Who’s to blame when a baby dies at homebirth?

who is to blame question

A mother puts Mountain Dew in her baby’s bottles, by age 2 the child is suffering massive tooth decay. Who’s to blame?

Most of us would have no qualms about blaming the mother who put the soda in the baby’s bottles. The mother did not intend that the child’s teeth should rot, but she bears responsibility nonetheless.

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]There’s nothing beautiful about the preventable death of a baby.[/pullquote]

A mother fails to put her toddler in a car seat for a trip to the grocery store. Along the way the car is hit by another driver, the baby is ejected through the windshield and dies on the pavement. Who’s to blame?

Most of us would have no qualms about blaming the mother who failed to put the child in a car seat. The mother did not intend for the toddler to die, but she bears responsibility nonetheless.

A mother decides to give birth outside the hospital despite having a history of two previous C-sections. Her uterus ruptures during labor and the baby dies. Who’s to blame?

According to homebirth advocates: no one.

Terall was hoping to have a natural birth since both of her sons were c-section births and extremely hard on her body. Terall did the research and found the perfect Birthing Center for her. They respected her birthing plan and she was confident in the facility… On her due date, 12/28, she went into labor at the center. Her contractions became more severe. In the midst of a contraction Terall felt a huge burst in her stomach…there was an excruciating pain that never went away…almost like a constant contraction. Something was severely wrong.

…[W]hen the midwife checked their son’s heartbeat there was none to be found. Terall was rushed by ambulance to the closest hospital…but it was too late. Terall’s uterus ruptured due to scars from her previous c-sections and dislodged the baby and the placenta causing their son to lose oxygen and blood flow. Terall was rushed into the operating room to stop her internal bleeding…

Who’s to blame?

The mother feels guilty:

…She said “I am so sorry. I thought I was making the right choice, I thought having you naturally in a tub, without drugs would be best. I wanted you to hear beautiful music when you entered this world. I didn’t know, sweetie….

But instead of accepting responsibility for choosing to attempt a VBAC outside of a hospital, she  blames those who performed her previous C-sections:

I didn’t know that having c sections with your brothers would come back to haunt me and ultimately kill you. I didn’t know my scar tissue was going to rupture and force you out of my womb…. Mommy didn’t know… I didn’t know. I will always love you my perfect boy. I am grateful for Love Song, Memories fade and this…these photographs will be all I will ever have of my baby.”

From the comments:

You are not to blame; it wasn’t something that you saw coming!!


This was NOT your fault, it wasn’t because you choose vbac. You choose the option you thought wss safest and had the lowest risks. Please do not blame yourself for doing what you thought was best.


Please do not allow the enemy to to fill your mind with lies. This is not your fault.

I shared the story on my Facebook page under the comment “Another baby who didn’t have to die” and got this in response:

Your … a piece of shit for taking this beautiful sad story and turning it into propaganda. Things happen. I feel terrible for the loss of this family. But, this ob is a shitty person who needs to have her license revoked vbac is common it has its risks just like any birth. I fully plan on vbac with my next.

There’s nothing beautiful about the preventable death of a baby whether that death occurs at homebirth or when a child is ejected through the windshield during an accident. I suspect that the same people who are counseling this mother not to blame herself because she “didn’t see it coming,” would not be so sanguine about the dead child ejected through the windshield. Obviously that mother didn’t see that coming either, but that would not have absolved her of blame.

What does it mean to blame someone for a bad health outcome?

A 2015 paper, Who can blame who for what and how in responsibility for health?, attempts to answer the question.

The concept of personal responsibility for health forms part of the political and philosophical landscape of professional health care, and yet it is poorly understood. Responsibility can be presented as a tripartite concept consisting of (1) a moral agent having (2) responsibilities understood as obligations and (3) being held responsible for them, that is being blamed in failing to meet them.

In the case of the child with rotten teeth, we believe that her mother is a moral agent who shirked the obligation of protecting the child’s teeth by putting Mountain Dew in baby bottles and should be held responsible for the massive tooth decay.

In the case of baby who died on the pavement, we believe that his mother is a moral agent who ignore her obligation of protecting the child by putting him in a car seat and should be held responsible in part for the child’s death.

What’s supposedly different about homebirth?

It can’t be that homebirth supporters believe that the mother is not a moral agent. And it can’t be because they believe the mother has no moral obligation to consider the baby’s survival; these are the same folks who experience spasms of indignation over women who don’t attend assiduously to prenatal nutrition.

It can’t be the fact that the mother never anticipated the outcome. The mother who failed to put her baby in a car seat for a trip to the grocery store never anticipated that she would be involved in an auto accident along the way.

The problem seems to occur for homebirth advocates in connecting the failure to meet obligation to responsibility for the outcome. Yes, the mother had an obligation to consider injury or death of the baby as a consequence of her choice, but, uniquely in this situation, we aren’t supposed to blame her for ignoring that obligation.

But the attempt to assert that the mother is not responsible when a baby dies at homebirth is deeply undercut by the notion that she deserves praise if the VBAC attempt is successful and the baby survives. Praise is the flip side of blame. In order for someone to be eligible for praise in the healthcare setting, they must be acknowledged to be moral agents with healthcare obligations that they have fulfilled. Therefore, they must be eligible for blame when they fail to fulfill those same obligations.

So who’s to blame when a baby dies at homebirth? The mother is to blame … no matter how desperately homebirth advocates wish to pretend otherwise.