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

[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.

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.

Here is a well known study that shows that vaginal breech birth in a hospital setting is safe: http://www.ajog.org/article/S0002-9378(05)02440-3/abstract

It does not appear that safety is really the issue.

[Anonymous]

Anonymous wrote:

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.

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.

Here is a well known study that shows that vaginal breech birth in a hospital setting is safe: http://www.ajog.org/article/S0002-9378(05)02440-3/abstract

It does not appear that safety is really the issue.

My link didn't work but it's called the Premoda study and it showed that vaginal breech birth in a hospital setting is a safe option for good candidates.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

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.

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.

Here is a well known study that shows that vaginal breech birth in a hospital setting is safe: http://www.ajog.org/article/S0002-9378(05)02440-3/abstract

It does not appear that safety is really the issue.

In what universe do you actually think that she was a candidate for vaginal birth? High risk in every way possible?

Hospitals provide services based in part upon what their insurers consider a prudent risk. The climate in America, which considers any birth injury a tragedy, does not allow for risk.....see above. If standard of accepted care is a section, then the mother could and would revoke her consent not to do same retroactively if anything went wrong.


My link didn't work but it's called the Premoda study and it showed that vaginal breech birth in a hospital setting is a safe option for good candidates.

[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.

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.

Isn't this what AMA forms are for?

[Anonymous]

Not really. In these instances the women argued that they would have said yes of course if they had REALLY known what would happen.

[Anonymous]

The choices women have are so limited that many people who would never consider a home birth (like myself) find that it's their only option to have a VBA2C or avoid a c/s- even with the most "VBAC friendly" docs. Things have really changed on the past year, and not for the better, even with the new AGOC recs.
No wonder she was so afraid. She's probobly heard a million stories of how wrong things went in the hospital. And the birth centers wouldn't take her- she must have felt so alone. I feel bad for her, I feel bad for Karen for taking the chance, and I feel for the baby.

[Anonymous]

so whose fault is it, the mother's? or the lawyerss? or the health care system? the lack of social safety nets for families that have birth tragedies?

Just because docs are getting sued for liability in situations where they MIGHT not be truly liable, doesn't mean that there aren't other problems here...it's kind of a cop out for any doc to say every problem is the result of our legal system. The lawsuits are just a symptom of larger problems, IMO.

[Anonymous]

The problem is not getting sued -- the problem is getting the verdict against you. Any given the average jury, with grieving parents on one side, and a deep pocketed doctor and hospital on the other, money getting awarded regardless of fault is not unheard of.

I've experienced jury making a decision they felt was fair, rather than the one supported by the evidence. I was traveling and got held up at knife point. The perpetrators were caught, and tried. The jury found them them not guilty on the theft charge, but guilty on the knife charge (even though some of the stolen goods were found in their possession when they were arrested). That outcome makes NO actual sense, but the jury basically made the decision that while robbing tourists was fine, using a knife to do it was inappropriate and that was where they drew the line.

[Anonymous]

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.

Well, with Bradley classes, like anything else, you need to be an informed consumer. Personally, I feel that the class gave me a lot of great information. I didn't buy into 100 percent of what it taught, and chose to have my son in a hospital, but felt that I learned a lot that was useful.

[Anonymous]

Anonymous wrote:

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.

Well, with Bradley classes, like anything else, you need to be an informed consumer. Personally, I feel that the class gave me a lot of great information. I didn't buy into 100 percent of what it taught, and chose to have my son in a hospital, but felt that I learned a lot that was useful.

You need to be an informed consumer about where you get your information? I don't actually disagree, but at some point, you have to trust a source. Unless you're going to conduct your own research trials... There's so much blame-shifting that goes on.

[Anonymous]

Why does anyone have to be blamed? If the parents want to sue someone, that's their prerogative. But, I don't think they are the ones who initiated the case...

[Anonymous]

RE: “it’s NOT about you”:

I this inflammatory comment (and the ones leading up to it). I also wrote about 5 COMPLEX responses here without taking the side of either hospital or homebirth, but promoting safety in calculation of risk. Mother’s HEALTH matters. The experience? DISTANT SECOND. And I’m noticing how many people respond to this “inflammatory” one but totally ignore the intelligently written others, by me or many other posters with a respectfully ‘camp do-what’s-best-for-every-situation-not-just-what-you’d-planned-for-yourself” stance. Much easier to jump on the quick answer than to have to argue against the well-articulated ones, I guess. Certainly easier to vilify anyone who disagrees with you (or at least doesn’t agree 100%). And if you think saying parenting being “not about you” translates to “screw you”, then you have much more than birth plans to figure out. BOTH MOTHERS AND FATHERS.

And to the poster who argued against my comment meaning “your child's health and safety should obviously trump the mother's desire to have a home birth/avoid a c-section. In many cases, both can be accomodated, but not all.”, you’re wrong. THAT’S EXACTLY WHAT I MEANT.


And by the way – people who prefer a hospital don’t necessarily prefer the medicalization of the “experience”. YOU CAN SPEAK UP. I personally faced a very difficult birth and MANY parts of it should have been better, but do NOT condemn hospitals for it. Rather, I learned to speak up for myself no matter where I give birth. I didn’t like how they dealt with my complications but I do know they were real, medically surprising (though they run in my family), and require further hospital births. THEY CAN’T DO ANYTHING YOU DON’T CONSENT TO. I know that now. I will use that now. IF HOMEBIRTH IS SHAPING UP TO BE A SERIOUSLY INCREASED RISK AS IN THIS CASE, THEN YOU CAN INVEST THE SAME AMOUNT OF RESEARCH IN YOUR PROVIDER AND HOSPITAL AS YOU WOULD IN YOUR HOME BIRTH TEAM. And while I very much agree that it’s a sad and terrible thing that a breech vaginal birth won’t even be tried much in hospitals anymore, attempting this at home was riskier than the hospital’s c-section. Risking more for yourself won’t change the system that let you down. It’s just endangers you. And just b/c you don’t like c-sections doesn’t mean you don’t genuinely need one!

I didn’t imply that all homebirthers overrate the experience – I was responding to some posters who do. And this overrating of the “experience” part of birth when it comes to the detriment of the mother OR baby’s health is troublesome to me. HEALTH AND SAFETY OF BOTH in the forefront. So in the end, NO, it’s NOT about your birthing experience, it’s about a successful outcome. The minute your personal experience comes before that, you’re not making wise decisions anymore.

[Anonymous]

It's really nobody's business except the woman's and her partner's. I don't see, how in a world where there is choice concerning abortion (which there should be) there would be so much condemnation about choice concerning birth. If we trust that women are smart, sovereign humans (and we must, really) we must let them make their own decisions about matters of their bodies. Maybe my opinion or yours is that the mother here made an unwise choice, but it was hers to make and hers to live with.

[Anonymous]

Anonymous wrote:It's really nobody's business except the woman's and her partner's. I don't see, how in a world where there is choice concerning abortion (which there should be) there would be so much condemnation about choice concerning birth. If we trust that women are smart, sovereign humans (and we must, really) we must let them make their own decisions about matters of their bodies. Maybe my opinion or yours is that the mother here made an unwise choice, but it was hers to make and hers to live with.

Exactly! People in this discussion have been so distracted by their own personal opinions on what is right and wrong in this particular case that they seem willing to give up their own rights and allow the government to make choices about their own medical care for them. We need to look at the bigger picture and say that it is not okay for the government to choose what is the right medical choice for us in any situation. You can't pick and choose these things and say that it's okay for the state to force a woman into surgery in a case like this where we might agree that surgery would have been the best decision. I am having a hard time understanding why so few people seem to understand this fundamental point.

[Anonymous]

Anonymous wrote:

Anonymous wrote: People in this discussion have been so distracted by their own personal opinions on what is right and wrong in this particular case that they seem willing to give up their own rights and allow the government to make choices about their own medical care for them. We need to look at the bigger picture and say that it is not okay for the government to choose what is the right medical choice for us in any situation. You can't pick and choose these things and say that it's okay for the state to force a woman into surgery in a case like this where we might agree that surgery would have been the best decision. I am having a hard time understanding why so few people seem to understand this fundamental point.

1) This entire thread relates to the case at hand - I think it's pretty good that posters are still remembering that 70+ pages in.

2) I'm not really seeing a lot of people saying home birthing should be illegal as much as people saying this woman should have made a wiser choice given her numerous warnings from all fields to use the hospital, till (seemingly from the limited information at hand) she found someone who told her what she wanted to hear. Being allowed to birth at home doesn't mean you HAVE to when it's clearly dangerous, or vice-versa. I mostly see legal arguments in here about whether or not the midwife should have agreed to take this on, and the fact that she did so without a license in that particular state. I also see concern for the fact that not all midwives are good (just like not all OBs are bad), and that dedicated mothers might be getting falsely encouraging home birth information in atypically dangerous cases.

3) Like anything, one's freedom ends where another's begins, including one's child. Since in this case the child died and not the mother, the gray areas of at what point dose it constitue irresponsible action are brought into the forefront. It's similar to the arguments of parents not believing in any medical intervention v. a very sick child, but with even more arguing given the differing beliefs on what could have saved the child, if anything. There won't be a resolution, but both sides have valid points.