Save the Children has issued a report on the State of the World’s Mother’ 2013, entitled Surviving the First Day. This report concentrates on death on the day of birth.
Unfortunately, the analysis of developed countries used deeply flawed data to reach an erroneous conclusion about the first day death rate in the US. What shocked me most, however, is that to illustrate first day death in the US, the organization (?unwittingly) used a photo that I recognized as a CPM attended homebirth death that was almost certainly preventable.
In other words, the face of first day death in the US is preventable death at homebirth.
Why did Charlotte die shortly after birth? Her mother, Angela Rodman, tells the story on her blog.
Charlotte was born at the Bella Vie Birth Center, owned by Desiree LeFave, CPM. It’s not an accredited birth center. Indeed that appellation “birth center” is a misnomer. It is homebirth at a rented house.
In the typically clueless way of American homebirth midwives, Charlotte, unexpectedly dropped nearly dead into the midwives’ hands. And, unbeknownst to the midwives, Charlotte was suffering from intrauterine growth restriction.
When they placed her in my arms, this bloody tiny bundle they kept calling my baby, I knew something was wrong. I felt, with that bone deep Mama knowledge only mothers posses, that my baby was not long for this earth. I could feel her soul struggling to depart even as I held her close for those few precious seconds.
Then my primary midwife took her from me, I heard someone say I need resuscitation now and everything went crazy…
I sat on the birthing stool, rubbed her foot and talked to her. She opened her eyes and looked at me. Jonathan moved next to me and started talking to her. She opened her eyes and looked at him. There was blood being pulled out of her stomach. They were trying to resuscitate her. Everything was very chaotic…
A midwife I had never met was crouched next to me, rubbing my leg, checking my bleeding, and I asked her over and over: “Will she be okay? She’s too small. Is she too small? Will she be okay? What’s wrong?” She rubbed my leg and told me they were doing everything they could.
I was losing a lot of blood. I watched the blood spill onto the floor and roll underneath the board Charlotte was laying on. I don’t do well with the sight of blood; I thought I was going to faint. I kept thinking I should point out the blood loss, but I couldn’t form my thoughts into words.
Someone said, “Hey, where is that blood from?” and Jonathan said, “She needs Pitocin, give her a shot of Pitocin!” I had a midwife crouched on either side of me and I received two shots of Pitocin in each thigh.
… Charlotte struggled to breathe. Her color was terrible, grey and pale. It was obvious her connection to me was helping her stay alive and allowing her to be resuscitated.
Charlotte was transferred by helicopter to the NICU at Salem Hospital. Unfortunately, they could not save her life.
Charlotte’s mother had difficulty getting to her daughter’s side. Because of her hemorrhage, she could barely stand, but eventually, she made it to the hospital.
I don’t remember when a nurse came in with the baby, but I remember her being placed in my arms. I was absolutely freaked out by her weight, the blood around her mouth and nose, the tube that was still in her mouth. I didn’t understand why she had tubes in her when she was dead.
When I next looked up everyone was gone, it was only Jonathan, Charlotte and me. We sat in those awful plastic chairs, he wrapped his arms around us and for a moment we were three, just like we had planned.
Fortunately, for her next pregnancy Angela Rodman was followed by an obstetrician, delivered in a hospital and has a healthy baby to show for it.
Why did Charlotte die? Obviously no one can know for sure, but it couldn’t have helped that Charlotte’s mother gave birth at home (not a real birth center), that her midwives, self-proclaimed “experts in normal birth” didn’t pick up on Charlotte’s probable distress during labor and were incapable of performing the expert resuscitation that may have saved Charlotte’s life. They were in such a panic that they didn’t even notice that Angela was hemorrhaging on the floor.
And now, in a report that will be widely read and make its way around the world, the face of neonatal death in the US is a CPM attended homebirth.
I myself have given birth to two happy, healthy children at this birth center. I know this mother’s story well. I also have a friend who lost her son after giving birth in the hospital. A week overdue, she was sent to be induced because of low fluid. 24+ hours later she had given birth to a boy who was brain dead. Now I don’t know if his outcome had anything to do with being in the hospital or not. But a part of me wonders if he wouldn’t be alive today had she used a midwife and NOT been induced. Maybe he had lost oxygen days before the induction. Or maybe (just maybe) the stress and trauma of an unnatural induced labor was too much for his little body to bare.
What I will say is that her experience only strengthened my resolve to have may next child at Bella Vie. I do trust birth and my body. I trust these women who, by the way, can lose their license for malpractice because in Oregon they have to be licensed by a state board, they have to carry malpractice insurance.
Not too mention, out of over 500 births, this is the only infant loss this birth center has had. How many hospitals can say that? What is the infant death rate for hospital births in the this country. This birth center, and others like it, publish their statistics on an annual basis. How many hospitals do that? In a country where we spend the most on maternity care, how is it that we have the worst maternal and infant death rates of the industrialized nations?
Babies die in hospitals. Babies die at home. The sad reality is that babies die. Sometimes it can be prevented. Sometimes it can’t. But no one can say, without a shadow of a doubt, that no baby dies within 24 hours of birth at a hospital.
It’s a question of rate. In Oregon, babies die at the hands of CPMs at a much higher rate than they do in hospital, comparing low-risk women. That’s a documented fact. https://www.google.com/url?sa=t&source=web&rct=j&ei=51T1U8zdIdH9yQTh6IHQCw&url=https://olis.leg.state.or.us/liz/2013R1/Downloads/CommitteeMeetingDocument/8585&cd=1&ved=0CB4QFjAA&usg=AFQjCNG3QVkOoVuToNz4NrEp2bcm6SMNAw&sig2=e0Dpnf_mXTLAlf9HAbsvNg
Oregon state does not require that direct entry midwives carry malpractice coverage. See Oregon Administrative Rules, Chapter 332.
Licensure is not required in Oregon state either.
Infant mortality is not a correct measure of obstetric care. It is neonatal or perinatal mortality.
Take a look at this brief statement from Judith Rooks, CNM, that was presented to Oregon legislature.
https://olis.leg.state.or.us/liz/2013R1/Downloads/CommitteeMeetingDocument/8585
If you honestly think a post dates low AFI patient is better off at home with a CPM, you are stunningly ignorant of the risk that situatin entails. You are also ignorant of what infant mortality covers. Google the definition sometime.
Of course babies die in hospitals. Preemies, druggies, defects, high risk babies (for example a post dates low AFI). The babies that die outside of a hospital are almost always healthy, low risk babies. Saying that the birth center has only lost 1 completely healthy low risk baby is nothing to brag about. It’s abysmal.
Maybe an induced labour is harder on the baby I’m not sure but in a hospital they monitor them very closely, I highly highly doubt the baby would have fared better with a CPM.
wow, ignorance abounds… a part of you wonders if he wouldn’t be alive today had she used a midwife and NOT been induced? You’re not serious, right? Unfortunately, people like you are the reason why CPM’s stay in business and continue to kill babies. You just don’t know what you don’t know… and they are counting on that..I am sad for you and women like you who live in the fantasy world of “trust birth” and continue to blindly trust lay people with your lives and the lives of your babies.. that mindset kills a lot of babies as you have no real knowledge of obstetrics and the many serious complications that can arise in pregnancy and childbirth… I’ve worked in L&D for years and there are so many wonderful Obstetricians out there… find a good one and you will have the best of both worlds, wonderful care and a safe delivery… with someone who is actually educated and qualified..
Hospitals are required to report a variety of outcomes to a collection of state and federal agencies on an ongoing basis.
We absolutely can NOT say that no baby dies within 24 hours of birth at a hospital. However, we do know that the most common causes of death in the neonatal period are prematurity and congenital malformation. These causes account for a little more than half of the 4 neonatal deaths per thousand births in the U.S. in 2012.
The neonatal mortality rate for term, singleton, vertex, physician-attended births in hospitals in the U.S. was .93 per 1,000 between 2006 and 2009. The neonatal mortality rate for term, singleton, vertex, midwife-attended births in hospitals was .32 per thousand. (Physician rates are higher than midwife rates because hospital midwives transfer high-risk cases to the physician service.)
If Bella Vie has hosted 500 births (roughly the same number as a quiet month in a major OB unit) and had one death, their neonatal death rate is 2 in 1,000.
When an unexpected neonatal death occurs at a hospital, no one shrugs and says “hey, our stats are still pretty good.” There is a morbidity and mortality review process that attempts to identify the causes of the death, and make sure that it doesn’t happen again. Has Bella Vie gone through such a process?
How many hospital deaths could have been saved by a home birth? I don’t see that data here. Also, how does one home-birth death mean that their data collection was flawed? Just wondering.
I’ve never heard of a single hospital death that could have been saved by a home birth. The only instance I can imagine is malpractice, and at least that gets investigated properly in a hospital setting rather than swept under the rug as we see in so many US midwife cases.
As for your second question, the deeply flawed data is a totally separate issue to this home birth and death. I think you should read that portion again and try following the link.
An incompetent doctor who kills or injures someone will lose
his or her license. An incompetent midwife who kills or injures
someone gets to keep on practicing. Hospital deaths have a built-in
mechanism to prevent them from reoccurring. Out of hospital
midwife-caused deaths do not. So I don’t see any hospital deaths that could be prevented by a home birth. Do you?
Data collection was not flawed. The analysis was flawed. As Wren says, follow the link. The short answer is that different countries use different definitions of neonatal mortality and perinatal mortality, making these numbers not directly comparable between different countries. Many countries cheat and do not include all deaths. America includes all deaths in the statistics.
How many hospital deaths could be prevented by homebirth? Zero.
Some maternal deaths occur in hospitals from hemorrhage secondary to cesarean section. We can accurately say that those mothers would not have died from that cause at home as there are no cesarean surgeries performed in homes in North America.
That assumes that the C-section was avoidable and unnecessary, not a safe assumption. The woman who dies of a hemorrhage as a result of a C-section might have died of infection, or obstructed labor at home.
Wait, wait, wait. You’re joking, right? You understand that comparing rates inherently includes malpractice, right?
It’s like if someone said that using a car seat decreased child death in car accidents by X% and someone asking, but how many times did the car seat do more damage than good due to malfunction? Yeah, some percentage of deaths might be caused by a faulty car seat, but we know that using a car seat is still the right call because of the RATE, which already takes malfunction into account. Get it?
This must be a Poe? After all, people don’t ask how many of the people who died from other things (heart attacks, gunshot wounds, pneumonia, ect) would have been “saved” if they stayed home instead of going to the hospital.
All of these negative comments and judgement. Not just on Angela’s decision to homebirth but on her blog, on her religion, on her writing. Just because it’s the internet doesn’t mean you have the right to bully people. Don’t pretend you are making fun of her using scripture or her putting her picture up because you are trying to save babies. You are doing it because you have a sad life and you’re lashing out on other people anonymously online. I know Angela and I’m glad she refused to come read the comments here. How sad.
This post and the author’s response brings to mind a current campaign to end texting while driving. A blank screen with simple letters in the center like “Be there soo ” or “Where R ” and then a stark message about it being the last words of that person’s life. Do the families of these people want their bad decisions plastered all over the public domain? It would be easier to believe it was simply a tragic accident unrelated to texting. No, they have chosen to bluntly state that their beloved family member died because of a stupid choice. And by letting others know that their deaths were the result of texting, maybe that will prevent someone else from making that same dangerous decision.
And much like the person who says that they can safely text and drive, others believe that homebirth is safe and that nothing bad will happen to them. There are plenty of people who text while driving and they are excellent drivers and know how to text safely. Ms. Rodman may not have intended to use her daughter as an example of the dangers of homebirth, but Charlotte is a perfect example. And, much like “Hurt by Homeirth”, maybe the death of Charlotte will help prevent the death of other babies.
those commercials are so painful, and remind me too that I can wait to text. If I feel an immediate need, I almost have to force myself to pull over into a parking lot. That’s how insidious the habit becomes.
There was a single-car accident, high school aged driver, on my street just last night. The police said alcohol wasn’t involved, so that leaves texting as the primary likely reason that an otherwise awake and alert driver went off the road into two mailboxes and a tree before rolling the car back into the road.
One night I watched a car ahead of me slowly drift off the road while the (adult) driver texted. I honked my horn seconds before she actually left the road, and she looked up and corrected.
When I was a kid, if you missed your exit on the interstate, the driver would go to the next one. Today, it’s common to see people go to the shoulder, back up all the way to the exit, and force their way into the stream of traffic going onto the exit. Or just abruptly cross multiple lanes to get to the exit.
There’s a level of impatience and ego-centrism involved in all of this. It’s sad, but not surprising, that it manifests in the NCB movement as well.
Angela Rodman responding to this post:
“If one grieving mother or father reads about Charlotte and feels a little less alone, and if even one baby is saved because I was brave enough to speak about my loss, that woman, and everyone who frequents her blog, can say all the nasty, slanderous things they like about me.”
At least we’re in agreement about that. That’s why it is absolutely critical for readers of Charlotte’s story to understand that Charlotte didn’t have to die, that homebirth increases the risk of perinatal death, and that licensed Oregon homebirth midwives have a death rate 800% higher than term hospital birth. Otherwise, how will they learn what Rodman learned the hard way and put into practice in her second pregnancy.: it is safe to be followed by an obstetrician during pregnancy and to deliver in a hospital.
As an aside, I’m also disturbed by the use of Rodman’s photo and story as the “face” of neonatal death, because it raises the spectre of racism and classism. The face of neonatal death in the US is the face of young, poor Black women who have trouble accessing health care. It is not the face of a rich white woman with health insurance who chose to risk her baby’s life for an “experience.”
“While working on the Save the Children project I asked the Lord to keep me humble and help me mind my words. I feel so much pride when I get to share about Charlotte, but I wanted to curb the pride so my words didn’t become about me, or how amazing I think I am. I wanted the focus to be babies and what can be done to ensure children have the best start at life.”
I find this quote deeply disturbing for two reasons. First, there’s nothing to be proud about when a baby dies. Second, the irony is that pride was probably a major factor in Charlotte’s death.
Pride is what leads a homebirth advocate to pretend that she knows more about childbirth than an obstetrician. Pride is what leads homebirth advocates to imagine that they have “researched” birth when all they’ve done is read a bunch of propaganda on websites written by homebirth advocates. Pride is what leads homebirth advocates to “trust birth,” somehow believing that their thoughts are so powerful that they can prevent obstetric complications.
It is the pride of homebirth advocates that leads to preventable perinatal deaths. How awful to compound it by being proud of Charlotte’s story.
Hit the nail on the head about pride. I had pride and then I was humbled at the cost of my son’s arm and almost his life. It’s a tricky thing because when one has so much pride in a dangerous choice, it feels almost impossible to help dissuade them from making a poor choice. I’m writing my story right now for “Hurt By Homebirth”, but I’m having trouble thinking it will help change someone’s mind who is bent on having one. I am doubting it will make any sort of difference (maybe because I was such an idiot that it might not have changed my mind with my first child). Do you ever get emails about if other’s stories have or not?
I have a lot of friends who homebirth and my story hasn’t dissuaded them in continuing to practice it. They just never think they’ll be the one to have something go wrong. How do we break through that pride?
Share with your heart and be truthful as to what your beliefs were at the time…. people will relate. I know what you mean though, I read Hurt by Homebirth and it initially didn’t change my mind. I remember thinking “well this isn’t an issue of birth, it’s an issue of negligent care provider, and mine is so much more well-skilled and would never do _____” (fill in the blank with negligent act on behalf of the midwife)…. but the more I read, the more I learned that some times it’s just the birth itself that becomes complicated and it doesn’t matter how skilled the care giver is, the being HOME leads to disaster. One home birth story may not change some one’s mind. But many stories all together in one place (HbH) can and does.
Thank you for being brave and sharing your story.
All the time! The Hurt by Homebirth stories influence more people than the rest of what I write. I suspect it’s because it helps women see that it really can happen to people like them.
There have been people who posted here saying they were dissuaded from homebirth by this site and hurt by homebirth.
I find it disturbing too. The urge to want something good to come from such distress is understandable, as is the desire to talk about a lost child. I can even get that there is some cold comfort pride in finding you are still standing – but one does wonder what she thinks should be done to improve things.
Buying into the NCB approved versions of motherhood doesn’t often lead to humility, it seems to me, whether it is Birth Goddess or Mater Dolorosa.
“Pride is what leads a homebirth advocate to pretend that she knows more about childbirth than an obstetrician. Pride is what leads homebirth advocates to imagine that they have “researched” birth when all they’ve done is read a bunch of propaganda on websites written by homebirth advocates. Pride is what leads homebirth advocates to “trust birth,” somehow believing that their thoughts are so powerful that they can prevent obstetric complications.”
Oh man. THIS. This this this. It is so tricky b/c one doesn’t even realize it is pride until after the fact….. hindsight. That eye-opening, revealing, knock-the-wind-out-of-you hindsight.
“I’m not going to argue with someone who thinks I deserve to be without my Charlotte because of the choices I made.”
It takes some doing to reach that conclusion. When and where has anyone said that women deserve to lose babies?
The grief this woman has had to suffer deserves some respect. I don’t think her anger at those who do not accept her version of events does, much. Demand the right to make choices by all means, but don’t insist on universal approval if they turn out to have been unwise ones.
I’m curious as to how she thinks her story can prevent the death of any future babies if she doesn’t believe her choices or her caregivers’ choices led to Charlotte’s death.
Unfortunately, Angela Rodman has (according to today’s blog post) realized that the bump in traffic to her site comes from here (she calls us “a site I’ve had problems with before”) and she is quick to say that she is not reading our comments which she somehow knows are ‘vile’ without reading them, and, a few bible verses later, all is good. “If one baby is saved because I was brave enough to speak about my loss…” Only, Little Bird, please, how are babies going to be saved if you yourself refuse to look at your decisions and their consequences. I am truly sorry for your loss, but it comes from the fact that you made some really LOUSY choices. Patty Couch as a midwife? Come ON, honey!!! You want biblical truths? You and Charlotte were sacrificed on the altar of Birth Choice.
You shall know the truth and the truth will set you free. We live in hope.
Speaking of scriptures, it sounds like the blind leading the blind over there.
Just came across this. Don’t even know where or if to start. http://www.improvingbirth.org/2013/05/selfish-women/
The author actually defines “traumatic birth” as not being treated as the most important person in the room, just after disregarding medical complication.
She also claims PPD is caused by “traumatic birth.” Youch. And just in case anyone doubts your assessment, Box of Salt:
Just stunning. This takes a real problem (women who are treated badly during delivery, which undoubtedly happens) and trivializes it. It absolutely trivializes the women who were actually mistreated by their medical providers or (in the case of so many midwives in America) non-medical providers.
It also trivializes actual trauma.
I am kind of enchanted by the idea of someone explaining that they were traumatised by not being treated like the most important person in the room, and that it caused PPD.
It is to be hoped these special snowflakes never have to deal with any real problems.
Why are these writers so bad with words? Why do they push their case to the point of absurdity? The way women are treated IS important, and I hate it when you see (on TV) midwives being bored and unsympathetic. But treating it as a performance worthy of some kind of award is ludicrous. What do they want? High drama or easy and no big deal? Control or vulnerability? If it isn’t perfect it must be traumatic, a definition of the Drama Queen approach to life.
My last birth “experience” sucked, hubby and I both had the stomach bug so he wasn’t much help, it was the middle of the night and the nurses sucked (put us in a room and pretty much left us alone until actual delivery). I feel a little sad that it wasn’t “magical”, but he arrived safely, even being 10 lbs/posterior/meconium/shoulder dystocia/broken clavicle. There actually *was* medical trauma but I don’t feel traumatized. I did feel traumatized and a bit PTSD after my 1st child was born poster w/ major dystocia, blue and limp. Thank GOD we were in a hospital and they were able to resuscitate him. Each birth added stress bc of things like dystocia, precipitous birth w/ cord wrapped around baby, what would happen if there was a quick labor and a stuck baby with a compressed cord? So yeah, with #4 I spent the last month camped out at L&D since we were 30 mins from the hospital and I wasn’t going to risk my baby’s safety.
I don’t get this.
Why would you do interviews to “raise awareness” of neonatal and perinatal loss, while honestly believing that *in your specific case* the outcome wasn’t preventable.
Raising awareness, *isn’t* about making people more aware, it is actually about fund raising and instituting measures to decrease occurrence.
Suicide awareness, for example isn’t about saying”oh well, some people just kill themselves, let’s support their families”. It is about making people aware of how to seek help for themselves or their loved ones and raising funds for counselling and support services.
In my rant response to mellissa’s comment below, I almost went that direction.
If she does not want her story to be used to be used to prevent others from dying, then why did she give it to “Save the Children”?
I can imagine other possible answers, but they are far more insulting than anything said in this thread.
I am all for raising awareness that the hazards of childbirth are not yet something that can be ignored and forgotten – but I get irritated when the problems of affluent countries get muddled up with the plight of less fortunate women, where the suffering is mind boggling, and there doesn’t seem to be much political will to do anything about it.
I can see an argument for raising awareness that isn’t about prevention – awareness that parents do, in this day and age, lose their children and how to treat them courteously and compassionately; ensuring that counselling and grief services are available in maternity wards and NICUs (no, they aren’t always); making adequate provision in law for the maternity/bereavement leave required by a woman who has given birth but has no baby to care for; providing lactation counselling to a lactating woman with no baby; making follow up services available to check the health of women who have given birth but aren’t being checked out at the same time as the well baby checks, because they don’t have a baby to be checked; studying the social, mental and physical challenges faced by bereaved parents in both the short and long term with a view to ameliorating them, and so on.
But the organization is called, “Save the Children”
I’m checking out more of Charlotte’s mom’s blog. Not good. There is a lot of dishonesty there. How can she allow this? She proudly links to a recent Huffington Report piece about Charlotte’s birth where she descibes being released from the hospital the next day without adequate grief support services. She makes no mention that Charlotte was not born in the hospital, therefore hiding from the reader the true details that led up to Charlotte’s death. And she says that Charlotte’s death was not preventable as if that were a fact, even though she herself has admitted that she has had doubts.
And the parts of her blog that aren’t dishonest are just sloppy. She says that 11,300 babies die *each day* in the United States. No, that is 11,300 first-day-of-life babies in an ENTIRE YEAR. More than 2 orders of magnitude off. No wonder she is able to dismiss what happened to Charlotte, she must think term babies with no birth defects die frequently. She doesn’t understand how incredibly rare such deaths are in hospitals.
Wow, how can someone be so sloppy as to think it’s even possible for 11,300 babies to die every day in America? That would easily account for *every* child born! Just a moment’s thought should be enough to eliminate that as even a possibility.
Found a news article discussing this at http://news.yahoo.com/why-many-newborns-dying-us-195235445.html and reading the comments was an exercise in constant facepalm. At least there are a lot of people calling BS on some of the ridiculous things that are being said.
Reading that kind of ignorance must make doctors crazy. I forget the context now, but I muttered under my breath about how anti-vax people make me crazy, to my kids’ pediatrician. She responded, “Not as crazy as they make me.”
I used to check in on her blog regularly, but anybody with half a brain can see she is not honest with herself or her readers. It got to be an exercise in frustration. At least she had a hospital birth with her second and is planning another with her third.
Does everyone realize this is a real woman who lost her loved and wanted baby? Why on earth would anyone want to add to her pain and heartache by even implying there could have been something done to prevent it? Maybe instead of guessing about what caused this or that, you should ask yourself what you could do to help this mother feel supported and loved during this excruciatingly painful time in her life!!
Am I wrong to speculate that Mrs Rodman has given her permission to be the face of “Neonatal death in America”, and desires to have her story shared? Speculation about ways to prevent this from happening again is expected.
Yes, isn’t the point of the report to highlight mistakes different countries are making that lead to preventable neonatal death? It seems to me she has given permission to be the face of preventable neonatal death here in the U.S. What mistake have we made here is the U.S.? Giving lay midwives permission to practice medicine.
In other words, she is aware at one level but cannot openly deal with accepting it. Yet.
Yes, she was a real woman who made a terrible choice and her baby died as a result. I’m not trying to make this mother feel supported. I’m trying to prevent deaths like Charlotte’s.
As the recently released statistics from Oregon show, planned homebirth with a licensed homebirth midwife has a mortality rate 800% HIGHER than term hospital birth.
Charlotte’s story is an excellent example of the incompetence of homebirth midwives. They didn’t recognize fetal distress. They didn’t recognize IUGR. They didn’t know how to perform an expert resuscitation. They panicked and didn’t notice that the mother was hemorrhaging.
If Charlotte’s mother wants to pretend that her baby’s death was unpreventable even though it is obvious that she would have had a much greater chance of living if she had been in a hospital, she’s free to do so. But duping Save the Children into using her photo as an example of neonatal mortality in the US is another story altogether.
If she didn’t want anyone else to find out the truth, she shouldn’t have offered the picture.
What do you mean by duping? Isn’t she offering up her experience to the Save the Children report as an example of what not to do?
ETA: Whoops, I read more. She actually denies that Charlotte’s death would have been preventable….So then why the heck did they include her in a book about preventing preventable neonatal death? I am so confused.
Maybe making this mother feel supported and loved is her partner’s job? Maybe it’s her parents’ job? Or her friends’ job?
No one wants to make this mother feel more pain. Still, do you realize that Dr Amy isn’t a grief counselor for bereaved mothers? She’s an obstatrician and it’s her job to raise the alarm, so that no other mother would lose her loved and wanted baby.
Do you realize thatby advocating a ‘tactful’ silence you are an enabler to feeding dangerous delusions to women? Right now, a dear friend of mine is advised by a few doctors for a certain procedure but she reads stories of happy endings and she is very hesitant what she should do. And enablers like you who sympathize with loss mothers but give no thought what silence about unfortunate outcomes means are one of the reasons women like her have such doubts. Why on earth would anyone want to add to other women”s pain and heartache by being respecfully silent about vital information?
This is a very old story. Not the point though.
It’s MORE important to get her daughters story told, and point out that it WAs indeed, preventable, so other Moms are warned about possible consequences.
She wanted to raise awareness about babies who died on their day of birth-so you can’t just say “oh there are many babies who have died on the day they were born” and leave it at that. Why did they die? How does the quality of care and the choice of caregiver that attended the pregnant/laboring woman factor in? Did the choice of birth setting play a part? There is no use calling attention to something if you aren’t willing to connect the dots about how to prevent it from happening to someone else.
If what happened to this woman could not happen to anyone else, if it were an isolated circumstance or freak occurrence, then maybe I would agree with you. It’s responsible to look at bad events like this so we can understand 1) Why they occur, and 2) How to prevent them from occurring to additional people.
Would you say that after Michael Jackson died, no-one should have discussed what is doctor did wrong, because it would be insensitive to his family who was still grieving his death?
It is certainly lousy to contribute to anyone’s pain, particularly the extraordinary pain of a grieving mother. But trying to save the next innocent child’s life and the next family from heartbreak is more important than sheltering this loss mother, as sad as she is, from the realities of her actions.
I do think this really is a conundrum. NOBODY would want to add to a mother’s pain, and none of us could really fathom the ways people find of coping with it; what would add to one’s distress and what might alleviate it. But if you put your story on the internet – and I can understand why people do that – you cannot insist that people take what you say at face value. Cocooned in impossible grief, I imagine one gets used to taking what ever self-protecting measure one has to to get through the day – and that ought to include not reading comments here. For all I know, anger at comments like ours may be cathartic, but it is unrealistic to assume that one’s own view, one’s own highly subjective and partial account, will automatically be taken at face value. When you reject the resources of modern medicine, for whatever reason, on the grounds that nothing bad will happen, it is inevitable that others will speculate about the wisdom of that decision. When people say “I know the risks”, they should remember that one, and figure out how to deal with it.
This mother has opted to cling to the idea that her daughter’s death was inevitable, and if that helps her no-one should openly challenge or judge that. But if you write a story that gives leave to the rest of us to doubt that, accusations of being mean are a bit tiresome. Denial is human and common and maybe essential sometimes, but I do wonder whether it is durable, and whether the psychological double think works long term. Not terribly helpful if it causes you to take the same course a second time, or encourage others to do so.
For pete’s sake, she allowed her picture*** to be used by an organization called “SAVE THE CHILDREN”
How can you “save the children” if you don’t figure out what causes the problems in the first place?
if this family had chosen a hospital for their baby’s birth, the labor would have been monitored using a fetal heart monitor. The nursers would have known if this baby could not tolerate contractions. This baby could have been saved by c/sec.
Like so many other homebirth/unlicensed birth center babies who are in the ground rather than in their families’ arms. 🙁 It pains me so much to think about. This country needs to frigging catch up with the rest of the developed world and have legal consequences for these charlatans posing as “midwives”.
You cannot, of course, say for certain that this baby would have been saved by a CS. If she had stopped growing because of a failing placenta, then there could be no guarantees.(Are no guarantees.) What the inconveniences of hospital bring is simply the knowledge that your baby had the best chance of making it, and most of us want that.
Competent prenatal care might have identified the growth restriction and the baby could have been delivered early. Not ideal, but often better than starving in the womb.
The executive summary of that report states “We have identified the three major causes of these deaths- complications during birth, prematurity and infection” and later say that birth attendants need to be well trained
So maybe using this pic isn’t so ironical after all
Psst… Typo in the title: “hombirth”.
Thanks. Fixed it.
That is just so sad. 🙁
It makes me all the more grateful I chose from the beginning to have a hospital birth, even if I was caught up in woo at the time. My daughter is alive and well because of it, there is no doubt in my mind.
She’s taking a nap now, and I just might go snuggle her after reading this.
Question: What exactly is meant by “stripping the membranes”? I keep seeing people talking about doing that but I’m not sure what they mean.
I had it done with my second. Using a gloved finger, the midwife or doctor separates the membrane that connects the amniotic sac to the wall of the uterus. The thinking is that this causes the release of prostglandins that can start labor.
I had been in prodromal labor for about 10 days when I went in and was miserable. I had been dilated to 3 and 50% effaced for much of that time. While I can’t say that having your membranes stripped is pleasant, it finally put me into active labor and I was admitted to L&D within 2 hours of having it done.
Notice in Angela’s story that before her second birth in the hospital the ‘midwfe’ strips her membranes. I’ll bet you anything that that wasn’t cleared with the OB.
Do you think that stripping membranes is a bad thing, attitude devant? I got the sense that my CNMs felt sorry that I had been having contractions for such a long time with no progress, and that they offered this as a means of doing a “soft” induction since I was 38 + 5 (not yet at the “approved” 39 weeks).
When I was admitted after having this done, I was at 5 cm. and proceeded to be stalled there for 8 hours. The CNM started pit (which apparently my body didn’t like because they turned it off), but she didn’t break my water until about 10 hours after I was admitted. Once she did that, it was only another hour and a half until my baby was born. I know that there is concern about cord prolapse once the water is broken, but I sometimes wonder if it wouldn’t have been over faster had she simply ruptured my membranes to begin with.
moto, the jury is still out on stripping. Some concern about GBS, if mom is a carrier, etc. My horror was that this CPM was stripping membranes on someone she was acting as a doula for, without the knowledge and consent of the OB.
Stripping the membranes sometimes is an appropriate action. So is rupturing the membranes. But in OB “one size does NOT fit all”. There are situations where either or both actions are definitely not advised.
NCB advocates so often are so doctrinaire: “my way or the highway” when really maternity care is rather a smorgasbord — the art is fitting the treatment to the patient, as no two women, no two pregnancies, or two labors are ever the same.
Ah, I didn’t realize it was a CPM. I was thinking CNM since it was a hospital birth. I’m quite sure that an OB wouldn’t be pleased about that, rightfully so!
All it did for me was cause a vasovagal reaction that made me puke and then pass out! 🙁
Using a gloved finger, the midwife or doctor separates the membrane that connects the amniotic sac to the wall of the uterus.
Times like this I’m glad I’m a hematologist and not an OB. That sounds difficult. And uncomfortable. Glad it worked out for you, of course, but my visceral reaction is “ewww”.
I had it done. Also called “sweeping the membranes”, a gentler-sounding and perhaps more appropriate term. It is a “natural” way to start labour, but some people see it as meddling with the start of birth. I had it done when I was 40 weeks, and the contractions started 12 hours later, then delivery 30 hours after the contractions. I don’t think there is a GBS risk because the amniotic sac stays intact. There’s a Cochrane review about the procedure, it does shorten labour and reduce the need for medical inductions, but there are “side effects” like bleeding, and I almost fainted after the procedure. The bleeding was like a menstrual period for me and considering the bleeding that happens with childbirth, not really a big deal: http://summaries.cochrane.org/CD000451/membrane-sweeping-for-induction-of-labour
Agree with above. sweeping membranes is the only proven method to decrease the need for induction of labor. It is uncomfortable, but if it hurts…you STOP!!! It takes all of 10 seconds and can only be done if you are already dilated. Some patients have a vasovagal response (faint or feel faint), so you delay sitting up for a few seconds after the exam. With a ridiculous push by some to avoid c-section at all cost, and induction being almost as bad, I am continually surprised at the number of patients who decline this option…usually because of preconceived ideas that are inaccurate
The bit about them not noticing the mother was bleeding all over the floor because they were panicking is a perfect illustration of why you want a hospital. What a mess.
“As I was being wheeled into the hospital I remember being glad someone else was in charge. I had no idea where we were going, but everyone else seemed to know exactly what to do.”
And that is EXACTLY why a person should be in a hospital when anticipating an event that – like it or not! – poses a higher risk of life-threatening bleeding and death. HB midwives act like birth is as safe as a stroll through a vineyard on a sunny day, which begs the question – if it’s inherently safe, then why does anyone need a midwife??
My heart goes out to this family. Such a beautiful little baby…
“if it’s inherently safe, then why does anyone need a midwife??”
Exactly! If it is really as safe as they insist, and if ANY intervention is more likely to cause problems than help, then logically the “safest” birth is an unassisted one. This is the line of reasoning I (and many other women) followed into deciding on a UC. Thankfully, I haven’t had any kids yet, and I’ve learned better since then.
They need an audience.
I remember with my very much regretted- shoulder dystocia homebirth… after everything had calmed down (son was breathing again and heartbeat steady, the placenta was delivered,and I got to the bed, injury of son noted,), the midwife turned to her assistant and asked, “Do you know how much blood she (me) lost?” “Um…I don’t know.” “What would you guess?” “Hmmm…I’m not sure.” They fumbled around with the the chuck pads and were looking at the blood soaked carpet and just guesstimating… Top notch healthcare right there… especially since the risks of uterine rupture and hemorrhaging increases with s/d. Meanwhile, I just lay there; 4th degree tear not getting stitched, feeling faint and dizzy and vision blurry with my broken son being held by my husband.
So another example of baby in trouble and not having any professionals/extra professionals to care for the mother at the same time.
I’m sorry this mother does not have a live baby to cuddle with… and I feel so humbled and grateful and selfishly thanking God that my traumatically homebirthed 5 year old is upstairs sleeping, resting up for his day at therapy tomorrow.
I’m so sorry your son continues to have problems from his delivery.
I would argue that it’s more about having competent practitioners. When my son was born (at home) my midwife (who was a CNM and ND) and her assistants (an ND student and an L&D RN, respectively), seemed to have it down to a science monitoring how each of us were doing. My placenta ended up detaching but for some reason I couldn’t deliver it and they had to remove it manually (which sucked, I wouldn’t have minded an epidural for that-but oh well, it was over quickly). Before I even realized what was going on, they had given me Pitocin and had IV fluids set up (they also gave me another med-don’t remember what it was). An hour later I was so much better and had no lasting effects from blood loss.
My point is that just because you’re at home doesn’t mean you can’t have protocols about who is in charge of what in any given situation. They also had all their equipment set up in a manner so they could get to all of it quickly and knew exactly where all of it was (they were able to get to the pitocin and IV so fast). Same goes for the high-tech resuscitation equipment that they bring to every birth (my midwives were trained in one of our cities best NICUs on infant resuscitation). In no way shape or form did they act like “birth was as safe as a stroll through the vineyard on a sunny day.” No one ever left me unattended and they stitched up my tear as soon as I was ready. For what it’s worth, they also had a back up obstetrician and excellent relationships with all the hospitals in our area.
Essentially, I think it’s downright criminal that this midwives didn’t have a protocol for who was supposed to take care of the mother in the event that there was an emergency with the baby. A situation like that means the mother needs more attention and assistance not less. Being out of hospital is no excuse for lax/non-existent protocol and incompetent care. Midwives not noticing a woman is hemorrhaging or attending to a woman with a 4th degree tear (indeed even a tiny nick) are examples of bad practitioners who abused the trust of their patients, not examples of how all practitioners act simply because they are not in a hospital.
Oh my heart aches for this poor woman, I can’t even imagine her pain.
This story supports so many practices in today’s hospitals including active management of the third stage of labor. Induction a week earlier with active management of the third stage would have resulted in a live baby and a postpartum mom without significant blood loss.
Meanwhile, one of my natural birth friends has posted some article on the acog talking about how pitocin “may” cause more problems for babies than previously thought. She says “Oh see, every mom needs to educate herself!” *barf*
I wonder what kind of prenatal care this lady was getting, if any. The baby was supposed to be 38 weeks gestation and is under 6 pounds? Either IUGR (which should have been picked up on U/s or exam) or the dates were wrong. Known IUGR would have been an indication to move to a hospital for the birth, it any semi-legitimate home birth practice.
She was getting prenatal care by charlatans.
I had an OB. My due date was confirmed by date and a 12 week us that were in perfect agreement. My baby was born at 39+5 weeks and he was 5 lbs 13 oz. just a couple ounces heavier than officially SGA. My measurements and weight gain were spot on. Third tri us aren’t standard practice in healthy low risk pregnancies. Sure the com care wasn’t up to snuff, but there are things we can call them out on and things we can’t.
But your baby was not SGA. Those few ounces statistically make a difference.
But was Charlotte? If she was 38 weeks and 5 lbs 7 oz she wasn’t technically SGA or LBW either, was she? Where does this claim of IUGR in this specific instance come from?
Well we can say for certain that she was low birth weight (LBW) which is defined as a birth weight less than 5lb 8oz at birth no matter the gestational age. Whether she was SGA or not depends on accurate dating. From what I gathered from her story, the mom was surprised when she saw how small the baby was because she had thought she was at term but when she saw her size started to worry that her dates had been calculated wrong and that the baby was actually a preemie. She brought up this concern to midwife (CPM) much later and the midwife reassured her that she hadn’t been a preemie because the baby looked to her estimate to be 38wks. Hard to know without medically reliable info. I’m sure the autopsy provided a reliable gestational age estimate, but she doesn’t share those findings.
Some perfectly healthy babies are just small. I was 6 lb 3 oz, one of my sisters was 6 lb 12 oz, and my youngest sister was 5 lb 14 oz. We were all full-term, no complication babies. We’re just little. I’m the tall one at 5’3″ 🙂
But you miss the point. Neither you nor your siblings meet criteria for growth restricted. You were all somewhat below average but none of you were small enough to be SGA. Yes even some babies that do meet criteria for SGA are “perfectly healthy”. But *as a group* they are high risk. The reason is that whatever it is that is causing the growth restriction(be it genetic problems, poor maternal circulation, weak placenta etc) makes the baby on average less able to tolerate the stress of labor. During a contraction, blood flow to the baby is greatly reduced. Babies who go into labor with marginal blood flow to begin with may not survive. Even the ones who are born without incident are at higher risk for death as a newborns: difficulties with regulating temp, feeding, breathing. SGA is NOT just a cute variation of normal.
When I was reading up on what happened to mine, I learned about symmetrical and asymmetrical growth restriction – the babies who are just destined to be small versus those who stop growing. I didn’t know that congenitally small babies could also be a warning sign – is that common? I did also read that missing IUGR happens too often and adds to the “unexplained stillbirth” figures. Proper detailed ultrasound that checks abdominal measurement with head circumference should pick it up. That wasn’t available when I had mine. In fact, there was a strong argument between an eminent consultant who insisted by daughter was growing normally and a more junior doctor who thought she wasn’t.
I stand corrected. There’s obviously a lot more going on with IUGR than just smallness, and the baby’d be even smaller than we were. Slowed or stopped growth rate, etc. The original comment made it sound like any baby under 6 lb at 38 weeks (~2 weeks before any of us were born) was at risk, and that didn’t seem accurate. However, I should have looked into what IUGR actually was and what its diagnostic conditions were before saying anything. That’s my bad.
Angela Rodman’s midwife is a story in herself. She had a job at a local hospital as an OB tech. Job description is basically stocking rooms and cleaning. But she claimed it as evidence of her experience and training saying she had “participated in” (as in cleaned up after) hundreds of births. She is so woefully undertrained that the local midwives basically wrote her out of their group. However she did go on to proclaim herself an expert in breech deliveries….
OB techs here scrub C/S and do more than just clean up. If one that I worked with said she had participated in hundreds of births I would say it was true. It’s still woefully undertrained though. I think normally it’s an nurse aide with on the job training or an OR tech with on the job OB training.
It was a Community Health Systems hospital. The job description is stocking and cleaning. It is online if you want to see it—-but this person was not a scrub tech for C/S —- the job description has changed since her tenure.
Thanks, and sorry, I didn’t mean to question you but to stick up for scrub techs who have a more clinical role. It’s still very limited but the ones I have worked with are hard working valuable members of the team….who would never go around giving medical advice!
I am sure she WAS valuable to the team, as cleaning and stocking, and getting mom the things she needs ARE important.
They just do not translate into the type of experience one gains being an OB or CNM, thats all.
This is the problem exactly- the job makes her sound so legit. If you hadn’t worked with her, worked in the same hospital during the time she was there, or knew the job description and how it has changed since she left (it is online, and is identical except for the CS stuff), you would NEVER know she was merely a helper that stocked the rooms.
And Im sure she KNOWS THIS, and uses it to her advantage. I don’t know any employee that wouldn’t try to pass themselves off as more knowledgable than they are, in order to get up the ladder quicker. The issue is that she is doing something that can KILL, which is why there must be checks in place to stop people like her.
Hey, Stacey! So glad to see you back.
Where were you? Or was it the site that didn’t let you comment?
What are you up to now? Having ‘interviewed’ another killer midwife recently? I remember being in awe when you described your meeting with Faith Beltz.
I never left, its just that Disques has me sign in w my google ID, so lots of my comments come up as Renee Martin, instead of Staceyjw. Both are me, just depends if Im signed in or not 😉
I have interviewed another killer MW, visited another BC, and even testified against them at the Oregon legislative session a few months back.
If you aren’t in the FB group, you should be. The open one is “Fed up w natural childbirth”, but here’s a closed one too. You can get added to it by going into the public one first, then you can delete yourself from the open group (or not, I like the open group).
Staceyjw!! Didn’t Patty Couch used to work at this birth center?? You know, the midwife who “worked for years in L&D”?
At the hospital I work at, our OR Techs were LPNs for years prior to training as techs and there are a few OR techs who have been techs for years and trained with the OBs. But regular techs NEVER get to scrub in for a CS, and certainly not someone who just cleans up and stocks rooms.
This IS Patty Couchs mess.
That is even worse. This poor woman probably thought that she was getting great care from someone who had years and years of experience attending pregnant and laboring women.
That baby is so beautiful. She looks like she could wake up any minute. Very sad.
The other jaw-dropping part of that story is that when the paramedics were called, they couldn’t get the ambulance up the winding picturesque drive to the old farmhouse which is Bella Vie. Nice planning, eh? “Five minutes from the hospital” but you’ll have to walk the first 300 yards…..
I wonder why this picture was included in the report.
And I also wonder why Melinda Gates signed off on a report that used incredibly flawed data to reach an unjustified conclusion about developed countries.
For your first question, I have no idea. Photogenic couple? As for your second question, there are people who work for the Gates Foundation who are pretty into the NCB tropes……such as Amie Newman. BTW, Amie happens to be a big TFB fan—I know because the reason I’m banned from TFB is that Amie was whining about your link to her blog and I pointed out that she seems to be doing just fine with the Gates’ family. WHAM! Banned!
It’s just so ironic that the only early neonatal death they could think of was a CPM attended homebirth.
Ironic but not unexpected given the relative risk of neonatal death in a CPM attended homebirth versus a hospital birth.
Actually, it’s totally appropriate that the “face” of neonatal death in the U.S. is a CPM-attended death. Most neonatal deaths–as the report basically says–are due to lack of access to skilled attendants and effective intervention. That’s the very definition of lay midwifery in the U.S.
Read the first page of her blog – Ms. Rodman talks about her contact with Save the Children and links to a USA Today story in which she was quoted: http://www.usatoday.com/story/news/nation/2013/05/07/mothers-newborns-children/2137163/
Of course, she claims Charlotte’s death was not preventable. The denial is so deep.
She had a consultation after the fact with a local MFM specialist who evaluated her for recurrent causes of stillbirth and found none. The autopsy showed no anomalies. Her take from all that was that the cause of Charlotte’s death was unknown and unknowable. She feels this information vindicates her and her midwife. Most people without her huge blinders on feel that it does exactly the opposite.
I’m reading through her blog now and she wrote a post in December that she had a dream that she had both children, but Charlotte was still a baby and incapacitated – due to lack of oxygen before birth: “In that moment I understood Charlotte had been deprived of oxygen at some crucial moment during birth and was incapacitated as a result. She was alive, but barely. She would always be my baby. She would always be incapable of living a full life. I turned from the conversation, guilt weighing my shoulders down, gathered my babies and prepared to leave. I was sad she couldn’t color a picture like her brother, and I was upset that I had somehow placed her in a position of living when her body and mind clearly weren’t meant to do so. Then I woke up.”
Again I ask any mother contemplating a home birth: is this what you want to live with for the rest of your life? No break from grief, even in your sleep? Is a pretty view out the window and girl talk about eating placentas really that important?
That is an excellent point. I have seen women say they are prepared for their baby to die and can’t help but think “You have no idea”.
A mom who is using this “MW” (Patty Couch) said this same thing. She knows about this death, about how she was a cleaning lady, and STILL defends her saying “but shes learned so much since then”.
Hope all goes well for her.
How can anyone *possibly* be prepared for their baby to die? That doesn’t even make any sense.
The only scenario I can think of is if the parents find out at some point during the pregnancy that the baby is incompatible with life, and will not live beyond a few hours or days after birth. And while I don’t think “prepared” is the right word, I think that doctors do their damnedest to do their best for those families and try to help them process the grief in a way that is best for them.
I know a couple that found out at 32wk their baby had a teratoma in his brain that rendered him ICwL. They scheduled a Csection at 34wk, since that was the only way for this poor baby to be born and they held him for the hour or two before he passed. It was heartbreaking, but they knew they were not going home with a live baby.
They don’t actually think that their baby will die. That only happens to mothers who eat junk food and/or don’t believe in God (or Goddess). Or who have inferior genes, too bad, so sad (loser).
Precisely. You only say it if you don’t really believe it can happen to you.
It’s one of those meaningless things people say when they literally have no effing idea what they’re talking about.
One thing I have yet to see on the blog of a loss parent is “I was prepared for this.”
If there weren’t so many stories of “MW”s that lose babies exactly like this, well, maybe it would be unknowable. But its a textbook case of MW negligence.
Let’s see, the baby was rushed to the hospital, at which point, it was helicoptered to the NICU in Salem (I trust the “birth center” does not have a helicopter pad)
Despite all that, the baby was still alive when it got to the hospital in Salem.
Even if it is true that the birth center was “only 5 minutes from the hospital,” how can anyone say that those extra minutes that it took to get the baby to the hospital didn’t hurt?
How much could have been done by the hospital staff in the time it took to get her to the hospital? In life and death situations, minutes count.
BTW, did anyone else notice that it was her friggin husband who had to tell the midwives to get her some pitocin for her PPH? If not for him, they would have killed her, too.
How about the cost. According to this post (http://angelarodman.blogspot.com/2010/09/you-deliver-me.html) the resuscitation and transfer was billed at $25,000, including $12,000+ for the helicopter alone. So much for saving money with homebirth.
One reason I really, really, really miss Astraea’s blog was that she had this one awesome post where she toted up the cost to the State of Oregon from the failure of her midwife to give her Rhogam. She became isoimmunized and had a very traumatic second pregnancy with premature delivery—-she was well into six figures without even counting all the consultations she had BEFORE delivery.
On the topic of costs, does anyone know the status of the lawsuit against the state of Oregon file by parents of a severely damaged child at homebirth?
I loved that blog. It was fascinating and damning and well-written.
I found out I was isoimmunized with my last. Just from hospital costs we reached 6 figures! That does not include all the testing and appointments during the pregnancy.
The baby wasn’t taken to Salem Hospital. There was an error by Life Flight and they made the choice to take the baby to McMinnville. If people are going to keep dissecting this birth story, at least get the facts straight.
I am just going by what the mother wrote on her own blog.
Did you have an actual point to make?
As Amy says, it is the mother who claims it was Salem Hospital. Blame her for the mistaken belief.
And thanks for trying to distract from the point with idiotic trivialities.
And that was where the whole “just call for a Lifeflight” line of discussion came from.