow. I guess that’s why I keep everything private. Disqus is the only one I’m on other than FB and all of it is private. I do worry about nut cases like Katie McCall, you just never know. But I guess in the online world, you are never truly private. A good hacker can find out anything, if they want to.

          • Bombshellrisa

            I don’t put where I went to school (I purposely put “didn’t finish high school” on mine) and nothing about where I work. One of the crazies my FIL was dating and then dumped started showing up at my former place of work, coming in through the ER asking for me at odd hours and it escalated to things like parking beside my car and waiting for me to get off work in the morning . She is seriously ill mentally and blames my husband and I for their break up. Now that he is dead, she claims he owes her money.

          • Cobalt

            Many years ago, my then-boyfriend had a friend whose mother blamed me for breaking up her marriage, although they had divorced years before I met my boyfriend, his friend, or her. I never met the husband, he divorced her and ran as soon as their son went off to college. She never stalked me, but would berate me if she ever happened to see me. I also wasn’t the only one who she did that to, over time her target would change. Overall harmless, but certainly very unpleasant in the moment.

          • Bombshellrisa

            It’s strange the scenarios that people build in their head, even worse when they can’t differentiate those from real life. I never saw this woman when they were dating, but the problem is I do know her, completely unrelated to my husband. She will call my husband but never tries to engage him in person, while she saves the more blatant attacks for me as I am the “real problem”. It waxes and wanes, everything will be ok for months and then she will show up out of nowhere and start ranting. Not unlike some of our more memorable posters here.

          • Cobalt

            And since she is harassing you here, with her linked FB profile, and so many screencaps of it exist (I know half of us have them), if she tries any consequential harassment it will be easy to show that it’s her. If she has any sense she’ll want to avoid the legal trouble resulting from further harassment/doxxing.

          • Stacy48918

            That’s a good idea. I haven’t screen capped the posts with my name.

          • Samantha06

            That’s pretty scary, actually. I use a different email for disqus. Can people do that even if your profile is private?

          • Bombshellrisa

            Mine was temporarily public, to share a post about a missing animal and to promote a community post. I usually have it private because i have some real nuts who refuse to leave my life, courtesy of my (now deceased) FIL. One of his exes was copying pics of my kids and posting them on her Facebook and calling them her grandchildren.

          • sdsures

            Creepy? Yes. Obsessive? Yes. Sick? Not sure.

          • attitude devant

            Yeah. I noticed that. Did you tell Dr. Tuteur she was doxxing you on that post?

          • attitude devant

            adding: she does seem to go after you Stacy.

          • Who?

            I think it’s an apostasy thing, in particular certain religions are very hard on those who leave, even tougher than on those who don’t yet believe. ‘You were one of us, and you left us.’ Which is a fair enough thing to be worried about, who better to beat an organisation than someone who understands the thinking but no longer agrees with it.

            Not of course that Katie is involved in anything like an organisation, but you know what I mean.

          • Stacy48918

            I think that’s part of it. We see that a lot here, especially with trauma/loss mothers that dare to speak out. Look at all the comments on that recent PopSugar article, or take Ashley Martin’s new FB page – THE DAY she started it a crazy homebirth supporter parachuted in to criticize her. Whatever it takes to silence the opposition.

          • Stacy48918

            I didn’t even think of it. I’m not too perturbed by it. I don’t have anything to hide now. I had the “Stacy” handle when I was married so my ex wouldn’t know it was me if he read on here. So it’s appropriate that she of all people would search out my real name.

          • sdsures

            “Stalked”?

          • Stacy48918

            Eh, hyperbole. What’s the appropriate term for “specifically searched out my name on FB (i assume) so she could insert it in her SOB comments in a semi-threatening way”?

          • sdsures

            I suppose it would only be truly worrisome if this escalated to doxxing? I mean, other than that, it’s limited to FB comments, and how much are you going to let them affect you? If she truly threatens you, report her. Also, take screen caps.

          • Guesteleh

            Being an asshole?

          • Guesteleh

            P.S. Ask Amy to delete anything that has your real name.

          • Stacy48918

            I will.

          • Who?

            Creepy and pathetic I believe are the technical terms. And she wonders why people choose to be incognito.

          • MLE

            I was wondering about that! Run for your life!

          • Mishimoo

            I wasn’t sure if that was your real name or not, and didn’t want to give her the pleasure of making a fuss, but damn. That is creepy!!

          • Stacy48918

            Yea, I purposefully ignored it too.

    • yugaya

      She thinks that this post isn’t about her.

      • attitude devant

        Was the Sarah Buckley post about her?

        • yugaya

          She only mentioned Buckley once or twice.

  • The Bofa on the Sofa

    I guess I don’t understand what is meant by the “bio-technical model” of care.

    It seems that she is referring to the approach where we do things like, try to prevent people from dying? I am trying to figure out the alternative.

    The “native family was happy the mother didn’t die” scene is just bizarre. Recall how NCBers are the ones who are proclaiming how “a live baby and mother is not all that matters.” But here she says that it doesn’t even go THAT far! All they need is for the mother not to die in childbirth and that is sufficient! So it’s not just that “a live baby and mother are not all that matters, but are at least a minimum” it is that “a live baby and mother are not even necessary.”

    That is just horrid.

    • Roadstergal

      I thought ‘If the baby doesn’t die, it’s a success’ was a pretty shitty approach to care, neglecting the health, integrity, and pain of the mother and brain function of the baby. Hearing that it’s actually closer to ‘If the mom doesn’t die and I get paid, it’s a success’ – I don’t even.

      Actually, I wonder if that’s giving them too much credit. The homebirth midwife (from the UK! where the standards are so much higher!) trying to say a HB was a success despite the mother dying because it was ‘a lovely’ homebirth? These people are monsters.

      • Rosalind Dalefield

        There was a case in NZ where the homebirth association reported a ‘beautiful birth’ of a dead baby boy. I don’t see how being delivered of a corpse, when you went into labour with a healthy baby, can be ‘beautiful’, myself.

        • Samantha06

          That’s just creepy..

    • sdsures

      “I guess I don’t understand what is meant by the “bio-technical model” of care.

      It seems that she is referring to the approach where we do things like, try to prevent people from dying?”

      Yeah, like science and stuff. Because we all know “Math is hard!”

      • The Bofa on the Sofa

        So is wearing seatbelts an example of the “bio-technical model of driving”?

        Hey, just because lots of people die when they get thrown through the windshield in a crash doesn’t mean we should try to prevent that from happening.

        • Cobalt

          Well, that wouldn’t happen if people would just use the “driving backwards” model of navigation!

        • sdsures

          Must be. *sarcasm*

        • Stacy48918

          See we have the solution for that up here in NH – only state in the union without a mandatory adult seatbelt law. I’m sure no one goes through the windshield in the Free State. /sarcasm.

          • sdsures

            The UK has a similar law mandating adult seatbelts and appropriate securing of small children.

          • Who?

            Does it make insurance premiums higher?

          • PrimaryCareDoc

            No. We don’t even require auto insurance here. Live free or die, man.

          • Who?

            That is huge, are you serious? Not even third party in case your car injures someone else?

            It’s a whole other world out there.

          • PrimaryCareDoc

            Yup. That’s why I pay extra on MY insurance- it’s an “uninsured driver” premium- in case I get hit or injured by one of these losers.

        • Francesca Violi

          No, seatbelts is just cascade of interventions: according to her logic it is riding a car that means succumbing to the bio techincal model of moving, since we have feet. And in poor countries people still walk miles to draw water or to reach school because they can see this reality, not because they have no choice: so we should do it too.

    • Tosca

      Sounds like an impoverished community where maternity care is so inadequate that a dead baby and a live mother is a reasonable outcome. Remember, it’s not that long since childbirth was the biggest cause of death among women. It still is in some parts of the world.

      In industrialised nations we know a better way. It’s called medicine.

    • Francesca Violi

      This family, grateful because at least the mother is alive, just tells me that they are all too aware of how inherently risky (and not safe!) giving birth is, both for baby and mother. A dead baby is a pretty possible outcome, and even a dead mother. On the other hand, to us, the “normal” output of delivery is mother and baby both alive and safe, because that’s what happens most of the times thanks to modern medicine. Is she really saying that the first scenario is what we should aim to go back to?

      • The Bofa on the Sofa

        I wouldn’t say “aim to go back to” but she is very clearly saying that it should be considered acceptable and those who would strive to improve it are just succumbing to the “bio-technical model” of healthcare.

      • Busbus

        Yes, that’s how I read it, too. How could she not feel how unfair it is that there are still far too many places in the world where a live and healthy baby and mother can NOT be taken for granted as much as it can here!? Yes, this family was maybe right to be thankful to the midwife; without her, the mother might very well have died, too. But how can you actually be there and witness such a tragedy and come away thinking that the family wouldn’t have given ANYTHING for the type of medical care that could have given them a healthy baby, too, if they had had a choice!?

        It makes me think of those CPM midwife students who are “practicing” on women in third world countries to get the “numbers” for their certification (sometimes with horrible results for the local midwifery community, if you read up on it – such as making demands as to how many women they “need” to see within the few weeks they are there; subverting funds and manpower that were needed for other things; creating havoc in local organisations by funding and supporting only those midwives and doctors who put up with their demands but not others; etc. – I can look for the links to the blog articles I read about that if anyone is interested. They were part of an internal debate about racism within the midwifery community that broke out maybe a year or two ago, if I remember correctly). And most of these CPM students think they are doing something honorable instead of recognizing that they are using those pregnant women as guinea pigs simply because they have trouble finding enough first world women – who actually have a choice – who are willing to risk hiring a CPM midwifery student for a home birth.

    • yentavegan

      The bio-technical model of care aims to deny and deprive women of their inherent right to experience the empowerment of giving birth. The bio-technical model of care sees laboring women as a sickness in need of a cure, rather than as a natural and awe inspiring act of creation. The trade off is that with the bio-technical model of care the small percentage of infants who would not have survived otherwise are saved, but the mother is stripped of her humanity. THIS IS WHAT THE NCB communtiy believe. This is their dogma.

      • Roadstergal

        I still don’t get it. Why is it a natural and awe-inspiring act of creation if you do it at home with a midwife poking at you, and suddenly not when you’re at a hospital with ObGs and nurses around? What is it about having medical care and pain relief that makes it any less awe-inspiring?

        To me, modern Ob care is perfectly in keeping with the ol’ ‘takes a village’ model of care that I’m assuming midwifery came from? The mother is not alone in this journey, taking advantage of knowledge and wisdom acquired over time to her benefit…

        • Cobalt

          My kids were all born in hospitals, my first with the kind of hospital experience that turns people towards NCB ideology. I was still struck by the amazing feeling of meeting my baby and aware of how profoundly my world had just changed by this new child.

          Not everyone has that “heart-exploding” feeling when they first meet their children, but whether you have it or not has nothing to do with what room you’re in or who is standing next to you.

      • DiomedesV

        Excellent summary. Add in a hefty dose of optimistic bias allowing you to believe that your infant, or one you care about personally, would never be one of the small percentage, and you can see how people are blind to the risks to themselves and others.

  • Daleth

    “Only those entrenched in the bio-technical model…”

    Translation: “Only those familiar with basic modern medical care.”

    So apparently it’s a bad thing to be able to save the lives of babies?

    • Samantha06

      It interferes with the primary goal- the “experience”, so, yes, to them it’s a bad thing.. *shudder*…

      • sdsures

        Sometimes my seatbelt hurts me, but I still always wear it. Same logic.

        • Roadstergal

          Oh gawd, for the year I had my collarbone plate in, seatbelts chafed like a motherfucker when I was in the driver’s seat. And I never had an accident, ergo I was subject to painful unnecesseatbelt interventions…

          • sdsures

            Ever try one of those seatbelt velcro pads?

  • moto_librarian

    So according to Geradine Simkins, it’s okay for babies to die of preventable causes in the developed world because it happens in the third world? I simply cannot get over the callousness of her worldview. If anything, she should be advocating for worldwide availability of the obstetric interventions that she takes for granted. I am sure that the family of the midwife “in another country” was grateful that the mother had survived, but I am also certain that they still mourned the loss of the child. This dismissive attitude dehumanizes people in the developing world because it suggests that they do not value the lives of their children. That is NOT true.

    • Comrade X

      Sexist, ableist and racist. These people are the perfect trifecta.

  • Guesteleh

    This is old but for giggles I googled Amos Grunebaum Homebirth and found this: Am Journal of ObGYN’s Anti-Homebirth Campaign Sacrifices Lives of 100 US
    Women Per Year
    . Written by Judy Cohain. Oy.

    • StThomas

      I like the bitr at the bottom of the page: “Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of GreenMedInfo or its staff.”

      • Samantha06

        Check out Rebecca Dekker’s disclaimer at Evidenced based birth.. pretty unbelievable, it’s a page long and at the end of it she says something like, “your only recourse if you do not agree with this blog is to stop reading it”..

    • no longer drinking the koolaid

      Even better is the bio info that she is a CNM, but is unlicensed in Israel and this allows her to practice EBM rather than following protocols. She thinks she is so right about everything. She has some divine gift of knowledge and she needs to impart it to other midwives and physicians.
      She has been asked to leave several lists where EBM is discussed because of her bizarre theories, statistical cherry picking, and argumentativeness.

      • The Bofa on the Sofa

        1) What is EBM?
        2) What is MWT (mentioned below)?

        • moto_librarian

          EBM – evidence based medicine (Judy Cohain actually claims that being unlicensed allows her to do this).
          MWT – Midwifery Today

          • PrimaryCareDoc

            Her bio from Midwifery Today:

            “Judy Slome Cohain is a masters degree certified nurse midwife in the US who has been living and working in Israel since 1983 as an unlicensed midwife. This twist of fate enables her to practice evidence-based midwifery, instead of less-than-optimal protocols to protect a license. Judy runs or walks every day and eats lots of chopped up parsley with hummus. She has always danced to her own drum, which gives her an understanding for women who like to dance to their own drum at birth.”

            Batshit.

          • Bombshellrisa

            She actually thought the part about parsley and hummus was interesting enough to put on a bio? Is that some joke I just don’t get?

          • The Bofa on the Sofa

            But she eats lots of it!

          • Roadstergal

            I eat as much as I can, because it’s damn tasty, but I never saw the need to put it on my CV.

          • The Bofa on the Sofa

            And I don’t mean to sound stereotypical or anything, but I would assume that hummus with parsley would be pretty common in Israel. It would like if she moved to Hawaii and boasted that she ate a lot of pineapple.

          • Bombshellrisa

            And she WALKS everyday. As opposed to the rest of us, who crawl about as we move from task to task during our day

          • The Bofa on the Sofa

            Yeah, I “run or walk” every day, too. It’s just that I walk a lot more than I run.

          • KarenJj

            I walk everyday and adore parsley and hummus.. I should tell my work and ask for a raise. I’m sure clients are impressed.

          • Comrade X

            Hold on, are unlicensed midwives allowed to practice in Israel?

          • No, they most emphatically are not. I checked this. My guess that she represents herself officially as a mere doula who “just happens to catch the baby” when the labor “is very rapid.” AFAIK she deals with the English-speaking, crunchy variety of women, and if no one makes a formal complaint about her, the police probably are unaware of her. Homebirth demand is very low in Israel and the cost of insurance is very high. I know most of the midwives who will attend homebirths and more than one a month is a “busy” practice

      • Samantha06

        “she has some divine gift of knowledge”

        It’s that “other ways of knowing” thing again…

        • no longer drinking the koolaid

          For her, it is beyond that.

      • She has been reported to the Ministry of Health by yours truly but unfortunately I don’t have protekzia in the right department, so I don’t know if anything has been done. If she is doing homebirths unlicensed in Israel, then she is breaking the law. Homebirths attended by an Israeli- licensed midwife are frowned upon, but not illegal.

    • PrimaryCareDoc

      Wow, she is a nutcase. From her article:

      here are only 5 complications that have been shown to be responsible for intrapartum stillbirth:

      Amniotic Fluid Embolism: Has yet to be documented at an attended planned homebirth and very rare in hospitals so could not account for many stillbirths. (1/20,000 US hospital births and only 30% fetal loss when it happens)

      Uterine rupture – The unscarred uterus will not contract hard enough to implode in the presence of a trained attendant without intervention(Williams textbook) and scarred uterus and prostaglandin/Pitocin augmentation are generally risked out of planned attended homebirth. If uterus ruptures, it typically stops contracting, the fetal heart drops, or there is bleeding and mother is transfered to hospital so would not account for homebirth stillbirths in this study.

      Complete Placenta Abruption- does not occur at planned attended homebirth because it occurs in high risk women, or inductions neither of whom deliver at planned attended homebirth.

      Cord Prolapse- occurs at a rate of 1/3,000 full term, singleton, vertex hospital births, mostly due to routine amniotomy. Happens less frequently at homebirth due to restriction of use of vaginal exams and amniotomy- perhaps 1/10,000 births and the attendant is usually able to hold the head up to prevent pressure on the cord preventing damage or death.

      Shoulder Dystocia- may account for 1/5,000 stillbirths at home but could not account for 1.6 deaths per 1000 (1/625 births) at planned attended homebirth. Shoulder dystocia occurs more frequently at hospital births (1/200) and than homebirths (1/500) because much of shoulder dystocia is associated with diabetics and epidurals. 10% of cases of true shoulder dystocia result in fractured clavicles, fractured humeri, contusions, lacerations, or birth asphyxia. Stillbirth is a rare outcome. (4) Death occurs so infrequently that a rate has not been calculated.(4)

      Early Onset Group B Streptococcus (GBS) infection of the full term newborn would not account for Apgar 0 at birth. The onset is typically during the first 24 hours after birth and accounts for less than 1 in 50,000 perinatal deaths in the first week of life.

      There is no theoretical explanation for planned attended homebirth having 1.6/1000 intrapartum deaths. The basis of the conclusion, that homebirth is dangerous is based on manipulation of birth certificate data about antepartum stillbirths which has no relevance to place of birth.

      So, in her world, those are the only five things that can cause a intrapartum death. I especially like how she says that a placental abruption will NEVER happen at come, just because. And there will never be a uterine rupture at home, because a uterus will not dare to explode in the presence of a home birth midwife. And a cord prolapse won’t happen at home, and if it does, NBD.

      What a nutcase.

      • Bombshellrisa

        And because CPMs give such stellar prenatal care and are on top of everything, there just couldn’t be any complication from a pre existing condition. Never.
        What kind of manipulation does she think can be done with birth certificate data?

      • Young CC Prof

        The evidence contradicts my armchair theory, therefore the evidence must be lying.

      • Young CC Prof

        Oh, my, I just read it. The math is so catastrophically absurd…

        This woman literally has no idea what causes perinatal death.

        • Amy M

          Is this the same looney who believes that wanting an epidural equates to heroin addiction? Or was that Penny Simkin? I tend to lose track of which lunatic said what.

          • PrimaryCareDoc

            Same one. And anesthesiologists are akin to drug dealers, slinking around street corners.

          • Bombshellrisa

            Penny Simkin is the “pain and suffering aren’t the same thing” childbirth and doula educator. This is part of her education sheet about epidurals “There is a very specific hormone balance that occurs during unmedicated birth that can allow for the pregnant person to experience the birth without suffering. Let’s be clear: there’s a difference between pain and suffering. Pain is the pain of a twisted ankle that you know will be okay in the long run. Suffering is not knowing how damaged your ankle is, not knowing when or if the pain will go away, not knowing how to cope with it – essentially, suffering is the terrible side of pain. Sometimes you have pain and you know it’s fine, so you either continue through it, or you sit it out, but you don’t cry, you’re not scared, you’re not feeling traumatized. With good labor support from your midwife/doc/doula/partner, you can have an unmedicated labor where you expect pain, but you have a rush of endorphins, your hormones coming together in just the right cocktail to help you through. You know that you’re getting a baby out at the end, and you know that nothing is going wrong, so you just keep going. With an epidural (or other pain meds during labor), this hormone cocktail is irrevocably interrupted.”
            There is an illustration with a laboring woman in what looks like a very scrunched up position on a bed, and pictures of what a forceps and vacuum delivery are like

          • Cobalt

            I can see the “difference between pain and suffering” part. Doesn’t mean that pain shouldn’t be treated if it’s bothersome. And the rest is bull.

          • Bombshellrisa

            The part about not knowing how bad things will be of how long it will last or if it will go away sounds just like labor to me.
            In her doula classes, she still talks about how the doctor praised her for being a “trouper” during her labor.

          • Stacy48918

            Agreed. In euthanasia discussions people frequently ask if their pet is in pain. Often they aren’t. Is end stage renal failure and 10-12% dehydration painful? No, probably not, but their pet is certainly still suffering.

            But to say that because the pain of labor doesn’t match her description of suffering then it shouldn’t be treated is ridiculous.

          • yugaya

            “Pain is the pain of a twisted ankle that you know will be okay in the long run. Suffering is not knowing how damaged your ankle is, not knowing when or if the pain will go away, not knowing how to cope with it – essentially, suffering is the terrible side of pain.”

            Her semantics suck even more than her pain biology.

          • moto_librarian

            If I ever met Penny Simkin, I would tell her that she is nothing but a liar. I had a supportive partner, good labor support, etc., and I sure as hell was suffering. I saw a lot of her videos in my childbirth class, and I believed her. I resent her and her bullshit to this day.

          • attitude devant

            My fave piece of her BS is that if labor stalls it must be because of unresolved conflicts between the woman and her partner. Or undisclosed infidelity. Nice, eh?

          • yugaya

            *pukes*

          • Amy M

            I don’t think it was her BS, but I know one of them put forth the idea that stalled labor was because the mother didn’t really WANT the baby or feared motherhood. Gross.

          • Samantha06

            Wow, that is beyond sick.. another excuse to blame the mother if her baby dies… I can hear it now, “Too bad the baby died… probably for the best, we “know” that women with stalled labors sometimes had a subconscious fear of motherhood..”

          • Kq

            That used to be the reason given for morning sickness. Still is in some NCB ccircles.

          • Dr Kitty

            Yeah…no.

          • Sarah

            Mine stalled because of rage. At epidural denial.

          • Rosalind Dalefield

            Because it’s always the mother’s fault. Riiiight.

          • JJ

            No Penny. Women do get traumatized by painful labors, even with midwives, a doula, and a supportive partner present.

            One of my close friends had a homebirth in the fall. She had a 36 hour labor. When the baby was born she was sitting in her blood feeling like she was going to pass out and her anus was damaged. She suffered and is now battling PPD/maybe PTSD. She had to move out of the apartment her baby was born in because she is so traumatized.

            Another fun fact: When I gently encouraged her to wean her baby so she could get more help/sleep/personal time, her midwife told her something like her baby would be getting food but not be getting nutrition. I told her that it was going to be hard to breastfeed from the mental hospital and she laughed and gave the baby a bottle 🙂

        • yugaya

          Or maternal deaths. I looked at the causes of death and studies that are available, and was left wondering from where she pulled that “100 women a year die FROM c-section” number.

          • PrimaryCareDoc

            She pulled it out of her ass. Where she gets the rest of her information.

      • Dr Kitty

        Ms Cohain appears to have forgotten cord accidents, and that some placentas are crappy and simply are not able to provide sufficient oxygen to a baby through hours (days) of labour, leading first to foetal distress and then to asphyxia.

        • Young CC Prof

          But her theory says that placentas and umbilical cords are made with magic birth sparkles, so none of those things can happen, unless doctors touch mothers with their evil instruments and steal the birth sparkles.

          • momofone

            My son’s placenta had no sparkles, and now I know why– clearly they were stolen by my OB, who kept talking about things like making sure he had oxygen and was healthy, as if those were the most important things. Go figure!

          • Cobalt

            I vomited out all my sparkles in the first trimester.

        • Not to mention her “figures” on amniotic fluid embolus. I myself have been present at three (more than I should have seen, statistically, but that was my luck) during my career and both the mother and fetus died in each case.

      • Kq

        Wait, “risked out” means it CANT happen? Because they’re oh so thorough in their risking ou?! Pull the other one!

      • Beth

        my favorite is the part where she says all the high risk conditions are risked out of homebirth. Because we’ve all seen how THAT always happens.

    • Amy Tuteur, MD

      I’ve written about her several times before, including:

      http://www.skepticalob.com/2013/11/judy-slome-cohain-makes-a-video.html

      • yugaya

        “I happened to have worked with Dr. Lerner, the creator of shoulderdystociainfo.com”.

        Ouch.

    • yugaya

      She is stating that c-section is an intervention “with no benefit to the health of a newborn”

      NO. BENEFIT.

      Well, that also answers the question how many c-sections Judy Cohain thinks are ‘unnecessarians’ – all of ’em.

      • Cobalt

        Well of course. Newborns are already born, so what good would a cesarean do them at that point?

        There’s quite a cohort of fetuses that benefit, though, so they can become newborns.

    • attitude devant

      OMG. did you see her recent article that claims that women didn’t used to die of post-partum hemorrage? It’s purely because we disturb labor, doncha know? Yep. Not historical. Her evidence? (Wait for it!) It’s not mentioned in the Talmud. So there you go.

      • yentavegan

        Rachel, the mother of Joseph, bled to death giving birth to Benjamin. So yeah, it is mentioned in the Torah ( the Talmud expounds on laws of the Torah)

        • Guest

          You beat me to it! (see above)

        • sdsures

          See my reply above regarding PPH.

      • PrimaryCareDoc

        And she references 20 BILLION years of evolution. Snort.

        • Young CC Prof

          The universe isn’t quite that old…

        • Julia

          Ha ha ha. 2 minutes of internet research reveal that placental mammals evolved around 90 million years ago, so yes, for most of those 20 billion years she is correct!

      • Amy M

        Having never studied the Talmud, I will ask: how often are women mentioned in the Talmud at all?

        Certainly women come up in the Torah, and infertility and death in/from childbirth are there. As a totally-not-doctor-at-all, I’m willing to go out on a limb and say that women have been dying of PPH since they started giving live birth.

        I read the misopristol article below, and at least one commenter wonders why PPH is such an issue in developing nations, when “its so rare” in the Western world. Aren’t they lucky that they live somewhere where death via PPH is so rare because of 3rd stage management and access to pitocin? I imagine ready access to Csection prevents some PPH, instead of having a woman labor for 3 days and hemorrhage to death due to that.

        • yentavegan

          Women are mentioned/spoken of/ referenced all over the Talmud.

          • Amy M

            Thanks! I went to Hebrew School, but the Talmud wasn’t ever brought up, so I really know nothing about it. I appreciate your patience with my ignorance.

          • Amy M

            Here’s how Judy reached her crazy conclusion:

            http://www.researchgate.net/post/When_did_postpartum_hemorrhage_start

            Here’s a reference to death in childbirth (not specifically PPH) in the talmud:

            http://www.come-and-hear.com/shabbath/shabbath_32.html

            And just for shits and giggles, check out this completely insane person:

            http://birthofanewearth.blogspot.com/p/dear-friends-i-am-pleased-to-announce.html

            Maybe some of you have heard of that last one? I never did until now. Wow.

          • attitude devant

            Birth of a New Earth? She has a Masters Degree! (“…in Science!”)

          • The Bofa on the Sofa

            She has a Masters Degree! (“…in Science!”)

            So do I…:)

            ETA: that’s a picture of MY Ask Dr Science button that I just took now in my office.

          • Mer

            I have an Associate in Applied Science! I too can write horror fiction and ask for donations now! (actually I don’t have my AAS yet, but this is the internet and I can totally make things up, right?)

          • Mer

            I can’t even take that last one seriously, it’s just so utterly ridiculous and over the top. Seriously? NICU’s are the dark bowels of medical technology, doctors are performing experiments and ultrasounds are indicative of great evil. I just cannot take any of that seriously, its so utterly ludicrous it reads as satire. I mean I know that’s not what the author intended but I mean its just over the top.

          • yugaya

            “The Centers for Disease Control, she says, are responsible for causing the deaths of thousands of unborn babies, because vaccinations cause a massive spike in fetal deaths.”

          • yugaya

            “Jeanice Barcelo comes through a tragic lineage of the haunted womb, from a mother and grandmother who never bonded with their children. In reporting that 75% of mothers have received an epidural during labor prior to birthing their children, she is in a sad majority of children who did not receive the love they should have when they first appeared in the world.

            That means that three quarters of the children who are born in this country do not receive the optimum amount of love from their mothers that they rightfully should, and looking at the world around us, the sad
            result of that tragedy is all too clear.”

            Darn. Her grandmother had an epidural, and first time I got offered one was for the birth of my weeest child six years ago.

            So not fair. 🙂

          • Cobalt

            More likely explanation is hereditary mental illness. The accusations she’s throwing aren’t sane.

          • Cobalt

            That Birth of a new Earth page is just beyond comprehension.

          • sdsures

            Yes, they are.

            But PPH? Not so much, although it’s possible that the matriarch Rachel died of PPH whilst giving birth to her last child Benjamin. The wording is unclear. Anyway, interpretive religious texts, last time I checked, weren’t on the medical school syllabus.

          • Amy M

            Yeah, I bet a lot of things that happened back in the day weren’t mentioned in the Talmud, maybe things the people didn’t know about, things they didn’t understand or things that were so common that they didn’t bear mention. Welp—the fact that grass is green isn’t mentioned in the Talmud, so it must not have been green until more recently.

          • yentavegan

            If you count wheat as grass, then green grass is mentioned in the Talmud….it’s kinda funny and totally OT to our discussion but …..

          • Amy M

            Well, substitute something else then, but you get my point. 🙂

          • sdsures

            I get yelled at in emails for being off-topic. Green grass of the Nile, pursuant to Joseph interpreting Pharaoh’s dreams might be in there.

          • sdsures

            People were more used to the phenomena of death back then. It was no less tragic and horrible for the family to deal with, but one way of compensating for that was to have as many children as possible. Twelve kids (OK, let’s just focus on Leah, who had 8, I think)… Eight kids is a LOT of births for one woman to go through. I find it very hard to believe that they were all uncomplicated enough to ensure that she lived to have the next one.

          • Amy M

            I guess anyone who lived long enough to have 8 kids was blessed with relatively easy births, but certainly something could have gone wrong with any one of those, and there were plenty of others who weren’t so lucky.

          • sdsures

            I’m probably going to eventually get smacked for being off-topic, but I’m not the one who started the discussion in the first place. Historical attitudes toward birth have a place in this forum, I think.

          • Amy M

            I’m not complaining. 🙂 I think its on topic considering the attitude of that midwife who thinks that people in developing countries are less affected by the death of a baby (or mother). Of course I don’t know, but I’m going to guess that as long as people have been human and capable of emotions and attachment to other humans, that the loss of a baby (or mother) would have caused grief. Maybe not to every member of a community, but certainly to those primarily affected.

          • sdsures

            I appreciate that. But Dr Amy is, despite the fact that many of my posts here are upvoted. She also prefers I not rejoin the public group for similar reasons: if I see people there acting in a similar way to NCBers, I have called them out on it in the past. Why should they be an exception?

          • If childbirth didn’t kill you, and you didn’t have infertility problems, there wasn’t much you could do to avoid having lots of children. BTW the authors of the Talmud were aware of the dangers of too frequent childbearing– one of the categories of women instructed to use contraception was a “nursing mother”, the assumption being that a child was suckled until two.

          • The Bofa on the Sofa

            In the words of Robin Williams from his early career impersonating televangelist Dr Gene Scott, “There is no such word as ‘audit’ in the bible. Check it out!”

          • sdsures

            There doesn’t tend to be much green grass in the desert.

          • Young CC Prof

            Actually, historical evidence suggests that in biblical times, far less of the middle east was desert. Deforestation + irrigation agriculture + climate change…

          • sdsures

            Figure of speech.

          • Depends on the season. And our “desert” is dirt, not sand, with springs and oases and wadis. “Wilderness” is really a better term. There is a surprising amount of vegetation– and not all of Israel is desert, anyway.

          • sdsures

            s I said to the last commenter, figure of speech.

        • Alcharisi

          PPH specifically I have not come across in the Talmud. Some things that are discussed in the Talmud, however, include whether you are permitted to break the Sabbath to rescue a woman in childbirth (you are), and whether you may cut up a stillborn infant in order to extract it from a woman who would otherwise die (you are.) So, even ignoring her horrifying methodology (the Talmud is neither an OB textbook nor a medical history) her attempt at an historical point falls pretty spectacularly flat.

          • Kira

            Yup. And the #1 rule in Judaism is that the saving of a life takes precedence over everything else. You are *required* to break the Sabbath to save a life. You are also not allowed to risk your own life unnecessarily, so a case could be made that homebirth is against Jewish law.

          • Who?

            There was a lovely comment on the post about Maria Zain, where the
            commenter said that they were exhorted to trust God, but also to tie their
            camels.

            I think I’m sensing a theme here-perhaps ‘Your deity helps those who help themselves’?

          • Alcharisi

            Granted, there are a lot of things you could make CASES for or against according to Jewish law that might or might not fly in actual halakhic practice. Which only further goes to show that her attempt to poskin OB/GYN (as it were) from the Talmud is beyond ridiculous.

        • SporkParade

          Well, one of the six orders (sections) of the Talmud is called “Women.” http://en.wikipedia.org/wiki/Nashim Then there’s the part that is entirely about uterine bleeding. Or it would if the Talmud ever stayed on topic, but it doesn’t. http://en.wikipedia.org/wiki/Tohorot

      • sdsures

        Oy.

      • Kira

        WTF?! I’m a practicing Orthodox Jew and this is insane. So if a cause of death isn’t in the Talmud, it didn’t happen? No. Just no. No rabbi would ever agree with that. Ridiculous.

        • SporkParade

          As a traditional weirdo Jew, I totally agree. I don’t have enough education to talk about the Talmud, but I will make two points about Judaism and childbirth. 1. Jewish law categorizes women in labor as “sick people in mortal danger.” 2. The main dirge we sing on the anniversary of the destruction of both Temples begins with the verse, “My God, Zion and her cities/Are like a woman undergoing contractions/And like a virgin girded in sackcloth/For the husband of her youth.”

          And since I was pregnant for the anniversary of the destruction of both Temples, my immediate reaction to the line was, “Holy hell, what did I get myself into?”

        • Busbus

          During my last pregnancy, I was looking for Jewish prayers about birth and I found some very moving old prayers – basically very long and serious pleas to Gd to bring you safely through this time of mortal danger and pain.

          And, Jewish sources aside, did Cohain never wonder about all the orphans in old stories, the fairy tale Queens who die right after their baby is born (just think of Snow White’s mother), the abundance of (yes, usually evil) step mothers? Mothers used to die like flies – at least that’s the impression I came away with. And if you look at statistics, that’s probably about right. Ugh. It’s frightening, and I am SO SO GLAD that I don’t have to fear for my life every time I am pregnant the way that so many women had to throughout the ages.

  • A

    “And only those entrenched in the bio-technical model think that that it doesn’t, or shouldn’t happen.” WHAT?! Just… I can’t… This woman just said babies SHOULD die! “It’s a matter of perspective.” In other words: “There is no wrong and there is no right, meaning my killing babies is not wrong!”

    Do you think anyone could read that book and still choose her as a midwife?

    • Samantha06

      What’s unfortunate is that lots of women, even having read that, will still choose women like her to deliver their babies..

  • namaste863

    That quote from “From Calling to Courtroom” absolutely made my blood run cold. A fair number of the regulars on this site are practitioners of the “Helping Professions.” I myself am not a doctor, but a Social Worker. I’m hardly an expert on the ethical standards of medicine, but I have to assume that there is a degree of overlap. What I do know is that if I tried the CYA based tactics this nut job is advocating, I.E. The lies, the deceit, asking colleagues to turn the other way while she basically does whatever the hell she wants, not only would I lose my lisence to practice, They’d probably throw my ass in jail. Just disgusting.

    • Mel

      As a teacher, if I tried to pull any of that, my colleagues would be actively trying to thwart me while getting the police involved…

  • Kira

    That “From Calling to Courtroom” quote is shocking and horrific. What person in *any* situation would ever be okay with someone performing any medical procedure after asking everyone to turn their backs and cut off their cameras?!?! I would immediately stop any procedure if I heard that and I’d call 911 in a skinny minute. It’s chilling and sickening.

    • Medwife

      I deliver in a hospital and every OB and CNM who does deliveries there asks family to turn off their cameras during the actual birth. Turning their backs… That’s a weird one. But everyone is asked to leave during epidural placement.

      ETA: now I’ve read that full quote and I feel like barfing. That there is so scary. Why would someone who thinks like that continue to practice??? If they have to bald faced LIE and be unsafe?

      • Kira

        Good point, but there are nurses and techs in the room during epidural placement (there were during all mine). And I have lots and lots of recourse if something goes wrong through negligence. And even if they don’t allow cameras for the birth, no one is turning their backs. I understand that doctors and hospitals need to protect themselves (I’m a proponent of torte reform), but good care is still their top priority. Not so with this woman.

        • moto_librarian

          My husband was allowed to stay for my epidural, but he couldn’t see anything as he was holding me during placement.

          • Kq

            Same here.

          • Medwife

            I know that policy varies from hospital to hospital. Some women would prefer their partner be the one holding them during the placement, and many partners would be fine doing it, but watch, I’d talk an anesthesiologist into letting my patients be an exception to the rule and that dad would hit the floor.

          • Samantha06

            There was an incident at a hospital I used to work at, where a father, standing and holding his wife during her epidural placement, fainted and fell on the nurse. She was injured and out of work for months. They changed policy so anyone in the room had to be sitting during epidural placement, no exceptions. One day, I had the misfortune of having to tolerate a particularly meddlesome doula who was “insulted” when I told her to sit down during the epidural. I got quite the chuckle out of that!

          • The Bofa on the Sofa

            It is standard practice at vet clinics to not let the owner’s hold the animals during exams/treatments. In fact, when my wife graduated vet school, everyone in her class got a sign that said something like that (“For your safety, please allow our staff to hold the animals”). It’s because staff are trained on how to do it properly, and you can’t count on owners or husbands to do it right.

          • Samantha06

            Exactly. Even before that policy went into place, I was never comfortable letting husbands or other family members hold women during epidural placement. It’s just not safe or appropriate.

          • Dr Kitty

            Eh…my vet didn’t get that memo. I hold my cat.
            But then my cat has “very calm cat” across his chart in big letters, so maybe there is a different policy for the crazy cats and scary dogs.

          • Stacy48918

            Oh we make exceptions all the time…but if you get bit holding your cat, it’s still technically your vet’s fault and if you sued them you would win, hands down.

            Vets have been sued and lost just asking owners to muzzle their own dog or take their own cat out of the carrier. Whatever happens in that building is *MY* responsibility, no matter what.

            Besides the liability thing, I just can’t concentrate on the pet AND the owner, especially in critical cases. The first thing I do is separate animal from owner. It’s better for everyone.

          • Samantha06

            I agree. I always step out of the room when the vet needs to do something my dog doesn’t like, like nail trims. She puts on a “show” when I’m there too! lol! As soon as I leave, she is fine! When I was selling my house, I left when the home inspector came, and my realtor stayed with my dog. She joked with me that my dog was so much better when I wasn’t there! She is a just a little spoiled though…

          • Medwife

            That was comforting to read. For years I’ve felt guilty for being unable to hold my sick, actively suffering cat through her euthanasia. She was seizing (this was long before I was any kind of health care professional, too). I couldn’t handle it and had to leave. I’ll now think of it as my vet being able to give my cat better care without my ugly-crying all over the place!

          • Mishimoo

            We had one come into my old work that LIKED being shaved. She’d lay still and purr, with no sedation needed even for her bath.

          • Mishimoo

            This is exactly why our dogs are overdue for their vaccinations (thanks for reminding me) – I haven’t had the time to go with my husband and supervise. He forgets that not all dogs are friendly, how intimidating our large dogs can seem to people, and not all dogs are at the vets are healthy, so he unthinkingly lets ours say hi to everyone which could end rather badly.

          • Bombshellrisa

            My strange dog has made a habit of licking the stethoscope when he gets shots. He loves that thing and his shots are done without a hitch. Nasal sprays are something different and the level of drama in the room from him is too much.

          • Mishimoo

            That’s adorable! Ugh, nasal sprays aren’t much fun.
            Ours are scared of heights, so don’t like the exam table and attempt to lie down on it when possible. (Especially when the thermometer is involved).

          • moto_librarian

            I can see how this would be an issue. My husband was a Navy medic and not the least bit squeamish, but even he didn’t watch them put the needle in.

          • Dr Kitty

            I specifically asked my husband to step outside while they put in my IV, did the spinal and catheterised me for my CS.
            He’s squeamish and I felt happier that by the time he came in I was comfy on the operating table and nicely covered up with drapes.
            I knew he’d only worry if he saw needles and tubes.

        • Medwife

          That’s huge, the constant presence of nurses. You can make everyone turn off their cameras and you can even kick family out of the room, but you will never be totally alone with a hospital birth provider.

      • Montserrat Blanco

        There is a difference between asking people to leave so that you do not need to attend someone with an anxiety attack in the room and trying to do not have witnesses. At my epidural placement were about 10 people, none of them my family members. Any of those people could have reported a case of bad practice, actually better than my family. She is asking for NO witness, that is different.

  • Amy Tuteur, MD
    • no longer drinking the koolaid

      All the talk of rogue midwives must be bothering someone because Robbie Davis-Floyd will be discussing it at an MWT conference.

    • Karen in SC

      what’s the baby death count of that panel?

  • Amazed

    Oh yes. Babies die. No one can deny that.

    The difference, Geraldine Simkins, you fucking bitch, is that BOTH in the third world and the bio-technical model babies die only after everything that can be done has been done.

    Yes, fucking bitch, the developing world is MUCH closer to the bio-techinical model than your woo in this regard. There, birth attendants do everything they can for babies, just like bio-technical model does. It’s just that their resources are scant, scant, scant. Nothing like a homebirth midwife who REFUSES to use all the resources available.

    I daresay that “babies die” is a mentality those families and birth attendants resort to so they won’t go mad with grief and helplessness. Not a problem fucking bitch and her fucking “colleagues” (do hobbyists have colleagues, I wonder) are EVER going to encounter.

    • T.

      ^^^ This. People in all the World accepts death only as a last resort. Midwives in the developing World will do everything they can. That she suggests it is otherwise to support her horrid ideology is just disgusting.

  • Julia

    That quote “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” is absolutely sickening. I literally just lost my appetite. I can only hope that in the long run this serves to discredit those who wrote it.

    I also think this callous “sociopathic” inhuman mindset is present not only in these birth junkies but in a lot of woo: alternative cancer treatments that turn people away from effective therapies, anti-vaxxers… Pretty much all of the above points apply to those as well.

  • Alicia

    I am blown away that a document from MANA is so dismissive of the loss of a baby, and advocates lying to patients and in court! To have some midwives doing that on their own is bad enough, but to have what is considered their main professional organization advocate those things is just unbelievable! I had no clue MANA was this bad. Wow! I wish this was more commonly known!

    • manabanana

      The more you learn about MANA, the worse it gets.

      Technically, the “book” (ebook, whatever) From Calling to Courtroom, is not a MANA publication, but Geradine Simkins contributed to it and she was the President of the MANA board of directors as well as the Executive Director of MANA for many years.

  • PrimaryCareDoc

    I do not, and never will, understand the la-de-da attitude of “some babies are meant to die.” How can someone with that attitude call themselves a health care professional? I recently had a young patient die of a very aggressive cancer. Even though I know intellectually that there is nothing I could have done differently to change the outcome, on the day she died I went into my office, closed my door, and sobbed for an hour. I’ve poured through her chart to see if there is something, anything, I could have missed that might help me learn from this tragedy. I think about her every day.

    Is it over the top? I don’t think so. I’m a doctor. I do this job because I love make sick people better. That’s the point of being a doctor. To toss up my hands and say, “Eh, it was meant to be?” Inconceivable.

    • Alicia

      You are the perfect example of a true caregiver. I don’t understand the “meh, babies die” mentality either. Yes, in some places of the world stillbirth or death during birth is still unfortunately common, but that doesn’t mean that there is a mentality that the deaths are no big deal. The deaths still matter though the people just have different coping strategies. I bet in all of those places the birth attendants wish there was something they could’ve done different if they had the access to the level of health care that exists in the first world. I imagine that they mourn with the families, which is why Geradine Simkins saw the midwife being embraced, instead of disappearing or getting defensive or dismissing the death. True caregivers are those who try everything they can with what they have available, and who are just as affected by a loss as the family is. The actions of so many midwives show that they aren’t true caregivers, and it is disgusting how they act.

    • Amy

      Exactly! Babies and children aren’t “meant” to die. People are “meant” to die after a long life if they’re in the hands of competent providers. When my 90-year-old grandmother had metastatic lung cancer after 70-plus years of smoking, at that point, hospice care letting her die peacefully at home surrounded by loved ones was the correct, loving choice. If she were a baby struggling to breathe after her parents and providers had deliberately chosen a setting lacking access to lifesaving equipment and personnel? Not even on the same planet.

    • just me

      I can’t understand why or how any pregnant woman would want someone with that view responsible for birthing their baby. ??? Seriously I just don’t get it.

      • Samantha06

        I know, I wonder that too… it has to be denial, cult mentality and brainwashing. Look at cult leaders like Jim Jones. He convinced all those people to drink poison and kill themselves..

        • Kq

          And more to the point, to feed the prison to their children.

          • Samantha06

            That too! Reminds me of HB midwives..

      • Sue

        Exactly. If they don’t see their role as helping make the process safer, why have them there?

        You can get your neighbour to sit in the corner and knit, for free. AND they’re more likely to call the ambulance when you need it.

    • Sue

      The only way this can ever approach the truth is with some early miscarriages, when it is clear (from the subsequent analysis) that the foetus was never going to develop due to some catastrophic abnormality. Sometimes it can be reassuring to know that a pregnancy ended for some reason.

      For a viable baby to die, though, due to neglect? Entirely different.

      How anyone can make ”naturalistic” judgments like “some babies are meant to die”, while typing comments on the internet, is beyond comprehension. If you don’;t want to interfere with nature, go back to hunting and cave-dwelling.

    • Stacy48918

      ” I’m a doctor. I do this job because I love to make sick people better.
      That’s the point of being a doctor. To toss up my hands and say, “Eh,
      it was meant to be?” Inconceivable.”

      I can’t even imagine thinking that way about MY patients and they have fur. That anyone thinks that way about human babies is reprehensible.

  • Allie P

    “Only those entrenched in the bio-technical model think it…shouldn’t happen.” Yep, that’s medicine in a nutshell. I’m totally comfortable with that definition. “Hey, you know this thing that kills people? Let’s figure out how to stop that.”

    The idea that any of these people in developing nations wouldn’t leap at the chance to have fewer dead people is ridiculous and delusional. Traditional midwives in developing nations will always use modern medicine…. IF they can gain access to it.

    Here’s a great article about birth attendants in rural Mozambique more than happy to trade out their capulanas (traditional cloths used to sop up birthing blood) for misoprostol. http://www.npr.org/2011/06/29/137479308/drug-that-saves-womens-lives-carries-controversy They don’t have needles or refrigerators, and Pitocin isn’t an option for them. If this woman can’t see that the reason mothers and babies die in childbirth in developing nations is because providers don’t have the means to save them, then she’s out of her mind.

    • T.

      It is also profundly racist. These people aren’t to be used to hightlight your -wrong- belief. They would likely leap at the possibility of less babies dying.

      • SporkParade

        I wonder if it’s at all related to the discovery that people routinely assume that women and people of color are less capable of feeling pain. The distressing thing is that the research on the subject shows that women and people of color are included among those who think that women and people of color feel less pain.

        • Amy M

          Sure, and people used to think babies couldn’t feel pain either. I think its a direct case of no voice=no pain. Yes, technically grown women and people of color could speak, but for a long time here and still in many places, what they had to say didn’t count. It’s a lot easier to justify mistreating people if you can convince yourself and others that they don’t feel pain, just like you. These sociopathic midwife types probably don’t view the people in developing countries as people—they are merely subjects to be practiced on, should the opportunity arise. Or myths to emulated.

          • SporkParade

            It’s so weird to me that people used to think that babies feel no pain. How did they explain that babies pretty clearly show signs of being in pain when they are in pain?

            The first thing that turned me off to NCB, before I got deep into the anti-woo, was reading a YouTube comment on a birth video about having watched a different video of a “native African” giving birth unattended in the jungle near a river and how beautiful that was.

          • demodocus’ spouse

            What? No crocodile midwife?

    • Young CC Prof

      Good article. The comments section, however, is pretty awful.

      • lawyer jane

        OMG, I can’t believe there are US midwives in the comment sections arguing against providing the drug! They call it “drugging the symptoms.” WTF!!!

        • fiftyfifty1

          Drugging the symptoms. Yep if my symptom is “bleeding to death” and you have a drug to stop that, yes I would like you to give it to me.

          • momofone

            Amen. Drug my symptoms. I insist.

    • AmyH

      Yeah, couldn’t we substitute any killer disease there and have it make as much sense?

      Heart attacks kill some people, and only those entrenched in the bio-technical model think it shouldn’t happen. I mean, if diet won’t control the problem, do we really want these people cumbering the earth?

      Measles and whooping cough and tetanus kill some people, and only those entrenched in the… whoa, wait a minute, that one already sounds familiar.

  • yugaya

    Those who were caught, convicted and sentenced ( including those among them who manage to have their felony conviction vacated) will often publicly display ticking the same boxes for increased likelihood of recividism as convicted sexual predators:

    – employment instability
    – antisocial orientation
    – self regulation problems
    – hostility
    – lack of victim empathy
    – denial of crime
    – low motivation for changing their ways.

  • SporkParade

    I have to admit, this article makes me really uncomfortable, not because I don’t think it’s true that there is inexcusable indifference to perinatal death among homebirth midwives, but because I feel like sociopaths get an unfair bad rap. There’s already a huge problem of society marginalizing people with mental disorders. We feel free to use medical terms like “psychopath,” “sociopath,” “schizophrenic,” and “bipolar” as insults. The fact is that most sociopaths are productive members of society, and we really only notice they exist because an extreme subset of them do weird things like become serial killers. And since no one chooses to have a personality disorder, using it as an insult is exactly as inappropriate as using “retarded” as an insult.

    • Amy Tuteur, MD

      I don’t mean it as a tongue in cheek insult, but rather as a serious question. There’s something very wrong with women who are responsible for the death of baby, but refuse to hold themselves accountable and view any attempt to hold them accountable as “persecution.” The average person is devastated by the concept that he or she might be responsible for hurting a baby; it is not remotely reasonable to preside over one death, let alone multipe deaths, and then view yourself as the victim.

      The behavior of these women is chilling.

      • SporkParade

        I know, and I you are probably correct about them. It just makes me uneasy since I suspect that the NCB crowd will take it as an insult rather than a serious question and since I have seen people I care about stereotyped as violent or unstable due to mental illness.

        • Amy M

          I see your point, but would be fair to say that while most sociopaths DON’T hurt people, those who DO hurt people IN THIS PARTICULAR WAY, fit the profile of sociopath?

          • SporkParade

            More than fair.

      • lawyer jane

        To me they read as narcissistic/BPD. But I also think some of them are just plain dumb and actually believe that their training is sufficient. And some of them also probably have a cult-like belief in “natural birth” that affects their reasoning.

        • The Bofa on the Sofa

          My impression that they just come off as smug. Maybe it’s just me.

          • Samantha06

            Arrogant and blase too.

    • KarenJJ

      I think the problem is not so much that sociopaths are working and contributing to society, but that the ones that come up again and again appear to working in an area of intimate care with no boundaries and no midwifery organisations seem to see a problem with the trauma they are causing.

      How anyone can inflict “power birthing” again and again against women despite it being so obviously incredibly painful? And yet no midwifery organisation has issued a statement against it or a warning about this particular practice.

      • Amy Tuteur, MD

        And it in just these areas that professional standards and regulations are especially criticial. There are sociopaths in medicine and nursing, too (consider some of the Dr. “Wonderfuls), but standards and regulations exist to rein them in, punish them for violations, or even expel them from the profession.

        Standards exist to protect patients, most of whom are unusually vulnerable. The fact that homebirth midwifery deliberately has no standards speaks volumes.

    • Dr Kitty

      The definition of a Personality Disorder though, is not having unusual or abnormal personality traits, it is that one has dysfunction in one’s life because of those traits.
      Most people with sociopathic traits do not have a PD precisely because they are able to function as productive members of society.

      Homebirth midwives with sociopathic traits may have found a career path that is uniquely suited to sociopathic women, because the traits that would cause dysfunction in almost any other profession simply aren’t drawbacks in Homebirth midwifery.

      Just like there are a lot of adrenalin junkies in Trauma Surgery and a lot of very detail oriented introverts in Radiology, there seem to be a lot of sociopaths in Homebirth midwifery, because it is a career path where those traits are not a drawback.

      The problem then isn’t just with the people who are drawn to the career of Homebirth midwifery it is with a career where those traits are accepted and allowed to flourish.

      A lack of remorse and an inability to learn from mistakes SHOULD cause major professional dysfunction in midwifery. If they don’t, it isn’t just a personality issue, it is a problem with the whole profession.

      • KarenJj

        “A lack of remorse and an inability to learn from mistakes SHOULD cause major professional dysfunction in midwifery. If they don’t, it isn’t just a personality issue, it is a problem with the whole profession.”

        Aha – that is the best summary of the issue!

        What will is take for the midwifery profession to take a public stand against poor behaviour of midwives towards women and babies? How poor would the behaviour have to be and what safeguards would a midwifery organisation place to protect the women and babies they care for? Would it be better to put them in place sooner than later?

        • Amy M

          They’d have to abolish the CPM and make the CNM the only acceptable route. If they want homebirths to be acceptable, they’d need to come up with a system, maybe modeled on Canada’s and lobby real hard to get that implemented in the US. They’d need regulation, mandatory malpractice insurance and consequences for flouting laws and standards. I doubt this will happen though, because its too hard, time consuming and doesn’t pay enough.

          • KarenJJ

            They would in the US, but it doesn’t explain the Australian College of Midwives being silent about some of the nuttier midwives and “ex”-midwives. Or even actively encouraging them:

            For example: here’s an International Day of Midwives virtual conference speakers list from 2013 – includes Hannah Dahlen along with Lisa Barrett and Gloria Lemay and shows a sponsorship badge from the Australian College of Midwives.

            http://vidm.wikispaces.com/International+Day+of+the+Midwife+2013

          • KarenJJ

            Interestingly both Hannah Dahlen and Lisa Barrett didn’t present at the 2014 conference plus the Australian College of Midwives sponsorship badge has dropped off. No idea why and a quick Google search has enlightened me.

          • KarenJJ

            hasn’t… not has…

          • KarenJJ

            And OT but wow my commenting has been awful – mixed past and present tense in the same sentences, missing crucial words. Embarrassing.

          • Dr Kitty

            Isn’t it the wee hours of the morning where you are?
            Bed time maybe?

          • KarenJJ

            Bedtime (but wasn’t too late – around 10pm).

          • Kq

            Rage does this to all of us sometimes.

          • Amy M

            Excellent point. Well, I guess the Australian and UK woo infested midwives would have to get some integrity and denounce the dangerous people in their midst and stick to science over fairy tales. How likely is that?

          • KarenJJ

            I don’t know. I guess it might help to know why the Australian College of Midwives pulled out of sponsorship of the 2014 conference below? Are they undergoing a change of heart? Will the ACM denounce the policy (from Hannah Dahlen) called “Towards Normal Birth” as being too much focussed on process over outcome ?

      • anh

        my sister has a very severe narcissistic, histrionic, and explosive personality disorder. She’s unable to work and incapable of maintaining healthy friendships or relationships. A minor misdemeanor like not answering an email in time results in being screamed at or sent abusive messages. Something as benign as our mother buying my daughter a gift without consulting her results in weeks of screaming threats and accusations of our cruelty and abuse towards her. She perceives everything as persecution against her. Every action anyone takes is an insult.

        The only reason she’s not a homebirth midwife is that she couldn’t get into a program. She’s obsessed with homebirth and lambasted me for getting an epidural. She has also told me that babies are often meant to die.

        • Dr Kitty

          That must be tough for you.
          I’ll admit, people with emotionally unstable borderline personality disorder are my kryptonite. I find it very hard to manage them as patients, and they are my “heartsinks”.
          Having a family member who is so challenging to be around must be very difficult.

          I am glad they didn’t let your sister into a programme, it suggests some vetting of candidates.

    • MLE

      It doesn’t strike me as an insult at all. Reading this, I felt physically sick on behalf of the victims we know about and future victims as well. I know I’ve seen many react to the latest disaster on this blog with a frustrated and anguished WHY, as I have myself, and this is a disturbingly accurate answer. All too late women realize they were part players in some CPM’s birth fantasy. Anything that can elucidate that for these mothers before they or their baby come to harm is helpful, and not at all an insult or attack.

    • Guesteleh

      This makes me cranky because the reason people with mental disorders get marginalized is because they are really difficult to be around. I have a history of mental illness in my family, I myself have a diagnosis and I live in a community with a large population of homeless mentally ill people. I have a lot of sympathy and empathy for people struggling with mental illness and as a society we do a crappy job of identifying it and treating it. Having said that, it is just flat out fucking hard to be around someone who is mentally ill. It has a huge negative impact on the lives of the people around them. I keep seeing this stuff online about not stigmatizing the mentally ill which is a nice sentiment but doesn’t do much for you when someone close to you is hallucinating and refusing treatment. Or when the treatments have terrible side-effects that make it impossible for someone to be compliant with their meds. Or when you have someone who refuses in-patient care but can’t be institutionalized because they aren’t homicidal or suicidal.

      • Cobalt

        Or when it’s your kid and it’s not one of the “cute”, sympathetic disorders. You’re trying desperately to get treatment (even though nothing really good exists for a lot of ped psych disorders, it’s hard to even get a diagnosis) for a child that you love dearly while they are actively hurting you and most of your community support structures collapse because your kid is “that kid” and nobody wants to be around them and perfect strangers feel totally ok with walking up to you to explain that what you should be doing is “more discipline”, by which they usually mean “a good whupping”.

    • Kq

      There are a huge number of mental disorders that are unfairly maligned. Sociopathy (correct term: antisocial personality disorder) and narcissism are not among them. Psycopathic disorders are, as many “psychopaths” are harmless and living with a terrible disorder – and some are dangerous. Bipolar, borderline, schizophrenic – those are unfairly maligned. But sociopaths and narcissists do not benefit from loving compassion. They *feed* on it.

    • sdsures

      I absolutely agree with you that psychiatric terms can and are overused by the public, who largely don’t have a firm grasp of the DSM. It’s tempting to assign labels to things – it makes them, so we think, easier to understand. But psychiatry and personality disorders (i.e. sociopathy) are more complicated. I know what Dr Amy is trying to say; I’m just not sure it’s the best analogy.

  • GiddyUpGo123

    That “babies die; it’s part of life” quote is upsetting on so many levels. I don’t understand how anyone reading that could get to the other end of the paragraph without feeling deeply disturbed. She’s just flat-out saying that the “bio-technical” model is wrong in thinking that we should ever try to save a baby.

    “I have traveled extensively in other countries, mostly developing nations, and people understand this [babies die] reality elsewhere.” Guess what, lady, in developing nations, people understand the reality of starving to death, dying from malaria and being stoned to death for breaking backwards laws and that doesn’t fucking mean that that’s the way it should be, just because that’s the way people *understand* it.

    So let me just paraphrase that whole train wreck of a statement: “Babies die, and that’s the way it should be. Only people who are actually medically competent to do so seem to think that we ought to save them. I have traveled extensively in developing nations, where they haven’t been exposed to medical science and have been conditioned to accept infant death as a normal part of life. This is good, because it means that midwives don’t have to feel bad when a baby dies, and also because those families will still worship the midwife who let it happen because she didn’t kill the mother along with it.”

    • Who?

      And it is also quite schizophrenic. On the one hand the midwives know all about birth, trust birth and nature, and really care about mothers and babies. On the other hand, babies die. For the first statement to be true, it has to follow that some babies aren’t meant to live, given that not all do. And yet how many midwives tell their clients that during pregnancy?

      There seems to be a lot more talk about the deaths of babies than the deaths of mothers at homebirth. Is that because most of the risk is for babies-perhaps particularly if there has been no real pre-natal care? Or because mothers call for help for themselves? Or is it not the case at all and for some reason I’m more tuned in to the news of babies dying?

      • SporkParade

        Yes, childbirth is more dangerous to the babies than to the mothers. It was already true before modern medicine, and has become increasingly true thanks to Pitocin and blood transfusions to treat postpartum hemorrhage and induction and medications to prevent pre-eclampsia from progressing into eclampsia.
        But I feel the need to ding you for your use of schizophrenic as a pejorative. Because that’s apparently what I’m doing in this comment section for this article.

        • Who?

          Thanks for that information.

          And the ding is a fair call-I wasn’t that comfortable with that word myself, but couldn’t think of another that conveyed the side by side apparently totally disconnected thinking I was imagining they engaged in. And even as I type that I realise it was the wrong word anyway since that isn’t what schizophrenia is about.

          One of the challenges is to find a word that describes the style of behaviour Dr T is describing. Perhaps there isn’t one, which is fine.

          • SporkParade

            What’s the adjectival form of “cognitive dissonance”?

          • MegaMechaMeg

            Internally inconsistent?

      • Dinolindor

        This makes me think of the policy that someone brought up yesterday – making the mother sign something saying that anything that goes wrong is because of the mother not eating correctly, etc. But how is that possible if “some babies aren’t meant to live”? It’s talking out of both sides of the mouth.

        • Bombshellrisa

          It’s just more cover your *ss tactics.

        • anotheramy

          Wait, What?! They make the mother sign something in advance accepting responsibility for something out her control? That’s just wrong on so many levels. But, OBs are the big meanies for “not treating pts as individuals, playing the dead baby card, not listening” riiiiight.

          • Samantha06

            Well, it does take all of the responsibility off the midwife, and after all, isn’t that their goal? Talk about con artists… they have no qualifications, take no responsibility for their actions, put all the onus on the mother for anything that happens, and actually convince mothers to sign contracts agreeing to all of it… damn!

    • no longer drinking the koolaid

      The part of Geradine’s comment that bothers me also is the seeming hypocrisy of it. She has spent a lot of years working with the Native American groups in northern Michigan and talking about health disparities. You would think she would be able to extend that concern to other cultures, rather than make the comment she did.

  • Ash

    See Mary Cooper’s statement about prematurity in Midwifery Today. That is some sociopathic stuff.

    So you negligently throw away a woman & baby’s life by not advising the woman to seek medical care…and there is NO REMORSE. And from MT, a trade journal, not even the slightest trace of condemnation.

    http://www.midwiferytoday.com/articles/ed_prematurity.asp

    Mary Cooper should have been devastated that she led this woman astray but appears to have no regret.

    • PrimaryCareDoc

      I know. It basically says, “I ignored pre-eclampsia for WEEKS, but it was all mom’s fault.”

      • Anj Fabian

        You forgot the subtext of
        “If she had listened to me, she wouldn’t have ended up in a coma!”.

        That’s mind boggling.

      • JJ

        Because TEA.

    • Amy M

      OH MY GOD.
      Of course! (forehead smack!) The cause of most prematurity is: lack of prenatal care! Those crazy midwives! If only someone had asked them 100 years ago, think of all the babies that would have been saved! And of course, the remainder of prematurity (and its resulting deaths and morbidity) is caused by: inductions! Yes! They have all the answers.

      While lack of prenatal care can certainly play a role, (and a doctor please correct me if I am wrong here), the associations between that and prematurity are:
      1)failing to diagnose an issue that could lead to prematurity
      2)correlation with lack of PNC and poverty
      3)correlation with poverty and women of color, who have higher rates of prematurity.
      Simply failing to go to the doctor, in and of itself, cannot CAUSE prematurity.

      And then the inductions! A baby induced at 39weeks is not premature. Even if the dates WERE wrong, the near term preemies aren’t the ones dying! GAHHHHHHH!

      • AmyH

        Know what’s scary? I recognize that site, because I remember with my first pregnancy I was looking up and relying on some kind of info from there as presumably factual. (Water birth stuff, maybe?)

        That was before I really studied this site enough to figure out what was going on, but I think it’s safe to say most women don’t.

        You guys helped me a lot with my first pregnancy, to throw the idea of a home birth out the window, to start with, and then to realize that I probably could trust my dr not to sabotage my birth. But I still went into the hospital somewhat apprehensive, with the ideas that I needed to avoid Pitocin and epidurals and be mobile and what-have-you.

        Once they insisted I start Pitocin (6 hrs or so after ROM with virtually no progress), and I got the epidural, and baby was here and happy and I wasn’t exhausted from 48 hrs of labor… Let’s just say I have a different perspective on the baby that is supposed to arrive by the 31st (and I confirmed with my dr yesterday that I don’t feel the need to go past the due date waiting for baby to “decide to come”).

    • Dr Kitty

      I think it is worth quoting, in full:

      “Mary Cooper, who has done 2800 births:

      I do not often have premature babies. I do remember a young Amish mom having her first baby. I had four prenatal visits with her and from the start she would not follow my advice concerning drinking water or tea and how important good eating was, especially fresh food and protein. Each visit she was spilling protein and her blood pressure was creeping up and she was swelling. During our last visit, I talked to her once again about flushing her body with fluids and eating well. Toxemia developed quickly and it was hurtful to both mom and baby. Her husband called me and told me how swollen her face was and that she had a headache and ringing in her ears. I told her husband to take her immediately to the family doctor. I went to see her the next day, but she was not home. Two days later the University Hospital Neonatal Unit called me to ask about the tests the mother might have completed with me. Baby was born three months early weighing 1 lb 14 oz and was 15 in long. The mother was in a coma. She awoke and healed, but baby was still in the hospital three months later.”

      Yes, preventing prematurity is all about prenatal care!

      You know what might have prevented this premature birth and maternal morbidity? Instead of telling this woman to drink more fluids and eat more protein, perhaps REFERRING HER TO AN ACTUAL DOCTOR who could have started anti-hypertensive medications, magnesium sulphate and given her steroids to give her baby’s lungs the best chance possible of developing.

      Pro-tip: if you have a pregnant lady with positive dipstick for proteinuria, high BP and oedema, you refer to hospital, you do not give out recipe sheets. You refer on the first occasion, you do not
      continue to review, watching a worsening clinical picture and tutting that she’s not drinking enough tea!

      If it was as quoted, Mary Cooper’s care provision was negligent.

      • Amy M

        One of them (in the editorial) even said so herself: she doesn’t really take on women who are high-risk for prematurity, so she doesn’t see it much. How they can leap from that to: well, simply eating right and being in the presence of a midwife for an hour 1x/month would prevent prematurity…I’m left gaping like a goldfish.

      • Ash

        Don’t some lay midwives use the argument that they are not licensed medical professionals, ergo, they can’t be held to any standards of negligence?

      • GiddyUpGo123

        There are two particularly sickening elements of that quote. The first
        is I’m pretty sure that midwife was clueless and probably believed her own idiotic advice, otherwise I don’t think she would have posted all that publicly. The second
        is that I would bet money that mom *was* actually following her advice,
        drinking tea and eating kale or whatever, and because she wasn’t
        improving her dumbass midwife decided that she was lying about it. It
        takes a pretty hefty amount of ignorance combined with an utter lack of
        concern for your patient to ignore symptoms that alarming or think you
        fix them with some echinacea.

      • anotheramy

        Quotes like this (and what dr Amy posted about) are why I shouldn’t read this blog while breastfeeding. The stupidity and tragedy make me upset and my milk doesn’t let down well. I’m not a midewife (or even close to one) but these mistakes/ tragedies are just such basic knowledge!! Like, Physiology 101, people! …Just awful.

        • The Bofa on the Sofa

          Quotes like this (and what dr Amy posted about) are why I shouldn’t read this blog while breastfeeding.

          “I read it to the baby and he squirted breastmilk out his nose!”

      • Who?

        Why would Mary bother doing all those checks if her only action was going to be handing out recipe sheets? Seriously all she is doing is giving herself an opportunity to give a lecture, which is going to do no good (as opposed to most lectures which people really appreciate and pay attention to, okay, snarky there) because the content is rubbish.

        And then flicks the patient off to the doctor when the symptoms become unbearable, by which time I’m getting the feeling a fair bit of damage is already done-why on earth would she not send her to the doctor way earlier?

        So now it is the patient and doctor’s fault. Nice work.

    • Young CC Prof

      That story was HORRIFYING. The midwife tried to kill both of them, and it was pure luck that she failed. If she’d even once referred them to a doctor, the mother would not have wound up in a coma and would probably have had time for steroids for the baby’s lungs.

    • Amy M

      My children, btw, were born at 36 weeks. They were and are fine—they didn’t even go to the NICU. I credit their not being born earlier to the excellent prenatal care I had, and their lack of NICU time to the steroid shots I was given (at 28 or 29 wks gestation) so their lungs would mature faster. The OB did the best she could, but fully expected them to be pre-term because they are twins, and it is not fully understood why pre-term labor can begin spontaneously, and it is certainly not understood how to prevent it.

      Granted, this is one anecdote, but I had LOADS of prenatal care, including a month of hospital bedrest. This didn’t prevent pre-term labor. I did not have pre-e or GD or any other pre-existing condition. If prevention of prematurity was as simple as these clowns believe, NICUs wouldn’t exist and American perinatal mortality would be the lowest in the world.

    • Daleth

      Wait… inductions at 40+ weeks cause prematurity?!?!?!?!??!?!

      I don’t even know how to parse that.

      • Young CC Prof

        The logic goes something like this:

        Babies know when to be born, they are born when they are ready. Therefore, babies who haven’t been born yet must not be ready.

        The conclusion follows logically from the (absurd) predicate.

  • Young CC Prof

    It really does seem to be true. The manipulation, deliberately making mothers emotionally dependent on them. The lying, the way they walk away from bad outcomes like they don’t matter and never ask, “What could I have done to prevent this?”

    Now, I am sure there are HB midwives out there who are perfectly nice human beings with just a bit too much woo on the brain and not enough real knowledge of biology. But the “Sisters in Chains”? The leaders of the “movement?”

    The folks who lie, delete, ban, manipulate statistics, silence families who’ve had bad outcomes, they know what’s going on, and they go ahead and do it anyway.

    • KarenJJ

      It doesn’t help when the midwifery profession looks to be rotten from the top. The leaders know what’s going on with some of these midwives. I personally believe that Hannah Dahlen knows what’s going on, but they won’t denounce them publicly and won’t set an example for their profession whereby they won’t tolerate midwives that hurt women and babies. It makes me doubt midwifery organisations as much as some of these midwives.

      • Amy Tuteur, MD

        It is grossly unethical for homebirth midwifery to have no safety standards. It’s a glaring indication that homebirth midwives don’t care about what happens to babies or mothers.

        If there were safety standards, then the midwife could be at fault for a bad outcome. In the deliberate absence of safety standards, homebirth midwives are announcing that no matter what happens, it can never be considered their responsibility.

        • Margo woozealand

          Margo WooZealand. I am learning a lot from this site. So…question, is it that Homebirth midwives in America are separate from midwives who work in hospitals….are hbm not fully trained licensed midwives, are they all lay persons calling themselves midwives, if so, that seriously sucks. At least in NZ midwives are trained, have to apply for annual practising certificate every year and have to adhere to standards set by Council, attend an emergency day update once a year and a neo Nate and adult resuscitation day once a year, to be able to maintain their Practising certificate.You can’t practice midwifery without your APC and can be put under supervision or struck off for not meeting standards of care….midwives can have their practice investigated by Health and Disability, which is separate from the midwifery council.

          • Dr Kitty

            Margo that is exactly what we are saying. In some states in the USA you can call yourself a MW and deliver babies with absolutely no training or oversight.
            In others you can be a CPM- which is a certification which can involve attending as few as 25 births, a correspondence course and an MCQ exam.
            It isn’t exactly rigorous training.

            These Homebirth midwives may or may not carry drugs and oxygen, may or may not attend births alone, may or may not be legal in their state.
            CPMs have no standards or practice, no guidelines, no referral criteria. They are free to take on VBAC, breech and multiples if they want. They may or may not be able to arrange ultrasound scans and blod tests. They may or may not transfer care to hospital in a timely and appropriate manner.

            They don’t carry insurance, their own peer review process is designed to circle the wagons and protect the midwife and if they do cock up there is very little that families can do to get justice.

            That is why Dr Amy and most of the posters feel that Homebirth, as currently practised in the USA, is very, very unsafe.

            If that, as a well trained midwife, doesn’t fill you with horror, I don’t know what will.

          • Margo

            Margo WooZealand…Thankyou for the comprehensive information. And yes…I am horrified.

          • DaisyGrrl

            I would also add that most homebirth midwives in the US (with the possible exception of CNMs), do not have hospital privileges.

            So with a transfer to hospital, the mother has complete discontinuity of care. Some CPMs will continue to act as a doula in the case of a transfer, but it’s not uncommon for them to dump and run, leaving the mother in the hands of complete strangers without any proper medical chart or history.

          • Dr Kitty

            Margo, look at the piece about prematurity in Midwifery Today linked to above.
            That’s the CPM trade “journal”.

            Can you imagine yourself or any of your colleagues in NZ writing that piece or agreeing with the care plan Mary Cooper undertook?

            Do you see the problem?

            The HB midwives are lacking in basic medical skills and knowledge, and see this, not as a failing, but as a benefit, “a different way of knowing”, “a more holistic model of care”, “trusting birth”.

            So you get people who think it is absolutely fine to sit and watch someone with pre-eclampsia get worse, over the course of weeks, and just advice her to drink more tea and eat pmore fresh food and protein, with no insight that earlier diagnosis and intervention by actual medically trained experts could have improved the outcome.

            There was no remorse, no reflective learning, no “what did I do wrong and how can I stop it happening again”, just head shaking and “sometimes moms don’t listen to our advice about diet”.

          • Margo

            Margo WooZealand …yes I read the article….I was angry!! No insight demonstrated at all….protein in urine!!!! Whaaaaa. and no follow up screening tests…..yes, I was dismayed and gob smacked.

          • Dr Kitty

            So…that’s where the majority of posters here are coming from.

            They’re against Homebirth as currently practised in the USA, because it involves charlatans, quacks and sociopathic birth junkie hobbyists with no professional standards or accountability.

            They would like Homebirth proponents in NZ, Aus and the UK to be honest that while you are less likely to end up with a CS or episiotomy if you choose HB, you are more likely to end up with a dead or disabled baby, and to make those risks clear to women, because they are not equivalent.

            Very, very few of us are actually against the idea that women, who have been truly informed about the risks, can choose to give birth at home. Most of us just want a guarantee that anyone attending a birth in a professional capacity is an actual trained professional, that women aren’t being mislead about how safe Homebirth is. We’d also like a recognition that not all women want a non medicated “normal” birth, because pain relief in labour is also valuable, and it is not a moral failure to choose CS or epidural, or to have required them for medical reasons.

            Don’t you think that those are reasonable ideas?

          • In the US, the usual “birth attendant” in hospital is a registered nurse, not a midwife. Having certified nurse- midwIves on staff is still pretty much the exception to the rule. CNMs usually function either as independent practitioners, like doctors, taking private patients or in a group practice with doctors. In either case the staff nurses in L&D will assist them. It’s a different model entirely than the European one, where the only “nursing” personnel in L&D are midwives.

          • The Bofa on the Sofa

            are hbm not fully trained licensed midwives, are they all lay persons calling themselves midwives, if so, that seriously sucks.

            As the others have said, that’s exactly what it is.

            In fact, it’s so much the case that hb midwives are “not fully trained licensed midwives” that the bulk of them (the cpms – although there are a few CNMs that do hbs, they are a small minority among both CNMs and HB MWs) can ONLY do homebirths, because they do not have sufficient credentials to be able to work in hospitals.

            Once you understand that, this blog makes a lot more sense.

            [ETA: I see DaisyGrrl beat me to it by 45 minutes)

        • yugaya

          Are there any professional guidelines or standards of professional conduct of American homebirth midwives that are specifically aimed at preventing or limiting the possibility of abuse of power of authority? Majority of them seem to be blissfully unaware of what they are doing and why it is wrong.

          • Guesteleh

            No standards at all. None. And deliberately so. They’re proud of it, even. It’s crazy.

      • Young CC Prof

        Yes, that is exactly the problem. All professions presumably have some sociopaths in them, but normal professions have some mechanisms to control people’s behavior and disciple folks who do terrible things.

        • KarenJJ

          Yes, the medical profession has have doctors that have done some terrible things; Harold Shipman, Graeme Reeves, Suresh Nair, Stuart Fischbein and Robert Biter – but we know about them, have heard their names. They’ve been jailed, on probation and/or lost their licenses etc etc.

          • Dr Kitty

            In the case of Shipman, there have been several systemic changes put in place to ensure that no one else could do what he did.

            Seriously. The response in the UK has been to put in place revalidation, appraisals and changes to how controlled drugs are monitored, and the changes were largely driven by the profession.

            The response wasn’t “he was an aberration, it’ll never happen again” it was “oh hell, we should never have let this happen, how can we make sure it can’t ever happen again”.

  • KarenJJ

    I’ve been reading this site for the past 5-6 years and I’d have initially thought this was exaggerating things. Of anyone, midwives should understand women and women’s worries about giving birth and be able to provide guidance and assistance. Over the years though Ive read enough that I now come to find myself nodding all the way through this post. The ongoing stories that show a lack of respect to women, babies and a powerful natural process that can turn deadly in seconds, has been eye opening.

    And hearing from the mothers themselves and how captive they have felt under some of these midwives. How charming these midwives can be and how manipulative and vicious they are when they start losing their “control” over you. I’ve also been privileged to hear some of the info behind the scenes from some of the mothers themselves – the behaviour and callousness has taken my breath away. Midwifery is certainly dealing with some sociopaths in their ranks and the professional organisations have been completely unable to recognise it and deal with it. They need to get past their denial and start denouncing publicly the actions of these midwives. They blacken the reputation of the lot. And my own mum was a midwife so I don’t say that lightly.

    • Samantha06

      Until the lives of women and babies become a priority, and families are better informed and educated, I don’t things will change a great deal.