Idaho homebirth practice presides over 3 neonatal deaths in less than a year

Lisa Barrett is getting a run for her money. Barrett, an Australian homebirth midwife, has presided over 5 preventable neonatal deaths in approximately 4 years. It only took Jerusha Goodwin and her colleagues at The Baby Place 10 months to rack up 3 entirely preventable neonatal deaths.

How do we know? Back in mid 2010 the state of Idaho decided to license homebirth midwives and creating a reporting process for bad outcome. No sooner did they create a reporting process than they started receiving reports of preventable neonatal deaths resulting from appalling negligence. The news story is here, but only the official documents can detail the true scope of the horror.

Death #1:

ii. On October ll, 2010, Respondent delivered N.H.‘s infant daughter, C.H., at The Baby Place…

iv. During the final stages of labor, C.H.’s fetal heart rate dropped significantly to 60 beats per minute.

v. Shortly after birth, Respondent failed to ensure that C.H.’s umbilical cord was clamped before a student midwife cut it. As a result, C.H. lost a significant amount of blood.

vi. The Baby Place‘s records documenting the birth of C.H. fail to state that C.H. was a nuchal cord delivery or that C.H.’s umbilical cord was not clamped before it was cut, which resulted in significant blood loss.

vii. On October 11, 2010, C.H. was transported by ambulance to the hospital. At the time of her admittance to the hospital. C.H. had “respiratory failure since birth” and “severe” hypoxic-ischemic encephalopathy. Additionally, C.H. had an initial pH of 6.5 with a base deficient of -30. C.H. died on October 25, 2010.

viii. Respondent failed to inform paramedics or physicians that C.H. was a nuchal cord delivery, that C.H.’s umbilical cord was cut before it was clamped, and that C.H. sustained significant blood loss as a result of the failure to clamp the umbilical cord. Additionally, Respondent failed to provide paramedics or physicians with relevant medical records or relevant details regarding the labor and delivery process.

Death #2:

ii. On August 9, 2011, Respondent delivered H.T.’s infant son, O.R., at The Baby Place.

iii. At the time of delivery, 0.R. was at least 42 weeks and one day in gestational age.

iv. Near the onset of labor, H.T. reported having “greenish” vaginal discharge. Additionally, when the spontaneous rupture of membranes occurred, there was meconium in the fluid and 0.R. was not born for another 19 hours.

v. H.T.’s labor was abnomrally protracted, as she was in active labor for approximately 48-and-a-half hours, the infant was at the plus 1 station for approximately nine hours, the pushing phase lasted approximately l0-and-a-half hours …

vi. During the afternoon of August 9, 2011, Respondent instructed H.T. and other midwives at The Baby Place to state that the pushing phase began at 3:00 p.m. despite the fact that H.T. actually started pushing at approximately 10:00 am. and continuously pushed until the time of birth
at 8:40 p.m.

vii. At the time of birth, O.R. was “limp, unresponsive and pale,” had meconium staining around the mouth, and had a heart rate of 80. Respondent then began resuscitation efforts but did so ineffectively, as O.R. was on a flat surface without the head tilted back and the mask was not properly sealed.

viii. The Baby Place waited approximately ll minutes after 0.R, was born to call paramedics.

ix. When paramedics anived at The Baby Place to transport O.R. to the hospital, they determined that he had an APGAR score of 2.

x. Respondent failed to provide a report of O.R.’s condition or progress to paramedics or hospital physicians. Respondent also failed to ensure that H.T. and 0.R.’s records from The Baby Place were transported to the hospital with O.R. Respondent first provided the hospital with the relevant medical records on August 12, 2011 at 4:32 p.m., which was three days alter O.R,’s birth and after O.R. died in the hospital.

xi. O.R. died at the hospital at approximately 3:41 p.m. on August 12, 2011. The autopsy stated that the cause of death was “anoxic brain injury secondary to prolonged vaginal birth complicated by meconium aspiration.”

Jerusha Goodwin’s mother Colleen, also a midwife, presided over death #3:

ii. R.R. is a Type 1 diabetic. Respondent provided care to R.R. without providing R.R. with written notice that she was required to obtain care from a physician for her diabetes as a condition to obtaining maternity care from Respondent. Additionally, Respondent did not obtain a signed acknowledgment fiom R.R. that she had received written notice of this condition for maternity care.

iii. On June 29, 2011, R.R. had flu-like symptoms and had been vomiting and had diarrhea throughout the day. These symptoms continued on June 30, 2011.

iv. During the labor process, the fetal heart rate frequently dropped to below-average levels and even dropped into the 80s. Respondent failed to document these below-average heart rates in The Baby Places’ records.

v. During the labor process, Respondent instructed R.R. to push when R.R. was not fully-dilated.

vi. During the labor process, Respondent provided R.R. with a one-page document explaining Group B Streptococcus (“GBS”), which recommended that “all women be tested for GBS at 35-37 weeks of pregnancy.” R.R. signed the form and waived the GBS test, but later stated that she “had no idea what [she] was signing,” as she was in a great deal of pain and was not provided with an adequate explanation of GBS.

vii. At 1:59 a.m. on June 30, 2011, Respondent called paramedics due to fetal heart rates that had decelerated to dangerous levels in the 80s. When the paramedics arrived at The Baby Place at 2:06 am., Respondent failed to ensure that R.R. was ready to be transported. Additionally, Respondent delayed paramedics from entering R.R.’s room for at least four minutes.

viii. Respondent failed to fully-cooperate with paramedics. She had to be asked questions multiple times before responding and would not provide adequate infomation regarding R.R’s condition. Moreover, Respondent initially failed to state why transport to the hospital was necessary. Additionally, Respondent failed to provide paramedics with R.R.’s medical records from The Baby Place…

xi. R.R. gave birth shortly after arriving at St. Luke’s Boise Medical Center. The infant was pronounced dead at approximately 3:03 a.m. on June 30, 2011.

xii. During the labor and delivery process, Respondent failed to keep complete and accurate records…

xiii. Approximately one year after R.R.’s pregnancy, Respondent asked another midwife to “re-do” R.R.’s labor charts. In or around June 2011, Respondent retrospectively created one page of chart notes from R.R.’s labor.

xiv. Respondent later stated that R.R. was uncooperative during labor and would not allow her to adequately monitor the fetal heart rates.

Both midwives have had their licenses suspended. They deserve far worse. There is not a single mitigating factor in any of these 3 deaths. All three involved gross malpractice as well interfering with transport and lying by the midwives.

These women should be in jail. But, in the world of homebirth advocacy, a pile of dead bodies is nothing more than an inconvenience. Predictably, homebirth advocates are rallying in support of these midwives:

Last night in the rain, about 30 parents of those children staged a rally of support here at KTVB studios. Many said they saw the report and felt compelled to share their positive experiences with The Baby Place.

Tracy Ryan told KTVB she came to the rally to speak for both women currently under investigation.

“This is a stand of support — a stand of support for two midwives in our community who have served these families, and now we are standing to serve them,” Ryan said.

I suppose that it’s fitting though: ignorant, immoral midwives supported by ignorant, immoral followers. That’s the world of homebirth advocacy.