Step 1: ignore homebirth deaths

OOPS sign with clipping path

Hi, folks! It’s Ima Frawde, CPM. It’s time for some honest talk about homebirth deaths.

No, silly, not how to prevent them! How to hide them.

I admit it; it’s been a very bad year for homebirth midwifery. Licensed Oregon homebirth midwives have a death rate at planned homebirth of 9X term hospital birth. Colorado homebirth midwives have a perinatal death rate 2.5X higher than hospital births (including premature births!). Australian homebirth midwives have a death rate 5X higher than term hospital birth. Even our vaunted friends, the midwives of the Netherlands, are facing scrutiny because their low risk death rate (home and hospital) is nearly 3X higher than high risk birth attended by obstetricians.

What’s a midwife committed to making 100% of her income peddling quackery to do?

Don’t worry, I have a 5 step plan for hiding addressing homebirth deaths.

Step 1: Ignore the homebirth deaths.

Use the homebirth midwives of Oregon and Colorado as your guide. Collect your statistics, analyze them on the off chance that they might show that homebirth is safe (in which case we’ll publish them). Then ignore them. If you ignore them and act like it’s no big deal that lots of babies are dying preventable deaths at homebirth, our supporters will too.

Step 2: Stop collecting statistics.

Let’s follow the example of homebirth midwives in North Carolina, Maryland and a variety of other states by refusing to collect mortality statistics. Very clever, huh? If we refuse to count the homebirth deaths, no one else can, either.

Step 3: Pretend that some deaths can and should be dropped from the statistics.

Congenital anomalies? That’s not our fault; remove them from the homebirth statistics, but keep them in the hospital comparison group. Intrapartum deaths? Hide them in the stillbirth rate.

Step 4: Baffle them with bullshit.

Invoke quantum midwifery and pretend that the Heisenberg Uncertainty Principle means that no one can truly “know” how many babies died because, like Schrodinger’s Cat, they can be dead and alive at the same time. Invoke chaos theory because it sounds cool.

Step 5: Pretend that this is a human rights issue.

Sure a bunch of babies are dead who didn’t have to die. But it’s my right to make money a woman’s right to “choose” that’s at stake here. Lie, and insist that any attempt to reduce homebirth deaths is an effort to outlaw homebirth midwifery. Glorify those midwives who have presided over homebirth deaths (especially those who have presided over lots of deaths) and insist that any attempt to hold them accountable makes them into martyrs.

There’s actually one more step, but it’s a secret among us midwives:

Step 6: Rely on the ignorance and gullibility of homebirth advocates.

Let’s face it, you can tell those nitwits mamas anything and they’ll believe it. As we know, anyone who actually thinks trusting birth is an effective strategy is willing to accept whatever nonsense we dish out. Fortunately!

And if a bunch of babies die in the process,  remember: just like you can’t make an omelet without cracking some eggs, you can’t protect “normal birth” without killing some babies. S#it happens; get over it.


This piece is satire.

25 Responses to “Step 1: ignore homebirth deaths”

  1. May 8, 2013 at 8:58 am #

    I like this topic and I hope to read more.

  2. May 4, 2013 at 10:24 am #

    Step 5: Pretend that this is a human rights issue. thank you

  3. Bombshellrisa
    April 18, 2013 at 6:30 pm #

    Step 16: List any education you have received. A BA in Studio Art is sure to impress, as well as any distance training you have studied in pursuit of a degree in midwifery. If you go in for that sort of thing. After all, what really should count is that you feel MOVED to catch babies and participate as a birthkeeper and space holder in the scared dance of motherbabyplacenta.

    • Aunti Po Dean
      April 20, 2013 at 5:17 am #

      Scared …giggle …funny typo

  4. Guestll
    April 18, 2013 at 5:47 pm #

    Step 15: When presenting yourself as a “VBAC expert”, be sure to reference the time you spent midwifing in sub-Saharan Africa…where you undoubtedly saw a metric shit ton of VBACs. (true story, you can’t make this stuff up)

    • Bombshellrisa
      April 18, 2013 at 6:25 pm #

      Also reference any time spent in third world countries “training” to be a CPM. What counts is if it SOUNDS compassionate and impressive. Works for the likes of Darby Partner and Robin Lim.

  5. Bombshellrisa
    April 18, 2013 at 5:24 pm #

    Step 13: Remind your clients that you are an “expert in normal birth”. Make them sign a contract that states you are an expert, but they have the responsibility to eat healthy, drink kale smoothies and raspberry leaf tea and do prenatal yoga and start birth affirmations as soon as possible. If they do not do all of these things, you can’t be held responsible for the outcome. Make sure the client contract includes the clause that you don’t have to accompany them to the hospital in case of transfer or even identify yourself as the birth attendant when you call 911.
    Step 14: Refuse to elaborate on transfer plans. Transfers only happen if the client 1) doesn’t trust birth, 2) eats something unhealthy and tricks their body into growing a baby too big to birth normally or 3) wimps out and doesn’t find the kiddie pool and aromatherapy soothing enough

  6. yentavegan
    April 18, 2013 at 5:23 pm #

    Instruct the bereaved parent to refer to the infant as born asleep.

  7. suchende
    April 18, 2013 at 4:27 pm #

    Also, “the question shouldn’t be if home birth is safe, it should be why obstetrics isn’t catering to every wish of the birthzilla, driving them to OOH births!”

  8. antigone23
    April 18, 2013 at 4:06 pm #

    Also, act like since the absolute rate of death is still low, the relative rate of homebirth vs. hospital birth deaths doesn’t matter at all. 2 per 1000, 0.4 per 1000, either way, it’s a small number, nothing to be concerned about.

  9. Amazed
    April 18, 2013 at 2:57 pm #

    Step 12: don;t forget to remind the bereaved parents that at least they had a really lovely spontaneous birth and that they had done what all loving parents would have done: ensuring peaceful arrival to the baby. Labour didn’t hurt the baby. It actually slept through it.

    • BeatlesFan
      April 18, 2013 at 6:33 pm #

      Labour didn’t hurt the baby. It actually slept through it.

      This makes me want to stab someone.

  10. April 18, 2013 at 2:26 pm #

    Step 11: Convince your clients that there are extremely pressing issues they should focus all their attention on, such as putting hats on babies. That way they are too wound up to notice all the deaths at the hands of midwives.

  11. Aunti Po Dean
    April 18, 2013 at 2:12 pm #

    Step 10:
    Use the word ” rate” instead of “number.” Then you can say the rate is low because the numbers are low even though the rate is actually high

  12. April 18, 2013 at 1:33 pm #

    Step 9, call Katie McCall as soon as a baby passes away to ensure your spot on the Sisters in Chains page, otherwise you may be paying for your own bail.

    • April 18, 2013 at 1:34 pm #

      *ensure* been working too much, I mean *insure*

      • Hannah
        April 18, 2013 at 1:47 pm #

        I think you were right the first time.

        • April 30, 2013 at 2:49 pm #

          I thought I was, my stepson insisted it was insure. I associate ensure as the nutritional drink we give to residents that are below their ideal weight range.

          • theNormalDistribution
            April 30, 2013 at 4:13 pm #

            No, you were right the first time. Some people argue that ensure and insure are interchangeable, while in some places either one or the other is preferentially used. For those that (correctly, imo) do not consider them interchangeable, ‘ensure’ refers to taking action to make sure something happens, whereas ‘insure’ refers to taking action to limit damages if said thing actually happens.

  13. Bombshellrisa
    April 18, 2013 at 1:19 pm #

    Step 8: Consult the web book “From Calling to Courtroom”. This will help you understand how to raise awareness for your plight and manipulate people into supporting and funding you. Notorious midwives with multiple losses have written for this text, making it a collective of “expert advice” on reframing the issue.

  14. fiftyfifty1
    April 18, 2013 at 12:34 pm #

    Step 7: Make sure you are BFF with all your mamas. How else will you be able to emotionally manipulate them (…er I mean emotionally support them) after your incompetence causes the death of their babies? This way they probably won’t contact the authorities and nobody will be the wiser (and they might even hire you on for the births of their Rainbow Babies!!).

    • auntbea
      April 18, 2013 at 1:28 pm #

      Be sure to act really sad. If you are actually a sociopath, carry saline drops.

      • Aunti Po Dean
        April 18, 2013 at 2:17 pm #

        And be sure not to comb or cut your hair ready for the TV cameras

  15. April 18, 2013 at 12:04 pm #

    Step3: Pretend some deaths can and should be dropped:

    “Oregon death rates? They’re excellent if you don’t count Portland…”

  16. Daniel Descheneaux
    April 18, 2013 at 11:04 am #

    It seems a shame that you have to clearly label your post as satire. But there are folks dumb enough to take it at face value and quote it out of context, I suppose.

    Still your fan,

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