Homebirth midwives shed accountability like water off a duck’s back.
Preside over a homebirth death and other midwives will promptly hold a rally for you without ever even bothering to investigate whether you handled the case properly.
Spew utter lies about research that shows an increased risk of death at homebirth and other midwives link to your lies.
Collect data on 28,000+ homebirths and find out that homebirth dramatically increases the risk of perinatal death, and just hide the data. Other homebirth advocates won’t mind.
But this latest technique for avoiding accountability is a new low.
I’m referring to Better Birth of Utah that had this to say in response to a client lawsuit alleging malpractice:
On a couple of occasions, we have discovered too late that a client is mentally ill, and her illness did not allow her to accurately perceive the events of labor…
That’s right. The folks at Better Birth have resurrected the classic sexist trope flung at women for millenia: don’t listen to that woman who is complaining; she’s crazy!
How many women, both poor and deprived or even rich and privileged have been “put away” into asylums because they dared question authority, whether that was the “authority” of their husbands, the Church or the State? Imputing mental illness to women who raise uncomfortable issues or make inconvenient accusations is one of the oldest sexist gambits in the book.
The folks at Better Birth claim that they are committed to accountability:
Our goal is to give every client the very best birth possible. Because we’re human, we don’t always succeed in that goal. When we have fallen short we are incredibly grateful to those clients who have given us the gift of negative feedback. Over the years we have used that precious information to change and improve our practice, our systems, and our facilities. As long as we exist we expect to continue that process and get better and better at serving our clients.
Really? They have a funny way of showing it.
At least they get points for full disclosure. Anyone contemplating choosing Better Birth can’t say they haven’t been warned. If you have a bad outcome or question their care, they will publicly label you as mentally ill.
It’s difficult to imagine anything more immoral or unethical.
I read this women’s website and she sounds absolutely mentally ill. The fact that you are using her to get YOUR point across about how you disagree with homebirth is just as sickening as what you are claiming Better Birth to do.
Dr Amy isn’t using me for anything. I asked her repeatedly to feature my story to try and get the word out about this place. If you think I’m just some lone crazy you should check out the other stories about Better Birth on the internet from other people (some of them posted years before my website opened up), because the owner has pulled the same gaslighting BS on other clients. Her standard response to problems is to ignore the person complaining, and if she has to be bothered to respond she simply denies anything happened or blames the client for whatever went wrong. As for sounding mentally ill- I can’t control what you or anyone else thinks of me, but I do want to encourage you to examine your beliefs about people with mental illness. You’re kinda spitting on a lot of people and implying that anyone with a mental illness is delusional or not worth believing about their own life experiences. That’s a pretty awful opinion to have, and its not based in reality.
The appeal has been filed, and I have a ton of evidence that treating sexual abuse survivors differently is an industry-wide standard in maternity and gynecological care. They finally messed with the wrong person!
Can someone explain to me how, regardless of if Shameon actually has a mental illness, this is not a HIPAA violation to talk about a patient like that?
I spouted off on a thread on this somewhere below, but the bottom line is that it’s likely the midwives involved aren’t covered by the HIPAA rule, which only applies to entities that conduct certain specific activities electronically, such as billing or transmitting records to insurance companies.
What they did is certainly a violation of ethics by any standard.
Its a violation of their contract with me (and really, every patient who has complained about them online, so a bunch of ex patients really). In the contract they alert patients that they aren’t subject to HIPAA, but also promise to keep your health information in the strictest confidence and they will only release it if required by law. Its like the contract is a list of things they DIDN’T intend to do or something.
whats with all the stuff about nitrous on their website. how is that natural birth?
All interventions and actions magically become natural and normal as soon as the HB MWs are able to offer them.
Pretty sure I’m done doing EMDR for the memories finally! It’s been one hell of a year.
Utterly disgusting. I hope they are somehow held accountable for their deplorable behavior.
nope! the department of professional licensing doesn’t care. This is like the 5th time I’ve dealt with them for various reasons, and they are fucking worthless. I do actually check the rules before I report anything. There are violations. DOPL just doesn’t do anything about it. I’ll just go forward with my legal plans then.
I didn’t expect much from them because of the last few times, but it still really hurts to get the letter that says they won’t do anything to help.
I wish there was something I could do to help. Though not regarding birth or delivery, I was in a situation in which my complaints about serious problems that needed to be addressed fell on deaf ears, and there’s nothing I could do to rectify it. It’s maddening, and it’s worse than wrong.
“This is like the 5th time I’ve dealt with them for various reasons” haha maybe you’re not mentally ill, but definitely an extreme drama queen.
Whenever I think HB MWs cannot stoop any lower in the quest for zero accountability, they manage to go lower. This is so despicable I am having a hard time finding adequate words to describe it.
I have never heard so many horror stories of disrespect of boundaries, medical assault (aka, actual birth “rape”), and general paternal thinking and actions, as I have heard about HB and HB MWs. Like so many other things, its the guilty that harp on their bad actions, projecting them onto others. Quite like a cheating spouse that is obsessed w their partner cheating and harasses them about it daily….
They have laid claim to a heritage that they have zero to do with- the heritage of MWs as the sole carer of women, holder of female only space, and having special knowledge. In the middle and dark ages, for example, this meant abortion, BC, and how the woman’s anatomy looked/worked (externally at least). A MW that knew too much about these things, or was too visible, would indeed be run out of town or burnt as a witch, because giving women any power or knowledge of their bodies/reproduction was an absolute no-no. They did try to protect women in the only way they knew how, with only the primitive tools that existed.
The modern HB MW has nothing to do with these MWs, no matter how many claims they make, and how often they call themselves elders. It is disgusting how they claim feminism, but them go on to use everything patriarchy has in its tool box in order to keep their patients in line. Its gross, and such a violation of sacred trust. They also say that these MWs would deny all of science today, and this is outrageous, and an insult to the intelligence go women everywhere.
Ah THIS!
”Our goal is to give every client the very best birth possible.”
“Give”??
Some sort of God complex going on at ”Better Birth”. This seems to make any alleged arrogance amongst OBs pale into insignificance.
I know. I wanna tell them “Hey, your paternalism is showing. Nice how you adopt the tools of patriarchy in order to oppress the vulnerable.”
Their in hospital vs out of hospital section is a right laugh. Some very bold claims including 90% of caesereans are unnecessary and at hospital you WILL be encouraged to have an epidural because it’s easier for staff, you WILL be hooked to an IV and unable to move, you WILL have to ask permission to go to the loo and that WILL undermine your confidence and increase your pain. Not may, will. It’s pure scaremongering, I had a baby in a US hospital six months ago and none of that happened. Also my doctor always waited for my contraction to end before he checked me and said he would do it as quick as possible because it might hurt. Definitely a bonus not having a sadist deliver your baby.
It’s even crazier given that in Utah, there are practices with OBs and CNMs that will bend over backward to help you do a natural birth in hospital if that’s what you want. When I went to the hospital with a prodromal labor scare, the nurses at the triage room in L&D asked me all about my preferences. The midwife who assisted with the delivery of my son (OB used forceps to manuever his head past my pubic bone, then she took over when I pushed him out) double-checked about my skin-to-skin preferences, cord clamping/cutting. I breastfed my baby in the delivery room! I was in the pushing phase/laboring down for five hours (in retrospect, not sure that was wise, but no one was pressuring me to get done for anyone’s golf game.)
I wound up wanting an epidural, but the hospital has a dedicated room for natural L&D with a tub!
A therapist I spoke with from a practice that specializes in birth trauma would disagree with you. She claims that the problem of provider caused birth trauma is a lot worse in Utah than in other states she had practiced in. SHe believes that it is because of the LDS culture surrounding childbirth- women are not allowed to express negative feelings about having children. Ever. Even if they have a story like mine they have to act like it was totally amazing. Its their entire role in life according to the LDS culture. Its why women aren’t allowed to have the priesthood- having babies is supposed to be the reward. SOmeone was even dumb enough to tell me that having to pee every hour of the night was ‘heavenly father preparing you for when the baby is born’.
Sexual abuse by authority figures (teachers, doctors, nurses, bishops, etc) is rampant here as well, because obedience is taught as a virtue and people are unwilling to believe that a mormon man would do something like that. Its a toxic culture that makes for the insensitive police force that I described in my story
Oy. I am a practicing member of the LDS church currently living in Utah, and yeah, Utah LDS culture is screwed up. I am seeing changes starting to happen, though slow in coming.
Hey, I’m non-Mormon and from out-of-state, and while the nutsiness can run deep here, just wanted to say that I really had no problems having a great birth.
But your points are well taken, especially the part about “the guy has a temple recommend = get out of jail free card.”
Imagine that! A patriarchial religion that uses faith to control and police women. Color me surprised.
/snark
A nurse at one of my hospital births asked me if I preferred the word “contractions” or “rushes.” She even used organic hemp to tie me down to the bed! Ok just kidding on the second part.
My birth center horror story does not negate hospital horror stories. Neither way is the ‘right’ choice, you can be preyed upon because of the power differential and the lack of legal options to address forced treatment/examinations of pregnant women. The ACLU has been involved in cases of forced cesarean section & children being taken away from mothers who refused a section (even though their kids were not harmed by the refusal). The whole maternity care system is fucked up IMO, and all this “you’ll be fine if you go to _____ (an ob, a midwife, a cnm, whatever)” bullshit is a big part of what fuels the lack of meaningful action on behalf of pregnant women. It is a false dichotomy- you should have your wishes respected no matter which model of care you choose, and there should be concrete accountability for anyone who violates it. Accountability for it doesn’t exist anywhere unless you are rich and very determined,
Oh I know doctors/hospital staff can be cruel. I was in a rail accident in India in my early teens and the trauma surgeon (who was trained in NY I’ll add) coldly ordered three nurses to hold me down to catheterize me because I was refusing it and insisted I could get to the loo if they helped me. Had to inject me with a sedative to get it in in the end it was horrible and I wouldn’t wish that feeling of powerlessness on anybody. KumquatWriter said a nurse angrily inserted a cath into her at an American hospital. but for me that experience was a complete one off. In my 26 years I’ve probably had more than thirty hospital stays in various countries and I’ve got nothing else to really complain about (nothing serious). In England the nurses ignore you a lot and your buzzer often mysteriously disappears in the night hmm lol but that’s about it. I don’t take umbrage with someone saying you might be treated disrespectfully at a hospital, such and such might make you feel disempowered etc it’s the ‘I guarantee this and this will happen to you’, ‘they *will* do/say this and it *will* make you feel this way.’ That is scaremongering is it not?
I did have an angry cath nurse, but she was woo-infused and an outlier – she just was MY labor nurse and thus had an impact on me. The majority of people at the hospital were awesome
AGREE WHOLE-HEARTEDLY. And anytime you push for accountability, do expect to be called crazy. And if you are a provider who wants accountability, hell, they will make them feel crazy too. Let’s face it: healthcare for women is absolutely a wreck. We have no autonomy in care. We are ignored in research. We are treated like cattle. We lack options in treatment. Some of the diseases that impact women are not even noted and in fact are dismissed as psychological in nature and then minimized even when they are discovered. It’s all a mess. We may have entered the field en masse, but it’s going to take more than 30 years to get out of the mindset that women are hysterical, mindless baby making machines who need to be protected from themselves or tossed in an asylum if they don’t appreciate the “care” offered.
Is anybody watching The Big Bang Theory tonight? Sheldon’s sister is having a homebirth and he’s having to assist. Needless to say, he’s disgusted by the whole thing and is wondering why she didn’t give birth in a cave.
OMG, that sounds awesome! I am imagining Sheldon assisting at a birth and loving all of it. We are DVRing it to watch after the smalls goes to bed, so I can’t wait.
It was great!
What did Amy Farrah Fowler have to say about it?
How can a person “accurately perceive” the events of labor when she has likely been told that the pain of childbirth is a matter of cultural perception and conditioning, that she can choose and plan the circumstances of her baby’s birth like ticking off an a la carte menu, or that she is “responsible for her birth experience”? She’ll have likely been indoctrinated with fairytales of euphoria and orgasmic birth. Even if she is level headed and has more conventional expectations (which is becoming uncommon for younger women as the NCB ideology has permeated academia and childbirth education culture so heavily that much of what she is likely to hear or read is skewed from the common reality), is she to have a positive perception of the event of hemorrhaging into a bathtub whilst a midwife punches her prolapsed uterus back into her body, sans pain meds?
I went into my first birth with the realistic expectation that I would have a 1st or 2nd degree tear. Imagine my perception then when I sustained a 3rd degree tear and months of neuropathy and incontinence, among many other things. In what way are midwives preparing women for this reality with the mish mash of magical thinking that NCB promotes? Bad experiences are quite common. What percentage of women actually complete an uncomplicated drug free birth? 5%, less? Any rational person is going to diverge in their perceptions of the events of “normal” childbirth.
Also, having spent time in a cult-like religious group growing up, the language raises a flag. “It’s a cult!” is my immediate perception when I read their statement.
They are trying to say that I didn’t accurately perceive asking them to stop an exam that was excrutiating, and then later denying me food unless I submitted to a new exam (and inappropriate sexual touching during that exam). My husband was there too so its just incredibly stupid. I know what I said and what I did and what I felt, christ. Who the fuck are they to tell me what ‘really’ happened?
For anyone who is curious, they alleged in court that I have borderline personality disorder (I don’t) and that my blog is evidence of that. BPD doesn’t make people delusional, so I don’t know why they think it would be evidence against me if it were true.
Not to be really embittered and morbid, but I would guess if I was being a bit facetious that they are trying to suggest you are BPD because it is a less common and less understood disorder than anxiety/depression/PTSD, so it sounds a lot worse. Like a judge or whatnot might accept that someone is delusional if that person has BPD while a lay person might be more skeptical of someone being delusional with depression, regardless of the actual true realities of the disorders.
you know, the judge didn’t care at all. He found that allegation to be totally irrelevant because the person making it had never examined me. These midwives were desperately trying to evade the obvious conclusion that my story is true, and their friend is an abuser of women. They can’t admit it so they are choosing to believe the story that Tara Tulley spun to try and discredit me. Suzanne also seems to have difficulty admitting to any mistake- its a pattern I found in complaints against the birth center. SHe either ignored or excused whatever happened. 8 people failing to catch a baby (so it landed on a hardwood floor) is probably the worst example I found.
Well, just because they tried, doesn’t mean it’ll work or that it’s a good legal tactic. Although maybe they’re trying to publicly shame you as much as possible as a way of making more “proof” to use on their website to make people disregard the negative comments.
Also, if they admit they are wrong, they can’t deny you have a right to complain, which is what they’re trying to do on the website.
But it’s great to hear the judge saw through the bullshit though. I actually have a lot of faith in the legal system for the most part, and I hope the ability to confront them using the legal system allows you to fully display how wrong they are in an objective system.
Seems like testifying to someone’s diagnosis without ever having examined them is an ethical violation of the SW license. Just sayin….
yeah I submitted a complaint a few minutes ago (about both of them, actually).
Good for you!!!
Right on! You are doing something amazing here, you genuinely are. It is so hard to go through such a traumatic experience, then immediately turn around and fight to help make it never happen to another person. You are amazing.
Hey, just want you to know I understand. I had a great birth experience thanks to some great people but have to deal with a terrible hospital on a regular basis (the only choice I have in a rural area) that I am pretty sure has almost killed me more than once and may one day. Good luck with the complaints. At least you don’t have to go back there!
I’d hope it’d be a violation of something, although I guess they’re trying to pretend they’re actual medical practitioners?
Nah. The bpd ‘diagnosis’ is because it labels you as malingering, dramatic, difgivult, even just plain lying. That’s what they were trying to say. That she was blowing this whole thing far out of proportion or perhaps even lying about it. At least that’s been my experience what people attempt to use the bpd label as a whitewash to do.
I have noticed a lot of references to sexual or “erotic” touch in NCB literature (as a suggestion to midwives to establish a “strong connection” or redirect pain sensations). It is certainly something that Ina May Gaskin referred to frequently when I was still paying attention to that crowd (as did her husband Steven when he spoke about midwifery – because he was viewed as being an authority on the matter as well). It seems to tie into the whole idea of orgasmic birth or birth as an extension of sexual experience. If someone is comforted by that and there is a mutual understanding of expectations far be it from me tell them it’s not acceptable, but I would be appalled if anyone had touched me in a sexual manner during labor. I don’t completely discount people who claim their births were orgasmic ( I would still describe having my children as a spiritual experience) but it is absurd and abusive to impose that as a generalization.
I think its okay for people to do that if they talked about it and agreed first, but I don’t want people to be mistaken about my case. This woman was visibly angry with me. She wanted me to leave. It wasn’t a misguided attempt to “help” me, it was a way she knew she could get me to leave (and probably quietly disappear like the majority of victims). I had already waived my right to a refund so what did she care? I have no doubt that this is something she has done before.
You were treated absolutely appallingly and I hope that Better Birth is held accountable. I only mention the “practice” of what most people would consider inappropriate touching because I think it is a somewhat common practice and it’s illustrative of how “out there” NCB practitioners can be. I didn’t mean to imply that it was an attempt to “help” or any way consensual. It was abusive and malicious.
Regardless, she would have to consent to it, and if not it would be sexual assault, period. Even if she theoretically did consent to it, a strong argument could be made that the provider was in a position of authority and therefore abusing her position of authority.
Hey you are right. I totally didn’t think of that!
Hate to have to say: Been here, done this. You’ve not chosen an easy road. Good luck. They will throw everything they can at you, but I want to tell you a little bit of wisdom a lawyer told me. You keep telling the truth and wait. The liar will hang himself. (Or in this case, herself.) Usually on her own words.
I’m sorry. I don’t mean to make this about me. I decided to take it criminally first, because I wanted the offender on the sex offender registry FIRST, because it was important to me to get him nation-wide. It failed, despite the fact there were multiple victims spanning years and two communities. The police were good: they promised me they will get him eventually. But this is not an easy road. Not civilly, criminally, etc. When the investigation against my perp was underway (he was a healthcare provider), they investigated me simultaneously. I had PTSD. They made it worse. They even went on my Facebook. I lost seven friends the day they closed the investigation and those “friends” never existed. I am sure they were in my email, etc. It was awful. You become as suspect as the suspect.
I COMMEND YOUR BRAVERY AND TENACITY. Be patient. Hunker down. Have a life outside of this. That’s the best advice I have. Make sure you can pack it away and have a life anyway. I lived for every new notification from the Board, the cops, etc. Waiting for that moment of justice that ultimately never came. That doesn’t mean you won’t find justice, yourself, but I learned an important thing through all of it: it’s process, not just outcome. The process of holding someone to task for harming you, finally, as a sexual abuse survivor, is a powerful thing.
I was recently harmed by someone I was seeing, and I didn’t hesitate to go to hospital, follow through as best as possible, contact the police, etc. In the past I would’ve blamed myself and God only knows what else. This time it’s already over. Done. There’s no more shame in me. I’ve been able to, through the process of reporting that one care provider and all that followed, demarcate a clear line between what is MY responsibility and what belongs to others. This is a huge thing for survivors, as I know you’ve probably struggled (and mentioned in posts). It just got stronger and stronger and now I won’t take shit from anyone. It has made me a bit ornery.
I have long suspected the NCB model of care would hurt someone like you and I am sorry. For one vocal and brave survivor like you, you know there are hundreds of others who have been sucked into a “healing birth” without informed consent, and who are suffering quietly shamed, thinking that they failed again, and holding that shame in. So you’re already light years ahead.
I strongly recommend INFORMED c-section as an alternative to vaginal birth for survivors. It is no less painful, but it’s a different kind of pain. Some may find it a loss of control, but I felt like I had hired my team to perform a task FOR ME. That’s how I viewed it. That I was running that show. It was such a relief.
I’m a member of a survivors forum and when I ran it past survivors, many of them had c-sections for second births and found those c-sections healing and much easier to cope with. There is a degree of control in surgery you just don’t get in a vaginal delivery. And of course, for a vaginal delivery in hospital, there are also epidurals and birth plans that afford you protection and respect (though I live in an area where epidurals are hard to procure and I don’t trust my hospital.)
Of course, NCB whackjobs won’t present both sides… I’ve often thought about being a duola specifically for women who were sexually abused/raped.
The pragmatist- I tried to go criminal too, but the officer was eager to file my complaint as unfounded. I reported him to his supervisor for doing a really shit job of investigating, and when he was in court he said that the outcome of the case was that there wasn’t enough evidence to go forward. SO I think that changed something, like he will screw up less in the future. That is good enough for me. Change happens in very small steps.
thanks for your words. You and I seem to have a lot in common. You should blog about your experience (if you can). Just reading that someone else understands means a lot to me- after this happened I tried very hard to find a case similar to mine and couldn’t. I felt very alone.
I agree that it is sexual assault and an abuse of authority. I should have used different wording, I didn’t mean to insinuate that I thought it was anything other. I just believe that “sexual touch” has been institutionalized in certain NCB circles as being therapeutic and that lends itself to an increase in sexual assault.
No, I didn’t misconstrue it. I just wanted to mention to her that it had to be consensual, even if it was part of their philosophy of care. I took part in alt-med care that I learned later had aspects of sexual healing *apparently*. I did not consent to be “sexually healed”. I was 27 and he was 61 and he totally ran ripshod over me. I had no idea what I was getting into. So I just wanted to make sure she understood that whether or not it was part of the philosophy of care, she was never under any obligation to partake, nor should it have been suggested by the practitioner, nor is it probably legal where she lives. Here– in Canada– it is illegal under federal law, but it takes multiple victims to take down a provider when sexual touch is involved and the Crown is reluctant to go forward until they have many victims willing to take the stand. In my case, there were multiple victims who went to the RCMP and then many more who went to the Board, but a sexual abuse/assault survivor cannot be pressed into testifying, so frustratingly, we know there are more, but there is nothing we can do to make them come forward. I just wanted her to know that even if it was an implied part of the treatment, it’s completely f-ing irrelevant as it’s an abuse of power anyway, and she didn’t consent to top it off. EVEN IF SHE DID, STILL AN ABUSE OF POWER.
I’ve never heard of a non-NCB provider sexually abusing a client. It seems that sexual abuse from providers runs rampant in the alt-med community. I don’t know why, but that’s my personal experience.
Hey! I have hospital-induced Borderline Personality Disorder! Meaning, no one except one hospital and two nurses (who made it up to deny me care) actually believes I have it! Not my psychiatrist of 7 years, not my medical team, not my therapist. Nope.
We should exchange notes! BPD= the garbage diagnosis to silence women who demand better care than they are getting.
Meanwhile, BPD doesn’t make you so f-ing delusional you can’t note abuse. Your posts are making me angry for you and I don’t even know the whole story!
I actually read a piece by a psychologist a few years ago that said BPD was code for “hopeless and I don’t want to try to help them anymore”. Its like a black mark on your psych record if you try to get care. I’ve always found it very strange that it is considered a part of cluster B personality disorders.
She never did explain how someone with BPD wouldn’t know that they were being abused. I feel very wary of someone who would make a statement like that working with victims of abuse- she is basically saying someone who is diagnosed as borderline can never be taken seriously in the event of a rape or another type of abuse.
So many people who have cult experience, myself included, recognize the NCB movement having much in common with a cult. I have shared before that I left a Lamaze course ( fully paid for by the way and not cheap ) midway through because it was putting the hair on the back of my neck up with how much I felt I was revisiting my cult experience. I think the last straw was when I questioned something and I was met with a rather hostile “everything we say is evidence based” rather than the evidence. It was cult like in SO many ways, up to and including the amount of time you were expected to spend in class.
THANK YOU DOCTOR AMY!
For anyone interested, this is my story and my lawsuit.
http://shameonbetterbirth.wordpress.com/
Midwives band together to unite against women who have PTSD due to medical battery. It is so gross. They told me that I would be in charge of making decisions about my own care. I disclosed my abuse history to them in hopes that they would treat me appropriately (letting me have control over what happens, explaining what they are doing/why, etc) and they did the opposite. Now that I’ve sued the ‘midwifery model of care’ line flew right out the window, and now its ‘standard care’ to continue exams while a patient begs them to stop. No accountability, no integrity. The laws for midwifery in utah are up for review soon, and I am going to do everything I can to get more accountability for midwives in Utah. I am motivated and tenacious.
What they don’t seem to get at better birth is that it isn’t that these things happened to me- its THEIR REACTION. Every step of the way, its their reaction that caused more problems.
Once again, I really admire your ability to fight for yourself even though it means outing yourself and also having to continually confront your own traumatic experiences and the ways those may trigger you.. These people are actually horrible, and the casual way they toss aside your experience due to your history of mental illness is really sick on top of how horrible your experience was. (The email sent back to you from the center after you emailed about your complaint is actually infuriating.)
As someone with a history of anxiety and depression problems and also with some childhood trauma, the fact this birth center treated you in this way really hits home, which I guess is pretty obvious from my responses.
Thank you! I just couldn’t stand the idea of another woman having this happen to her, and no one official could do anything. That is how I overcame the shame and vulnerability of telling the tale (a big dose of therapy helped too, of course). I’ve realized that these places prey on the fears of women like me. I was into science, worked in healthcare, and I still got fooled because of emotional decision making. There needs to be a way to protect women and their babies.
I was lucky enough to have two great c-section deliveries done by an OB I adored, but thank you for being brave enough to speak publicly for other women who weren’t as lucky, and need someone to stand up for them.
”Shameon” – your perspective would be very interesting to hear. Could you write more on what they did that influenced you? This might also help other readers.
The ‘your body is not a lemon’ stuff in ina may’s guide to childbirth was very influential. The perspective that it didn’t have to be scary and horrible to have a baby. I had my body used against me and controlled in an abusive situation before, and feared it would happen during childbirth., I also had a fear of hospitals (which I caught from working inside one and witnessing patient abuses daily, iatrogenic infections, etc) made me very vulnerable to their line of thinking.
I am glad you have shared your experience. It’s helpful I think to any healthcare provider, crunchy or not, who is compassionate andwwilling to listen. It’s easy to see how the NCB ideas would appeal to you. Hopefully, the midwives involved will wake up and stop trying to shame you.
I keep coming back to this. Have you pursued this criminally? Just wondering. Haven’t read your whole story for triggers. Taking it in little bits at a time. Sorry if you said yes or no. But you’ve said there was inappropriate touching with a witness? Is that correct. That’s criminal.
There is no shame in telling your story. The shame is theirs. I just want to reiterate that. I like your moniker because it turns that right around. I was abused by a care provider for 1.5 years who claimed to be treating my PTSD. I didn’t get charges out of it, despite the fact he did it to multiple women, but he’s not practicing anymore. It took so much from me, but I would do it again. He was charismatic and well-liked and I’ve ruined his reputation. He won’t ever get his license back at least. If I have any advice for you, check out your statute of limitations and if you have time, TAKE IT. Take your time. Work with a lawyer who is patient and just take your time. I’m going to start the civil process now that I’m recovering from the intensity of the criminal process– it took 18 months. It’s a long haul and you can’t maintain the anger the entire time, you have to find a way to pack it away or it will drive you mad. IMO. With all due respect. I hope you are successful and I hope you shut them down. The satisfaction in taking this guy out of practice is huge. And I don’t feel any shame at all anymore about it! NOT MY FAULT. I went to him for help, like you went to this birth center for help. To have that help perverted is criminal and NOT YOUR FAULT. Many good wishes your way.
You are amazing. Thank you for doing this! It’s people like you who make change happen.
Thank you for being willing to share your experiences and help other women avoid having the same thing happen to them. I’m sorry that this happened to you!
They were absolutely negligent to not inform you that they could not stop an exam if your life was in danger. At least both my midwife and my OBGYN made this very clear to me, and when I decided to have a c-section instead, supported that choice. My OB said something along the lines of: “There may be times I will have to do things to you that you have no control over. Are you going to be okay with that?” And the answer was no. C-section it was and trauma-free birth. I’m sorry to hear this has happened to you. It is one of my pet peeves that NCB does this to survivors. I am also a survivor with PTSD and severe trauma in my past and it is already hard enough to get medical care without informed consent. I need to know exactly what is going to happen and then have some time to process it and decide how I will internally cope with it.
Totally OT –
For those of you who asked, good news, I got my last CT scan results and am cancer free! I would throw myself a party if I had the time.
In further off-topic news, my sister, currently 38w1d pregnant and out of state, has started showing early signs of placental insufficiency. The doc says the baby looks “too good to induce now”, and he wants to schedule a scan for Monday, and an induction for Wednesday (39w exactly). Fingers crossed for her to have a good, quiet weekend, and either to go into labor soon, or have an uneventful induction on Wednesday, please?
Why is the doctor waiting? Is it because of the stupid push against delivery before 39 weeks unless its an emergency? I don’t think I’d feel very comfortable with this if I was your sister. Perhaps she should seek another opinion?
I have raised all these points. Frankly, I think the right time for an induction was yesterday, and they’re just waiting for the situation to degrade. I see with the preemie mom goggle – 38 weeks is plenty of gestation! Let’s get that baby outta there! My sister seems actually reassured by the doctor’s opinion (which may be totally legit – I wasn’t there), so I’m keeping out of it. For now. With the known strong opinion that if she feels that even the slightest thing is even the slightest bit wrong, she should not hesitate to wake up her OB and go to the hospital.
Congratulations on your wonderful news!
I’m so glad to hear you got the news you were hoping for!
Of course I’ll be thinking of your sister.
Ditto! Congratulations on that great news, and all best wishes for your sister.
On the topic of this post, absolutely disgusting! How could they possibly think this was a good idea! Is it even legal to say this?
On the topic of the woman I told you about yesterday, she says she has already shown her records to several lawyers and they aren’t interested in taking the case. They have all told her, although there is strong evidence the records were tampered with and strong evidence of malpractice, it’s the death of a fetus in utero and therefore not profitable enough for them to pursue the case!!? They said it would be more profitable if the baby had died during labor and the doctor had not performed a csection, but under the circumstances of death it’s just not worth it to them! How can this be!? She said they kept emphasizing it was only a fetus!
For all of the talk of frivolous lawsuits, it is usually very difficult to pursue a malpractice claim. If she hasn’t already, it may be beneficial to contact a lawyer in another area or an advocacy organization of some kind. I live in a rural area and as a rule of thumb, local lawyers shy away from claims against our local hospital.
The myth of the frivolous suit and the “ridiculous, unfair” payout was created on purpose, so tort “reform” could be pushed to the benefit of the wealthy and insurance companies. Limiting the pay outs and making it harder for people to use the courts for redress is only going to hurt the average person. Its one of the very last, and often only, ways we can get some relief when mistreated, especially by an entity more powerful than we are (corporations, hospitals, etc.). And we all know that we cannot allow the 99% to have anything that helps them even the score with the 1%….
Often the McDonalds coffee lawsuit is used as an example, but its a perfect example of a need to sue to create changes,
exactly. I sued in small claims, for gods sake. It was my only viable option because attorneys are unwilling to take my case. the small claims limit in utah is 10,000$ so that helps (because it actually covers my damages), but if my child had been injured it wouldn’t be much of a help in covering the cost.
She should call local news stations. That is often a fruitful way to get attorneys to contact her instead of the other (exhausting) way around.
A close friend of mine had a similar experience – gross negligence during a preterm delivery where the baby died and my friend came very close to hemorrhaging to death. Just massive amounts of negligence all around – the OB, nursing staff, hospital, you name it. Multiple witnesses to all of it. My friend’s husband is an attorney, and he obtained the medical records and consulted with the best med-mal lawyers around, and not one of them would take the case because, in their words, “no one died.” In other words, since the baby died before he was born, he was “just a fetus” and apparently that wasn’t enough for a lawsuit. And since my friend managed to survive the ordeal without permanent harm (I guess psychological harm doesn’t matter? grr), they didn’t see a good case there either.
It’s so very frustrating to know that these people go on to continue practicing in such a dangerous way.
That is horrible and so frustrating.
If he was viable why does it matter if he was in or out when he died? If it’s likely he would have survived if not for their mistakes he should still count IMO. A viable foetus isn’t ‘no one’ ffs.
Ah, the Gloria Lemay defense. “Not really a human being!”
Long time reader and lurker, but this post actually pulled me out of my state of comfortable lurking. Holy cow this is disgusting. Talk about disenfranchising people who are not neuro-typical while publicly shaming someone with their private medical information. The idea that the mentally ill cannot be rational or cannot correctly perceive any experience demonstrates that society refuses to acknowledge that mentally ill people can indeed be rational and correct. This comment is actually worse than all of that, though, because the woman’s mental illness is being used to silence a woman’s experience. That’s so woman friendly and woman focused, no? And that’s pretty evil.
Maybe the mental illness was severe, and the person was irrational, but the comment did not read that way to me. It read like a way to make an excuse for a bad review or for someone complaining. (And if the person was severely mentally ill and the illness was ill managed enough to cloud the woman’s rationality, shouldn’t the clinic have referred her to care providers who were more suited to managing her mental health along with her pregnancy in the best way to keep the woman safe throughout her pregnancy and afterwards?)
Yeah, I’m probably being sensitive, but seriously, this reads so cruelly to me.
I disclosed a history of anxiety, an eating disorder, and abuse. None of those things cause delusions.
Thank you so much for the confirmation and also for sharing your story even though it means disclosing information you should not have to disclose in any public space.
I maintain that the comment from the center reads like a way of silencing someone who is completely rational and has a right to a voice and an opinion. I’m greatly saddened I assumed correctly.
Even if you had been schizophrenic, it should not be used as an excuse and outed the way they outed your mental health issues. An investigation ought to have ensued. Especially when there was a witness.
This case is so disgusting. Is there any excuse a HB MW won’t use?
It’s completely unprofessional for them to be giving post-hoc mental health assessments of former patients, let alone publishing the fact publicly. Midwives simply do not have the education and clinical training to assess and diagnose mental illness, and it’s overstepping the limits of their already tenuous practice to try and do so.
YES to your second paragraph. If someone is suffering mental illness that is so out of control as to make them incoherent, then they clearly need additional help, to deny them additional help is NEGLIGENT. But we live in a culture where mental illness is seen as separate from physical illness, even though the evidence doesn’t support that. It is more starkly, as my psychiatrist calls it in my case, “brain damage”.
My mental illness does not preclude the ability to think rationality if it’s controlled. It is controlled by having access to appropriate medications and environmental controls. In hospital it is controlled by having autonomy, knowing where exits are, not being tied down, not being abused by staff, etc. And the appropriate application of medications suitable for my condition and supports. I am a high-resource patient, but it is no defense for treating me poorly.
If I were to be abused by a provider in a birth, I doubt I could defend myself or remember it correctly because I have PTSD that involves a very high state of hyperarousal followed by complete dissociation and/or vivid flashbacks of violent assault. Pain triggers me. I am at high-risk of revictimization because of this.
This all sounds scary but it’s not so different than a patient who has had a heart attack and so is on medication and needs certain environmental controls in order to be healthy. A hospital strips me of many ways in which I personally cope with having PTSD, so it becomes a very difficult situation for me. So my only defense is to try and surround myself with people who are safe and who understand what my specific triggers are and help me feel in control of the situation. I liken it to having Diabetes and going to a hospital where they deny that you have have Diabetes, take your medication until you go into shock and then blame you for going into shock and then demand you get yourself out of it, and if you, don’t punish and abuse you. This has been my experience of navigating healthcare as a woman survivor with PTSD. I’ve had mostly bad experiences. I now have a good team of people, for the most part. I’ve had horrible things happen to me even when I’ve been as honest and forthcoming as I could be.
Aside from everything else, it’s just stunningly, breathtakingly bad public relations. The page, which is presumably meant to mitigate the effects of the titular bad reviews, not only doesn’t do that, but actually achieves the following:
1. Alerts readers who were unaware of the bad reviews to their existence;
2. Suggests that there are enough of them to be a problem to their business;
3.Demonstrates that clients’ privacy is not safe with them;
4. Provides potential fodder for further legal problems;
5. Gives Google yet another page with “negative” and “Better Birth” in the meta-data to index
If I were still doing strategic communications, I’d put this in my workbook as an example of crisis management gone disastrously wrong.
I wonder if any of these providers ever stop to think that maybe they caused some of the mental illness that they wish to disparage? Birth trauma is a significant problem with a toll that is largely psychological – maternal mental health is a serous issue – and behaviour like this only contributes to the stigma and taboo that prevents mothers from being able to adequately meet their mental health needs.
In court they denied that birth trauma was a real thing that providers could cause, that there was nothing they could do to prevent it and that it was my problem for having an abuse history. The ‘expert witness’ who testified to those facts did not disclose her close relationship with the birth center staff. She pretended to only be casually affiliated. I emailed the clinic she works at so that if she does this again (uses her LCSW credential to defend a friend accused of abuse) they will know its a pattern.
So if providers can’t cause birth trauma…and their actions can’t prevent it…WHY WOULD ANYONE CHOOSE HB?
Because, apparently they’ll still end up traumatised, even if they avoid the hospital interventions. So they shouldn’t have accepted you as a client, because, according to them, you weren’t going to have a good experience ANYWHERE.
Their logic isn’t even internally consistent.
It’s true. They are making false claims. That’s the shitty thing. They lied to you. They could never prevent birth trauma. It was all a ruse. Lawyer should get them on luring you into a situation based on false premise using their own expert testimony.
“The gas lamps aren’t getting dimmer, sweetheart, you must be imagining it…..”
Totally. Is that Charles Boyer there in the birthing room?
I have personally known women who have either used Better Birth or are currently using them.
One of them used them for two of her children’s births–one at the birth center and one at home. The birth center one was fine from what I’ve been able to gather, but the home birth was handled badly. After the birth, Suzanne Smith pulled on the cord to get the placenta out, and caused the mother to hemorrhage. It got resolved, but Suzanne left while the mother was still in the tub.
I know another mother who had the exact same midwife and who hemorrhaged too. It turns out she has a blood clotting disorder that hadn’t been diagnosed at that point. She went with a hospital provider her next pregnancy.
Another saw them during her first pregnancy, until she couldn’t pay up and she went back to her original OB. She is seeing them again. She has been struggling with depression and anxiety (I think she has a OCD diagnosis too) and they keep telling her to get this supplement (I think it’s EMPower Plus or something) that costs at least $50. A “specialist” they consult with has also told her that Zoloft would not help her, never mind of course, that the drug is frequently prescribed to people with social anxiety problems. It doesn’t help that she herself absolutely does not want to take prescription drugs, so the midwives are feeding off of that. I am very worried for her because she has bought into so much woo.
Has your friend with social anxiety seen Better Birth’s page on this? Is she comfortable with their willingness to out mentally ill patients to further their own interests?
Given her diagnoses, she should seriously consider running as fast as possible (maybe CNM care is a viable alternative for her?).
I’m not sure. If she has, she probably has just shrugged it off. She is very easily influenced by the woo, it’s not even funny.
We do have CNMs in our county. They have a great reputation, great statistics, and they are supportive of natural birth if that’s what the mother wants and as long as things are going well. I would know, I had my daughter with them (in the hospital). Unfortunately, she thinks that CNMs are just “medwives” and don’t know as much about women’s bodies as CPMs do.
That’s too bad. If you think you can, it might be worth it to forward the page to her and ask if she’s comfortable with their attitude toward mental illness and patient privacy. I know it might be counterproductive to bring it up so if you can’t, I understand.
She’s so brainwashed at this point that it wouldn’t change her mind, and since she has been seeing them for some time now (she’s due next month), she most likely knows about it. She already knows my opinions on out-of-hospital birth, but has dismissed them and called me rude for saying that the CPM credential is a joke compared to the CNM credential (which is what the midwives in other developed countries have the equivalent of).
I’m scared that the only thing that will change her tune is if something bad happens during her birth, and considering how young and vulnerable she is…I don’t want to think about it.
That sucks. Sometimes all you can do is watch as they willingly go forward and be ready to help pick up the pieces in the aftermath.
I hope your friend has an uneventful birth and is satisfied with the experience. I wouldn’t wish what happened to Shameon Betterbirth on anyone.
you can have her contact me on facebook if you want. I don’t judge her for choosing them, she should just know what they will do if one of their employees makes a mistake.
slandy- can you put me in contact with them? I would like to share the stories on my web page to warn other women.
I’m afraid I can’t. One of them, I have no contact info for and she has moved away. We just met in the mother’s room at church and talked about our respective birth stories. Another has minimized how stupid Suzanne was during the delivery.
The last one, I’m afraid, is completely head over heels in love with Better Birth right now, even though they’re telling her to spend $50 on a supplement that will probably not help her depression and anxiety.
thank you for the information anyway. Since I came forward a bunch of people sent me private messages about how they knew BB was terrible so everyone who decides to say it publicly is helping spread the word.
As awful as I feel it is to pretend a supplement will be as effective as medication, I hope the birth center at least have referred the woman to a counselor so she can get effective help managing her depression and anxiety problems that will also work (unlike the supplement.)
Compare this to my experience with a completely woo free OB, not exactly known for being Dr Friendly. She delayed shoulder reconstruction to be able to do the last portion of my prenatal care and my C/S. She did that just to make sure I wouldn’t have to explain my mental health history to another doctor and set of support staff (complicated by the fact that I work with all the people who would now be privy to that info). I would never have asked her to do such a thing, but she decided she was able to do this for me.. She wouldn’t have told me about her problem but someone asked me why my doc was doing my operation when it was known she wasn’t doing surgery until after her recovery period. I then asked her that question! She has always gone the extra mile to ensure I get the best care .
Ditto! My OB/GYN here moves mountains for her patients day in and day out, including me. I would not have received appropriate healthcare if not for her. At all. Nice thing about having an OB/GYN is that they don’t just screw off after baby is born. You can continue to see them as long as you need to, so they can develop long-term relationships with you, unlike a midwife who is just there for a short time.
“…we have discovered too late that a client is mentally ill, and her illness did not allow her to accurately perceive the events of labor…”
A question for those of you who work with women in labour/post-partum. Do you find that mentally healthy women will always accurately perceive the events of labour, even in the presence of unrelieved pain or other trauma? If a woman has a difficult labour with several complications, how likely is she to accurately remember events? I would think that being in acute and unrelieved pain along with the general messiness of childbirth would make a 100% accurate recall difficult if not impossible for most women.
I’m mostly asking because the Better Birth people seem to be going nuclear on the idea of pre-existing mental illness when I think there are perfectly reasonable approaches to take that don’t even assume malfeasence on their part. Taking this tack tells me they are in the wrong and are fully aware of it so will sling mud in a desperate attempt to make the problem go away.
I have post traumatic stress disorder from being there, from the events they claim I ‘perceived incorrectly”. The events are seared into my brain and I re-experience them daily (bodily sensations, emotions, visuals, etc). I remember it better than anyone, believe me.
I don’t doubt your story at all. I’m especially glad for you that your husband was with you so he could confirm your story to you (my understanding was tgat the midwives were trying to make you doubt your recollection).
But even if you had an inaccurate understanding of what had happened, so what? You had a traumatic experience and it was their job to respond to what had happened and gone over your records with you respectfully. It’s clear from their correspondence that they were not interested in helping you through what had happened or changing their practices. They were gaslighting you from the start and that’s not acceptable.
Definitely. Shameon Betterbirth knows what happened, but a great many people who’ve experienced a medical emergency DON’T know exactly what happened, or who did or said what. Pain, shock, fear, drugs, they can all mess with perception and memory. It’s not uncommon, and it’s something healthcare providers need to be prepared to deal with.
I’m guessing that they’re taking the mental illness route because otherwise they’d have to admit that childbirth can be traumatic despite the provider’s best efforts? It’s just weird.
I recently witnessed the immediate aftermath of an accident with multiple fatalities. I was not involved or hurt in any way, but I have no memory of seeing any blood or bodies (and from the press photos and other witness accounts, I would have). I remember seeing the vehicles, the first responders, and one person being wheeled away on a stretcher under blankets. Now, from my vantage point, there is no way I didn’t see carnage. My mind just didn’t register it for whatever reason. A person standing next to me could have seen the opposite – bodies out in the open with no memory of the vehicles/emergency workers. Neither of our perceptions would be invalid and neither of us would have to be mentally ill to have experienced things the way we did.
All that to say, if I don’t have a proper memory of what I saw as a witness, how would I expect anyone to remember things 100% accurately if they were involved in the accident? It’s a normal reaction to trauma and not a sign of mental illness.
tl;dr: the midwives are the crazy ones.
I want to comment on this as a mentally ill person who is also a mental health professional:
The notion that merely having a mental illness would interfere with memory or perception is offensive. There are SOME mental illness symptoms which interfere with perception or memory, and not all mentally ill people have them. Even those that have it do not have it all the time.
Unless someone is diagnosed with a mental illness which would interfere with perception or memory AND a professional is of the opinion that their illness interfered with their perception or memory AT THAT MOMENT, there is no reason to doubt the word of someone with a mental illness.
I understand most people do not have the expertise to know that, but as someone who is ignorant, why assume?
Look, I have a mental illness that very occasionally interferes with my memory and I agree that is no reason to doubt the word of a person with mental illness. Dealing with mental illness is difficult enough without having experiences discounted as “all in your head” or somehow less reliable simply because you have a mental illness (whether or not it had any bearing on the situation in question).
However, that wasn’t my question. What I was asking in my post was why, if the birth centre is claiming that the individual is not remembering the event accurately, must they do so using the “mental illness” label? I was asking if it was reasonable to expect ANYONE (mentally ill or not) to have a 100% accurate recall of a painful and traumatic event (and yes, giving birth is painful and can be quite traumatizing). I personally feel that they are using this supposed mental illness as an excuse to try and silence and marginalize a woman who was horribly treated, rather than address her complaints appropriately.
Sorry Dr. A. but I’m gonna award points to the birth center on this one since they only labeled their patients as mentally ill to the press not the courts. You must admit that forcibly hospitalizing patients is a disturbing trend in the mainstream medical establishment even if it’s pretty uncommon.
Wait, so forcibly hospitalising an extremely small number of patients who presumably are found to need it using lawful methods is somehow worse than labelling patients mentally ill without the knowledge to even diagnose them as such and doing it in public?
Nope – if you read comments on this site, you’ll see that they ABSOLUTELY brought these allegations into court. The client is already starting the appeals process.
Support for the “trend” assertion? Or are you basing this off a couple of recently publicized incidents? You admit it is “uncommon.” Do you have a problem with judicially authorized confinement when someone is a danger to her/himself or others? Thinking of Amanda Bynes — is it okay that her parents were able to commit her so that she didn’t kill herself or someone else? As long as due process is followed, I’m fine with it.
When have doctors forcibly hospitalized patients who sued them for malpractice? Oh, right, NEVER.
In my opinion, one way of dehumanizing people struggling with mental health problems does not make another way okay. Some of the recent medical cases have been really awful, dehumanizing, and cruel. Those cases are wrong. (Which also does not mean that all cases of forcibly hospitalizing mentally ill people is wrong. I don’t necessarily like the way it is applied a lot of the time, but there are cases where it saves lives.) However, this unrelated case is also horrible and wrong in a completely different way.
Just because one party is wrong, doesn’t make another party right.
They labeled me mentally ill to the courts too, using a very unethical midwife friend who had just obtained her LCSW. These women rallied support behind a midwife that killed a baby using prescription drugs and surgical tools without proper training. Their motto seems to be “throw women under the bus if they made midwifery look bad”. These are big names in utah midwifery care, too, keynote speakers and legislative consultants and utah midwives organization past presidents. They are supposed to be leaders, the benchmark of midwifery care in utah, and they have proven themselves to be scum.
Forgive me is someone has already asked this but has there been any thought of legally addressing this as a HIPAA violation?
Generally, HB MWs are NOT covered under HIPAA because they are not ?medical professionals?. They love this- they are not medical professionals until billing time….
TL;DR:
“If you’ve seen a negative review of us online, rest assured that the woman who wrote it–whose name you’ll see there on the review–is mentally ill. Srsly.
You of course are perfectly sane and normal, so feel free to disregard the opinions and experiences of those women. It doesn’t apply to you!
Love,
Better Birth”
There is NEVER a reason to publicly out one’s own patient as mentally ill, even if she is mentally ill. It is a flagrant violation of patient privacy.
This is yet another example of the fact that homebirth midwives are not health care providers; they self serving, unethical lay people who will say and do anything to get their birth junkie high and get paid for it.
So often, my response to something I hear about a homebirth provider is a shocked “But that’s completely unprofessional!” or “But that behavior is indefensible!” I have to remind myself, that these (ahem!) caregivers were not trained in ANY sort of professional ethics or behavior. The law of their world is literally what they can get away with.
Is there a way for the US government to then either force midwives to have a midwifery degree or not practice? Where’s the regulating body for them? Here in Canada, midwives have a great track record with both baby and mother’s health and safety.
Having enjoyed to care of midwives, it’s more personal and at least I know who will be attending the birth of my child as opposed to the “OB lottery” of going into the hospital and getting whoever is on call, I believe that midwives have a place in the modern health care system, but just like doctors, they need to be held accountable. Here in Saskatchewan, private midwives are simply not allowed to practice outside of the health care system. Period.
I chose a home birth because I found that in the hospital, they seem to push procedures on you, such as encouraging you to take pain medications you don’t want. I find it quite ironic that we’re told all the things we shouldn’t do while pregnant (such as no rare steak, no ibuprofen or cold medication) because it could cross the placenta and harm the baby, but that’s all thrown out the window when we’re in labor and we’re offered narcotics that do cross the placenta.
I don’t consider myself a rabid natural birther, but do I want to avoid a c-section? YES!!! I’ll always pass on major surgery if given the option. I would never dream of telling someone they were stupid for going to the hospital to give birth, but after doing the research (yes I have a college degree and so does my husband) on home birth here, I think I’m entitled to chose that for myself and my baby if I find it to be safe. Sadly, babies and mothers die in hospital because of infections or mistakes made by health care practitioners, no matter the education of the practitioner.
As devil’s advocate: you can find almost everything to back up or dispute your own opinion on the internet if you look hard enough.
Canadian midwives are better educated. I still personally won’t have one. I want an on and loved the ob I ended up with. Though I technically wasn’t her patient she was awesome with me. It wasn’t horrible by any means. She checked up on me and let me sob to her. She was awesome!
Bobbi, I am also Canadian and delivered in a hospital with GPs who work primarily in an ob clinic. We met each of the GPs who provide coverage to the clinic so we would know the doctor on call.
My experience of delivering an a canadian hospital is the complete opposite of yours.No one pushed drugs or procedures on me (despite my repeated requests for an Epi which were brushed off) the same hospital let my cousin push for 5 hours (in any position she felt comfortable) before doing a section as having a vaginal delivery was very important to her ( baby monitored and doing well of course!).
Tl:dr. It sounds like you had a bad experience and that the ncb community is giving you a way to feel certain that bad things won’t happen this time. But your experience does not equal the sum total of how hospital births are done in canada. If you want a home birth, go for it but do it with some intellectual honesty. Hospitals and doctors are not all the same and a homebirth is not a panacea for your last experience.
/ end rant.
I have never said that my experience was the norm in Canadian or any hospital. I also specifically said that I would never deny a woman’s right to chose how she wants to give labor. The home birthing community is NOT giving me a way to “feel certain that bad things won’t happen”. I’m well aware of the risks, but I’m also well aware of the risks in hospital. They’re pretty much the same. There was a whooping cough outbreak in our hospital when my daughter was born that I was never informed about. THAT I complained about and got no reply. Both my husband and I have done a lot of research about midwives and home births and are convinced that it’s the best option for us.
I’ve also never said that OB’s are horrible and I would never have one. If I was a high risk pregnancy, absolutely! I want an OB there. Since I’m not, I would let my GB attend my birth, but she doesn’t do that. So, I chose a midwife. I believe in freedom of educated choice (which I’ve done),
My point of my comment was that the midwives in the states need to be regulated. Their stats are terribly compared to us.
Please don’t lump me in with the people who take everything they read on blind faith. I’m not one of those people who thinks everyone should do as I do.
I apologize if I misinterpreted the intent of your post. I agree that in general canadian midwives are well educated, well regulated health care providers and that the existence of the cpm designation is atrocious.
However, there is a large spillover effect into the canadian birth community (see: mrs.w’s posts on the lack of availability of maternal request sections and a serious deprivation of her rights and autonomy) which makes me wary of the other content in your posts yesterday and today.
As an example, I would point out that only 4/ 15 sentences in your post related to regulation, with the rest being a classic mix of ncb tropes (drs don’t provide personal care, hospitals force you to take drugs, epidurals are harmful, hospitals= procedures, hospitals encourage sections, babies die in hospitals too, I’ve done my research). These are the very sentiments that under qualified midwives use to garner support for their terrible care, and are also demonstrably inaccurate as blanket statements.
As a side note, I wanted to alert you to a comment I made on yesterday’s posts about the availability of forceps at a homebirth. Given your history this may be relevant.
I would like to state unequivocally that I support the right of any mother to choose her healthcare (though I may not make the same choices), what alarms me is people making those choices based on less than full information of the risks and benefits.
” I’m well aware of the risks, but I’m also well aware of the risks in hospital. They’re pretty much the same.”
Those two sentences don’t go together, Bobbi. I fyou were truly aware of the risks, you would know that they are not the same. Therefore you made a choice that was not fully informed.
The brushed off requests for epi’s bug me – it strikes me as a deprivation of desired health care services. I wish we measured this phenomenon. By your tag, I assume your in BC – I fear it is a common practice here given our exceedingly low rates of epidurals.
I am indeed a bc resident. I was actually fairly upset about the Epi being brushed off as I had said repeatedly in my appointments prior that my birth plan was “get an epidural!”, no one mentioned that it was a bit of a pipe dream :).
I shouldn’t have been surprised as I saw this practice fairly frequently as a nursing student.
I had a debrief with the doctor afterwards and did complain to the hospital. I don’t think it made much difference in the grand scheme of things, but improved my feelings about the situation. I do wish more ppl would take their concerns to the patient relations departments, though I understand that many people are not comfortable/ aware of this option.
If I had another baby I would seriously think about going to a larger centre with more anesthesiologist coverage and a different culture, which is frustrating because I loved all other aspects of my care.
Unless that larger centre is Vancouver the epidural rates don’t breach 40%…frankly, I think it is a bit of a scandal that just hasn’t managed to get attention. I’d love to do a survey and know exactly how many moms in BC ask for epidural pain relief during labour and can’t get it…
So let’s see: which is worse? To be going through a traumatizing, excruciating experience and begging for help and pain relief or to not be in very much pain and be offered pain relief and decline it?
I WOULD SAY THE FORMER. The woo permeates our hospitals. Pain is just a state of mind, you know. Do some breathing and think about something else.
My experience in Canada, in the present day (not ten years ago, when opiates were often given for pain *in general*) is that we have developed a severe aversion to prescribing opiates in any situation, unless you’ve cut a leg off or our bleeding from an ear or something. I’ve watched it degrade. It’s a philosophical turn and a harm reduction strategy. And the epidural issue is just an issue of funding for dedicated OB anesthetists.
Definitely that way in the USA too. I’ve been through a hairline tibial plateau fracture with no pain relief of any kind. (it was initially misdiagnosed, but even after correct diagnosis I wasn’t given pain treatment.) I have chronic pain, I don’t treat it.
I also had a bad experience with grossly inadequate pain relief after surgery. The surgeon wrote pain meds “PRN,” which means you get them when you ring the call bell, wait for the nurse to show up, then wait for the nurse to have time to actually get the injection. And the nurse wouldn’t even put you on the to-do list until you were due for your next dose. And of course the entire script he wrote was about half what I needed. (I did look it up, and it “should” have been enough, but it wasn’t, and the hospital had no way to increase the dosage.)
Some individuals have genetic subtypes that make narcotics much less effective. Then you either need to use a much higher dose or go to non-narcotic methods of pain relief (or both). I am looking forward to the day when we have the technology to subtype people on admit to the hospital so we will know ahead of time. Right now, if you are one of the unlucky ones you may get seen as a wimp or even get mistaken for a drug seeker (there are drug seekers that travel from hospital to hospital for admit for “pain control”. It still takes long enough to get outside records that it can take a couple of days for you to get the proof you need to realize the truth).
It really sucks and I use my c-section experience like a blanket of protection. I WAS opiate-niave having not touched anything but two codeine the entire pregnancy, and my surgeon SAW me on a ton of morphine… way more than anyone should have been cogent on and I could easily have a perfectly reasonable conversation and was still in pain. I had nursing staff ask me if I was doing IV drugs and I just wept. It was really awful.
I also have a great ENT who is old as trees who told me the folk wisdom that redheads like me are “bleeders” and “need a lot of pain meds” and has postponed a surgery because he said I’d be a trainwreck. (it was cosmetic anyway) and when I ruptured an ear drum was liberal in the application of pain meds and didn’t judge me. Just a paternal, “You red heads are always like this.”
It is true that I also bled very badly during my c-section. So I think older doctors have seen this as a sort of folk medicine over their years of practice, and younger doctors are coming out of med school aware of it, scientifically. When I found out it was an epiphany. It explained why medical procedures in the past requiring anesthesia didn’t work and why I never seemed to respond to pain medications at hospital. There doesn’t appear to be anyway to type it. It would be nice to find out.
And yes, in my case, it’s ended up being that I think my GP kind of believes me, my OB/GYN absolutely believes me, my psychiatrist believes me, and I’m one of the fortunate ones who does get pain medication to pain. And it gave me mobility and a life back. 🙂 But just last month I had a doctor accuse me of being an IV drug user. And it hurts because actually, not only am I not an addict, but I quit drinking years ago, too.
I’m red-headed and I think I have a mu-receptor mutation. I was opiate-niave and very resistant to opiates. I was labelled an IV drug user. I woke up during surgery at 5, have never had adequate pain control until now (when a specialist stepped in and INSISTED I be medicated to pain scale and not to prescribed ideas of how much I should be taking) and I am still routinely accused of being a drug addict/IV drug user and told there should be “no way I could be standing/driving/talking”. It’s so weird to me that medicine ostensibly understands pain so well, enough that resident doctors at our hospital ER have told me they know that red-heads like me are often more likely to require additional anesthesia, but that it seems no one listens. I fear any time I am in pain. I’ve learned to not ask for pain medication but to just bring my own. I fear for my son who is tawny headed but pale as me, and who has been difficult to sedate and to anesthetize. I treat his pain aggressively and to his expression of pain, much to the chagrin of my inlaws who think I am babying him. I just remember a childhood of uncontrolled pain. Ear infections and strep throat and so on where I was in so much pain I think it was traumatizing. When he had eye surgery, I insisted that the ped surgeon give me codeine. He only needed it for 48 hours but you know what, he needed it. Some kids might not, he did. Some adults might be able to withstand the pain of an umedicated delivery and others may not. Some adults may be able to tolerate a ruptured ear drum and walk it off, and me, I can’t.
The moral judgments on pain piss me off. I happen to be a sensitive person and my sensitivity allows for good things, too. I feel pleasure as acutely as I do pain, for one. I write music and I am an emotional, generous, loving person. I am the same as a mother. I am claiming my right to be “too sensitive”. Screw it.
Pain has chased me my whole life. Now I have chronic health issues and that really sucks because I live in fear of having my pain medication yanked at any time, and that would leave me bed-ridden and unable to parent. When I was in uncontrolled pain, in traumatized me and made me crazy. I can’t imagine ever going back to that place. It got to the point where I couldn’t even articulate what the pain felt like: I just thought it was all in my head and did my best to block it out.
Ibuprofen during pregnancy can cause fatal heart problems in the newborn. Certain cold medicines increase miscarriages. Both of these medicines are used to treat mild discomforts. In contrast epidurals are a safe and effective treatment for what is the most severe pain a woman is likely ever to encounter in her life. So if a hospital worker offers an epidural it is “ironic” exactly how?
How about morphine? How safe is that for the baby?
I also disagree with “the most pain in her life”. I’ve had pancreatitis and a ruptured ovarian cyst. Those two things were far more painful to me than labor.
I also don’t consider a migraine headache a mild discomfort. Ibuprofen is about the only thing that works for me when I have the odd migraine, so when I’m pregnant, I suffer. I suffer gratefully, as I wouldn’t want to hurt the baby with pain meds, but it’s just another reason why I’m turning down pain meds for pain relief during labor this time.
I don’t believe epidurals cross the placenta. The medication is in the spinal dura. That is the most common medication offered, and desired, by laboring women in the US.
Morphine and epidurals are the only options I was given and so when the epidurals didn’t work for me, I chose not to take a narcotic.
Anything that goes into your blood stream will cross the placenta, so epidurals, maybe not, but morphine and it’s derivatives, yes.
A lot depends on the amount and the type of administration. There is a lot of fear and hype around epidurals that is not true.
Is morphine the same thing as pethidine/demerol? Medical staff were upfront to me about the fact that this passe to the baby and has risks. I didn’t want to use this stuff for that reason.
Morphine (and the other narcotics) are safe during pregnancy. Unlike ibuprofen, they don’t cause heart problems and they don’t cause any birth defects. They have only 2 potential risks:
1) If a woman takes them at high doses on an every day basis, her baby will be born with a physiologic narcotics dependence and will have to be weened off slowly. This is obviously not an issue for a labor-only use.
2) If narcotics are administered close to the time the baby emerges, they can still be in the baby’s blood stream and cause respiratory depression. Then the baby will need a shot of narcotics-reversal medicine (Narcan) at birth. If you don’t even want to consider this potential risk (even though easily reversible), an epidural would be a much better choice for you if you want pain relief. Epidurals don’t cross to the baby so cause no sedation of the baby at all.
For women who get migraines during pregnancy, the medication of choice for the pain is Tylenol. If that alone can’t control the pain, the next step is a narcotic pill. As I mention above, narcotics are safe during pregnancy.
I just want to say how much I love it when someone spouts off their supposed information and real experts come in and provide long, detailed explanations of what really is true. Contributors like DrKitty, fiftyfifty1 and AD are basically “Pablo’s First Law of Internet Discussion” personified. We all learn a lot from great contributors like them.
Perhaps the main thing we learn is, don’t make shit up, because you will be schooled. Newbies don’t always appreciate that.
” I’ve had pancreatitis and a ruptured ovarian cyst. Those two things were far more painful to me than labor.”
How nice that you had such an easy labor! I wish all women could have labors as easy as yours. The world would be a better place wouldn’t it? I’ve had a ruptured ovarian cyst myself, and although it was painful, it was nothing compared to my labors. My labors were far, far more painful. They did offer me prescription pain relief for my ruptured cyst, but I turned them down. I felt I was coping well enough with the pain, so I didn’t feel it was worth it to me to take a narcotic which tends to make me a little nauseous and sedated. But I didn’t get offended that they offered it to me, even when they asked me “Are you sure?”. After all, how hard is it to say “No thanks, I’m doing fine”?
I passed a kidney stone. It hurt like hell. Labour hurt worse!
People often seem to think that their labor, medical condition, etc felt like X so therefore they know how another person feels. I love what one of my first nursing instructors used for the definition of pain– “pain is what the patient says it is”
I’ve never had a ruptured ovarian cyst or a kidney stone or pancreatitis. For me, labor was the worst pain I’ve ever experienced. When I got my epidural, they asked me where on the 1-10 pain chart thing I was at. I said “well, 10 is supposed to be the worst pain, and I can imagine that getting shot at close range in the face would hurt more than this, so I will say a 9.” I mean, is it possible there are things that would be more painful to me than labor was? Of course. But was it the worst pain that I had experienced ever in my life? Yes, and I wanted pain relief. If we have another kid, I will want the pain relief earlier. Looking back, I see no redeeming reason for letting the pain get that bad. I would probably get an epidural around a 5 or 6 instead of a 9. I mean, I can handle a 5 or 6, but why let it get to a 7, 8, 9?
To Bobbi, in response to the post you wrote and then deleted that quoted “Ask.com” as defense of why it is wrong for doctors to offer narcotics during labor and where you stated that C-sections were risky for babies:
You go to “Ask.com” for your medical advice? Oh dear…
A planned C-sections has been proven to be safer for baby than a trial of labor. But a C-section is slightly more risky for mom than a vaginal birth. So you have to balance what’s best for the baby with what’s best for mom. I think a woman has to decide for herself which is more important for her. A lot of factors go into it, that’s for sure!
Wow. This discussion went way off the rails since everyone became fixated on my choices for pain relief and labor. My original question never did get a response!
Does no one know if there is a regulatory body for midwives in the US? Why are they allowed to practice with no education? That’s truly shocking to me.
Well, there’s NARM, and MANA, and also the ACNM for nurse midwives. None of these seem to have any teeth.
In the case of MANA and the ACNM, the only power they have is to eject a member, which has little effect on a midwife’s ability to practice. Their mission is, in a way, antithetical to that of governing or regulatory bodies; MANA and ACNM are advocates specifically for their members, not the public, although at times those interests may overlap.
NARM and the American Midwifery Certification Board (who issues the CNM and CM credentials) can strip a credential, which would effectively end a CNM/CM’s career (although some CNMs are also credentialed as women’s health NPs). The effect of removing a CPM credential would depend upon how the midwife’s state regulated non-nurse midwives. Some require the CPM for licensing, some do not. (And of course, some don’t require any licensing at all.)
No, I don’t think people care about your choices. Them being yours.
What people in this blog, and other skeptical blog, care about is wrong facts. Epidurals passing in the newborn bloodstream and morphine being dangerous to the fetus is not true.
It is like I would go on to Skeptical Insolence and say that the HPV vaccine don’t work and for this reason I am going to get pap smears twice as much as normal, or go to Bad Astronomy and tell the Earth is flat and for this reason I’ll never go to Australia, since I would fall out of the World.
I can make as many pap smears as I wish, and of course I can not go to Australia. Still HPV vaccine works and I am in no danger to fall out of the World from Australia (I could be poisoned in a hundred of charming way though).
There is no real regulation of HB MWs on the federal level in the USA. It is left up to the states. They have their own “regulating body”, MANA, which is a joke at best and actively harmful at worst.
Many of us on here are active in local, and state, politics, and are working for positive change.
Correction: MANA is not a regulatory or credentialing body, it’s a professional organization (like the AMA). NARM is the credentialing body for CPMs, so they have the power to strip a midwife’s CPM credential. (I’ve made that error myself in comments; it’s easy to confuse them.)
It’s truly shocking to most people when they discover that midwives practice with little regulation and almost no oversight.
The average person thinks that American midwives are like the midwives they see on television or have in their own countries. It’s not so.
And no, of course Ask.com is not my first choice for medical advice. My health care practitioner is, be it my GP or my midwife, who BOTH have medical degrees.
Uh huh.
I’m a GP.
I concur with Dr Amy.
High dose opiates for a prolonged period in pregnancy can cause neonatal withdrawal. Which is usually predictable and manageable.
Occasional use of opiates in pregnancy to treat severe pain will NOT cause neonatal withdrawal.
Oral or IV Opiates in labour may cause neonatal depression, which is reversible with narcan and can be predicted. Epidural or intrathecal opiates don’t have that effect.
Unrelieved pain causes tachycardia, tachypnoea and surges of stress hormones like cortisol and adrenalin. There is no reason to believe that this is better for a foetus than being exposed to small amounts of opiates in utero.
PS…I’ve had a ruptured ovarian cyst…it wasn’t that fun but I could walk and crack jokes even during the worst bits. The same cannot be said for the majority of labouring women. Your experience of labour pain is not typical.
Was it your GP or your midwife who told you that opiates in pregnancy were wrong and that C-sections were risky for the baby?
Opiates for pain are completely safe in pregnancy.
Most opiates are a category C drug to be used if the benefits outweigh the risks. Animal studies have show some adverse effects in the fetus but there are no well controlled studies that have been done. Sure, they appear to be relatively safe, but you can’t say this definitively. It is between the individual doctor and patient who decides if the benefits outweigh the risks. Not commentators on a website.
You are seriously misinformed about the use of pain meds in pregnancy and delivery.
You do get that not every woman experiences the same level of pain in labour and that not every woman experiences pancreatitis or a ruptured cyst, right? Arguing that your labour was less painful than some other things you’ve experienced therefore pain relief in labour is somehow a terrible thing to offer is ridiculous on many levels.
I don’t really understand the “pushing pain medication you don’t want” canard. If you’re in that much pain that being offered pain medication is so disturbing to you, wouldn’t it be unethical NOT to offer it? And maybe the desire to decline effective and safe pain relief for obvious pain is the perspective that should be reexamined.
I have freakishly easy labours and both times it was obvious to everyone that I wasn’t in pain. No one offered medication and if they had I would have had no issue declining it because I genuinely did not need it. Just as I would have no problem declining pain medication in any other circumstance where I wasn’t suffering bad pain.
As in Canada, regulation of the medical professions is not done at the federal level. It’s up to each state to have laws governing the conduct of midwives. Some states don’t allow midwives, some allow CNMs only, some allow CPMs, and some don’t have any laws. CPMs lobby hard for licensure at the state level because they can then charge insurance companies (and Medicaid/Medicare?) for reimbursment.
Thanks! That was what I was curious about.
Yep-Medicaid. Pays for homebirth in my state (washington) with CPMs.
All the bodies that regulate midwifery are state entities, not national. If you think its a travesty start writing some senators.
Funny how things can seem “ironic” when you don’t know what you’re talking about.
Accurate risk-benefit assessment requires knowing both, as much as possible, in detail. It would seem that you do not understand how epidurals function, nor what the actual risks of morphine are to infants, their duration, and what benefits to the mother might outweigh those risks.
”Sadly, babies and mothers die in hospital because of infections or mistakes made by health care practitioners, no matter the education of the practitioner.”
Bobbi – intra-partum death is almost unheard of in hospital. Babies who die of neonatal sepsis acquire it from maternal infection, not from the hospital.
” I find it quite ironic that we’re told all the things we shouldn’t do while pregnant (such as no rare steak, no ibuprofen or cold medication) because it could cross the placenta and harm the baby, but that’s all thrown out the window when we’re in labor and we’re offered narcotics that do cross the placenta.”
Perhaps you are not familiar with the difference between teratogenic effects (things that can harm a developing fetus) vs medications given during the birth of a fully developed, viable baby. Narcotics are easily reversed.
” (yes I have a college degree and so does my husband)””
(Not in any health-related field, evidently)
Bobbi, others have addressed the inaccuracies in your posts below, but there are a few things I wanted to mention. I delivered in Ontario with RMs. You aren’t guaranteed getting your primary or your secondary when you deliver – or even your third or fourth – which is why during antenatal care, SOP is that the patient sees almost every midwife at least once. This is really no different than being an OB patient in a practice with multiple OBs.
As for your comments on pain, I’ve also had a ruptured ovarian cyst, as well as two compound fractures (thankfully, not at the same time). I also miscarried my second pregnancy at 13 weeks in the middle of the night and passed out in the ambulance from the pain and shock. Additionally, I once worked in post-quake Haiti for four days with an abscessed molar. My face blew up like a squirrel. Couldn’t get anything stronger than ibuprofen, which did nothing, and there were bigger fish to fry. None of those experiences touched the pain of labour for me — none even came close.
My husband and I both have graduate degrees. Neither of us have degrees in medicine or even science. We’re not qualified to be “doing the research.” Nor, apparently, are you.
Would this qualify as a HIPPA violation?
no they aren’t bound by hippaa, but they did promise not to disclose info about me in their contract. They have no evidence of their claim about my mental state, so I consider it libel and will sue if they don’t take down their claim.
How can you call yourself a healthcare provider and not be bound by HIPPA? I thought my opinion of midwives couldn’t go much lower but this is a surprise.
icing on the cake:
the owner of better birth helped draft the direct entry midwifery act in utah so she made sure that there was basically no accountability to start with.
Shameon, I just can’t fathom that whether they think so or not they aren’t bound to be silent on every aspect of you and your care in every instance but for your care and when the law mandates they must reveal your health ( mental or otherwise ) information. I have known many instances when nurses or doctors would have loved to have been able to tell our side of the story, but the truth is, we are legally ( never mind ETHICALLY ) bound to remain silent. I have a really hard time believing that CPMs are so different, even if they want to believe themselves to be, it shows clearly that they ARE NOT professional.
HIPAA only applies to HCPs that transmit records electronically, as for billing insurance or EMRs. That means the vast majority of “legitimate” (as in legally recognized) HCPs are covered.
I don’t think that’s true. I just looked at the HIPPA site and found this–
“Your Health Information Is Protected By Federal Law
Most of us believe that our medical and other health information is private and should be protected, and we want to know who has this information. The Privacy Rule, a Federal law, gives you rights over your health information and sets rules and limits on who can look at and receive your health information. The Privacy Rule applies to all forms of individuals’ protected health information, whether electronic, written, or oral.”
Susan, Squillo is right. Not every provider is a HIPAA covered entity. Also, the Privacy Act, is another totally separate law, and only applies to the federal (US) government.
Well, it’s certainly not my area of expertise. I think I have lost this argument before somehow. But even if it’s not illegal before it was every a “law” we were obligated to keep health information private!
Medical ethics would certainly require keeping such information confidential. The Catch-22 is that those who aren’t covered by HIPAA (alt-med types who can’t bill insurance) are least likely to conform to professional ethics standards.
Isn’t that strange. I guess it fits very well with “midwifery ethics” being so bizarre that they fight for “human rights in childbirth” thinking that it means THEY have a right to delivery unsafe care anytime the patient demands it and they have a right that doctors don’t have to post their patient’s health care information on the internet in order to defend themselves. And believe me, I know of situations doctors would love to be able to do that- but they have to take whatever is thrown at them online and there is no legal or ethical way to respond.
”Not every provider is a HIPAA covered entity.”
One would assume that a professional would maintain client confidentially without having to be required by law…
The Privacy rule covers all forms of information, but only those providers who transmit info electronically are bound by it:
Confusing, I know, but that’s the way it is.
Thanks. So bizarre. Hoped it could help her. Somehow it seems like it should cover pen and paper people too.
So “communicating electronically” doesn’t include posting protected info on a website?
Would it include emails sent between staff members of BB or their witness? Is everyone absolutely SURE all discussions about the case were face to face or on the phone?
I think the fact that HIPPA and Privacy Rule DON’T apply to everyone who claims to be a HCP is a major flaw with the system.
If you want to act like a legitimate HCP with access to confidential data, you need to be covered for breaches of your responsibility to protect it.
It probably wouldn’t cover those things, although I could be wrong. HIPAA was not intended as a way to regulate providers’ communications or privacy; the law was an initial step toward health care reform, aimed mostly at insurers, to ensure portability, curb potential abuses, and streamline procedures (HIPAA=”Health Insurance Portability and Accountability Act”). The privacy rule was actually part of the streamlining, to bring standards to electronic billing, which was a complex hodgepodge of companies’ individual systems, forms, etc.
So it was never really intended as a way to prevent providers from sharing information. There is an assumption that professional ethics covers that.
That is not how hospitals teach it, and that isn’t how the fines are given out. I’ve mis-faxed something before and it was a huge pain to deal with because HIPAA most definitely holds people accountable for WHY they are transmitting information to any other entity.
http://www.ama-assn.org//ama/pub/physician-resources/solutions-managing-your-practice/coding-billing-insurance/hipaahealth-insurance-portability-accountability-act/hipaa-violations-enforcement.page
Right, because hospitals are a covered entity. Faxes, emails, etc. sent by an employee of a hospital or other covered provider are covered (see the “Covered Entity and Specified Individuals” section of the page you linked.) HIPAA was never intended to cover providers who do not submit electronic billing or participate in EMRs (like some HB midwives). If you’re really interested (or need help falling asleep), you can read the final rule on privacy standards in the Federal Register (http://www.hhs.gov/ocr/privacy/hipaa/administrative/privacyrule/prdecember2000all8parts.pdf), but the gist of it is in the summary:
It is true that they are not covered. Just try and make a complaint and you will find out right away.
Would this client have a case of HIPPA violation?
Even if she is mentally ill, there’s no reason to suppose she is not in touch with reality.
There are VERY specific circumstances under which a mentally ill person is out of touch with reality, and unless you can say with some certainty that she met those criteria, it’s not even worth dignifying with speculation. It’s just naked bigotry.
That post by BetterBirth is truly incredible.
“Unfortunately, sometimes there is nothing we can do to assuage a client who is unhappy. Sometimes clients have expectations that are impossible to fulfill. Sometimes we are not informed of problems until long after the birth is over. On a couple of occasions, we have discovered too late that a client is mentally ill, and her illness did not allow her to accurately perceive the events of labor. These cases sadden us deeply. …
“If you have read negative reviews from clients such as these, we would like you to know that sometimes what is posted is untrue or grossly distorted. …
“We know reading reviews can be helpful in deciding whether to entrust someone with your care. You can click here to read many heartfelt comments from clients who loved our care, and you can even see the original handwritten notes if you’d like. After seeing the positive, if you are still concerned about negative reviews, you are welcome to call or come in and talk with us about it. In the end, you will have to decide who has greater credibility with you, the happy clients and staff at BetterBirthLLC or the anonymous posters of shocking stories.”
*** *** ***
Yikes. There’s more, but this is truly amazing. Asking people to take sides in a dispute.
And how do we know some of the glowing reviews weren’t written by mentally ill women who left with a completely distorted idea of the care they received? How many positive reviews should we disregard on this basis?
This sort of reminds me of that Kitchen Nightmares episode profiling Amy’s Baking Company, you know the one where the celebrity chef actually walked out, saying the owners were beyond his help. Afterward, local diners made a habit of leaving nasty reviews on the restaurants Facebook page. The owners responded by attacking the locals (they were mean, they were crazy, they were trolls), and when that backfired claiming that their Facebook page had been hacked. Ultimately, the credibility of the owners was trashed. I can only wish the same on “Better” Birth.
“Sometimes clients have expectations that are impossible to fulfill. ”
You mean, like a living baby? What a completely unreasonable expectation!
Let’s pretend for a moment that the client was actually severely mentally ill like Better Birth of Utah claims (for the record, I DO NOT think that was the true situation here). If that’s the case, and the “gift” of negative feedback is so “precious,” what are they doing about it? Are they using new mental health screening protocols? Are they having in-service training by a qualified mental health professional so that their employees are more aware things to look for and how to appropriately care for the affected women? Are they developing a plan for when to involve mental health professionals in their midwifery care? It seems like all they have said is “We think this woman is crazy (but apparently, only displays symptoms after delivery…it’s like one of those pesky babies that has a perfect heartbeat and then suddenly drops dead into your hands). We, as her supposed care providers, are ignoring her feedback. We hope you do the same. There’s nothing to be learned from her. Carry on.” What a complete lack of professional responsibility. They should be ashamed.
YES! I don’t think their patient was/is mentally ill (at least her posts on her don’t sound like it), but treating the mentally ill is part of health care. You don’t get to pull the “b*****s be crazy” line and shrug it off.
Small point of clarification, a person can have a serious mental health disability / mental illness and not be disordered in writing or thinking. Mental illness =/= talking to people who aren’t there, etc. Mental illness covers a large number of diseases, impairments, and disabilities.
Thanks!
Additionally, if you have a well controlled mental illness you can easily be indistinguishable from anyone else most/all of the time.
The combination of mental illness and poor medical care can be quite problematic for the patient. Even if the illness is well controlled, it’s easy to discount the patient’s perception as not based in reality even if it is.
Heck, even a person with a poorly controlled mental illness should not have their account immediately discounted. Such a person is even more in need of protection from unethical care providers than the average person because they are more likely to be disbelieved.
“Such a person is even more in need of protection from unethical care providers than the average person because they are more likely to be disbelieved.”
Yes. This is a vulnerable population for abuse. This place is making it sound like she has some kind of moral failing.
Very true and good point.. I’ve struggled with depression for years, so I guess I’m “mentally ill” in some sense. But I’m not irrational. I don’t have problems perceiving reality.
I interpreted BB’s attack as implying ShameOn had an illness that distorted her view of reality somehow.
Which is why it doesn’t make sense for Better Birth to point to mental illness as an excuse. Mental illness is not freakishly uncommon, so they need to be prepared for it and if they are not prepared for it, they need to tell patients that up front.
”If that’s the case, and the “gift” of negative feedback is so “precious,” what are they doing about it?”
SPOT ON!
Actual professionals use incident and complaint data to continuously update and improve their practice.
Ideologues are immune to improvement.
I’m not trying to start waves, (though I’m sure this is the equivalent of tidal waving the plastic boat in the bathtub) but don’t you, Dr. Amy, treat women who want home birth about the same way? There must be something wrong with them, uneducated, incompetent, all that jazz? I love your blog, I like a little abuse when I’m feeling blue, it’s fun to come here and have you yell at people without actually yelling (yes ladies and gents, I know, ‘she’s giving scientific informant, she’s a doctor, you’re an idiot,’ yeah yeah yeah I got it) but the way you wrote this article makes me feel like you are being a bit hypocritical. If there is such thing as being bad, as you say about homebirthers and midwives, then are you immune? If some woman came to you and told you ‘I had a great Homebirth, totally smooth, healthy baby I felt great blah blah blah’ the first thing I can think of you saying (which you love to comment on people’s home birth stories) ‘what a dumb woman, you’re lucky you and your baby are alive, how stupid and irresponsible for putting your baby at risk like that!’. Isn’t that about the same as someone who is All about natural birth saying ‘going to the hospital is dumb, you’re an idiot blahs blah blah’. Seriously. I’ve been trying to be a better person, you don’t have to have a religion or certain believe just to be better. But what I’ve learned is, that everyone is human. Period. Every doctor, midwife, convict, mother, father, everyone. You are no better than anyone else, and no one is any better than you. Do you like Brussel sprouts? I don’t, but I know they are good for me. Is it right for someone to come up to me and yell and scream and berate me because I don’t eat or like them? It’s not right, just like you berating people, but cuss happens. Put yourself in someone else’s shoes. Just because you have en education means nothing. You’re human. That’s it. I respect the time, effort,a nod intelligence it takes to go through school and do what you did. Does this mean you can take better care of my disabled military veteran husband than I can? Cuss no, when it comes to my husband and my house, you’re the idiot. You don’t know I spend hours upon hours putting food away, working a farm, or processing deer to provide for my house. Telling him to take his meds doesn’t work, they make him feel sick and terrible, so we had to go holistic, he feels great. The point of this is, you don’t know what other people think or feel to get them to the choices they make. You can come back and tell me that they make these choices based on junk science and anecdotes, and that’s fine. What about me? I become catatonic at the doctors, I was raped twice in my life, once by a family friend! I can’t go tot he ob/gyn without panicking, crying, and freaking out. I’ve been to counselors, therapists, gone on meds. Nothing works. What about that? Is it still okay to the hospital to give birth? For me, I may as well plan a c-section. It hurts to think that people have put so many bonds on others, you are not a god,or special. In any way. You aren’t the only woman, you aren’t the only mother, you aren’t the only ob, you aren’t the only doctor, you aren’t the only one who graduated Harvard. Other than, there is only one of you, there is nothing special about you except what you want others to think is special. Sometimes when I read your comments, I feel like I’m reading something from the westboro baptist church. On their site, it says ‘time we spent caring about your FEEEEEEEEEEEELLLLLIIINNNGGSSSSSS’. Wow how rude. But every time I read something from you, I get that. I get that, I’m better than you and I hold the word so you listen to me or I will tell you what a moron you are and make sure you know it. Tell me, when’s the last time you cured AIDS? Detected cervical cancer in a patient and helped them get through getting rid of it? Walked on water? Solved the world hunger crisis? When’s the last time you stepped up and actually helped other people? Your fellow human beings? And please don’t come back with ‘my website has saved lives!’. Yeah, so all the studies you have can only be found right here on your site and no where else? No website, no books, no nothing, only you? That sounds pretty silly, like you think you are the end all. Like I said, I’m not mad, and I love your site. But I think everyone, you and I included, should put ourselves in others suffering, we should ask ‘why is this person hurt? Why do they feel they need to hurt others? Can I do something to lessen the hurt?’ Sometimes the best thing you can do, is listen. And it’s awful hard to listen, when you tell everyone that you Are the one true way of obstetrics. And no, I’m not going to sit here and have a study off with you. I know the first thing said is going to be ‘show me your studies! See? She can’t show me any studies! Ha ah ha see everyone I’m right and she’s dumb!’ And yes, I’ve gone through tons of your posts and comments, you love to do that. That’s just fine. I’m sorry you feel the need to hurt others and be rude. But as a human being who is not special or different than the homeless guy at walmart, I love you for being you. I don’t agree with the meanness, but to each his own. I hope you find some peace, like actual peace. I hope you find something that captivates your heart and moves something inside you. I think you are a beautiful,amazing, intelligent woman. I think your particular skills can be put to better use than slamming others. (Midwives, homebirthers, lactivists, etc) these people are your sisters period. We are all, just human.
Tell me, when’s the last time you…Walked on water?
Given the weather in the northeast right now, the answer is probably this morning.
I truly do not understand the point of your post. Dr. Tuteur is human and can make mistakes? Sure, duly noted. What does that have to do with whether BB should be telling people that anyone who complains about them is mentally ill?
“Tell me, when’s the last time you…Walked on water?
Given the weather in the northeast right now, the answer is probably this morning.”
TCAMN, you win the internets today!
Wow. I kinda stopped reading partway through that lonnnnnnnng rant, but I would point out that Dr Amy is not publicly calling her own patients mentally ill. She owes no duty of care to the people who post here or elsewhere publicly about their home births.
And also, while I can understand how people are turned off by Dr. Amy’s sometimes’ harsh tone, and yes, she has called homebirthers stupid….she has not implied they are mentally ill and should therefore be written off and shoved under the rug. My impression, after reading here for a while, is that perhaps she thinks/hopes they can be taught why/where they are wrong, and that anyone who might be “on the fence” about the subject of homebirth might be swayed to the scientific side of things. But nowhere here, have I seen her or anyone, say that 1)the entire population of rabid NCBers are mentally ill and/or 2)that mentally ill people should be disregarded, disrespected and cast aside. Stupid and mentally ill are two very different things.
Damn, sorry Wren, that was meant for Doodles, not you.
” If some woman came to you and told you ‘I had a great Homebirth, totally smooth, healthy baby I felt great blah blah blah’ the first thing I can think of you saying (which you love to comment on people’s home birth stories) ‘what a dumb woman, you’re lucky you and your baby are alive, how stupid and irresponsible for putting your baby at risk like that!’. Isn’t that about the same as someone who is All about natural birth saying ‘going to the hospital is dumb, you’re an idiot blahs blah blah'”
Not even remotely.
Do you actually think that mental illness and ignorance are the same thing?
I don’t recall you calling anyone mentally ill. I think you use the term narcissist in terms of the personality TYPE, not the personality disorder. Stupid, ignorant, willfully blind to consequences, and evil are all perfectly reasonable ways to describe people who harm women and children. And sometimes women who harm their children. And personally, I do think some of them are mentally ill and undiagnosed, but I’ve not felt uncomfortable on this blog, ever, and have never minced words about having my own mental illness. If I felt as judged here as I did in other places (NCB boards I once frequented) for needing medication during pregnancy and lactation (or for needing extra supports and combo-feeding, I would leave.) I think NCB drives people who are mentally ill underground and places the burden of cure on the patient or on magic, like homeopathy.
Isn’t it nice to parachute into a blog and then retreat after you rant? You write “it’s awful hard to listen, when you tell everyone that you Are the one true way of obstetrics” and yet that’s kind of what you’re doing. Dr. Tuteur has ALWAYS supported qualified, credentialed midwifes, such as nurse midwives that actually go through real training. Her beef, and she has stated it over and over again is with the “lay midwives” that not only know little about birth, but serve as a hindrance.
I’ve dealt with many, many cocky OBs in my life, but I’ve never once met one that claimed to know everything. I’ve also never met one that would claim that a woman who had taken issue with their care was mentally ill, unless they clearly presented that way, and believe me, you see all kinds in the ER.
“Just because you have en education means nothing.” No, it does mean something. Especially when a lay midwife claims that they can fix postpartum hemorrhage by putting placenta beneath the tongue. Education serves to set people apart somehow. Ask yourself this…would you trust a “self taught” engineer over someone with an advanced degree and several years of experience to build you a bridge? True, the first one might be fine, and maybe the second, third, and even fiftieth, it’s that one time where you need the training that it counts. This is the underlying point that Dr. Tuteur tries to make here.
Couldn’t read all of this either. How is Dr Amy finding midwives labeling a negative feedback complaint as someone with mental illness appalling anywhere related to Dr Amy posting about undereducated unlicensed and uninsured Homebirth midwives caring for pregnant women, many of them high risk?
Yes the issue here is you seem to think ignorance and mental illness are one in the same. Pointing out someone is uneducated and ignorant, things an individual can control and change, is exactly the same as publicly calling someone mental ill, a condition they have no control over and can only manage and not ever change. Besides, anyone is qualified to make the call someone else may be uneducated about a topic they are educated about. It’s completely inappropriate for a person, who is not a doctor in the mental health field, to decide to diagnose and publicly announce someone has a mental illness. I hope you now understand the difference between ignorance and mental illness. I think you are ignorant, but would never speculate on your mental health because I have no training in the matter!
Paragraph breaks: not just for everyone else.
If you’ve been raped, you could have a planned c-section. I really, really appreciated mine.
The rest is sounding like a concern troll and EVEN FOR ME (lol) that was just TL;DR.
I know midwives aren’t supposed to be mental health experts, but one of the advantages of midwife care is supposed to be that the provider spends a lot of time with the patient, getting to know her, both in terms of her obstetric needs and her life over all. Now they’re claiming that they didn’t notice that more than one of their patients had mental illnesses so severe that they were reality warping? Inability to perceive labor suggests a serious thought and perception disturbance…that wasn’t noted at all by the care providers in the preceding 9 months. How is that possible? In short, even if their version of what happened were correct, it suggests that they’re not very good care providers.
“Bitchez be crazy!” is one of the classic ploys to discredit and silence women, going back (literally) millenia. It is just disgusting to see it used by people who claim to be ‘with women.’ It’s gotten me to thinking of other ways in which NCB advocates use the playbook of the patriarchy to keep women down. Some of these are general and obvious, like the biological essentialism which reduces me to a walking womb/vagina/mammary gland. Others are more insidious, like the idea that I have to literally turn off my critical faculties, so that I can ‘trust birth’ blindly. I’m trying to think of more—help me out!
Math, science and other commonly accepted facts are “men’s knowledge” which women can’t/won’t/shouldn’t have to handle, so women have “other ways of knowing.” Or, depending on the time period and place, different spheres of knowledge (limited to having babies, raising them, and household tasks.) Sometimes, women attempting to grasp men’s knowledge would lead to 1)shriveled reproductive organs/hysteria 2)burned-out brain 3)death (possibly brought on by the community finding out the woman was stepping out of line) 4) “un-sexing” herself.
Then there’s always the old “that time of the month” thing, which is a variant of “bitchez be crazy” but is a little more specific. You know, “bitchez be crazy and unstable for 5-7 days of every month so they have to be sent to a different place/kept separate from men/considered unclean” and if they touch a man’s weapon/food/penis/etc, he’ll die or whatever the superstitious belief was.
The idea that being hysterical/sexually uptight is the reason that births don’t go well and the “cure” for that which is relaxation through sexual stimulation of “the button” during labor. Ina May is displaying the worst of Freud here.
It’s weird that I run into this in pain management all the time. That somehow my status as a survivor of rape/incest means that I perceive pain differently. I don’t see how this is relevant, I really don’t. It seems Freudian to me. I was sitting with a woman at a recent mandatory pain seminar (which ironically they make you drive 1/5 hours to attend, which flares my pain and certainly does not fit within their “pacing yourself” philosophy) and she said that the doctors hounded her relentlessly about her sexual history. Personally, I wish I had never disclosed. I had been rather tight-lipped about my history up until my pregnancy and then, feeling empowered by it and the care I received, decided that I could be more open and it’s bit me in the ass enough already. Now I am very careful not to mention PTSD, rape, or any issues about these things when trying to get care for other health issues. Instead I try to suss out ahead of time what I’m getting involved in. It’s so frustrating and unfair. I don’t see why I need to disclose whether or not I’ve been sexually abused in order to see a neurosurgeon or get cortisone injections unless it becomes relevant to my care and believe me, at that point, I will disclose what is necessary. It seems like a bizarrely narrow, biased, victim-blaming focus, as they do not ask about any other trauma such as early death of a parent, divorce, or adult traumas like job loss, etc. And if you disclose, then it’s all about anti-depressants, right away. It’s frustrating. I have a torn disc in my back. It has zero to do with whether I was raped or not. Thanks. Give me something for pain and fix it. If I need to tell you about anything, I will. I am getting more and more angry when interacting with healthcare for this reason. I am really unclear as to why it’s necessary information, unless I am seeing my gynecologist. I’ve decided from now I am only going to discuss SEXUAL trauma with my gynecologist and if she thinks I need to tell someone else I will. It’s been used against me now to deny me care too many times. I am done trying to change the system to a more gentle system for survivors and more interested in surviving the system intact, with dignity.
The idea that a Good Woman is self-sacrificing. No pain meds, bloody nipples, don’t worry about your pelvic floor etc. The religious side of patriarchy.
It’s so gross.
The idea that women only get their ideas from men and can’t think for themselves. They use this to explain why female OBs support ideas that go against the NCB playbook. Apparently even intelligent, well-educated women can’t make up their own minds about issues and are turned into mental zombies when exposed to the ideas of male OBs.
Use of the “Clueless Guy” excuse. This has been used by sexist men to get themselves out of tasks like housework and changing diapers. Now it’s being used by NCB advocates to get women to ignore any concerns about homebirth expressed by their male partners. “He’s worried about the dangers of an HBAC? What does he know about birthin’, he’s just a clueless guy”.
Just an FYI: my mental illness risked me out of homebirth ON THE FIRST VISIT in a functional Canadian midwifery clinic. Just sayin’.
Plus, they still remained dedicated to me, regardless, and reached out to appropriate care as necessary.
Thank you !!