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Who cares about the babies who die at homebirth?

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Bitter grief is often an unselfish motivator.

Consider organizations like Mothers Against Drunk Driving, started by parents who suffered the ultimate loss, to ensure that other parents would not have to endure the death of a child. Consider the various laws named after children who were abducted and murdered, championed by parents who wanted to make sure that no other family’s life would be shattered by crushing grief. Consider websites like Love, Light, Laughter and Chocolate – One Mom’s Journey where a mother shares her excruciating grief at the loss of her beautiful daughter Meghan in an effort to prevent other children from dying by pulling down heavy furniture on themselves.

Where is the organization to ensure that no other mother has to endure the preventable death of a child at homebirth?

There is no such organization.

Why? Because the mothers who have lost a child to a preventable homebirth death often collude in protecting the very individuals who have contributed to or caused that death.

It’s quite remarkable when you think about it. It’s not because of guilt over the deaths, since many campaigns are started by women like Meghan’s mother who feels terribly guilty that she did not bolt the heavy furniture to the wall. Yet she is willing to admit to and confront that guilt in an effort to save your child.

What’s even more remarkable is that not only do most homebirth loss mothers fail to make any attempt to prevent future infant deaths at homebirth, they work hard to prevent any homebirth midwife from being held responsible for the actions that led to the death. They refuse to participate in prosecution or disciplining of the individual midwife involved; they refuse to testify against their midwife; they actively oppose any attempt to restrict homebirth midwives’ scope of practice; and they promote increased licensing and reimbursement for obviously incompetent practitioners.

Why the big difference? I suspect that its because homebirth is an integral part of the self-image of homebirth mothers. Meghan’s mother Kim is wracked with guilt that she did not bolt the heavy dresser to the wall, but she recognizes that if she had realized the danger, she would have done; now she wants other mothers to recognize the danger before a tragedy occurs. In contrast, homebirth mothers have been told repeatedly by relatives, friends and medical professionals that homebirth poses a real danger of death to their baby, and they have denied, or even embraced that danger in an effort to bolster their self image within a community of like minded believers. To admit that homebirth led to the preventable death of the baby is to admit that they weren’t educated at all; that rather than being special for choosing homebirth, they’ve marked themselves as gullible and selfish.

Homebirth mothers are different from other mothers in another important way. Homebirth is about them, their needs, their desires, their self-image. The baby is nothing more than a prop in a piece of performance art. Given the choice between protecting the star or the prop, homebirth loss mothers usually choose to protect themselves.

Why can’t they hold homebirth midwives accountable? Homebirth midwives lack the education and training to provide actual medical care; indeed many boast that they fully intend to do nothing at the birth. Their primary function, then, is praising the mother for her outstanding performance. Holding the midwife accountable will inevitably turn a source of support into a source hostility and many homebirth mothers are so desperate for praise that they crave it even from the women who let their babies die.

Think about just how aberrant and abhorrent that it. Can you imagine the mother of a child who died because someone drove drunk praising the decision to drive while intoxicated and refusing to testify against the perpetrator? Can you imagine the mother of a child who died at the hands of a sexual predator advocating for the freedom of sexual predators to follow their urges? Can you imagine the mother of a child who died after pulling down a heavy piece of furniture on herself announcing that “death is a part of life” and “some children are just meant to die”?

No, I can’t, either. Yet time and time again I have read and written about homebirth loss mothers praising deadly midwives, praising the “experience” of a vaginal birth of a dead child, refusing to cooperate in disciplining the midwife responsible, advocating for more “freedom” for homebirth midwives, and, most grotesque of all, choosing to risk their next child’s life by having a homebirth.

Who cares about the babies who die at homebirth?

No one, apparently. Certainly not the mothers who insist that they “would do it all again even knowing the outcome.” Certainly not the mother’s friends who brazenly insist that no one should publicize even public stories of homebirth death in order to “protect” the mother. Certainly not the midwives who make no attempt to learn from their mistakes. Certainly not the homebirth midwifery establishment, which is actively engaged in a campaign to hide homebirth deaths by refusing to release their own statistics.

I am fortunate to know a few brave women who are working privately to prevent any mother from experiencing the devastation of the homebirth loss that they experienced. They are working without benefit of lobbyists, support groups or donors. They are working, despite the pain, to make sure that other mothers never experience that same pain.

There is one other person who cares about the babies who die at homebirth: me. That’s the primary reason why I started the predecessor of this blog nearly 7 years ago, and why I maintain it to this day. I fervently believe that most babies who die at homebirth did not have to die. I fervently believe that American homebirth midwives shouldn’t be taking care of houseplants, let alone mothers and babies. I fervently believe that homebirth advocates dupe women into risking their own babies’ lives because they are desperate for validation. I also fervently (and probably naively) believe that when the American public becomes aware of the death toll that homebirth midwifery organizations are strenuously trying to hide, there will be consequences.

I would not describe myself as selfless since the fact is that I cannot stop myself from doing this. I am angry that women opt to risk their babies’ lives by choosing incompetent American homebirth midwives; I’m angry that American legislators have been duped into licensing these woefully undereducated and undertrained self-proclaimed “midwives” believing that they are no different from midwives in the rest of the world; I am angry that homebirth celebrities and industry leaders, many of whom are just as aware of the appalling death toll of homebirth as I am, are deliberately hiding their own data.

It is my concern for these babies and my anger toward those who cause and promote their preventable deaths that motivate me. That’s why people who like to write me profanity laced emails, post profanity laced comments, and generally deride me are simply wasting their time. I really don’t care what you think of me, because it’s hard for me to respect the assessments of those who are more interested in a mother’s self-image than a baby’s life.

I care about babies who die at homebirth, and the regular readers of this blog do, too. Now if we could only get everyone else to care, perhaps we could put an end to needless, preventable infant deaths.

Homebirth midwife: “I’ll be honest, I’m not really into the baby.”

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Over the years I’ve written many damning things about homebirth midwives, but nothing as damning as what they write about themselves. My central contention about American homebirth midwives (CPMs) is that they are under educated, undertrained hobbyists who care more about their experience than whether the baby and mother are injured or die. Along comes Birth Junkie to corroborate my claims.

On her Tumblr blog, she actually writes, with apparently no insight at all:

I’ll be honest, I’m not really into the baby… It is the process, the journey and watching a mom did [sic] deep into the depths of her soul that touches my tears …

She’s not really into the baby. Duh! That’s practically part of the definition of a homebirth midwife, a woman who attends births for the experience … her own experience that is. The baby, as in most homebirths, is just a bit player.

Of course we already knew that when she labeled herself Birth Junkie.

What is a birth junkie and why is she obsessed with other women’s births?

Many if not most homebirth midwives, doulas and, sanctimommies are quick to tell everyone that they are “birth junkies.” They consider it a boast, but in reality, it is evidence of serious shortcomings…

Being obsessed with birth, one’s own births and the births of others, is pathological. And being a birth junkie has nothing to do with birth, with babies and certainly has nothing to do with helping other mothers. The women who are birth junkies suffer from a crippling lack of self-esteem. Their only “achievement” is the faux achievement of having an unmedicated, and preferably an outlandish, birth…

Homebirth midwives are just birth junkies who took it a step further…

Most have no interest in a real midwifery program because being a birth junkie is not about birth and has nothing to do with preventing and managing complications. It’s all about them and their constant need for validation…

Birth Junkie elaborates:

I’m a Home Birth Midwife who loves the journey. Sometimes, I love the journey a wee bit more than the destination, even when it brings me to my whits ends and onto my knees. And when I hit a destination where the light shines in just the right way… and the clouds part in that perfect place… Its the same feeling I get when a baby is being born – a feeling of balance. the ‘both and’. all the parts becoming whole – Its like great art. I get this strong feeling inside that there is undeniably something bigger than me creating… and then ahhhh… my heart opens up, my tears are touched and I settle. I settle warm and safe into my body, with a huge shit eating grin on my face.

I, I, me, me. Nothing about babies or mothers because they are like needles and tourniquets to a real junkie: nothing more than props required to deliver the fix.

Birth Junkie helpfully counsels others:

You don’t need ANY of my degrees to become a home birth midwife. If you are in America, you can become a Certified Professional Midwife (CPM) the way I did it and learn everything you need to know in your hands on training…

In other words, you don’t need to know ANYTHING to become a homebirth midwife.

In addition to self-absorption and ignorance, it helps to fetishize the placenta by eating it, making art from it and encapsulating it. Don’t miss Birth Junkie’s post about placenta prints to view this inanity in all its glory.

Birth Junkie’s entire website is an exposition of birth porn. The better part of the last two centuries have been spent attempting to convince men that women are more than two breasts and a vagina, but Birth Junkie’s blog is decorated with pictures that reduce women to nothing more than breasts, vagina and a pregnant abdomen. Interestingly, there are precious few picture of babies, but I suppose that’s because she’s not really into the baby; she’s into her “journey.”

To anyone thinking about a homebirth, ask yourself this:

Are you into the baby?

If so, why would you hire an undereducated, undertrained, self-proclaimed “midwife” who wants to attend your birth to get her fix, not to make sure that you and your baby are safe?

Homebirth midwives are clowns, not health care professionals. Health care professionals have an ethical obligation to put your welfare and the welfare of your baby ahead of their personal needs.

I understand that a homebirth midwife bolsters many women’s fragile self-esteem by praising her as strong and “educated,” but is anyone’s self esteem so fragile that it is worth risking her baby’s life to get meaningless “you go, mamas” from a stranger who thinks your baby’s birth is all about her?

All I really need to know to be a homebirth midwife I learned before kindergarten

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I propose a new motto for homebirth midwives:

All I really need to know to be a homebirth midwife I learned before kindergarten.

By the end of kindergarten, most children recognized that their thoughts do not have the power to affect events. Homebirth midwives never learn this. They actually believe that “affirmations” can affect outcomes.

By the end of kindergarten, most children recognize that there is a very great deal that they do not know, but need to learn. Homebirth midwives never learn this.

By the end of kindergarten, most children learn that defying authority is not worthy of praise in and of itself. Homebirth midwives never learn this.

By the end of kindergarten, most children recognize that when you are caught red handed with the disaster that you created, shouting “It’s not my fault” doesn’t get you off the hook. Homebirth midwives never learn this.

By the end of kindergarten, most children realize that there are far more important things in life than getting the “experience” you desire. Homebirth midwives never learn this.

By the end of kindergarten, most children expect that there are consequences for hurting others, whether or not you “didn’t mean it.” Homebirth midwives never learn this and actually insist that they are being “persecuted” when held to the same standards as everyone else..

Homebirth 2012: death toll and more

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Thinking about homebirth?

Think again.

All the women below thought homebirth was a great idea, their bodies were “made to birth” and they were “educated” and their midwives were competent. They were wrong, and you might be wrong, too.

Is this fear-mongering? Damn straight it is! Only a fool doesn’t fear and respect the risk of death in childbirth.

It’s time for my annual review of homebirth, and this year the death toll is higher than ever before. I’m not sure if it’s because the death toll from homebirth, already triple that of comparable risk hospital birth, has risen further, or because homebirth tragedies receive more publicity, but both the news and my email inbox were filled with an extraordinary number of homebirth deaths.

Below are 23 cases of neonatal death at homebirth, plus one case of profound neonatal brain injury. Every single one of the deaths was preventable in a hospital setting. There were also 2 maternal deaths; at least one and probably both were preventable in the hospital setting.

These are just the highlights. There were additional cases of homebirth resulting in profoundly brain injured newborns that aren’t mentioned in this review.

Neonatal deaths

Another homebirth horror story
Unassisted birth of a single footling breech. Baby born dead

A medical student learns about homebirth
Mother attempting homebirth transferred to hospital and refused medical interventions. After ultimately agreeing to a C-section, baby was born profoundly brain injured and died.

I would do it all again … even knowing the outcome
Mother “cherishes” the attempted homebirth of a single footling breech, despite the cord prolapse that led to the baby’s death.

Just watched a newborn die in front of my eyes.”
EMT called to a homebirth when midwife could not resuscitate the baby. The baby died in front of his eyes.

Multiple homebirth deaths, endless regrets
1. Fetal distress, transfer to the hospital, baby dead.
2. Fetal distress, transfer to the hospital, baby dead.
3. Baby born severely compromised, ultimately died
4. Shoulder dystocia resulted in a dead baby.
5. Florence’s homebirth was “perfect,” except, perhaps, for the part where she died.

Denial: for homebirth advocates it’s not just a river in Egypt
Fetal distress not diagnosed by midwife; baby unexpectedly born dead.

This week in homebirth deaths
1. Homebirth; baby died of sepsis.
2. Hemorrhage during labor; baby died.
3. Baby died 2 days after homebirth.

Dr. Biter presides over a homebirth death
Prolonged labor, chorioamnionitis, baby dead already dead when mother transferred to the hospital.

Third homebirth death in North Carolina
Four days of labor, mother transferred to the hospital, baby dead.

Ever more homebirth deaths
1. Mother and midwife ignored the fact that the baby turned blue in the hours following birth; baby died of overwhelming sepsis the next day.
2. Fetal distress, transfer to the hospital, baby born dead.

Jailed midwife yet another example of why the CPM credential must be abolished
Mother and baby transferred to the hospital 6 days after homebirth. Baby had bleeding in the brain and retinas. Mother had a major infection because the placenta had not yet been delivered.

It was an awesome experience … too bad the baby died
Mother still believes her experience was “awesome” even though the baby was born unresponsive and ultimately died.

Yes, it is your fault that your baby died at homebirth
Midwife failed to diagnose fetal distress. Baby unexpectedly born dead.

Latest in homebirth deaths plus a near miss
1. Baby died after delivery from the breech position by a midwife whose license had been suspended.
2. Baby died of overwhelming Group B strep sepsis.

Two more homebirth deaths
1. Attempted VBAC at home, uterine rupture, baby died.
2. Fetal distress, transfer to the hospital, baby already dead.

Maternal deaths

In Australia: No choice?
In England: Mother bleeds to death at homebirth, but at least she had “a really lovely spontaneous birth”

Homebirth in the scientific literature

Two new studies show increased risk of death and serious complications at homebirth
Cochrane Review on homebirth is a piece of garbage
Cochrane Review, already noted for childbirth reviews riddled with statistical errors, claims that homebirth is safe based on one study of 11 women.

Homebirth in the news

The death toll of California homebirth
First rally for homebirth safety
Idaho midwives responsible for 3 neonatal deaths pay $5 million for a fourth disaster
Brilliant series on the dangers of homebirth
No wonder Colorado homebirth midwives hid their 2010 death statistics
Homebirth in the Daily Beast
Coroner: Homebirth deaths at Lisa Barrett’s hands were entirely preventable

Midwifery Today, a journal of buffoonery

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Are you thinking about having a homebirth with an American homebirth midwife?

If so, ask yourself if you really want to entrust the life of your child and yourself to a woman who “learns” how to manage life threatening complications from the “hints and tips” of other homebirth midwives?

Consider the following from the Facebook page of Midwifery Today, the premier publication of American homebirth midwives:

Can you share your favorite tips for stopping hemorrhage?

The next theme for Midwifery Today magazine, the print edition, is on Hemorrhage. We would like to include your favorite Tricks of the Trade to stop or prevent hemorrhage, in her pages. Could you reiterate (I know some of you have mentioned them before,) this time for possible publication in the magazine. Be a published author!

Postpartum hemorrhage is a life threatening medical emergency. There is a large body of scientific literature on preventing and treating postpartum hemorrhage. Moreover, there is consensus on best practices including the Obstetric Hemorrhage Toolkit, described as:

… [A] resource for health care providers to improve readiness, recognition, response and reporting of hemorrhage. Obstetric hemorrhage is a leading cause of pregnancy-related morbidity and mortality but has major opportunities for improved outcomes.

The folks at Midwifery Today either don’t know about the consensus on preventing and managing postpartum hemorrhage or plan on ignoring it in favor of unproven “hints and tips” from other homebirth midwives, as if a postpartum hemorrhage were the equivalent of a pesky wine stain on a tablecloth.

The editors and publishers of Midwifery Today are not the only buffoons. Consider the “tips” provided by the midwife respondents.

Amanda: If the placenta has not yet been delivered the cut end of an umbilical cord and also the amniotic sac have a higher natural oxytocin content than the placental tissue itself.

There is no evidence that ingesting any part of the placenta, umbilical cord or membranes can prevent or treat postpartum hemorrhage. Moreover, even if oxytocin were present in these materials, it would not survive the acid in the stomach. That’s why pitocin is given to women in an IV, not by mouth.

Amy: Prayer!

Really? REALLY??!!

Shari: I have heard cypress oil rubbed on belly directly over the uterus.

Sure. And the mechanism of action is ….??

The stupidity goes on and on:

Katie: Always keep my homeopathic phosphorus and secale around…

Lorinda Mae: lots of excellent suggestions already, but what has worked for me is CHLOROPHYLL.

And my personal favorite:

Ely: Someone mentioned chewing a hard cinnamon candy and blowing it in mom’s direction.

This is what passes for knowledge among American homebirth midwives, and this is what is being solicited by the premier homebirth midwifery journal in place of scientific evidence and consensus on best medical practice.

Sure, you may want a homebirth, but are you really willing to risk the life of your baby and yourself by hiring these clowns?

Yes the baby died, but my homebirth midwife was awesome

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Another homebirth, another dead baby, another loss mother proclaiming that her midwife was really, really nice to her.

In this particular case it is not clear whether baby Sarah would have survived had the mother been under the care of an obstetrician, since the baby may or may not have had congenital anomalies; but there is no question that the baby would have had a much better chance of surviving if her mother had had appropriate care for a postdates pregnancy and an ultrasound that had revealed any potential problems that might have been addressed in a timely fashion.

Be that as it may, the story shares the defining characteristic of many homebirth loss stories; the mother defends the midwife. And the key point always seems to be that the midwife was really, really nice.

You know what? Hour long appointments are medically useless. They don’t prevent death or disability; they don’t improve recognition of deviations from normal; they don’t accomplish anything besides stroking the ego of the mother.

Reading between the lines, it seems likely that the midwife dismissed the value of the tests that she discussed. All prenatal tests are reliable. That’s why they are part of the standard of care in the first place. Are they accurate? Yes, they are quite accurate for what they are designed to do. Screening tests, like the serum AFP (alphafeto-protein) test are able to distinguish betweeen those babies at risk for a neural tube defect and those who are not at risk. Diagnostic tests like amniocentesis and ultrasound are highly accurate at diagnosing abnormalities. What decision would a mother be willing to make based on what she knew? Even women who would not terminate a pregnancy under any circumstances can obtain valuable information about the baby that may dramatically increase the baby’s chance of survival in the face of an abnormality.

It’s not merely “possible” that testing would have revealed anomalies; it’s virtually certain. Early tests and late tests would certainly have revealed spina bifida if Sarah did indeed have it. Screening ultrasound would have revealed any additional abnormalities. A routine non-stress test and biophysical profile at 41 weeks may have revealed that Sarah was dying and offered the opportunity to save her life.

If all this seems familiar, it is because it is. I’ve lost count of the many times I’ve written about babies who died completely preventable deaths because the homebirth midwives involved were grossly incompetent. Indeed, just this week I wrote about a woman whose midwife left her in active labor to go shopping (!), who returned to deliver a lifeless baby that nearly died during a shoulder dystocia, yet the mother was fulsome in her praise of the irresponsible and possibly incompetent midwife.

There are some who suggest that this is a form of Stockholm Syndrome, where an abused person becomes emotionally attached to the person who has kidnapped or otherwise harmed them. I suspect it is something different. Although it appears that the mother is defending the midwife, she is really defending herself and her choice of homebirth. To acknowledge that the midwife was irresponsible, undereducated or incompetent is to acknowledge that the mother, far from being “knowledgeable” about finding a competent provider, had actually been clueless when it came to determining the midwife’s skills. To acknowledge that the midwife failed to prevent or even contributed to the baby’s ultimate demise is to acknowledge that homebirth is just as dangerous as 99% of American women believe it to be.

The emphasis on how nice the midwife has been is no coincidence, either. Homebirth is about risking the baby’s life for the mother’s birth “experience” and that experience starts during pregnancy. Who wouldn’t enjoy a provider who repeatedly congratulated you on your “education,” your “strength” and your “inner wisdom”? Most people realize, however, that prenatal care is not about being patted on the head, but rather its purpose is to ensure a healthy baby and a healthy mother. A “nice” midwife might enhance a woman’s fragile self-esteem, but it won’t do anything to save a baby dying a preventable death.

That’s why I have the greatest respect for women who have endured the horrific experience of losing a child at homebirth who didn’t have to die and are able to take a clear eyed look at what and who led to the preventable death. Homebirth loss mothers who speak out about the incompetence of homebirth midwives face terrible treatment within the natural childbirth community and they are very brave to persevere in spite of that treatment. Yet they are braver still to be able to overcome a far higher hurdle: the acknowledgement that their choice (often made with the best of intentions) was wrong, that they were not “educated” and that their intuition let them down when they needed it most. These women are a small, but unfortunately growing, group. Instead of protecting themselves and their egos they are still mothering the child they lost by standing up for him or her, making sure that others do not forget, and alerting women to the very real dangers of homebirth.

A woman’s virtue is not in her vagina

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For most of human history a woman was judged by her vagina, specifically what went into it.

As in the rest of the animal world, the male human’s greatest fear was of being cuckolded, raising another male’s child as his own. Hence the elaborate attempts to ensure virginity and fidelity, ranging from female genital mutilation to chastity belts, to burqas to honor killings. Women have been cut, confined and crushed, both literally and figuratively, in order to insure that their vaginae were not breached by any man besides their husbands. That extended even to forced sexual violation. Even today, women who are raped are married off to the rapist to preserve her “honor” or killed by the male members of her own family to preserve their honor.

In the past hundred years women have increasingly discovered what Sohaila Abdulai explained in a recent op-ed piece in The New York Times. Writing in the wake of a horrific gang rape in India that resulted in the death of a young medical student, she proclaims what should be obvious to everyone. Rape is horrible because it is a violation:

It is not horrible because you lose your “virtue.” It is not horrible because your father and your brother are dishonored. I reject the notion that my virtue is located in my vagina …

Here in the US we have undoubtedly made progress in divorcing a woman’s virtue from her vagina. That’s why it is very disturbing to find a group of women who continue to insist that women’s honor resides in her vagina, specifically what comes through it. Natural childbirth advocates have located women’s fulfillment and authenticity in her ability to push a baby out through her vagina. It is precisely this fetishism of the vagina that is responsible for the central tenets of natural childbirth advocacy, including:

  • the veneration of process (vaginal birth) over outcome (healthy mother and baby)
  • the insistence that vaginal birth is better for babies
  • the desperate search for purported advantages in vaginal birth, ranging from supposed decreases in everything from chronic diseases to tooth decay
  • an obsession with lowering the C-section rate
  • a rejection of the autonomy of women who prefer C-sections
  • hideous lies about the effects of C-sections on woman’s ability to bond with her baby
  • the bizarre concepts of birth rape and obstetric “violence”

These ideas, which are central to natural childbirth advocacy, locate a woman’s virtue in her ability to pass a baby through her vagina, and her “shame” in being unable or unwilling to do so.

It is hardly surprising that the originators and greatest proponents of the philosophy of natural childbirth, Grantly Dick-Read, Fernand Lamaze, Robert Bradley and Michel Odent, were and are men eager to trap women in traditional gender roles. It is deeply distressing to me, however, that most contemporary natural childbirth advocates are women, wittingly or unwittingly seeking to trap women in traditional gender roles.

A woman’s virtue is NOT located in her vagina. She is not at her most authentic and fulfilled by pushing a child through her vagina. And no woman should ever be shamed into thinking that being unable or unwilling to push a baby through her vagina is a failure.

There is no honor in vaginal birth and it is despicable for anyone to insist that there is.

Thank goodness I chose homebirth for the shoulder dystocia that nearly killed my baby

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I’ve always believed that there is no limit to which a homebirth advocate will not go to rationalize her decision to have a homebirth. Now I’ve had that belief confirmed.

A woman whose son suffered a severe shoulder dystocia, was born lifeless, waited 25 minutes for an ambulance and had to endure cooling therapy to preserve his brain function and may have sustained developmental impairment is actually crowing that it was the decision to give birth at home that saved his life.

When I first got examined by a midwife at home when my contractions started I was just 1cm dilated. I was in alot of pain but as this was my first baby obviously we all thought I would have hours and hours to go until things moved along.

… [O]ur homebirth midwife went off to do her Christmas shopping while we waited for things to progress.

So much for one on one midwifery care.

… just 10 minutes after rose had left my waters broke. Daniel had noticed mec in the waters which meant I would need to go to hospital to give birth. He rushed downstairs to call the midwives. I had started to get the urge to push and couldn’t stop. Ten minutes later a midwife arrived to examine me and saw that I was pushing Freddy’s head out. Rose arrived and they both realized that this baby was coming and coming fast! They told Daniel to call an ambulance.

Then disaster struck:

… Freddy’s head was out, he was stuck and he was lifeless. An ambulance from Sandhurst was dispatched and on their way. Sandhurst was over 30 minutes away.We were on our own.

The midwives struggled to deliver the baby for 5 minutes and finally he was born.

All of a sudden I felt release. The pain had gone and I felt a them place a lifeless 9lb 2 Freddy on my tummy just 28 minutes from when I got out of the bath. one of them shouted. The cord is snapped clamp it clamp it.!!!!!

Then for 15 minutes …..silence. I had my eyes closed. I felt the panic but I truly can’t remember alot.

In those 15 minutes Karen had scooped the mec out of Freddy’s mouth with Daniel’s T-shirt… Rose and Karen began to perform CPR on Freddy. …….Nothing. He was gone. They kept going and going and going. ….Nothing. I was laying on the bed crying, bleeding and in shock while they pressed on my precious baby’s chest and blew air into his tiny mouth.

The EMTs managed to resuscitate the baby. At the hospital he was subjected to hypothermia (cooling) therapy to preserve as much brain function as possible.

In a spasm of blithering idiocy, Freddy’s mother believes that the homebirth saved his life.

If we had opted for a hospital birth-

I would of got out of the bath, gone upstairs and my waters would have broken.

Daniel would of tried to move me as he knew I would have needed to got to hospital but I was in so much pain pushing I could not be moved. He would have called the ambulance……..No ambulance.

It would have been up to Daniel to try and deliver Freddy. There would have been no midwives to perform the McRoberts maneuver, to clamp Freddy’s cord, to perform CPR on him for 20 minutes.

Daniel would of tried to get him out. He would have told me to keep pushing. He wouldnt of known his shoulder was stuck. He wouldn’t know how to release it. Freddy would have still been inside me apart from his head when the ambulance arrived. He would have died and I would have probably died too.

It’s as if someone who was ejected from a car while driving drunk and unbelted shortly before the car burst into flames were crowing that it was the fact that he was drunk and unbelted that saved his life. Yes, that he was ejected and was not in the car when it exploded may have saved his life, but it was the decision to get into the car in the first place that nearly ended it. The assumption that the crash would have occurred in the absence of being drunk is completely unwarranted.

Similarly, it was the decision to choose homebirth in the first place that led to the events that nearly killed the baby. If Freddy’s nother had opted for a hospital birth she would have headed to the hospital when she began experiencing severe pain. Since her labor progressed so quickly, she would have been far along in labor by the time she arrived at the hospital. Had the mother been under the care of a remotely competent provider in a hospital setting, it is quite possible that the shoulder dystocia would have been resolved more easily, the resuscitation started sooner, the need for cooling therapy averted, and the as yet unknown long term damage to this child’s brain would never have happened.

Once again a mother who chose homebirth for no better reason than her “experience,” risked her baby’s life, nearly killed him, subjected him to prolonged oxygen deprivation and may have sentenced him to a lifetime of developmental disability is now trying to justify that choice. Pretending that it would have been worse if she had chosen hospital birth is like pretending that it would have been worse to drive sober and belted. In both cases, there is every reason to believe that the disaster would have not happened in the first place had a different choice been made. It defies comprehension that anyone could pretend otherwise.

Dear Childbirth Connection …

Dear Childbirth Connection

The email is entitled Reducing the c-section rate could save $5 billion annually and it was sent out by the Childbirth Connection, a group that lobbies on behalf of “natural” childbirth professionals like childbirth educators, doulas and midwives.

According to the email:

…For the benefit of public health – for the 4 million women who give birth every year…

What is at stake for payers? Not only do unwarranted c-sections create greater health risks for women and babies, this study shows that they also dramatically increase costs for employers and, through Medicaid programs, state and federal budgets. Medicaid programs paid nearly $4,000 more for c-sections than vaginal births, while for commercial insurers the difference topped $9,500…

Here’s my response:

Dear Childbirth Connection,

I’d like to reduce the C-section rate and associated expenditures. Please tell me exactly which specific C-sections of the more than 1 million performed last year are the unnecessary ones.

You do know, don’t you? Otherwise you wouldn’t blithely advocate that obstetricians reduce the C-section rate arbitrarily because that would result in preventable perinatal deaths, right? So don’t wait, tell me because I am breathless with anticipation. I, like most obstetricians wish I knew in advance which C-sections were unnecessary and which were not. You think you know so please share your incredible insights with the profession.

Wait, what? You have absolutely no idea which C-sections are necessary or unnecessary except in hindsight? And you have no intention of taking responsibility for determining which C-sections are unnecessary?

What methods have you developed to determine in advance which C-sections are unnecessary? None, you’ve developed none. Well it is a tough problem to solve, but surely you’ve spent millions supporting studies that will answer that question. What? You haven’t spent a penny researching methods to determine in advance which C-sections are definitely life saving and which are not?

Okay, but surely you’ve been researching technology that will demonstrate which babies will have shoulder dystocia, which breech babies will have trapped heads, and which babies aren’t getting enough oxygen. What? You haven’t spent a penny on that, either.

So let me get this straight:

The Childbirth Connection has absolutely no idea which C-sections are necessary and which are unnecessary, but they are sure that too many unnecessary C-sections are being done?

Why should we pay any attention to people who bleat about a problem they make no effort to solve?

And while I’m asking questions, I have a few more. Your letter claims:

…Maternal infections, prolonged pain, life-threatening complications, and childhood chronic illnesses…

First of all, there is no evidence that C-sections cause chronic childhood illnesses. I realize that the folks at the Childbirth Connection are desperately hoping that is the case, because then they could brandish it against those who point out that C-sections save literally tens of thousands of lives each and every year. But since is hasn’t been proven, why are you pretending that it has?

Second, how many lives are saved by C-sections and how many might be lost by arbitrarily aiming for a lower C-section rate. Let me guess: you have no idea about that, either.

You write:

The World Health Organization recommends a c-section rate of 15% or less for any country.

That’s not true, either. The WHO withdrew that recommendation more than 3 years ago, acknowledging that there had NEVER been any data to support ANY specific C-section rate. Why are you deliberately misrepresenting the position of the WHO, or do you simply fail to keep current with the latest recommendations in obstetrics?

And you say:

… [W]e must target the areas where we can reduce cost while simultaneously improving health and safety.

That’s about as helpful as saying that we should stop all violence and bring about world peace. Everyone wants it, but no one is sure how to reliably accomplish it.

Finally, I must ask:

Why are you obsessed with process? Isn’t the goal a healthy mother and a healthy baby? Shouldn’t the outcome be focus of our efforts?

Oh, right, I remember now. Your members can’t make any money from C-sections and you are promoting their economic interests. That’s why you concentrate on procedures and entirely ignore outcome.

I guess that’s why you complain about a problem that you are sure can be solved without having a clue as to the solution.

Send in the clowns … to defend Dr. Biter

With apologies to Stephen Sondheim:

“Isn’t it rich?
Isn’t it queer?
Losing my judgment this late in my career.”

That’s the sad song that many homebirth advocates could and should be singing, having made total fools of themselves over Dr. Robert Biter.

I’ve been writing about Dr. Biter since his hospital privileges were suspended in 2010.

The supporters of Dr. Robert Biter, the San Diego obstetrician whose privileges have been suspended by Scripps Encinitas can’t seem to figure out why this has happened. They ought to check the public records of the San Diego Superior Court website. Evidently Dr. Biter has been sued 6 times in the past 5 years! That must be some sort of record, especially when you consider that he has only been in practice since 2001.

Dr. Biter’s supporters included Ricki Lake, Rixa Freeze, Jill Arnold of the Unnecessarean, Barbara Herrera of Navelgazing Midwife, many other pregnancy bloggers and a Facebook group entitled “I love Dr. Biter.” They reflexively supported him without ever doing the most basic research that would have revealed the 6 pending lawsuits.

When the existence of the lawsuits was publicized, Ricki Lake backed away. It took a bit longer for Barbara Herrera to recognize that she had been conned. The rest didn’t care. The facts made no difference to most of his supporters.

And those supporters put their money where there mouth is. They gave money for Dr. Biter’s planned birth center, despite his own acknowledgement that the money was being funneled to his personal bank account, and despite the fact that there was no public record of any attempt to start a birth center. I guess if you are intent on making a fool of yourself, you might as well go all the way.

In the intervening years, Dr. Biter has been the subject of disciplinary hearings that revealed the details of multiple instances of medical malpractice and gross negligence (reports available at the Medical Board of California website). Still his supporters clung on and women continued to hire him to deliver their babies. Then in July of 2012, having already put his signature to a legal document requiring him to have another physician supervise him, he attended a homebirth by himself. The baby died and, as in the previous cases, the findings of the inquiry included malpractice and gross negligence.

Now Dr. Biter faces permanent suspension of his license. Although Dr. Biter has not contested any of the allegations against him and has actually acknowledged the truth of the accusations by signing documents admitting to them, he is still trying to con his supporters and they are still acting like clowns.

Katie McCall, the creator of the Sisters in Chains, the appalling Facebook page dedicated to homebirth midwives who are “persecuted” for no better reason than the fact that a few babies died here or there, recently offered Dr. Biter her support.

Just stopping by to give my love this new year. My it be an amazing improvement on the last for both of us.

Biter replies with his usual self-absoprtion:

… Truth can be slow at times, and it is amazing how people use our tragedies to their own self interests or self importance in the social media world…

Earth to Dr. Biter:

What’s tragic is the loss of innocent life and the injuries to the women who trusted you. The suspension of your license is best described by another word: justice.

The story of Dr. Biter is an object lesson in the way that homebirth advocacy works. Find a quack you like; do no research of any kind; ignore facts you don’t like; give money to con artists, let innocent people be injured and die. Rinse and repeat until the quack’s license is removed or she is arrested. Then pretend it is all a conspiracy.

“Don’t you love farce?
Dr. Biter’s fault I fear.
He thought that you’d want what he wants.
Sorry, my dear.
But where are the clowns?
Quick, send in the clowns.
Don’t bother, they’re here.”