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Midwife charged in DC? Karen Carr, CPM...
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Anonymous
Dr. Amy? Thanks for spreading your batshit crazy CPM-hating nonsense here. |
Anonymous
Actually, no. I have read Dr. Amy's site, and MDC, and I have a good idea of who's batshit crazy. Hint- people who routinely delete comments that they don't like, even when those comments are presented respectfully, are insulting to women. What- we can't stand to hear any dissent or our poor little selves will faint away on the fainting couch? Please. Also, my spelling tends to be better than Dr. Amy's (and many MDC posters', to be fair). It is interesting, though, that instead of defending MANA's refusal to release its numbers (which is indefensible as far as I can tell), you instead say that anybody who doesn't like the CPM credential (which is a joke compared to CNM credentials) is "batshit crazy." Great argument in favor of CPMs you have there. Please continue. |
Anonymous
Couldn't agree more!!! <<thumbs up>> |
Anonymous
I do actually agree with this one statement and I am not the PP who called you crazy by the way. I think you are frustrating but not crazy. I am the PP you are responding to here. I do not think all doctors suck or that all medical training is subpar. But sometimes that is the case. I hope we all know that. My point was (and I think you might be deliberately misreading all of my comments) that women are capable of researching their practitioners and making their own choices. That's it. I have never specifically defended the CPM credential. I have even said that I would not hire one myself and at my age and with my specific risks, if I were to give birth again, I would do it in a hospital with an OB/GYN. |
Anonymous
I absolutely agree that MANA should release its numbers. The same should be true for all ob/gyns and hospitals. VA requires reporting of c-section rates by provider and hospital but you can never find these numbers in DC or MD, or at least I could not a few years ago. Ob/gyns, hospitals and insurance providers do have have numbers for c-sections, inductions, and adverse outcomes but they will not release one thing unless legally compelled to do so. |
Anonymous
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Well, the issue is complicated because it is not just an issue of "telling a woman what she can do with her body." It definitely is an issue of that, but it is also an issue of telling a woman what she should do to protect the health of her child. There are two people whose rights are involved.
I know that the vast majority of mothers believe they are acting in the best interests of their children, but sometimes what the mother believes is in the best interests of the child doesn't make sense to most people. Consider the numerous court cases where parents have decided to withhold medical treatment from seriously ill children for religious reasons. Those parents believed that they were acting in the child's best interests, but most of us would disagree. Balancing the rights of the mother to make decisions with the child's right to be free from harm is difficult. |
Anonymous
I'm sorry I'm being frustrating- it really isn't my intention. I guess the point I'm trying to get at is that it's not really fair to say that it's a woman's responsibility to research her practitioner and make a choice based off of that when you're talking about CPMs. If you have several OBs and/or CNMs that have been recommended to you by friends and family, you know that they've all received similar training and hopefully are all competent to do what they're supposed to do. Your decision is mostly about personal compatibility, not the skills that that CNM/OB does or doesn't have. For example, you're probably more worried about the CNM's rate of using certain interventions (epidurals, CS, induction) and their personal attitudes about VBAC or NCB. Unless you've heard a horror story somewhere, your assessment really isn't about the CNM/OB's credentials; it's about how a typical birth by one of their typical patients lines up with how you envision your birth going. If CPMs are selling themselves as better/safer than hospital birth, and your CPM provides you with the names of a few happy clients, what does that really tell you? According to her credential alone, she's attended many, many fewer births than a CNM or OB. Is it then your fault when your CPM doesn't do appropriate neonatal resuscitation when your baby doesn't start breathing immediately, since yours is the first hypoxic baby she's encountered? Or what if she's attended over 1000 births, but when you ask about how many babies have died she says that there have been a few, but all were due to birth defects. Is that true? How do you know? What research can a woman really do to ascertain that her particular CPM is appropriately trained and prepared, since the CPM credential all by itself really isn't that reassuring? |
Anonymous
I don't find it difficult when the child is still inside the mother's body. Even though I hate the thought that some women will make choices I don't agree with, the fact remains that it is wrong to force a woman to submit to surgery in order to protect an unborn baby. And giving the government the power to determine when this might be necessary is very frightening territory. |
Anonymous
Again, the FBI isn't storming into anyone's house, dragging her to the hospital, and giving her a CS. Her right to choose what happens to her body is still intact. It's just her "right" to force her care providers to do something risky that's not intact. If all the providers you've talked to have said that the only option they can offer you is a CS, you can't force those providers to offer you something else. Medicine is not interior decorating, where the color of the carpet is totally up to the client. Doctors and nurses are ethically and legally obligated to offer the best care they can, not to give you whatever you want. If CS is routine for breech presentation in your area and that upsets you, organize women and start talking with hospitals and medical schools about how to change that policy. It would probably require recruiting OBs who have more experience with breech, as well as making it a part (if it's not) of the OB/GYN residency training. |
Anonymous
Well, what we are talking about is the point at which the child is coming out of the mother's body. |
Anonymous
Well for one, epidurals can slow down labor. Any decent doctor will advise you of this risk before giving you one. It is why doctors will generally not allow you to get an epidural until you have reached a certain point in your labor, even if you are already in a lot of pain. Slower labor frequently means c-section. C-section babies are at higher risk of everything, which is why even very pro-c-section OBs will always try vaginal birth first, if there are no medical reasons to get a c-section. Infections can also be introduced into your body and passed on to the baby at the site of epidural. Because an epidural makes it so a mother can't feel, she can't tell if something is going wrong (i.e. baby is stuck on publuic bone) and adjust her position to fix it. There is a reason why epidurals can only be done by a doctor in a hospital setting - they have serious risks. The benefits can outweigh the risks when it makes it possible for you to have a vaginal birth when you otherwise couldn't, or when it is used for a c-section. But outside those scenarios lets not kid ourselves - when you got an epidural you risked your baby's health for your own comfort. So don't judge the poor mother who lost her child so harshly -- any one of us could have lost a child because of a decision we made to make us more "comfortable". |
Anonymous
There is legal precedent that the mother's rights supercedes the child's rights when the mother is pregnant. Court decisions often consider not only the relevant facts in the case being presented but the legal precedent and effect on other situation the ruling will have in the future. One of the cases, in the decision, used the example that the rights of a child can not supercede the mother's right to determine medical options that would involve her. If a woman could not be legally required to undergo a c-section against her consent for the sake of her child anymore than she could be required to donate an organ against her consent to a sick child. I don't think the mother in this situation believed she was putting her rights above her child's rights. There is so much misinformation doled out by both the medical profession and the homebirth community that the parents may have lost sight of being able to dig through all the nonsense. I think the parents did not understand that low risk does not mean no risk. I also think that the discussion regarding better licensing for CPMs is valuable though not relevant to this case. From what I have read, Karen Carr is very knowledgable, very experienced, and probably on par with many of the best ob/gyns. She does not sound like an inexperienced mid wife or someone who have not witnessed enough challenging births to understand what is happening. She either made a serious judgement error by not transferring sooner, made a serious error by not monitoring a high risk mother earlier in labor herself instead of a less experienced birth assistant, or a complication occurred that did not show signs until it was too late. If later was the case then yes the outcome could have and probably would have been different in a hospital with immediate access to an OR. However, this would be true for any homebirth situation that developed a complication requiring an immediate OR. I think it is also valid to point out that hospital births present risks that homebirths do not. Infection, medical error during surgery and other fatal complications can happen there too. No one would ever consider blaming the mother for a fetal demise that occurred in a hospital due to risks only presented in a hospital environment. |
Anonymous
I agree that there are cases holding that they mother cannot be forced to submit to a C section for the benefit of the child. I assume that this is what you meant. The way that you stated it strongy overstates the status of the law, however. Roe v. Wade and Planned Parenthood v. Casey recognized that there is a state interest in protecting fetal life after viability, and that a state may prohibit abortion to protect fetal life during that period, except when it is necessary to preserve the life or health of the mother. The health and life of the mother supercedes the fetus's rights, but the mother's "rights" in a vague sense do not necessarily. But I was looking at the issue from an ethical, as opposed to legal, persepective. |
Anonymous
| But when the person who is advising the mother about her birth options is presenting herself to be a certified professional, when in fact, she's an amateur, that's where the issue arises. |
Anonymous
Well you do have some valid points here and these are some of the reasons that when I was in my early twenties, pregnant with my first child, and almost dead set on a homebirth, I looked into what it means to be a lay midwife and decided I wasn't comfortable with the qualifications (and in many cases the lack thereof). I knew someone well who called herself a lay midwife and she was pretty much just a hippy who had lived on a commune where she apprenticed with a midwife. We didn't have the internet and I couldn't find a nurse midwife who would attend my birth at home so I went to a birth center. It was a compromise for me- I really wanted that homebirth. So you see, here I was young and pregnant and terrified of hospital birth for many reasons and yet I was smart enough even without the internet to figure out that a lay midwife was not for me. I give other women the same credit. They can figure out what a lay midwife is. It's a person who doesn't have formal medical training but who may or may not have enough practical experience to attend birth at home. And it's up to the consumer to ask a lay midwife the difficult questions and decide on her own comfort level. I just can't be convinced that it's a good idea to give up this very basic freedom. And I definitely can't be convinced that we should allow the government to decide when we are too "high risk" to be allowed to deliver without being forced into surgery. |