Homebirths gone wrong

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There’s an eye opening thread on allnurses.com entitled Home births gone wrong.

American women thinking about homebirth should read it. You can’t give informed consent unless you understand the very real risks of your baby dying at homebirth.

Then there was baby that the midwife dropped on the bathroom floor and fractured the baby’s skull but didn’t bring him in until he started seizing.

It starts off with this question from a NICU nurse:

Do you see this often in your facility? In 2.5 years we have had 2 babies die and 2 be severely disabled from home birth… Recently we had a mom who was told she needed a C section by two different physicians at two different facilities for a breech baby and low fluid and she refused, signed out AMA and attempted a home birth with midwives. The baby of course became stuck with the body born and required a 13 minute code. We cooled her immediately for 72 hours and she spent two weeks on a vent. She just now is extubated but will require a trach because she can’t cough or swallow or gag so secretions just build up. She is more or less vegetative and on a slew of anti seizure meds. This stuff just really makes it hard for me to sleep! I feel like these poor innocent babies end up paying for their parents risky stupid decisions…

Other nurses respond:

Yes! There is a group of midwives in my area that deliver at home and at their birthing center that we see come in with their patients quite often. One of their patients was a similar story to yours. The baby was known to be frank breech a couple days before delivery but the midwives allowed mom to labor at home. Baby got stuck, was coded and died anyway (the baby was essentially dead when mom arrived at the hospital). Beautiful perfect baby who I’m convinced would still be alive if mom got a C-section. Overheard the midwife tell the parents that the baby obviously wasn’t meant to live.

We also had another baby that they removed from the birthing pool too slowly and the kid was an aspiration pneumonia/PPHN/whole body cooling.

Then there was baby that the midwife dropped on the bathroom floor and fractured the baby’s skull but didn’t bring him in until he started seizing.

And this:

We had one mom that was GBS positive and the local birthing center in town told her to shove a garlic clove up her hooha to kill the bacteria and the kid went into RDS about 4 hours after birth. The midwife told them just to drive the kid to the ER and when they got there the baby was sating in the 40’s and HR about 90. Totally blue and limp. GBS sepsis. When we were down in the ER trying to resuscitate the kid the mom asked me “when can I put him to breast again?”. I wanted to slap her. Then we went to get an emergency line into place and the parents tried to decline antibiotics because their midwife told them antibiotics were terrible for babies and not necessary. He ended up on HFOV maxed out on dopamine and dobutamine within an inch of death. Thankfully he lived…

And a maternal death:

Just during my short time in the OR we had 3 failed home births that ended catastrophically. One was a mom with placenta accreta who pushed against a 10lb baby for hours. We sectioned her in the main OR; She bled out right in front of us with her husband standing by her side. Hands down the worst case I’ve ever participated in. Baby made it…

Another maternal death:

I swear, the time has come to write a book to blow the lid off this “natural health” movement. I remember in clinical practice a mother who came in with HELLP and was stable, but due to the influence of her -non nurse- “all natural” midwife would not let us push IV fluids or magnesium. We lost her and the baby in a totally preventable seizure. Someone needs to write a book about all the ways the “natural health” community spews pseudoscience that at best helps nothing and in the worst cases, delays treatment till it’s too late.

And this:

It is hard not to get angry when parents who choose to forgo a hospital birth because of the big, bad medical establishment suddenly want us to do “everything medically possible to save my baby” regardless of how detrimental it is to the infant and in some cases completely futile. The hospital is spending millions of dollars to put their baby on ECMO and body cooling for a baby that is, without a doubt, going to be dinged (a NICU term) and possibly unsaveable when perhaps a few quiet conversations and some different choices could have resulted in a 2-3 day hospital stay and a healthy infant.

And this:

Almost 50% of our unit’s cooling babies were patients of these midwives and we have seen some absolutely clear cut negligence from them, yet they keep on practicing and consistently producing poor outcomes.

And this:

In my area we have a lay midwife that has lost creditably with the nursing staff long ago. When her patients come in they are train wrecks. Pushing for 5 hours against a 8 cm cervix, push with a FHR in the 90s…turns out that was the moms HR….baby had no heart rate when she come in by rescue for “exhaustion”, and a PP pt that was allowed to slowly bleed out for 6 hours before being brought in because she was “dizzy & couldn’t hold the baby to breastfeed”. They only gave her apple juice thinking it was her blood sugar. Turns out she had a cervical tear and retained placenta. These are just a few examples….and each time it happens, we have to wait for charting, prenatals and other information because she “has to gather my thoughts”.

And a baby with what sounds like an internal decapitation:

I’ve seen terrible things roll into triage when homebirth goes wrong. We had a woman come in who reported her water broke over a week ago but her midwife told her it was fine and to stay home. She was so infected you could barely stand in her room because of the foul odor. And baby was long dead. We had another mom roll in with her homebirth midwife who had been pushing for 12 hours and upon exam was found to have a closed cervix and the fetal heart tones were in the 50s. One more horror story, we had a home birth midwife attempt a delivery that ended with a severe shoulder dystocia which she attempted to resolved herself for nearly 30 minutes before coming to the hospital, at which time baby was long gone and the spinal column was detached from the aggressiveness the midwife had used to attempt to deliver the baby…

There’s plenty more in the following pages.

Thinking about homebirth? Think again.

  • Brackonfire

    This type of birth sounds tantalizing. It also sounds safe… (Sarcasm) I just want to reply on this thread “well I had a lovely hospital birth all four times and never labored in tears or for 3 days.” But that’s just sanctimonious. And I know sanctimony isn’t nice. I just feel like it sometimes. Is there any way at all that laboring for 3 days is safe or healthy? In 1986 my mom got a c section for laboring 48 hours with me and I was in distress and almost died it was too long. My husband’s older cousin was a still born as a result of his mother not getting a C-section right away after laboring 72 hours with no progress in 1972. So I know it’s all anecdotes but isn’t there some consensus that women should not labor for that long without progress? And what’s so special about stressing your own body out? See attachment for context.

    https://uploads.disquscdn.com/images/303a82960f227b01f91cf158f4d2cfc569e98eea3568d0eb83654decc27cdcff.png

  • sdsures

    Horrific. :'(

  • pre-e survivor

    question…a mom had a non-stress test at a midwifery clinic in AK, it wasn’t going well and a biophysical profile was done which revealed the baby was in distress. Mom was sent to a hospital and 2 1/2 hours later baby was born via emergency c/s. Is that amount of time between being sent straight to the hospital and baby being born considered normal or quick for that region of the country? My MFM’s office was attached to the hospital so that amount of time seems long to me. Apgars were 3/7 and baby had cooling therapy.

    • An Actual Attorney

      I’m on my phone, so can’t really search for it now, but there was a guest post about what really happens when a woman comes in for an emergency cs. I’m no doctor, but as I recall, that’s pretty normal. There’s a lot of tests that have to happen. They don’t start cutting right away.

      • Gene

        That was my post. 2.5 hours from arrival to section is not uncommon. Remember than the receiving facility may know little about the mother and may know nothing. Repeat US, labs, setting up the OR, etc. It’s not a neat little package that occurs in a 1 hr drama (including time for commercials).

        • pre-e survivor

          The closest regional hospital was five miles away so that is where mom was sent. Baby was transferred to the big Anchorage NICU a few hours later. I thought with the biophysical showing baby was in distress things might have moved along quicker. Decision for c/s was made after lab results. I’m just sad the little one has some brain damage as a result of the failing placenta, though they say baby is doing far far better than expected.

          • Gene

            Stat labs in my ED are supposed to be run within one hour of receipt. So, pt arrives, access obtained, send to lab, wait up to one hour. That’s AT LEAST 90 minutes right there.

          • pre-e survivor

            That makes sense, sounds like everyone did their best then. I am extra thankful for the access I had to excellent care.

          • Gene

            Hope things go well. People outside the medical field have no idea how long things take. And, honestly, mom is going to be the priority over baby. Mom must be stable first, then look after baby.

          • sdsures

            *winces*

          • Melaniexxxx

            OH MY GOD D: WTF

          • The Bofa on the Sofa

            People outside the medical field have no idea how long things take.

            The biggest source of misunderstanding is the idea that the midwives have any legitimacy in terms of medical preparation. I’m sure there are some midwives that have working relationships with hospitals and can make referrals, but most of the time, something coming from the birthing center is going to be treated as if they were coming straight off the street. No continuity of care, but it all starts right there.

          • Michelle Dardenne Arp

            Clarify what you mean by midwives. I hope to assume you mean untrained people calling themselves midwives. Certified nurse-midwives are HIGHLY trained individuals working in a variety of settings, including those who teach OB/GYN residents, medical students, nursing students, and nurse practitioner students, and midwifery students, such as myself. Certain types of other lay midwives are highly trained as well. The problem is that there are many people out there who call themselves midwives but are sorely untrained and inadequate. They saw a few normal births, read some stuff, and amazingly, think they are qualified.

          • BeatriceC

            Speaking generally, if people here are speaking of midwives in a derogatory way, we’re speaking of the fake midwives that are allowed to practice in most US states, not the real, trained midwives such as CNMs and the highly trained, credentialed midwives in other countries. We like those midwives. Well, at least when they’re doing what they’ve been trained to do. There’s a certain population of midwives in England that have gotten to emeshed in NCB ideology and are causing harm, but that sort of thing is the exception.

          • swbarnes2

            No amount of training can fix the ‘I am the queen of normal births, every birth I participate in is normal” attitude which some midwives, even highly trained ones, can possess.

            The lack of training is a symptom of the underlying problem which is vanity.

          • Karen in SC

            saw that one! guess it was better than the home c-section in Grey’s Anatomy

          • Azuran

            It could also depend on the kind of ‘distress’. it’s not black and white, there is a huge range of conditions that could require a various range of actions and time of action.
            I expect that if the baby either had no or extremely low hearth beat, they would have rushed a crash c-section. (which would probably still take at least 30 minutes for someone who came from outside the hospital).
            In many other situation, although there is urgency, it is better to take the time to fully assess the situation before rushing in, because you might cause more harm than good if you don’t.

          • Michelle Dardenne Arp

            I crashed somebody once out of the triage unit in 12 minutes. 30 minutes or less from decision to incision of the industry standard. But another post-er had a very valid point: it really depends upon what the FHR strip looked like upon arrival, and if considered stable upon arrival, the patient would not be crash-sectioned.

    • Michael Ray Overby

      Where was the MW clinic located vs. The big Anchorage NICU?

    • Cartman36

      As the resident Alaskan and without knowing where her MW clinic is and where the hospital is, I would say yes. It took over two hours for my unscheduled c-section at our local hospital because they had to call in a surgical team.

  • Squirrelly

    Reading the allnurses link I notice there are a few nurses who are supportive of homebirth. Mostly they cite witnessing unnecessary interventions or interventions gone wrong (improper foreceps, unecessary csections, bullying by doctors, etc) as evidence women are indeed sometimes better off with a homebirth. However, all the bad outcomes cited apply to mom and not to baby. (I suppose improper foreceps would affect baby but if foreceps are needed I dont see how a homebirth would make the baby less stuck.)

    My question then is are there any situations where baby is better off with a homebirth? If a hospital birth goes wrong then mom may suffer interventions but baby has access to a NICU. If a homebirth goes wrong then baby suffers from at least delayed care. Is there any argument for baby being better off at home? It just seems like homebirth is a transfer of risk from the mother onto the baby.

    • There are NO situations where a homebirth is better for either mother or baby than a hospital birth. Just because a considerable number of homebirths end satisfactorily does not mean that the potential for catastrophe does not exist. After all, the chances of killing yourself playing Russian Roulette are 1 in 6, which means 5 times the empty chamber is likely to come up…yet we all know that, even though each time sperm and egg meet there’s a 50% chance the conception will be a male, yet there are families with all boys and no daughters.

      Homebirth can be nicer, but never safer.

      • Haelmoon

        I don’t want to rock the boat, but there is one situation that I can consider planned homebirth better than planned hospital birth (but there are some strong cavets)
        Mom with a history of previous precipitous delivery. Especially in my region where occasionally roads are closed. I have some women plan a hombirth because they are rightly concerned about delivering on the side of the road (and the midwives live in their communities). However, I offer all of these women a planned induction of labour, because that is an even safer option. However, if they are contracting at home and the weather is questionable, I recommend that their midwife come to them first and can ride in the ambulance with them if early labour or deliver at home if precipitous again.
        However, these are low risk women with healthy pregnancies and well trained midwives. They are not choosing a particular experience, but rather trying to make sure they deliver with a qualified provider.

        • Daleth

          I hear what you’re saying, and having a midwife come to their house and ride in an ambulance with them (assuming they even have time to get loaded into an ambulance before baby arrives) is a smart solution.

          But that scenario isn’t “home birth vs. hospital birth,” it’s home birth vs. very high risk of delivering your baby in a car on the street or highway. So it’s not actually that home birth is better for these women and babies than hospital birth; it’s that hospital birth is highly likely not to even be an option for them.

          • Haelmoon

            Of course. I happen to work in a very pro-homebirth region (5% of our births actually), but I also have excellent MW colleagues who use strict criteria to risk people out. I think it can be a safe option, but never as good as a hospital if something goes wrong.

          • Empliau

            I was an AMA primip with precipitous labor, and even though I live in a suburban/urban era (the Los Angeles megalopolis), the L & D nurses told me that should I get pregnant again, I’d have to hang around the neighborhood of the hospital for the last week just in case.

          • sdsures

            I was an unplanned, premature, 28-week delivery in the car, speeding at 80mph to the hospital. (Thanks Dad, for the driving.)

          • Daleth

            Omg omg. So glad you made it!!!

          • sdsures

            So am I. I’m glad I found the Skeptical OB and all you guys. <3

        • The Bofa on the Sofa

          Alternatively, spend some time staying at a hotel near the hospital.

        • Brackonfire

          I have precipitous labors (number two was born 45 minutes after the first contraction) I am fortunate that I’ve ALWAYS lived less than 10 minutes from the closest hospital but I was afraid I’d give birth in the car. No labor lasts me more than 2 hours. Two hours was the longest actually and that was my first. Knowing this my Dr said I can always just be induced at 39 weeks and zero days unless some medical indication that I need to go sooner. So now I’m high risk anyway and see the high risk ob and I’m being induced no later than 39+0. They are opposed to car birth and home birth. I’m taking them up on the offer to evacuate baby before she tries to wiggle herself out. Lol. Sorry I know I’m late to this conversation. I just had to comment. I think of more women werent so opposed to the “unnatural” methods of inducing labor they might snatch up the opportunity to let their doctor pick baby’s birthday to save all the stress involved in precipitous labors. But they join baby center and the likes and get told “your body knows when to start labor” or “your baby should come when he’s ready” which is absolutely garbage. But moms keep falling for that stupidity instead of rolling their eyes and walking away from it. I will take a safe, secure “unnatural” induction where I can know baby and I are where we belong over the theatrical “my water broke!” Any time. So many baby center moms want theatrics. I just want safe. (Down from soapbox)
          60 days until the induction for me! Can’t wait to meet my baby #5

    • RudyTooty

      When would birth be safer at home? If the hospital is on fire. 4 alarm fire. No power. No blood bank. OR down. It might be safer to be at home in that situation.

      With a functional and staffed hospital, the risk of harm is lessened with access to medical services. People who frame the argument that ‘interventions cause harm and therefore should be ignored’ are looking at it from an individual perspective. The see that one person can avoid the risks of an epidural by avoiding a place that administers them. Yes. That’s true. But holistically and statistically speaking – the risk of harm overall is lower with close proximity to advanced medical resources.

      The nurses on allnurses who are supportive of homebirth (mostly) have a personal history with midwifery that clouds their view. They’re either former CPMs or had homebirths themselves. They actually can provide some pretty scathing criticism of homebirth and CPMs, but I suspect they still feel some loyalty to that former path. So when discussions of homebirth come up, sometimes they go on the defensive.

      • KatieBk

        There was a Stephen King short story about a pregnant woman who lives on a very small island off the coast of Maine – with no medical facilities available on the island – at a time when a zombie apocalypse is taking place on the mainland. That may be the one instance where birth would definitely be safer at home. https://en.wikipedia.org/wiki/Home_Delivery_(short_story)

      • Daleth

        I’m going to start making a list, based on your comments, of when home birth is safer than hospital birth. Here we go:

        Home birth is safer than hospital birth:
        1. When the hospital is on fire, with no power, no blood bank and the OR down.
        2. When a zombie apocalypse is in progress in the area where the hospital is located, but not in the area where the home is located.
        3….? Any more examples?

        • swbarnes2

          Slightly more realistic than zombies…if every hospital you could feasibly get to was under quarantine for having an out-of-control outbreak of something like Ebola. I bet women with proven pelvises would rather stay home than risk a disease with a high mortality rate.

    • Platos_Redhaired_Stepchild

      After reading this I’m going to say ‘no’. Any hospital with real doctors is better than ‘Birth Groupies’.

      http://flygirl.jezebel.com/what-its-like-to-be-an-ob-gyn-in-sierra-leone-an-inter-1719108749

    • Michael Ray Overby

      So you noticed that Trope or Bias as well? I found it Mightily Interesting.

      Mom’s had This, Mom’s had That. Mom’s got Bullied. None of this killed or damaged any babies though, right?

  • Platos_Redhaired_Stepchild

    These psychopaths pretending at obstetrics belong in jail.

  • L & D RN

    I could add a horrific homebirth story to your stories. This one happened within the past two months and was transferred to my hospital. It was preventable and absolutely the fault of the uncertified midwife presiding over the home delivery. The baby is not going to live. I can not give details because of HIPAA. This situation makes me so angry!!

    • RudyTooty

      It’s a challenge to share any detail at all about out-of-hospital births that are transferred in. Knowing the general location and the month would be enough to reveal who the patient is.

      Yes. There are many horrific homebirth stories. The neonatal mortality rate demonstrates this.

      The only way to hear these stories is if the woman or family chooses to write about it in a blog or discussion forum. And often they are wrestling with how they did not end up with the mythical birth they were sold by their midwives.

      Having a baby needlessly suffer and die due to shoddy care is a reason to be angry. I understand.

  • Mel

    The story of the mom with HELLP who died and lost her baby is making me sick.

    HELLP is fucking crazy dangerous for the mom and the baby. IV fluids, magnesium sulfate, two blood pressure drugs and betamethasone kept Spawn and I alive long enough to get a safe CS when I ended up in a hospital with unstable severe HELLP.

    Thanks to the level of “needed denial” that my brain entered to keep from freaking out, I didn’t put together why the nurses were taking my BP every 15 minutes for the 28 hours before my son was born or why the room filled with people every time Spawn shifted and we lost his heart-rate for a few minutes.

    I did not, however, object to that. That’s why I’m alive and damn near back to normal physical health and Spawn is working at expanding his lungs but other than that doing great.

    When the OB resident told me I had HELLP, I started crying. It wasn’t because I was scared of the future; it was because I was terrified of what would have happened if I hadn’t felt sick enough that night to call my OB. I knew what HELLP was before she explained it and I knew on a gut level that within a few hours to a few days my husband would have come home from work and – God help us – found me unconscious on the floor between ecclamptic seizures….or that I had laid down for a nap and never woke up.

    And I hate that another woman had that happen in a hospital because of an uneducated idiot.

    • Empress of the Iguana People

      *hugs* Glad you guys -are- doing well, though. So many seem to live with high blood pressure that we collectively forget it’s deadly until it smacks us in the face.

  • fiftyfifty1

    Question for Dr. Tuteur:

    It seems to me that you are directly reporting on fewer homebirth disaster cases than you used to. Instead you are writing more posts that dig deep into the psychology and sociology underlying the choice to embrace pseudoscience (whether it be in birth, nutrition, parenting, vaccinations or whatever.)

    So my question is whether we have any updated info on how many babies are dying or sustaining damage in homebirth disasters? Is it getting any better? I know you hear about a lot of deaths that you choose not to publish.

  • MaineJen

    Sadly the “midwives” were probably not licensed, and if they were they likely got no more than a slap on the wrist (if that!) from their governing body. In most cases the “midwife” just goes on practicing like nothing ever happened. She will never mention the loss to any of her subsequent clients, nor is she obligated to. Fake “midwives” (CPMs) are completely unregulated, there is no standard or best practice defined for them. It’s like the wild west.

    • RudyTooty

      I want to like your comment, but it’s not quite entirely correct. Gah.

      “Sadly the “midwives” were probably not licensed, and if they were they likely got no more than a slap on the wrist (if that!) from their governing body.”

      This is true, many of the laws that license CPMs do not provide sufficient protection from incompetent practice.

      “Fake “midwives” (CPMs) are completely unregulated…”

      Eh, they actually *are* licensed or legally recognized to practice in 30 states. So there is some regulation. Does that regulation do enough? Too often, no. See your first sentence.

      Glad you’re MAINEJEN – as this reminded me that Maine just enacted licensing laws for CPMs this past year.

      http://www.pressherald.com/2016/05/29/new-rules-will-require-midwives-to-be-licensed-by-the-state/

      Adding this link to highlight the absurdity of this whole midwifery licensing and regulation thing. Maine enacted a licensing law that requires midwives to meet more stringent educational requirements above and beyond NARM’s requirements (which aren’t enough either, but that’s another story), they explicitly prohibit certain births from occurring in the out-of-hospital setting such as twin births, breech births or vaginal births after cesareans, and a MANA leader and Maine midwife Jill Breen laments these new requirements – that by all reasonable standards would increase safety – as being too restrictive.

      Seriously. What a cluster. Midwives like Jill Breen are a big part of the problem, if not THE problem:

      ““When you’re making rules and you’re making plans, you want people to have the broadest options they could have,” Breen said.”

      ^she is advocating for nonregulatory regulation.

      Which is, actually, what some states have: it’s a regulatory body that doesn’t really regulate nor discipline the licensed practitioners. SIGH.

      • MaineJen

        Yeah, there is a fair amount of woo up here. 🙂

        I never really looked into midwives when going through pregnancy (I knew I would likely want pain relief during birth, and the last thing I wanted was to be talked OUT of that), so I missed out on the indoctrination. 🙂

        Of course she thinks it’s too restrictive…now when she tries to attend a breech, twin or VBAC at home and things go pear-shaped, she will actually get in trouble after they transfer to Maine Med in a panic. SMH

      • Chi

        Of COURSE they don’t want to be ‘restricted’ and ‘regulated’. They want to catch babies and be paid for the privilege and not take any responsibility for bad outcomes.

        As Dr T said. They advocate AGAINST all the things available in hospitals because they CAN’T offer them, so they paint them as bad or evil or unnatural.

  • Empress of the Iguana People

    um, Where do you live? Midwives in the US who do homebirths are rarely nurse-midwives, the only ones who have the educational equivolency of other nations

  • What licenses?

  • Montserrat Blanco

    They will not. They will continue to practice. CPMs do not carry insurance, if they get sued (unlikely as most people would not sue if they are not going to get money) they declare bankruptcy and they do not pay a dime. Most of the times if that happens they just move to another state.

  • What licenses? Seriously, a CPM “license” is an utter joke. You can’t pull licenses from people who don’t actually have them …

    • RudyTooty

      CPMs can be licensed or have legal authority to practice in 30 states.

      http://narm.org/pdffiles/Statechart.pdf

      Just like a nail technician or a nurse or a real estate agent has a license. It is a real thing. If you don’t agree with the authority granted by the license, or don’t agree that the rules stipulated by the license are sufficient to protect the public, I can understand your argument, and probably agree with you. But saying that CPMs don’t have licenses is unnecessarily muddying the waters with non-factual information.

      CPMs are licensed to practice midwifery in most states. And it’s not a joke, it provides legal recognition and authority to practice.

      However, these licenses often do not protect the public from harmful midwifery practices, nor do they provide meaningful and safe practice guidelines.

      • That’s entirely fair, and I was far too flippant. The threat of a license being pulled is nonexistent so far as I can tell because the group providing licenses just doesn’t do that, unlike a proper licensing organization, but that’s another thing entirely.

      • Lindsay Beyerstein

        Can anyone call themselves a CPM in the remaining 20 states?

        How many states allow midwives to practice without a license?

        • RudyTooty

          Anyone can call themselves a CPM if they earned the credential through NARM. Whether that means anything is determined by local jurisdictions.

          Some states license CPMs but allow midwives (including CPMs) to practice midwifery without a license. This is explicit in their licensing laws. The three I know about are Oregon, Utah and Minnesota. All three states license CPMs AND allow unlicensed midwives to practice legally.

          Some states have no license available but permit practice of midwifery – or at least don’t actively restrain midwives from practicing. The following are states where I know CPMs and other lay midwives practice without a license: Michigan, Hawaii, Oklahoma, Nevada, Massachusetts, Ohio, Pennsylvania.

          Missouri has a statute that allows CPMs to practice, but no license.

          There are only a handful of states where it is truly restrictive to CPMs and lay midwives: Illinois, Alabama, Nebraska – those are the states that I know of where lay midwifery is driven underground.

          In my opinion, the most dangerous environments (for patients) is in the states where midwifery (CPM-midwifery) is licensed but poorly regulated. The license creates an illusion of accountability and professionalism that does not exist.

  • Concerned Anon

    Hopefully things change. In Oregon, a couple birth centers have closed in the last five years and word is Andaluz is struggling because of the lawsuit against them and Alma has a GoFundMe

  • Mom of 3

    These are all horrific, but I seriously cannot get past PUSHING AGAINST A CLOSED CERVIX FOR 12 HOURS. Holy shit that is an entirely new level of incompetence.

    • The Bofa on the Sofa

      Remember, they refuse to do VEs and will use the length of the purple lone on your butt. That’s what happens as a result

      • Cody

        I guess. I still don’t understand how people could be this dumb. Am I seeming naive if I state that there must be some vital piece of information missing?

        I was baffled when I read that. She wouldn’t have even been feeling the urge to push, so if there was no VE, then no reason to push. If there was a VE, then also no reason to push because you’d realize that the cervix wasn’t dilated. It’s like the birth was attended by a 14 year old who saw the movie Knocked Up one time.

        Or is t possible that the cervix had become so swollen during labour that it closed up? I’ve never heard of it closing completely, but I’ve never been at a birth where a doc or midwife has been as negligent as what was described.

        • Who?

          That 14 year old of which you speak might be a better birth attendant than some of the birth hobbyists whose activities are reported here.

          • fiftyfifty1

            Yep, a 14 year old, or a cab driver or anybody really. They would have the good sense to get the laboring woman to a hospital.

        • Depends on how deeply engaged the presenting part is. My daughter, who is currently 33 weeks pregnant is feeling a huge amount of pressure, and ultrasound, not a VE showed the vertex is WAY down.

          • Empress of the Iguana People

            (Congrats on the impending grandbaby. Best wishes for your baby and hers)

          • Cody

            Yes but you typically don’t feel the urge to push until you are at least partly dilated.

        • Sarah

          It’s possible to feel the urge to push before full dilation. This is why examinations are helpful.

          • Cody

            I know. That’s why I was thinking she had been pushing against a cervix that was fully dilated and then the cervix could have swelled significantly.

          • Sarah

            Yeah maybe. That or she felt the urge to push before.

          • MaineJen

            That’s what happened to me; it was torture. Luckily, the epidural took all of that pressure away, and once I was fully dilated pushing was easy peasy.

          • Sarah

            Same, it was awful. Apart from the epidural part, unfortunately.

  • Rita Rippetoe

    I just noticed yesterday that the new issue of Mother Jones magazine has an article about increased rates of maternal complications. Ties it to increase in older woman giving birth. Has anyone read the entire article? Comments?

  • lawyer jane

    The older my boy gets and the more precious he is to me every day, the less I can believe that I entrusted his freakin’ BIRTH to those negligent crunchy midwives.

  • 3boyz

    Just regarding the the antibiotics, because it pisses me off so much when I hear crunchy types claim that doctors just push needless antibiotics: good doctors know full well that unnecessary abx are harmful and are actually quite judicious about prescribing them! My baby was just seen for an ear infection today and was not given any abx, doctor says to wait 2 days and see if it clears. This is the 6th or 7th in his nearly 1 year that he’s had an ear infection but he’s only gotten abx ONCE because the other times it did in fact clear up after 2 days. The same doctor also recommended my oldest child get a tonsillectomy when he started getting strep once a month becaise he was concerned about all that antibiotic use even though it was necessary (and he was right, no strep in the year and a half since getting the tonsils out). I just saw my own doctor last week for a sore throat. Strep test was negative, so she sent me on my way with a “prescription” for tea with honey. These are not quacky crunchy doctors. These are educated professionals who understand science and keep up with the latest and know full well not to prescribe abx willy nilly. When they do prescribe them, you KNOW they mean it! It’s the natural people, who for all their “education” seem to have missed that doctors have in fact changed the prevalent practice over theblast 20 years and no longer give out abx so readily.

    • Sue

      Spot on!

      I am a medical specialist in an acute area of hospital medicine, and have a full-vaccinated teenager who has never had antibiotics in her life.

      Know when to hold them, know when to fold them.

  • MaineJen

    OH…my…god. Some of those stories.

    Makes me look at my induction for prolonged broken waters without labor (#1) and my intrapartum antibiotics for GBS (#2) with profound gratitude.

  • Kelly

    I am also frustrated with the fact that nurses are spouting positive things about home birth. They of all people should know how dangerous it is.

    • Cody

      I think some of the nurses were occasionally commenting on home birth in countries where the practice is fully integrated into the medical care system though as opposed to the USA.

    • RudyTooty

      If the nurses don’t work in an out-of-hospital environment, they may not understand the extent to which many non-nurse midwives are under-trained and negligent with patient care.

      They really want to believe the myth of the beautiful, perfect birth. And they may know people who had beautiful homebirths and are swayed by these personal testimonials. .

      I have attended births in the home setting, in freestanding birth centers and in hospitals of various sizes. I no longer buy into any argument about less intervention is better (though I don’t have a problem with non-intervention birth, or low-intervention birth – when it is appropriate), I don’t believe interventions cause problems in birth (which is the standard argument of the natural birth promoters), and I can see the real risk of an increased distance to life-saving resources such as surgeons, an operating room, resuscitation equipment, OB nursing staff, NICU staff, blood products, and medications.

      The idea that proximity to these resources increases risk to women is ABSURD.

  • Kelly

    This makes me sick. It is just one story after another of these poor babies who suffered.

    • kilda

      And two women who died. 🙁

      • Kelly

        That is so crazy to me because you don’t tend to know many who have died in childbirth in this age but you do hear about a lot of babies dying. It makes it even worse because they died for their very wrong beliefs. I can’t imagine my husband watching me bleed out and die or leaving my children motherless because I refused actual medical care.

        • Lay people are pretty well protected from the truth in matters like this, because of the ethical dilemma of scaring women unnecessarily. Those of us “in the business” could write entire books about malpractice, negligence, and just plain stupidity.

          I was not yet retired whenmy daughter married. I stopped relating work-connected anecdotes to spare her anxiety — and she hadn’t even become pregnant yet.

          • Jennifer

            Shouldn’t they be anxious, and thus more aware, to reduce the risk of something like this happening? When someone dies in a car accident, the news isn’t held back to protect others from being afraid to drive.

      • shay simmons

        This is going to come off as callous, but the women who died were an S.I.W.

  • kilda

    horrifying stories. Also horrifying: except for the ones where the baby was clearly long dead, the midwife community will point to every one of them as evidence that hospitals kill moms and babies.

    • Steph858

      Now THAT’S an example of Fridge Horror.

  • Brooke

    There are incompetent midwifes and incompetent doctors. Nurses only see a homebirth baby if things go wrong, if its an emergency. They don’t see babies born at home safely.

    • Azuran

      Except that the number of incompetent midwives if MUCH higher than the number of incompetent doctors. And the risk of homebirth is much higher.
      And if your Doctor is incompetent or causes you harm, they are accountable, you can sue them, they can lose their licence and be fired. CPMs don’t answer to anyone, you can’t sue them, when someone manages to do it, they declare bankruptcies, when they are told they can’t practice anymore, they move to the next state. They lie to their clients, they hide the risks, they give improper and outright dangerous medical advice.

    • Montserrat Blanco

      Of course! The problem is that the parents did not “researched” properly the midwife! That is why they chose an incompetent one.

      The problem is not that there are incompetent midwifes. The problem is that when a homebirth midwife does something wrong she can continue practicing because she does not carry insurance malpractice and most parents will not sue since they are not going to get anything.

      If I do malpractice the patient or their family is entitled to a significant compensation and I will lose my licence to practice medicine. That does not mean I can not make a mistake and kill someone, of course, but if that happens the system makes sure I do not kill anybody else. I can be reported to the hospital where I work, the licensing organization in my country and of course I do have legal liability. I carry a malpractice insurance over 1 million bucks and I only deal with very sick patients that got very sick without my intervention, and would be dead in weeks/months without my help. Most homebirth midwifes carry zero insurance. That does not stop bad things to happen but it usually prevents bad things to happen again.

      • Azuran

        Geez, I treat dogs and cats and it is mandatory to carry malpractice insurance of at least 1 million. (2 millions if you work with embryos)

        • Montserrat Blanco

          I work in Spain. Most things are cheaper here (houses, food, salaries) it varies from country to country. 1 million here is a lot for malpractice insurance, most claims do not get that much even if it results on death.

          • Elizabeth A

            One reason for those lower malpractice awards is a single payer health care system. In the U.S., well, we don’t have that. If you have a disabled child, you or your insurance company has to pay for all the care that child gets. That’s not the only reason malpractice awards are so big here, but it’s a huge contributing factor. Estimated costs get up into the millions very quickly.

            My c-section was billed to my insurance for about $20k (insurance negotiated down, but it was still four figures). My daughter’s 32 day NICU stay was billed at several hundred thousand.

          • Montserrat Blanco

            We do have a great public health system. One day at the ICU is about 600 euros for the public health system and 0 euros for the patient. So, 32 days would be about 20000 euros, not several hundred thousands. My CS and my son’s two months at the NICU were free for me (paid by taxes).

          • BeatriceC

            Meanwhile, my 6 week antenatal ICU stay and my son’s six month NICU stay was well over $1,000,000 in the US, and that was 14 years ago. The US system can get expensive fast. ETA: out of pocket for me was about $20k.

          • Montserrat Blanco

            When I read those numbers I just get shaky.

          • BeatriceC

            I have spent a LOT in healthcare over the years. Two of my boys have a genetic bone disease and require frequent surgery and specialist visits, plus equipment. I finally got poor enough to get them qualified for SSI, and while the monthly check is small, the whole reason for getting the qualified for it was to get them covered under medicaid. I was hitting my $40k/year out of pocket maximum every single year until then. Once I wiped out my entire savings (including my retirement accounts), I finally qualified for them to get SSI.

          • Azuran

            ‘I finally got poor enough’ that is just so sad and horrible.
            Really, whenever I see American’s actively fighting against public healthcare all I can think about is ‘WTF is wrong with you people?’

            Sure, I pay lots of taxes. But it’s a stable amount, proportionate to my salary, on money that I actually have. I really don’t get how people can be against this.

          • BeatriceC

            See, that’s what people don’t get. Sure, taxes would go up with a single payer system, but the amount they’d go up is a whole hell of a lot less than paying for insurance plus out of pocket fees.

          • MaineJen

            But….’Merica! /s

          • Azuran

            That and it avoids having to face any kind of unexpected expense or stress in the case of an emergency.
            When my coworker had her baby at 26 weeks, she didn’t have to worry about if the insurance would pay for the ambulance transfer to another city, or what kind of treatment the insurance would cover, or paying co-pays or part of the treatment fees and right now she doesn’t have any medical debt for him. You don’t need to deal with that kind of shit when you are stuck alone, hours from home with your newborn in an NICU for 3 months.

          • mabelcruet

            I’m exactly the same with the ‘WTF?’ reaction. I know the NHS in the UK isn’t perfect, but it is accessible and provides a decent standard of care across the board for all patients, regardless of income, employment status or nature of their disease.

            What is currently happening with the government selling off various sectors of it to the highest bidder is frankly frightening. Our health minister (Jeremy Hunt) actually wrote a book about privatization of the NHS-under his term of office doctors went on strike for the first time in 40 years. He’s a mendacious, lying weasel, falsifying data to suit his own purposes and has made it no secret that he is emulating the USA model of healthcare because that’s where there is profit (and most members of parliament have finsnicsl interests in companies provding private health are services).

          • Montserrat Blanco

            Once I got poor enough… That makes me think. Here it does not matter how much you earn. If you/your spouse/your parents pay taxes you get free healthcare. If you are Spanish and you are so extremely poor that you do not pay taxes you also get free healthcare. You can have any type of disease, and whatever money you make you get free healthcare. Some people do have a private health insurance, so they can be in individual rooms all the time and things like that but the public health system is very good (I have never ever had private insurance) and you pay only some prescriptions according to your salary, (hospital prescriptions, incluiding chemotherapy, HIV treatment and hep C treatment are free for the patient). Every surgery, doctor appointment, A&E visit and hospital admission is free for the patient.

            If you are loaded and do not have a salary because you live off your rented properties you can get free healthcare by paying about 250 euros each month of taxes. You might earn 50000 euros every month off your properties, and you get free healthcare for 250 a month. I do pay much more, the system is quite complex and sometimes absurd but I have never heard of anybody getting poor for needing healthcare. You might earn less if you can not work, you might have less money to spend in going out but losing your retirement money… Never heard of it.

          • Montserrat Blanco

            I just wanted to clarify: for high earners without a salary you have to pay social security in order to get free healthcare (from 250 euros onwards) AND taxes on earnings, that can easily go over 40% of your earnings. Those of us that have a salary, pay social security and tax on earnings as well, but it is deducted directly on our monthly payment, so we do not even see it. I pay about 35% of my earnings in tax+ social security and my employer pays about 20000 euros to social security each year on my behalf on top of that, so yes, A LOT of taxes.

          • Montserrat Blanco

            So yes, single payer is cheaper. Salaries for healthcare providers are low, compared to other countries, that is one of the reasons why it is cheaper and you might end up on a 50 year old building sharing the room with other patients when you get hospitalized. The quality of the attention that you would receive from the consultants, nurses, etc is usually excellent and all healthcare professionals have an education very similar to those of other European countries and those in the USA.

            I do pay about 35% of my earnings in taxes to fund healthcare and public education between other things and VAT applies for everything you buy and depending on the “necessity” of the item you pay more (21% for a necklace) or less (4% for milk), for example, but any single item you buy or any single service you get is charged with a tax (apart from the tax on earnings).

          • Sarah

            Yep. That’s something I’ve pointed out on here before in response to Dr Amy’s posts about malpractice: this is one area where the legal and political climate is undoubtedly making a difference. Juries won’t refuse claims from parents of children who are severely injured and will need round the clock care forever because they know this is the one chance to get that care paid for.

          • Azuran

            It’s indeed extremely high. I doubt anyone ever got anywhere near that for a dog of a cat. For a normal dog or cat, it’s extremely unlikely you’d get over 10 000…..even 5 000. For a standard breeding dog, maybe 10 000-20 000, but probably only if it’s of a highly valuable breed, with a very good, registered breeder that does a lot of genetic testing, a backyard breeder wouldn’t get much. The only way you could possibly ever get over 100 000 would probably be if you had the highest raked champion male of a very rare breed of the entire world.

            Those who work large animals populations could need it. If you make a mistake that results in the death of a huge number of animals on a farm, a very highly quoted reproductive male or very valuable embryos, it can very quickly reach a couple 100k

          • BeatriceC

            Or exotic vets. Some species of parrots can be over $20k just to purchase. The blue mutation yellow nape amazon comes to mind. I think I just saw one sell for $30k. And that’s just the purchase price of the actual bird and nothing else. Black palm cockatoos and hyacinth macaws are others that top the $10k purchase price mark.

          • Azuran

            Indeed. When I was still in school, a guy even came in with a 10k exotic fish.

          • Dr Kitty

            Racehorses…
            A family friend is a vet for some of the best Irish stud farms, the insurance he carries is unbelievable.

            These horses are so valuable that the owners will often pay for their own vet to travel around the world with the horse. If you’re willing to drop thousands of dollars just to make sure that an unfamiliar vet doesn’t spook your horse before a race, imagine how much you’d sue for if your vet killed the horse!

        • Cody

          I’m a doula and I have insurance. I don’t give medical advice and I don’t deliver babies. Still have liability insurance because bad things happen sometimes.

          Mindboggling that midwives can practice without it.

        • mabelcruet

          In my spare time I’m an artist, and recently I’ve started taking my work to craft fairs and selling via an online shop. I have to have public liability insurance for that, in case someone…I dint know, eats a picture maybe. I’m insured up to £1000000 for pottering about with pictures. And yet women are happy to deliver with birth hobbyists with no insurance? The most dangerous day of their baby’s entire existance? You’d be safer delivering with a boy scout or a girl guide.

          • Empress of the Iguana People

            whoa…i wonder if americans are required to have insurance too. I’ll have to ask my potter friend when i see her again

          • mabelcruet

            The organisers of the craft fairs I exhibit at insist on an up to date certificate of insurance, if you don’t have it then they won’t let you have a booth. It covers damage that they might get from the pictures (splinters from the frame? Poisoning from the paints??, back pain from carrying it home???) and also damage that they might get from the craft booth (tripping over the tablecloth? Stubbing their toe kicking the table leg because they can’t see it due to the tripping hazard tablecloth??)

        • Brackonfire

          I’m always late to these…but my manicurist even has malpractice insurance. It’s my freaking nails.

          I think that says a lot.

    • RMY

      The issue isn’t as much that “things go wrong” it’s that easily preventable things “go wrong” with home births.

    • Heidi

      So? They mostly see cases, too, that wouldn’t have resulted in an emergency if the patient had sought real medical care and delivered her baby in a hospital. Even if it ended up being an emergency, it would have been a fairly common one for the hospital staff and most likely would have been managed and mom and baby would come out alive.

    • Jen

      How in the hell can you read these stories and make a comment like this? Any decent human would come away with tears and regret for those poor lost babies and the broken families. All would have been healthy and alive had they been delivered in the hospital as recommended.

      • Sue

        Brooke’s self-appointed role on this blog appears to be to help us see ‘the other side’ – no matter how ridiculous or illogical it is.

        “Is this the two-minute argument or the five-minute argument?” (Monty Python)

        • Sean Jungian

          #thatsourbrooke

      • Brooke

        Babies die in hospitals too. I’m not saying these stories are not sad or unfortunate, the fact that they are is even more reason as to why they shouldn’t be used to push an agenda and further create division between doctors and natural birth advocates. What do you think would happen if doctors said, okay, if you want to try a VBAC we can do that, if you want to wait at 41 weeks to deliver okay but let’s make sure everything is okay…these situations could be completely avoided if doctors worked with women instead of working against them because they want to work by the book and according to statistics.

        • Montserrat Blanco

          Yes, the problem is that babies die at home more than they die in hospitals, as even studies made by CNM have shown. The problem is that babies die more after 41 weeks than at 39 or 40 weeks. The problem is that babies die more at VBAC than at repeat CS. That is the reason why doctors try to avoid those situations.

        • Azuran

          And many do, But a huge proportion of those natural birth advocates are just way too far into the woo and aren’t ready to make any compromises.

          Hospitals and doctors have insurances and standards of practices. Unlike CPM, they are held accountable if things go wrong. How are they supposed to work with people like you? When they tell you about the risks, you accuse them of ‘playing the dead baby card’. They often refuse the proper prenatal testing to make sure they are good candidate. When they are told they are not good candidates they get mad and accuse the Doctor of wanting to push their own agenda or having a golf game.

          And then, the main problem is that when things go wrong, people are very quick to turn around and blame the doctor.
          I deal with this a lot. I do A LOT of so-so medical plans with owners because that’s all they can afford or don’t want to go to surgery or whatever. I tell them, to their face, multiple times, very clearly that it’s not the recommended treatment, that the risk of complication is higher, the chances of success are lower (and sometime slim to none), that there is a high risk of death. I make them sign a document stating they are refusing treatment and that it could result in death. And yet, when their pet’s condition worsen or it died, they always find a way to try to blame me and refuse to accept their responsibility in the outcome.

          Now try to imagine how it must be when it’s about a baby? Judges aren’t really moved by pet owners who complains that their puppy died after I told them it could die. They are, however, MUCH more sympathetic of parents who lost a baby. No matter how many time they refused treatment and how many times they were warned that it could die. No one is going to tell a grieving mother that her baby died because of her choices.

          Many doctors/hospitals or even the insurance companies don’t want to cover those anymore because they did and got themselves burned.

        • The Bofa on the Sofa

          Sober drivers die in car accidents, too.

          • FEDUP MD

            People wearing seat belts die in car crashes too. It doesn’t mean you stop wearing your seabelt. Well, maybe YOU do if you don’t understand the idea of risk reduction.

        • Sue

          Brooke: “Babies due in hospitals too”.

          Is there no standard trope this person doesn’t repeat?

          And, yes, babies die in hospital too, but almost never intra-partum, and not without a very extensive investigation.

          There has never been a death in hospital that would have been prevented by having a home birth.

        • momofone

          I don’t expect you to understand this, but there are times when there is no middle ground to find if competent care is delivered. Not everyone can safely try VBAC, or waiting. Sometimes “making sure everything is ok” means delivering under circumstances that would not have been the first choice of mother or doctor. You seem to want to take the average of medical advice and whatever woo-laden bullshit happens to be the catchphrase of the day, and it doesn’t work that way.

        • Gatita

          “they want to work by the book and according to statistics” THOSE BASTARDS.

        • Mariana

          I gave birth in a hospital twice, each with a different OB/GYN. First time we waited until 41 weeks, induced for 12 hours (because I wanted a vaginal birth) and then the doctor encouraged me to have a csection, because nothing was happening and I was exhausted. The second one I wanted a vbac, the doctor said it was ok, I waited until 39 weeks and he was a “true transverse”. I got tired of being pregnant and my baby was really stuck in this weird sideways position. I asked for a csection on an appointment on Friday, we scheduled for Monday and that was it. I have two healthy kids. I was treated with care and respect, and my wishes were respected at each step. I could have had a csection at 38 weeks with either kid (doctors here do maternal request csections), I could have waited until 41 weeks to see if my second baby would turn. I trusted both doctors to tell me if anything was a matter for concern, and I knew that as long as the risk was low, they would let me try to have things my way.

        • Melaniexxxx

          LOL. VBAC and postdates are no big thing for hospitals. Doctors see them all the bloody time. You have NO IDEA what you are talking about. Routine repeat CS isn’t a thing anymore, you are sorely out of touch

      • Platos_Redhaired_Stepchild

        “Any decent human would come away with tears and regret for those poor lost babies and the broken families.”

        Right there, that’s the problem. The lack of ‘decent humans’ in American midwifery.

        p.s. Brooke is a troll. If you can’t block through Disqus, try killfile chrome app. Its free!

        https://chrome.google.com/webstore/detail/blog-comment-killfile/kpoilnkelonbaapoapibddjaojohnpjf

    • Empress of the Iguana People

      Obviously, but not the point. You cannot know which situation you and your baby will be in until push comes to shove. Literally. Homebirth changes the very serious to catastrophic

      • Azuran

        And often, it changes the easily manageable into catastrophic.

        • Who?

          Without the birth hobbyist even noticing.

          • Mattie

            does it become catastrophic if nobody notices, or is it just a ‘totally unexpected inevitable tragedy’

          • Who?

            Depends which side of the conversation the speaker calls home…

    • Life Tip

      Right. And emergency responders don’t see all the kids that make it home safely without being buckled into their car seats.

      • The Bofa on the Sofa

        Or the drunk drivers that made it home and only ran over a few garbage cans and the kids bikes

    • Gæst

      Indeed. But the nurses see all hospital births, of which there are far more than home births. So when a nurse sees that most of the really tragic births are home birth transfers, that means that even though midwives are doing FEWER births overall, their patients end up with disastrous outcomes MORE OFTEN.

      • Brooke

        Its actually all anadotal evidence coming out of a forum. Which makes it completely meaningless. These stories could be exaggerated or could be from several years ago or could just be the ones they distinctly remember because homebirths are uncommon where as complicated deliveries in a hospital are very common. They could be made up altogether.

    • Who?

      Still awaiting the empathy upload.

    • Sue

      Incompetent doctors are held to account.

      Rogue midwives are celebrated.

      Brooke just disagrees.

      • Brooke

        Rogue midwives are sent to jail. Incompetent doctors like the one that almost killed my sister are allowed to continue practicing on low income women because no one cares about them.

        • Azuran

          No they aren’t. And if your sister’s doctor almost killed her, than I expect you made a complaint to his professional order, and IF he really did something that put your sister’s life in danger, then he’d face disciplinary measures. If he didn’t, that’s because he didn’t do anything wrong.

          • Brooke

            That doesn’t make sense. My sister would’ve needed to make the complaint and that does not mean that the doctor did or would’ve faced disciplinary measures. Why do you think malpractice lawsuits exist?

          • Montserrat Blanco

            Did your sister make a complaint or lawsuit? Did you do it on behalf of your sister? Did her or some family member raised a complaint to the hospital, the professional order or the legal system at all?

          • MaineJen

            One of my coworkers had a horrific experience with her OB when delivering her son (this is 20 years ago now)…he was way, way out of line when dealing with her, and she was humiliated and traumatized. She and her husband made a formal complaint to both the hospital and the OB group. When I went to the same OB group years later, that particular doctor was still there (and his bedside manner *sucked*), but he was no longer attending deliveries at that hospital.

            You CAN complain, and if there are reasonable grounds there WILL be consequences.

          • Montserrat Blanco

            I know. I am an actual physician looking after patients. I very well know that there are consequences. If you receive one complaint (as I have) for waiting times, you get a talk with your boss about how can we improve waiting times. If it is something like you were mistreating a patient… and if it happens more than once… I would probably lose my job.

          • MaineJen

            Probably should have put that as a reply to Brooke’s comment; I was trying to refute her assertion that there would be no consequences if her sister had complained

          • Azuran

            I think they think there are no consequences because they don’t actually understand what malpractice is.
            We have received maybe 5-6 formal complaints last year at my clinic. None of them ended up with any kind of consequences because none of them had any real ground for a malpractice suit. Generally, at most 5% of complaints are grounded.
            Medicine isn’t black and white, it’s not math. There is a lot of room for interpretation in there. Not getting a diagnosis right away isn’t malpractice (provided you did reasonable diagnostic testing) Even getting a false diagnostic isn’t malpractice, many diseases look the same and you can get conflicting tests results. An isolated complications following a medical procedure, or just absence of response to treatment isn’t ground for malpractice either.
            But people who are grieving needs to find someone responsible. Most of those accusation are just unfounded and come from a need to find answer and a lack of understanding of medicine in general.

          • Sue

            Brooke continues to make assertions in areas she has no idea about.

            Medicine is increasingly a regulated system – especially in hospitals, with regular audit, morbidity and mortality reviews, incident monitoring and reporting etc etc.

            Of course, the fact that Brooke claims a doctor “almost killed my sister” does not mean that this actually happened.

          • Azuran

            Oh I’m pretty sure it didn’t, knowing Brooke, it’s probably some shit like ‘she had a PPH after she was ‘forced’ to be induced at 44+ weeks’

          • Montserrat Blanco

            No worries! I am always glad to comment.

          • Azuran

            Well duh, of course your sister needed to make the complaint. Where do you think that the complaints come from? Out of thin air? As in basically everything in life, if you think you have been wronged, then yes, you have to make a complain.
            If someone breaks into your house, you call the police to make a complain.
            If someone is harassing you or assaults you, you call the police and make a complain.
            You get bullied in school? Complain to the teacher.
            What else did you expect?
            That’s what professional orders are for. You call them, make your complaint and they investigate to see if you have a case of not. If there is a case, then there will either be disciplinary measure.

            So, basically, you are complaining that the Doctor wasn’t held responsible…….after you have done nothing to hold him accountable? What did you expect? That it would magically happen? Then you are part of the problem, honey.

          • Box of Salt

            Brooke “That doesn’t make sense.” You got that part right.

            So did she or did she not file a complaint? Did she or did not she seek legal recourse through a malpractice suit?

            And if you (or your sister) did, and you shouldn’t be discussing this on an open forum, just say so and we can let it be. And I hope things work out for your sister and her family.

        • Montserrat Blanco

          Please do show me one CPM in the USA that has gone to jail. Just one.

        • rosewater1

          Faith Beltz. Lisa Barrett. Brenda Scarpino. All of these women have blood on their hands. Their hubris has killed babies. And as far as I know all of then are still free.
          Read what happened to Liz Papparella when she tried to bring Faith Beltz to justice.
          Then tell is again how wonderful homebirth can be.

    • RudyTooty

      Hi Brooke, I used to work with CPMs and lay midwives before I became a nurse and a nurse-midwife.

      I have never seen incompetence and negligence in a hospital setting that comes even close to what I observed among OOH midwives.

      I have seen *many* beautiful, peaceful, achingly beautiful homebirths. But that does not erase the recklessness and incompetence of the people promoting this model of birth.

      So I am a nurse who *has* seen babies born at home safely. I also have seen the risks those promoters are willing to take with their patient population – and the amount of suffering of their patients that they feel is acceptable to promote home birth.

      It’s unacceptable to me. I didn’t just see the train wrecks. I also saw the “perfect” births, the dicey births and the near-train wrecks. And I saw the ignorance that leads to more train wrecks. And I saw that there is no accountability and little recourse for patients who are harmed by these practices.

      • Sue

        Thanks for your comments, RudyTooty – which are clearly based on real insight and perspective.

  • Susan

    As much as the stories are awful and unsurprising what does also not surprise me is that some of these nurses seem to not take patient confidentiality seriously enough. I don’t care why or for what cause you don’t refer to specific patients at your facility for any reason.

    • The Bofa on the Sofa

      I don’t know own what’s said at the site overall, but there is nothing in the quoted material that would be a problem, is there? There is no identifying information. I listen to Dr Radio a lot and this is similar to the type of information they talk about in terms of cases. Given that is international radio they are highly monitored in terms of what they say, so if it were at all HIPPA questionable, they wouldn’t do it.

      • Heidi

        Yeah, I don’t think it’s a HIPAA violation. On the site, the nurses don’t even have their location listed. I really don’t see how someone could figure out what patient it is at all. Now maybe if the allnurses format were something like RN4Lyfe Nashville, TN and the nurse said something like, “Yesterday, we had a homebirth gone bad. The 27 year old woman had placental abruption, and both baby and mother died,” it would probably be a HIPAA violation because you know it’s in Nashville and the day it happened, you could most likely track the obituaries and figure out exactly who it is.

        • TsuDhoNimh

          Even then, HIPAA has only to do with ELECTRONIC RECORDS transmitted between facilities and insurance companies.

          Violating confidentiality … yeah, that probably happened.

          • An Actual Attorney

            Not exactly. That’s how a HIPAA covered entity is determined, but once an organization is covered, broad privacy rules apply.

    • MaineJen

      I didn’t see any names or identifying details.

    • Box of Salt

      Susan “I don’t care why or for what cause you don’t refer to specific patients at your facility for any reason.”

      Well, isn’t that stance convenient for anyone who wants to pretend these things aren’t happening.

      • Susan

        Definitely convenient for all sorts of people that do stupid things that harm themselves or their children that health professionals have legal obligations not to discuss their patients. There are exceptions like being a mandatory reporter, depositions, peer review. The internet or a close friend aren’t exceptions.

        Yes, absolutely frustrating when you are the health professional and I have even read things about cases I have been involved in online and seen the patient lie about what happened. We can’t comment. It’s not ok.

        Really, sort of suprised others disagree and no one seems to agree on this. Really has nothing to do with it being about home birth, could be the same thing if the ER nurse told a detailed story about a baby that died when parents didn’t use a car seat. If the parents could read it and know it was them– that’s a betrayal.

    • mabelcruet

      In what way are they breaching patient confidentiality? There are no names, no locations, no name of hospital or medical centre, and the stories are relatively vague without specific or unique identifiers.

      This is what Dr Tuteur refers to as babies being buried twice-buried once by their parents following the actions of these people, and then buried again by those people, and people like you who deny their baby’s existence by suppressing any discussion of them.

      • Susan

        “and people like you who deny their baby’s existence by suppressing any discussion of them”

        Wow.

    • Dr Kitty

      FWIW
      Even when publishing a case study in a journal, patient permission isn’t required as long as the patient is adequately anonymised.

      You absolutely can discuss patients provided that the totality of information provided is not enough to identify them.

      • Susan

        My feeling is that many of the stories, if the patient herself read it, she would know one of her nurses wrote it and recognise herself in it. Maybe that isn’t HIPAA maybe it is but it’s wrong in my book. I don’t care if it’s a story about a drug baby, a car accident, whatever, telling a story about a patient is wrong. Always was, even before the internet. I don’t think that’s burying the baby twice it’s just professional responsibility, sometimes being a professional sucks. Maybe the nurses involved changed the details but I don’t get that feeling reading this. I am not pro homebirth and a labor RN myself. It’s really that I think it makes my profession look bad.

        • mabelcruet

          In the NHS we have Caldicott Guardians who are a statutory requirement in each and every NHS facility, whether hospital, local community, general practice-everywhere. The Caldicott Guardian is mandated to oversee all processes and procedures where access to patient identifiable health data is involved. I was the guardian in a previous role, and discussing cases online where neither the patient, the clinician or the facility is identifiable to another individual is acceptable and well within the guidelines. The patient may recognise him/herself, but if no one else is able to with the detail provided (unless of course the patient breaks confidentiality and tells folk that they were the person in the anecdote) then that is regarded as maintaining confidentiality.

          A lot of health care lessons are learned by sharing data like this-in my own field of pathology, many national reports such as the CMACE/MBRRACE reports (looking into infant and maternal mortality), and CEPOD (looking at adequacy of death reporting), use vignettes to illustrate lessons learned.

        • Daleth

          A patient recognizing herself is not an ethical problem. By definition, you’re not violating someone’s privacy if they recognize themselves, because they already know their own medical information. You’re only violating privacy if SOMEONE ELSE recognizes them (and thus now knows their medical information).

          And I mean, weigh the consequences here: on the one hand, a patient recognizes herself and knows that her doctor or nurse told her story. On the other hand, by telling that story, the doctor or nurse may have enabled other doctors and nurses to save someone’s life.

          Hmm.

    • TsuDhoNimh

      @susan … AS long as you don’t reveal enough to clearly identify the patient, it’s perfectly legal.

      You should hear EMTs and other first responders when they start a stress-reducing bitch session. They are the ones that have to (seriously, it’s in the court records!) shove a midwife out of the way like a hockey player checking a rush on the goal so they can load a dying woman and her as-yet-unborn offspring into the ambulance that should have been called an hour ago. And leave an EMT behind to try to get some sort of patient records from an ass-covering blithering idiot of a “midwife” who doesn’t even know how to keep track if vitals signs on paper.

      We use LOTS of patient anecdotes, case histories and medical records during ski patrol training. Those who might have been present during any particular incident may flinch, but if you aren’t willing to examine exactly HOW that shit hit the fan, you can’t prevent the next incident from going bad on you.

  • The Bofa on the Sofa

    Obviously, these are all just Dr Amy sockpuppets

  • SL27

    My cousin is a NICU nurse, and while I haven’t heard her share the details of any home birth horror stories, she says they probably see at least one a quarter (4 a year) gone bad that end up in the NICU.

    For those who think a home birth is cheaper than a hospital delivery, a NICU stay is way more expensive than a regular 2 day stay.