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

[Anonymous]

You are letting your rage get the better of you, or perhaps you don't really know much about birth. When a baby gets stuck during the birth, the only option is to work to free the baby and complete the delivery. A speedy 911 call is NOT going to change the outcome. An EMT is NOT going to be able to offer anything greater than what the skilled midwife/OB is already doing. Even having an operating room three doors down is NOT going to help

And what about the 13 minutes after the baby was delivered?

If this had happened in a hospital, it wouldn't have gone this far, and if this had happened in a hospital, there would have been a NICU.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Assuming the statement about 13 minutes is true, I am utterly shocked...My daughter was born a few weeks ago in a large hospital. She wasn't breathing well (1-min Apgar was 3) and had to be resuscitated. The NICU people appeared within 30 seconds of her birth and got her breathing normally within a few minutes. I can't imagine waiting 13 minutes to call for help!

Your baby survived easily. This poor baby died. In the year 2011 in Washington, DC, there is no excuse for this sort of ignorance. It's tragic.

You do realize that there are other babies who die and/or are severely brain damaged - yes, even in hospitals - due to getting stuck? Yes, it is tragic, but it has nothing to do with ignorance. In rare cases, babies get stuck and die at birth. Awful but true.

Yup, and it's also awful but true that at a hospital there are lots of skilled people around, so if a baby happens to get stuck she gets unstuck pretty quick. This scenario in a hospital (20 minutes trying to "unstick" a stuck baby, followed by 13 minutes of trying to resuscitate the baby alone before calling for help) would be called malpractice.

And I do think it has to do with ignorance. If you are a professional homebirth midwife, you need to have a better plan then "oh well, babies just get stuck sometimes and die." Karen Carr represented herself as an expert at breech delivery after having delivered 40-50 babies, but the way she handled this birth makes me wonder how many of those other breech babies may have had oxygen deprivation.

Well sure, in some cases. IN other cases, no, the baby does not come out in time to prevent death and/or brain damage. Or, the resuscitation efforts damage the baby and/or do not work. You are deluding yourself if you think these birth tragedies do not happen in our local, modern hospitals.

[Anonymous]

Anonymous wrote:

You are letting your rage get the better of you, or perhaps you don't really know much about birth. When a baby gets stuck during the birth, the only option is to work to free the baby and complete the delivery. A speedy 911 call is NOT going to change the outcome. An EMT is NOT going to be able to offer anything greater than what the skilled midwife/OB is already doing. Even having an operating room three doors down is NOT going to help

And what about the 13 minutes after the baby was delivered?

If this had happened in a hospital, it wouldn't have gone this far, and if this had happened in a hospital, there would have been a NICU.

What makes you think the birth wouldn't have proceeded at a hospital? You don't have any evidence at all about this. I am also not sure what you think a NICU could have provided after a 20 minute dystocia that would have saved the baby. Again, it is extremely easy and comforting to convince ourselves that these things CANNOT happen in a modern, Washington DC hospital. BUT THEY DO. My suspicion is that this is why the prosecution agreed to a plea for the case.

[Anonymous]

In my opinion, this case did not go to trial to spare the parents any more pain and from the ultimate realization that this was their fault. How in the hell do you sit by for 13 minutes without calling 911 while Carr ATTEMPTS to resuscitate your child??? I'm sorry that is just horrible.

[Anonymous]

Anonymous wrote:You are letting your rage get the better of you, or perhaps you don't really know much about birth. When a baby gets stuck during the birth, the only option is to work to free the baby and complete the delivery. A speedy 911 call is NOT going to change the outcome. An EMT is NOT going to be able to offer anything greater than what the skilled midwife/OB is already doing. Even having an operating room three doors down is NOT going to help. Once a baby is partially born, there are no other magic answers; you have to finish getting the baby out, and if more than 10 minutes pass, the baby is just not going to make it unless there is a miracle. Maybe you take some personal comfort from thinking that a hospital could have saved this baby, and I think that as mothers who are horrified at this case, it is easy to believe that the right medical team could have saved this baby. However, I honestly believe that the outcome would have been exactly the same regardless of where the birth occurred. This is a risk - thankfully an extremely small risk - that all mothers take when they give birth vaginally.

I think your assessment that Carr was just trying to cover her ass by not calling 911 is wrong, too. In these situations, the only reason homebirth midwives call 911 is precisely TO cover their asses. Everyone knows that it is not going to actually help the baby, it just helps relieve the care providers responsibility. Just because something goes wrong at a birth, it does not mean that the care provider has some huge ego or did something incompetently.

This wasn't me, but good grief. Are you an OB? In a hospital, if a breech baby is partially delivered and the usual maneuvers aren't working to deliver the head, the most skilled practitioner there would probably place a few small incisions in the cervix to allow the head to be delivered. And if that didn't work, the Zavanelli maneuver would be attempted as a last ditch effort at saving the baby (pushing the baby back up and delivering via CS). You act like if a baby gets stuck during a hospital birth, everybody just stands around and says, "oh well, better luck next time." That's not how it works! Having help, surgical equipment, and an operating room certainly could have changed this outcome!

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Assuming the statement about 13 minutes is true, I am utterly shocked...My daughter was born a few weeks ago in a large hospital. She wasn't breathing well (1-min Apgar was 3) and had to be resuscitated. The NICU people appeared within 30 seconds of her birth and got her breathing normally within a few minutes. I can't imagine waiting 13 minutes to call for help!

Your baby survived easily. This poor baby died. In the year 2011 in Washington, DC, there is no excuse for this sort of ignorance. It's tragic.

You do realize that there are other babies who die and/or are severely brain damaged - yes, even in hospitals - due to getting stuck? Yes, it is tragic, but it has nothing to do with ignorance. In rare cases, babies get stuck and die at birth. Awful but true.

Yup, and it's also awful but true that at a hospital there are lots of skilled people around, so if a baby happens to get stuck she gets unstuck pretty quick. This scenario in a hospital (20 minutes trying to "unstick" a stuck baby, followed by 13 minutes of trying to resuscitate the baby alone before calling for help) would be called malpractice.

And I do think it has to do with ignorance. If you are a professional homebirth midwife, you need to have a better plan then "oh well, babies just get stuck sometimes and die." Karen Carr represented herself as an expert at breech delivery after having delivered 40-50 babies, but the way she handled this birth makes me wonder how many of those other breech babies may have had oxygen deprivation.

Well sure, in some cases. IN other cases, no, the baby does not come out in time to prevent death and/or brain damage. Or, the resuscitation efforts damage the baby and/or do not work. You are deluding yourself if you think these birth tragedies do not happen in our local, modern hospitals.

Good grief, what is with this black and white thinking? Of course there are still deaths and tragedies at the hospital. That doesn't magically make the risks of this homebirth situation on par with the risks at the local hospital. You can't say, well, it's happened at the hospital, therefore the baby had just as good a chance at home. The question is the speed at which the fetus/infant can get help, and the skill level of the practitioners. Do you really think that Karen Carr in someone's living room is able to respond to head entrapment as efficiently as the whole L&D staff? There's a reason why homebirth in the US has a higher neonatal mortality rate than hospital birth, and this case illustrates it quite well.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Assuming the statement about 13 minutes is true, I am utterly shocked...My daughter was born a few weeks ago in a large hospital. She wasn't breathing well (1-min Apgar was 3) and had to be resuscitated. The NICU people appeared within 30 seconds of her birth and got her breathing normally within a few minutes. I can't imagine waiting 13 minutes to call for help!

Your baby survived easily. This poor baby died. In the year 2011 in Washington, DC, there is no excuse for this sort of ignorance. It's tragic.

You do realize that there are other babies who die and/or are severely brain damaged - yes, even in hospitals - due to getting stuck? Yes, it is tragic, but it has nothing to do with ignorance. In rare cases, babies get stuck and die at birth. Awful but true.

Yup, and it's also awful but true that at a hospital there are lots of skilled people around, so if a baby happens to get stuck she gets unstuck pretty quick. This scenario in a hospital (20 minutes trying to "unstick" a stuck baby, followed by 13 minutes of trying to resuscitate the baby alone before calling for help) would be called malpractice.

And I do think it has to do with ignorance. If you are a professional homebirth midwife, you need to have a better plan then "oh well, babies just get stuck sometimes and die." Karen Carr represented herself as an expert at breech delivery after having delivered 40-50 babies, but the way she handled this birth makes me wonder how many of those other breech babies may have had oxygen deprivation.

Well sure, in some cases. IN other cases, no, the baby does not come out in time to prevent death and/or brain damage. Or, the resuscitation efforts damage the baby and/or do not work. You are deluding yourself if you think these birth tragedies do not happen in our local, modern hospitals.

Good grief, what is with this black and white thinking? Of course there are still deaths and tragedies at the hospital. That doesn't magically make the risks of this homebirth situation on par with the risks at the local hospital. You can't say, well, it's happened at the hospital, therefore the baby had just as good a chance at home. The question is the speed at which the fetus/infant can get help, and the skill level of the practitioners. Do you really think that Karen Carr in someone's living room is able to respond to head entrapment as efficiently as the whole L&D staff? There's a reason why homebirth in the US has a higher neonatal mortality rate than hospital birth, and this case illustrates it quite well.

Good grief, yourself. Are we really back to this nonsense about homebirth being riskier than hospital birth? The evidence does NOT support your statement.

And, I do believe that the outcome would have been the same in the hospital in this particular case. I think a "whole L&D staff" wouldn't have known what the hell to do with a breech head entrapment. It is just as likely that they would have irreparably maimed the mother AND still not have saved the baby.

[Anonymous]

Anonymous wrote:

Anonymous wrote:You are letting your rage get the better of you, or perhaps you don't really know much about birth. When a baby gets stuck during the birth, the only option is to work to free the baby and complete the delivery. A speedy 911 call is NOT going to change the outcome. An EMT is NOT going to be able to offer anything greater than what the skilled midwife/OB is already doing. Even having an operating room three doors down is NOT going to help. Once a baby is partially born, there are no other magic answers; you have to finish getting the baby out, and if more than 10 minutes pass, the baby is just not going to make it unless there is a miracle. Maybe you take some personal comfort from thinking that a hospital could have saved this baby, and I think that as mothers who are horrified at this case, it is easy to believe that the right medical team could have saved this baby. However, I honestly believe that the outcome would have been exactly the same regardless of where the birth occurred. This is a risk - thankfully an extremely small risk - that all mothers take when they give birth vaginally.

I think your assessment that Carr was just trying to cover her ass by not calling 911 is wrong, too. In these situations, the only reason homebirth midwives call 911 is precisely TO cover their asses. Everyone knows that it is not going to actually help the baby, it just helps relieve the care providers responsibility. Just because something goes wrong at a birth, it does not mean that the care provider has some huge ego or did something incompetently.

This wasn't me, but good grief. Are you an OB? In a hospital, if a breech baby is partially delivered and the usual maneuvers aren't working to deliver the head, the most skilled practitioner there would probably place a few small incisions in the cervix to allow the head to be delivered. And if that didn't work, the Zavanelli maneuver would be attempted as a last ditch effort at saving the baby (pushing the baby back up and delivering via CS). You act like if a baby gets stuck during a hospital birth, everybody just stands around and says, "oh well, better luck next time." That's not how it works! Having help, surgical equipment, and an operating room certainly could have changed this outcome!

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Assuming the statement about 13 minutes is true, I am utterly shocked...My daughter was born a few weeks ago in a large hospital. She wasn't breathing well (1-min Apgar was 3) and had to be resuscitated. The NICU people appeared within 30 seconds of her birth and got her breathing normally within a few minutes. I can't imagine waiting 13 minutes to call for help!

Your baby survived easily. This poor baby died. In the year 2011 in Washington, DC, there is no excuse for this sort of ignorance. It's tragic.

You do realize that there are other babies who die and/or are severely brain damaged - yes, even in hospitals - due to getting stuck? Yes, it is tragic, but it has nothing to do with ignorance. In rare cases, babies get stuck and die at birth. Awful but true.

Yup, and it's also awful but true that at a hospital there are lots of skilled people around, so if a baby happens to get stuck she gets unstuck pretty quick. This scenario in a hospital (20 minutes trying to "unstick" a stuck baby, followed by 13 minutes of trying to resuscitate the baby alone before calling for help) would be called malpractice.

And I do think it has to do with ignorance. If you are a professional homebirth midwife, you need to have a better plan then "oh well, babies just get stuck sometimes and die." Karen Carr represented herself as an expert at breech delivery after having delivered 40-50 babies, but the way she handled this birth makes me wonder how many of those other breech babies may have had oxygen deprivation.

Well sure, in some cases. IN other cases, no, the baby does not come out in time to prevent death and/or brain damage. Or, the resuscitation efforts damage the baby and/or do not work. You are deluding yourself if you think these birth tragedies do not happen in our local, modern hospitals.

Good grief, what is with this black and white thinking? Of course there are still deaths and tragedies at the hospital. That doesn't magically make the risks of this homebirth situation on par with the risks at the local hospital. You can't say, well, it's happened at the hospital, therefore the baby had just as good a chance at home. The question is the speed at which the fetus/infant can get help, and the skill level of the practitioners. Do you really think that Karen Carr in someone's living room is able to respond to head entrapment as efficiently as the whole L&D staff? There's a reason why homebirth in the US has a higher neonatal mortality rate than hospital birth, and this case illustrates it quite well.

Good grief, yourself. Are we really back to this nonsense about homebirth being riskier than hospital birth? The evidence does NOT support your statement.

And, I do believe that the outcome would have been the same in the hospital in this particular case. I think a "whole L&D staff" wouldn't have known what the hell to do with a breech head entrapment. It is just as likely that they would have irreparably maimed the mother AND still not have saved the baby.

Citation, please. We've been over this waaaay back in this thread, and the evidence supported that homebirth in the US is riskier for the baby.

[Anonymous]

Anonymous wrote:

Anonymous wrote:
Good grief, yourself. Are we really back to this nonsense about homebirth being riskier than hospital birth? The evidence does NOT support your statement.

And, I do believe that the outcome would have been the same in the hospital in this particular case. I think a "whole L&D staff" wouldn't have known what the hell to do with a breech head entrapment. It is just as likely that they would have irreparably maimed the mother AND still not have saved the baby.

Citation, please. We've been over this waaaay back in this thread, and the evidence supported that homebirth in the US is riskier for the baby.

And are you really arguing that a 43-year-old primip mother with a breech baby is a good homebirth candidate? Really? Her baby's risk is equal at home and at the hospital?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Assuming the statement about 13 minutes is true, I am utterly shocked...My daughter was born a few weeks ago in a large hospital. She wasn't breathing well (1-min Apgar was 3) and had to be resuscitated. The NICU people appeared within 30 seconds of her birth and got her breathing normally within a few minutes. I can't imagine waiting 13 minutes to call for help!

Your baby survived easily. This poor baby died. In the year 2011 in Washington, DC, there is no excuse for this sort of ignorance. It's tragic.

You do realize that there are other babies who die and/or are severely brain damaged - yes, even in hospitals - due to getting stuck? Yes, it is tragic, but it has nothing to do with ignorance. In rare cases, babies get stuck and die at birth. Awful but true.

Yup, and it's also awful but true that at a hospital there are lots of skilled people around, so if a baby happens to get stuck she gets unstuck pretty quick. This scenario in a hospital (20 minutes trying to "unstick" a stuck baby, followed by 13 minutes of trying to resuscitate the baby alone before calling for help) would be called malpractice.

And I do think it has to do with ignorance. If you are a professional homebirth midwife, you need to have a better plan then "oh well, babies just get stuck sometimes and die." Karen Carr represented herself as an expert at breech delivery after having delivered 40-50 babies, but the way she handled this birth makes me wonder how many of those other breech babies may have had oxygen deprivation.

Well sure, in some cases. IN other cases, no, the baby does not come out in time to prevent death and/or brain damage. Or, the resuscitation efforts damage the baby and/or do not work. You are deluding yourself if you think these birth tragedies do not happen in our local, modern hospitals.

Good grief, what is with this black and white thinking? Of course there are still deaths and tragedies at the hospital. That doesn't magically make the risks of this homebirth situation on par with the risks at the local hospital. You can't say, well, it's happened at the hospital, therefore the baby had just as good a chance at home. The question is the speed at which the fetus/infant can get help, and the skill level of the practitioners. Do you really think that Karen Carr in someone's living room is able to respond to head entrapment as efficiently as the whole L&D staff? There's a reason why homebirth in the US has a higher neonatal mortality rate than hospital birth, and this case illustrates it quite well.

Good grief, yourself. Are we really back to this nonsense about homebirth being riskier than hospital birth? The evidence does NOT support your statement.

And, I do believe that the outcome would have been the same in the hospital in this particular case. I think a "whole L&D staff" wouldn't have known what the hell to do with a breech head entrapment. It is just as likely that they would have irreparably maimed the mother AND still not have saved the baby.

Citation, please. We've been over this waaaay back in this thread, and the evidence supported that homebirth in the US is riskier for the baby.

Citation, yourself. Wax was discredited and is therefore not sufficient evidence either way. The best evidence actually shows that homebirth is as safe as hospital birth, and uses fewer potentially harmful interventions.

[Anonymous]

Anonymous wrote:Citation, yourself. Wax was discredited and is therefore not sufficient evidence either way. The best evidence actually shows that homebirth is as safe as hospital birth, and uses fewer potentially harmful interventions.

I wasn't referring to Wax, I was referring to Johnson and Daviss, as well as the state database of Wisconsin. Your cites?

http://www.dhs.wisconsin.gov/wish/measures/inf_mort/long_form.html

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:
Good grief, yourself. Are we really back to this nonsense about homebirth being riskier than hospital birth? The evidence does NOT support your statement.

And, I do believe that the outcome would have been the same in the hospital in this particular case. I think a "whole L&D staff" wouldn't have known what the hell to do with a breech head entrapment. It is just as likely that they would have irreparably maimed the mother AND still not have saved the baby.

Citation, please. We've been over this waaaay back in this thread, and the evidence supported that homebirth in the US is riskier for the baby.

And are you really arguing that a 43-year-old primip mother with a breech baby is a good homebirth candidate? Really? Her baby's risk is equal at home and at the hospital?

I don't think it is for anyone else to determine which birthing mothers are good candidates for anything. It is up to the woman to decide, period. All this language about the doctor telling us or letting us or making us or deciding for us....it is all bullshit and not something I will ever condone.

And yes, assuming a vaginal birth, I think the moms and baby's risk was pretty similar whether at home or the hospital.

[Anonymous]

The ultimate blame lies with the parents. First, a home delivery of a breech baby for a 43-year old first time mom. Second, waiting to call 911 after 13 mins of resuscitation. What were they thinking? Obviously, they weren't.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Citation, yourself. Wax was discredited and is therefore not sufficient evidence either way. The best evidence actually shows that homebirth is as safe as hospital birth, and uses fewer potentially harmful interventions.

I wasn't referring to Wax, I was referring to Johnson and Daviss, as well as the state database of Wisconsin. Your cites?

http://www.dhs.wisconsin.gov/wish/measures/inf_mort/long_form.html

Wow, I smell a Dr. Amy rat.

http://www.babble.com/pregnancy/giving-birth/winning-homebirth-debate/