Midwife charged in DC? Karen Carr, CPM...

[Anonymous]

"She wondered what the medical profession was doing so wrong that mother's like the one in this case are driven to making decisions that might not make obvious sense. "

That is one potential part of the equation, the other is the effectiveness of the NCB public relations effort. They are creating a demand in the market for particular services (doula, childbirth photographer, bradley classes, hynobabies, spinning babies, etc., etc.) that would not necessarily otherwise exist...just like 30 years ago none of the weddings I went to as a child had videographers, wedding programs, wedding favors, etc., marketing has convinced brides that these are an essential part of the wedding.

[Anonymous]

"That is one potential part of the equation, the other is the effectiveness of the NCB public relations effort. They are creating a demand in the market for particular services...'

Meh. One could argue (and they do) that many of the hospital interventions/rules aren't needed (monitoring, staying in bed on your back, pitocin to speed labor, epidural to calm the pain of artificial contractions from pitocin administered because the staff wanted you to get moving along and be on a schedule, taking the baby away from the mom for a "bath"...) I didn't have any of those added services along with my home birth you're saying are being marketed—I find them gauche, actually, and I don't think there's some big marketing machine behind NCB, although some small biz people get ideas for small businesses, that's probably not a big part of this.

[Anonymous]

Anonymous wrote:"She wondered what the medical profession was doing so wrong that mother's like the one in this case are driven to making decisions that might not make obvious sense. "

That is one potential part of the equation, the other is the effectiveness of the NCB public relations effort. They are creating a demand in the market for particular services (doula, childbirth photographer, bradley classes, hynobabies, spinning babies, etc., etc.) that would not necessarily otherwise exist...just like 30 years ago none of the weddings I went to as a child had videographers, wedding programs, wedding favors, etc., marketing has convinced brides that these are an essential part of the wedding.

hahahaha, pr effort, *snort*. You don't find this stuff unless you LOOK for it, and you LOOK for it usually because you're unsatisfied with the amount of care/attention you're receiving from your OBs. If more OBs had the time/patience to actually engage with their patients in detail about natural child birth methods, the things you're talking about wouldn't exist. Now, there are many reasons why OBs generally don't have the time, and on some level, maybe it shouldn't be ENTIRELY up to them to educate their patients about everything. My OB is very supportive of me taking a Bradley class, as well as seeing a chiro, and even referred me to the spinning babies website. This doesn't have to be an either or type of thing. It's a shame that it's become one for many doctors and NCB advocates alike.

[Anonymous]

Anonymous wrote:"That is one potential part of the equation, the other is the effectiveness of the NCB public relations effort. They are creating a demand in the market for particular services...'

Meh. One could argue (and they do) that many of the hospital interventions/rules aren't needed (monitoring, staying in bed on your back, pitocin to speed labor, epidural to calm the pain of artificial contractions from pitocin administered because the staff wanted you to get moving along and be on a schedule, taking the baby away from the mom for a "bath"...) I didn't have any of those added services along with my home birth you're saying are being marketed—I find them gauche, actually, and I don't think there's some big marketing machine behind NCB, although some small biz people get ideas for small businesses, that's probably not a big part of this.

I agree. The NCB community is way too decentralized for there to be a major marketing effort. Plus, the people who offer the above services are doing it as a labor of love, because it is something they believe in -- none of them make much money. In fact, I bet none of them except *maybe* midwives make enough to support a family or even just themselves.

The NCB cause has been "marketed," to the extent you can even use that word, by having books written about it (for example, I came to it by reading Naomi Wolf's book Misconceptions) and of course more recently by Ricki Lake, and getting attention from the media. It is not primarily a push to sell products, but to disseminate an idea, namely that medical interventions used during pregnancy, labor and birth can cause more harm than good if they are not used judiciously and only on those who truly need them.

[Anonymous]

I think it's pretty obvious what OBs did wrong in this particular case. They didn't offer the mother the option of a vaginal breech birth in a hospital where she could get an emergency C-section when the baby's head got stuck. It's clear that vaginal breech birth can be safe in a hospital with a doctor who is willing.

[Anonymous]

She was offered one with an MFf doc at vhc.

[Anonymous]

Anonymous wrote:I think it's pretty obvious what OBs did wrong in this particular case. They didn't offer the mother the option of a vaginal breech birth in a hospital where she could get an emergency C-section when the baby's head got stuck. It's clear that vaginal breech birth can be safe in a hospital with a doctor who is willing.

Maybe. Or maybe the mother in question heard so many times, "No OB will let you try that. They're just in it for the money and their own convenience" that she didn't even ask. Or maybe she did ask and the OB said "I'm willing to try but at any sign of distress we'll have to move to a C-section" and the mother didn't like that answer. How can you know?

[Anonymous]

Exactly.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I think it's pretty obvious what OBs did wrong in this particular case. They didn't offer the mother the option of a vaginal breech birth in a hospital where she could get an emergency C-section when the baby's head got stuck. It's clear that vaginal breech birth can be safe in a hospital with a doctor who is willing.

Maybe. Or maybe the mother in question heard so many times, "No OB will let you try that. They're just in it for the money and their own convenience" that she didn't even ask. Or maybe she did ask and the OB said "I'm willing to try but at any sign of distress we'll have to move to a C-section" and the mother didn't like that answer. How can you know?

According to several people who have weighed in on this thread, there is only one OB/Gyn in the area who does vaginal breech birth and he was not available for this birth.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I think it's pretty obvious what OBs did wrong in this particular case. They didn't offer the mother the option of a vaginal breech birth in a hospital where she could get an emergency C-section when the baby's head got stuck. It's clear that vaginal breech birth can be safe in a hospital with a doctor who is willing.

Maybe. Or maybe the mother in question heard so many times, "No OB will let you try that. They're just in it for the money and their own convenience" that she didn't even ask. Or maybe she did ask and the OB said "I'm willing to try but at any sign of distress we'll have to move to a C-section" and the mother didn't like that answer. How can you know?

We really don't know what happened here, but we do not from the mother's own words that she felt that someone failed her and her baby. It's tragic. Was it just the midwife, the birth assistant, her ob, or the entire medical/birthing community? I don't know if there's a clear answer but, if anything, discussion of this incident has shown problems across the board when it comes to the way pregnancies and births are managed in the country.

[Anonymous]

It's clear to me that the mother failed her baby and the tragic flaw is hers alone.

[Anonymous]

Anonymous wrote:It's clear to me that the mother failed her baby and the tragic flaw is hers alone.

Hers alone? Do we know that she would have attempted a homebirth had a "certified professional midwife" not been willing to lend her assistance?

She may have started out so ignorant of this subject (as are many, many people who are not generally ignorant) and trusted the people around her enough not even to know that KC was unlicensed/illegal, for those who think it makes a difference in the prudence of her choice to hire KC (I don't necessarily disagree.) The Washington Post couldn't even get the facts straight about her legal status in the state of Maryland, and I thought reporters/editors got paid to check these things out.

I can't speak to how KC represented the risks of this birth, but I've been in the homebirth market around here. Risks *are* pooh-poohed by many advocates of homebirth with CPMs. We're not islands. People bear partial responsibility for the influence they exert on those who hold the ultimate decision-making responsibility.

[Anonymous]

I wonder how many first time moms who were unsatisfied with thier birth experiences took CBE classes and were truly informed/engaged in the birth process?

I actually think that the CBE course she took - Bradley - played a huge and critical part in her decision to have a breech baby at home with an unlicensed CPM as a 43-year-old first-time mom. They made her "informed" that hospitals are full of a) doctors whose only concern is their upcoming tee time and b) MRSA infections, and that to be "engaged" in your birth you had to avoid a c-section because that isn't the "natural" way.

What I don't get and I'm fascinated by this thread and have read all 70+ pages:

This is a 43-year-old woman. If she has any friends at all, many of them have to have given birth. How do you end up on this island where a home birth in a high-risk situation with unlicensed help is the way you choose to go? Didn't any of her friends have positive hospital births? Didn't any of them tell her, "Yes, I decided to have an epidural and in the end it was OK?" Or, "Yes, I decided on VHC and I no one there did any interventions I didn't want?" SO few women in the U.S. choose this route for their births, I just wonder how it ended up being such an extreme position for this mom. When I got pregnant I asked everyone I knew who had babies about their experiences; I just can't imagine having such a narrow circle that this is the advice she got.

[Anonymous]

Anonymous wrote:

I wonder how many first time moms who were unsatisfied with thier birth experiences took CBE classes and were truly informed/engaged in the birth process?

What I don't get and I'm fascinated by this thread and have read all 70+ pages:

This is a 43-year-old woman. If she has any friends at all, many of them have to have given birth. How do you end up on this island where a home birth in a high-risk situation with unlicensed help is the way you choose to go? Didn't any of her friends have positive hospital births? Didn't any of them tell her, "Yes, I decided to have an epidural and in the end it was OK?" Or, "Yes, I decided on VHC and I no one there did any interventions I didn't want?" SO few women in the U.S. choose this route for their births, I just wonder how it ended up being such an extreme position for this mom. When I got pregnant I asked everyone I knew who had babies about their experiences; I just can't imagine having such a narrow circle that this is the advice she got.

You're right that this is highly unlikely, but is birth the only situation in which such a thing happens? It's the woman's own makeup -- her values, her personality, her experiences, her relationships, etc. -- and how that interacts with the evidence and/or voices in favor of one thing or another. It's almost comparable to how people change religious affiliations.

[Anonymous]

Anonymous wrote:I think it's pretty obvious what OBs did wrong in this particular case. They didn't offer the mother the option of a vaginal breech birth in a hospital where she could get an emergency C-section when the baby's head got stuck. It's clear that vaginal breech birth can be safe in a hospital with a doctor who is willing.

Hey, guess what? Hospitals and doctors don't have to do what you want. They can not do what you don't want, but if they don't consider your choice safe, they don't have to play. It has been proven in multiple cases that even if a woman refuses something, like a section, and signs a refusal, that when things go bad from her choice she can go say "oh I didn't mean it I didn't think anything would really happen." and the MD gets sued. It is that kind of nonsense that has this issue where it is today.