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So you discuss fears, but then do nothing to help mom with them? So if a mom says "I have been terrified of hospitals since my mom died, so that's why I want a homebirth" instead of "I want a homebirth because I've educated myself on the risks and benefits" you wouldn't then say, "Hey, would you like to talk about that with someone, because it sounds like something that you want to talk about more and something that has been affecting your life?" Because I do not attend women in homebirths if they are uneducated on risks and benefits. I do not take clients doing homebirth just because their sister did. I do not take clients who are dead set on getting an epidural just because their sisters told them to, and who refuse to do the research on risks and benefits. I'd drop her as a client like it's hot, because of situations LIKE THIS. Homebirth requires the parents to be extremely informed. And the risks of primip breech (the age is irrelevant) at home AFTER MIDWIVES TOLD HER IT WAS TOO RISKY are high enough that I would think that this fear of hospitals was the thing getting in the way of an informed decision. |
It is relevant. Heal yourself so your life is can be saved. Work through your issues and do what it takes to heal from the past. |
What a perfect choice of words. |
In this case she said both: I want to birth at home because I'm educated AND I have a big fear of hospitals. Mom could have already been in therapy so you are suggesting a need for MORE therapy until her fear is eliminated? This was her life trauma to deal with. She came to the pregnancy with it. It isn't going to be "gotten over" in 40 weeks. You may have dropped her, but this doula didn't. It is honoring the continuity of care part of what a doula does. She did not abandon her client based on her own biases. She supported the mothers informed consent. Why is this so hard to understand? The mother did nothing illegal or unsafe. Well, there is opinion about what is safe or not, but the mother was the judge in this and the doula supported her choice. Also - How do you know what the midwives told her? They don't do breech. Fact. You are making an assumption that they said it was risky. The told her to go to the hospital and talk with their physician back-up, Tchabo who does breech. That is a fact. Anything else is conjecture. There are CNMs that do breech birth at home in the Washington DC area. Her particular midwives didn't. They are not experienced in it. She sought out one who was. Fact. |
I don't know the first thing about Karen Carr and I am unqualified to argue any of the particulars in this case. But I worry that this sad story will harm the perception of home births and midwives in general, CNMs included. I went to visit my very sick FIL in the hospital last week, a retired OB/Gyn, who was feeling nostalgic about his life. He talked and talked about the hundreds of babies he helped deliver in Germany during his residency and here is what he had to say, to paraphrase:
"It was the midwives who taught me the most. These women were so knowledgeable. Most doctors don't know how to deliver babies. Their training teaches them to do too much. Too much manipulating and cutting and pulling. Most of the time birth is a process that will happen without any help from the doctor but doctors are trained to try to try to force things. The midwives knew how to watch and wait. They taught me everything. It was a beautiful thing to watch. This was a long time ago but I see it getting worse all the time with all the c-sections." Just want to point out, after his residency, the remainder of his career was practiced in the US. |
I’m not enraged – I’m stupefied by the tunnel-vision of each side blinding vulnerable expectant parents to the realities of their individual case’s reality and an loosely regulated system that allows people like Carr to, without true contingency plans, present themselves as professional godlike women b/c they “magically bring babies into the world on a rainbow slide of glittering gold”. Birth on mom's end may be a miracle of life, but it's still a scientific occurence. You can't dismiss the entire approach b/c you don't like parts of it.
So sick of reading this – it’s exactly why she should not, in HER case, have been at home in the first place. It’s why everyone but Carr said this. If this mother was truly terrified of dying in a hospital, everyone who told her to go to one failed her by not holding her hand and supporting her through something she really should not avoid. Carr instead took the $, took the power, and failed her further - she exploited those fears.
As someone else (not me) said earlier: 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.
Riiiiight. Because already having a huge problem with the birth doesn’t indicate increased probability of further complications post-birth for the mother or baby that one should prudently require presence of other professinals to assist with… I believe many successful (and smart) home-birthers here have posted here about how such prudence saved lives in their own case, and cannot believe what went down here.
Uh, no. Because the hospital wanted to go straight to c-section (rightfully so, I’d say). Even if trying the natural way, they probably would have would have moved to c-section far earlier in the process. What does it take for you to believe a c-section might be necessary, exactly? And to the poster who said that sometimes in hospitals the baby in this situation still dies: So because the measures aren’t always successful, they don’t need to be applied? Why have a midwife at all then? Since some babies and mothers die even with one anyway? Circular logic. No one here is saying death can’t happen in a hospital – they’re saying that in this case, if it had, it would have been after every possible effort had been exhausted – which was NOT the case under Carr’s care. Sorry, but looks like everyone saying a c-section was required in this case WERE RIGHT. Are we so intent on proving OBs are out to get us that we’ll endanger our own lives and baby’s lives? |
I really feel very sorry for the family that have to go through this. 43 years old pregnant with first baby, going through God knows how many years of trying and pregnancy only to have the poor baby boy died during delivery. I really feel very sorry for the family ... |
Please correct me if I'm wrong, but I thought earlier in the discussion it was pointed out that women cannot be required to have c-sections even if the baby's life is at stake. |
We should separate homebirth in general with the actions of this individual. 33 minutes, in my mind, is amazingly negligent with no possible excuse.
It is true that if the baby is stuck, there may be nothing the hospital can do in time to save the baby. If the baby gets stuck, even with an OR, the baby can and probably will still die. Keep in mind that stuck means that even if a stat c-section is performed, the ob/gyn may not be able to get the baby unstuck from the other direction. This still does not, in anyway, justify Carr not calling 911. She risked the mother dying or having serious complications if she could not get the baby out. Furthermore, there is no excuse for not calling 911 after a traumatic birth and a non breathing baby. At this point, it may have been too late too but she could not have known that with any certainty. One of the reasons often brought up for why homebirth is safer in European countries is not only consistent University training but better homebirth-hospital transfer routines. Homebirth transfers in the US can involve conflict between parents, midwives, and hospital staff. Hospital protocal may dictate that a homebirth transfer with a midwife or a mother coming after a homebirth to get checked out as a mother with no prenatal care who gave birth in a non-sterile environment. The hospital staff will run every test, separate the mom and baby, not accept any information given by the mid wife, and can become adversial with the parents and mid wife. This all may be necessary in an emergency medical situation but it seems to occur routinely for non-emergent situations. Some homebirth midwives and mothers will actively avoid transferring or going in after birth unless they really think something is wrong. This can led to them going in or calling too late. This does not justify Carr's actions in this incident but if we want to make homebirth safer improving the transfer protocals between home and hospital or hospital evaluation of newborns and mothers after a home birth in a non emergent situation could go a long way. It would at least make midwives who actively avoid transfers be more of a rare occurance than part of the general homebirth community. |
I hope the birth mother is being closely screened for post partum depression. |
100% agree with this underrated fact. CONTEXT. Routinely collaborative homebirths and transfers there really do NOT equal the adversial we have here. This should change, but cases like this certainly will NOT pave the way. |
The hospital could not have forced her - but with the guidance of a caring midwife, they might have convinced her to either have it straight away or at least feel confident in relenting when labor was not looking successful BEFORE the head got stuck. And even if not, they more efforts would have been made in saving the child and give him a fighting chance than 33 min of attempt with no preventative rescue call for him or the mom (mom could have gotten seriously and morbidly ill from this traumatic birth while Carr was attending to the infant). |
NP here. I strongly disagree with most everything you've written, but can also see that we have drastically different worldviews about healthcare and birth. So be it. However, the bolded part is just wrong. What does an OB do if a baby gets stuck? He works to get that baby out, even if it takes 20 minutes. You are naive if you think a baby has never been stuck for 20 minutes in a hospital before. And what if a baby doesn't breathe at birth? Well, the NICU staff tries to resuscitate it. Sometimes that is achieved after a couple minutes, sometimes it takes 10 or 20 minutes, and in some cases it doesn't work at all. Your statement presumes that as long as there is a hospital and a L&D staff present, ALL babies will be born within a certain amount of time, and that ALL babies will start breathing on their own within a certain amount of time. I can guarantee you that hospitals have worked to help a baby breathe for much longer than 13 minutes, and that is not malpractice as you say, but instead heroism. |
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