Homebirth midwives: bringing third world causes of childbirth death to the first world

Asia, old woman with grandchildren

You really have to hand it to homebirth midwives. Who else could resurrect third world causes of childbirth death in the first world?

Like their ideological soulmates, the vaccine rejectionists, they imagine re-enacting the “olden days.” And just like the vaccine rejectionists, who are single handedly bringing back, measles, whooping cough, and other vaccine preventable diseases that routinely killed children in the “olden days,” homebirth midwives are bringing back intrapartum stillbirth.

Intrapartum stillbirth is the death of a baby during labor. It is extraordinarily rare in the US today. A woman who shows up at a hospital in labor with a live term baby is almost certain to give birth to a live baby. Not so in the third world. Asphyxia (lack of oxygen) during labor is a leading cause of death in countries where women lack access to hospitals and obstetricians. Why? Because birth attendants in the third world have no way to tell if a baby is not receiving enough oxygen in labor and no way to fix it by C-section or forceps even if they could tell.

Similarly, homebirth midwives also can’t seem to tell if a baby is not receiving enough oxygen in labor, and when and if they do figure it out, they lack access to the obstetricians, anesthesiologists and operating rooms that could easily save the baby’s life.

Consider these two cases of homebirth death recently in the news:

1. ‘Perfectly healthy’ baby boy suffocated in womb:

The baby’s parents, Sarah Williams and Emmet Heneghan, had given evidence the previous day. Mr Heneghan described the scenes from that night in their home in Louisburgh, Co Mayo, in May 2011 as “farcical” as the baby’s heartbeat began to fade.

He had suggested that they go to the hospital, but the midwife’s car would not start so they had to travel in his.

Ms Williams also gave evidence that a doctor had told her that if they had left for the hospital earlier, her son would be alive.

Self-employed midwife Christina Engel, of Ballinrobe, Co Mayo, said she called the hospital to declare an emergency transfer as soon as she noticed the foetal heartbeat decelerating.

2. South Carolina has suspended the license of a free standing birth center and two of its midwives because of an intrapartum stillbirth.

The woman, who arrived about 9:43 p.m. Aug. 29, was 8 centimeters dilated by the next morning, according to a 7:15 a.m. exam, the documents said.

Then between 6:05 and 6:53 p.m. Aug. 30 [11 HOURS later!], the baby’s heart rate dropped from the 130s to the 110s while in utero. Just before 7 p.m., the documents note that “oxygen was applied at 10 liters per minute via a face mask.” But no physician was consulted, the documents said.

Around 7:30 p.m., the midwives took the woman to the hospital in her own vehicle, without consulting a physician or calling for an ambulance, documents said.

The midwives contacted Piedmont Medical Center and told them they were “en route with a mother that has fetal intolerance to pushing, meet us downstairs,” documents said.

When they arrived, a cesarean section was performed, and the baby was born without a heartbeat. Hospital personnel tried to revive the baby but were unsuccessful, state documents said.

Another third world cause of death is lack of access to someone with knowledge and equipment for advanced resuscitation:

3. The story of a blogger who is “pursuing healthy living.”

Finally, after 1 ½ – 2 hours of pushing, her head was coming out. I wasn’t sure she was really coming until they told me to reach down and grab her. She was still pink at this point. I reached down and grabbed her (under her arms I think) and started to help pull her out. They told me later that the moment that I grabbed her was when her coloring and muscle tone suddenly changed. They had never seen a baby’s color change so quickly before. She went from pink to white/blue, and she fell limp. I remember her head falling to her shoulder as I was grabbing her. From the sudden change in color and muscle tone, Sara knew something was wrong. As I pulled out most of her body, Sara took her from me and immediately started trying to get her to breathe.

What is it with these homebirth midwives and their refusal to call an ambulance?

During the pregnancy, Sara had explained that in case of transfer, she just drives to the hospital and calls ahead so they know she is coming and what is going on. If she called an ambulance instead, we’d have to wait for them to get to us, THEN drive to the hospital, so just driving herself gets the emergency to the hospital faster. (Not to mention that ambulances cost $$$$$.) It was also night time and we only live a mile from the hospital in a small town, so there should be virtually no traffic and she could drive quickly.

And, as usual, the mother refuses to take responsibility for her choices. In this case, apparently, its God’s fault:

It is hard to describe, but I genuinely felt peace at that point, that it didn’t really matter whether my baby lived or died or had complications, because I knew that whatever the outcome was, would be the way God wanted it to be. He wouldn’t make or allow this situation to happen if it weren’t for a reason. If God wanted her well, He would provide the miracles for her to live. If she died, then that was what was intended for her. God wouldn’t let something happen that was not the plan. Things were happening the way they were for a purpose. So I didn’t need to worry.

And once again, the drive to the hospital, in the midwife’s car turns into a farce:

On their way to the hospital, they hit a dip in the road too fast, which triggered some sensor in the car, shutting off all the electronics, and thus shutting down the car. Somehow, the BlueTooth was still working though, and they called 911. Sara had my baby in the towel and they started running (without shoes on, I might add) to the hospital. The 911 dispatcher had tried telling her to wait in the car, but she told them the policemen could catch up with her, as she was NOT waiting… After running maybe 1/3 of a block, a policeman picked them up and drove them the last 3 blocks to the hospital…

The end result:

When my baby arrived at the hospital, the doctors and nurses administered CPR and tried 3 times to intubate her. They gave her 3 doses of adrenaline/epinephrine, but couldn’t get a good heartbeat. At one point, they could get a heart rate of 60 (and it fleetingly even went up to 80), but it wasn’t a full open-close valve action…It was really just a flutter, forcing the heart to move without really beating. The heartbeat that they did get was short-lived and she never took a breath…

Dr. Pedi then tried breaking the news to DH that there wasn’t anything else they could do and that she was gone…

These are anecdotes to illustrate the point, but hard data shows the extraordinary epidemic of third world deaths at first world homebirth.

In March of this year, Judith Rooks, CNM released the most comprehensive homebirth statistics ever collected in the US.

The overall all rate of perinatal death at planned homebirth with a LICENSED midwife was 800% higher than comparable risk hospital deaths. While the rate of intrapartum death of term babies in hospitals is so small that it is effectively zero, in just one year alone three (out of 1235) babies dropped into a homebirth midwife’s hands unexpectedly dead … just as often happens in the third world.

Homebirth increases the risk of neonatal death because homebirth has resurrected third world causes of death in the first world.

Way to go, homebirth midwives!