Thinking about homebirth? Think about this difference between obstetricians and homebirth midwives.

Time for Accountability Words Clock Take Responsibility

Babies die.

The most critical difference between obstetricians and homebirth midwives is their response to these tragic deaths:

When faced with a dead baby obstetricians ask, “How can we prevent this from ever happening again?”

In contrast, homebirth midwives ask, “How can we avoid responsibility?”

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]“I want a bumper sticker that says, ‘Babies Die’.”[/pullquote]

Don’t believe me? Consider the irresponsible, self-serving blather from Jan Tritten, Editor of Midwifery Today.

Remember Jan? She’s the one who presided over the hideous spectacle of homebirth midwife Christy Collins crowdsourcing advice as baby Gavin Michael died.


In the wake of the baby’s death, there was no soul searching about the entirely preventable death of a baby. There was no reflection on what was done wrong and how future tragedies could have been prevented. There was nothing; Tritten simply deleted the multiple posts and comments concerning the tragedy from her Facebook page. She and the presiding midwife tried to bury Gavin Michael twice: first in a small coffin in the ground, then from the memory of anyone who had followed the story.

Her current column gives insight into her ugly fatalism and repulsive lack of concern for anyone but herself and sister midwives.


I remember Marsden Wagner once saying, “I want a bumper sticker that says, ‘Babies Die’.”

Ha, ha, ha. Are you laughing yet?

Although that sounds awful, he was reflecting his experience of frequently appearing as a witness in cases where midwives were being prosecuted for the death of a baby at a homebirth.

Why did Wagner have to appear frequently? Homebirth deaths ought to be vanishingly uncommon — as they are in Canada, where homebirth midwifery is tightly regulated.

He knew full well that many more babies die in hospital birth than homebirth, but these were not the cases that got the attention. The authorities—opposed to homebirth—would bide their time and wait for a baby to die under the care of a homebirth midwife. Then they would pounce on that midwife. It was another great way to deal with “the midwife problem.”

Pro-tip: when comparing the safety of two groups of providers, we look at death RATES, not absolute numbers. The death RATES at homebirth in the US are up to 800% HIGHER than comparable risk hospital birth. The death RATES at homebirth in the US are up to 800% HIGHER than homebirth in Canada.

Are midwives in Canada smarter, better educated, more extensively trained than homebirth midwives in the US? Yes on all counts.

That’s relevant if you care about protecting babies and mothers. Jan is only interested in protecting providers.

Life is a circle. Some babies live only a few months and may pass in utero… Some babies live 10 years, some live 80 years, but all will pass into the next world.

Ho, hum, babies die. How dare anyone try to hold homebirth midwives accountable?

Tritten’s lackadaisical attitude toward dead babies isn’t merely a betrayal of homebirth clients, it’s a betrayal of the long, proud tradition of midwifery.

There have always been midwives. Ever since our ancestors acquired the ability to walk upright, human childbirth has been fraught with extreme risk to both mother and baby. The first midwives were those who recognized that assistance in childbirth can minimize those risks.

Above all, ancient midwives were empiricists. Their very existence was predicated on the inherent dangers of childbirth and everything they did was devoted to preventing death and injury. They abjured magic incantations in favor of empirical observation. They noted what worked and what did not and faithfully strove to incorporate those scientific observations into practice. They didn’t simply throw up their hands and declare, “Babies die.”

Why would Tritten and other homebirth midwives betray the ideals of midwifery? Because they aren’t really midwives; they are women who can’t be bothered or lack the intellectual ability to complete real midwifery training. They are birth hobbyists who want to be paid as if they were real midwives, who want to be respected as if they were real midwives, but absolutely refuse to be held accountable as if they were real midwives.

It’s no different than if your neighbor decided she was qualified to declare herself a surgeon because she watched multiple seasons of the TV show Grey’s Anatomy. It’s no different from that neighbor insisting — each and every time someone died from botched surgery — that patients died from surgery in the hospital, too.

Which would you prefer, a real surgeon who cared whether or not her patients died and tried to prevent future deaths, or a self-proclaimed surgeon whose chief concern in the wake of a preventable death was to avoid blame for it?

Thinking about homebirth? Which do you prefer, a real midwife who cares whether or not her patients die and tries to prevent deaths, or a self-proclaimed midwife who cares only about avoiding responsibility?

Yes, sadly, babies die, but the critical difference between obstetricians and homebirth midwives is that obstetricians are desperately trying to reduce infant deaths while homebirth midwives prefer to pretend they’re inevitable.

Whom do you trust with your baby’s life?