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

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

You are letting your rage get the better of you, or perhaps

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.

“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.”

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.

“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.”

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.

"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."

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.

“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.”

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?

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.

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).

HOld up here. If the mother had been pressured into a c/s and then subsequently died (yes, it happens), then would Carr or the hospital be responsible for causing the mother's death? The best answer: let the mother decide for herself without coercion. Period.

[Anonymous]

An OB advises a c-section as the best way to deliver this baby alive. An OB has access to trained MEDICAL personnel and to life-saving equipment. An OB has delivered more than 40-50 babies over her/his 18 year career under these circumstances if he/she is attempting that type of birth.

Modern medicine is a miracle. It saves lives that otherwise would have been lost. Demonizing medicine when it comes to birth leads to this kind of outcome.

[Anonymous]

The best answer: let the mother decide for herself without coercion. Period.

The best answer: Let the mother make the decision understanding what the risks are. Period.

for the midwife - the best answer is: Don't bite off more than you can chew. Unless she told the mother than she had a nearly 10% chance of this outcome (a dead child) she misled her terribly.

I understand that the glitter and rainbow homebirth contingency believes that this risk is part of the circle of life, and therefore acceptable - but why? Why take the risk when modern medicine can reduce that risk?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

You are letting your rage get the better of you, or perhaps

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.

“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.”

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.

“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.”

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.

"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."

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.

“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.”

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?

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.

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).

The midwife's job is not to "convince" mom of anything. It is to provide her information, give her expert opinion based on the best available evidence and let the mother decide what she wants to do. It is called patient autonomy.

[Anonymous]

Anonymous wrote:An OB advises a c-section as the best way to deliver this baby alive. An OB has access to trained MEDICAL personnel and to life-saving equipment. An OB has delivered more than 40-50 babies over her/his 18 year career under these circumstances if he/she is attempting that type of birth.

Modern medicine is a miracle. It saves lives that otherwise would have been lost. Demonizing medicine when it comes to birth leads to this kind of outcome.

Not one single person on this thread has "demonized" modern medicine. The points that I've seen made are that modern medicine cannot guarantee a perfect outcome, that things occasionally do go horribly wrong in hospitals and under the care of doctors, and that mistakes can be made and accidents can happen regardless of training. Therefore -- and this is the most important part -- the individual should always be able to choose the type of care they want.

It is great that you feel so positively toward medical personnel, and hopefully you have full access to each and every drug, procedure and technique that you could ever dream of wanting. However, you should remember that not everyone has the same belief system as you do.

[Anonymous]

Anonymous wrote:An OB advises a c-section as the best way to deliver this baby alive. An OB has access to trained MEDICAL personnel and to life-saving equipment. An OB has delivered more than 40-50 babies over her/his 18 year career under these circumstances if he/she is attempting that type of birth.

Modern medicine is a miracle. It saves lives that otherwise would have been lost. Demonizing medicine when it comes to birth leads to this kind of outcome.

KC has attended the birth of about 40-50 *breech* births alone. This is significantly more than the vast majority of OBs.

I'm so tired of those who talk about how great modern medicine is. Yes, there are some great things about modern medicine; however, we have one of the worst maternal mortality rates amongst industrialized nations. The current medical model for obstetrics needs a complete overhaul.

[Anonymous]

Anonymous wrote: Actually you are just making that up. Who exactly is saying a C-section is required?

And other thing, just because you take away mom's options for vaginal breech birth by saying you won't provide that service, doesn't mean that she won't just go out of state or do it herself. All we have to do is look at the abortion issue to see that this is true. Just because somebody determines say that abortion is wrong and that we will outlaw the procedure, doesn't mean that there won't be providers offering this service and there won't be women for their own psycho-social reasons seeking them out. You are not the boss of another woman's choices on what to do with her body.

Informing someone of medical facts and risks is NOT coercion. The hospitals (OBs – all but ONE who wouldn’t be in town and obviously didn’t care enough to help her via someone else) recommended c-section, which no, she would not have been FORCED into (you have to sign). The local midwife services recommended the hospital, despite the c-section probability (so they must not have disagreed!). This woman was set against hospitals and no one – ESPECIALLY CARR – seemed to consider that what this poor lady needed was help in accepting her reality before someone got hurt. Saying a baby getting stuck at a hospital has no better chance than at home just proves the OBs and midwives right about their c-section stance. And had she attempted the vaginal birth at the hospital, she might have eventually yielded to the c-section BEFORE the head got trapped, when things weren’t looking good. I’m not saying the law should have dealt with this – I’m saying midwives failed her in making her choices which were probably fueled by extreme rhetoric against hospitals, OBs, and medical intervention. If this particular case still doesn’t sound like one where the home-birth and natural route may not be wise, then you (proverbial “you”) are not objective in your home-birth safety stance, and you are part of the reasons why so many distrust the approach as it currently is in the USA.

[Anonymous]

Anonymous wrote:

The best answer: let the mother decide for herself without coercion. Period.

The best answer: Let the mother make the decision understanding what the risks are. Period.

for the midwife - the best answer is: Don't bite off more than you can chew. Unless she told the mother than she had a nearly 10% chance of this outcome (a dead child) she misled her terribly.

I understand that the glitter and rainbow homebirth contingency believes that this risk is part of the circle of life, and therefore acceptable - but why? Why take the risk when modern medicine can reduce that risk?

What on earth is wrong with you? You are rude, condescending, manipulative and mean. There isn't one homebirth supporter in this entire thread who has said they would put the "experience" above the health of the baby. You are making shit up to be a pain in the ass. And, I do not buy your 10% risk. Another thing you are making up, or skewing statistics to say what you want them to say.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

You are letting your rage get the better of you, or perhaps

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.

“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.”

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.

“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.”

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.

"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."

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.

“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.”

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?

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.

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).

The midwife's job is not to "convince" mom of anything. It is to provide her information, give her expert opinion based on the best available evidence and let the mother decide what she wants to do. It is called patient autonomy.

Yes, yes YES!!!! So many people, doctors included, forget this. Whatever happened to the land of the free. Drives me crazy that people are free to intentionally kill their baby in utero yet Mamas are denied the right to choose the type of birth that is best for them and their baby.

[Anonymous]

Anonymous wrote:

Anonymous wrote: Actually you are just making that up. Who exactly is saying a C-section is required?

And other thing, just because you take away mom's options for vaginal breech birth by saying you won't provide that service, doesn't mean that she won't just go out of state or do it herself. All we have to do is look at the abortion issue to see that this is true. Just because somebody determines say that abortion is wrong and that we will outlaw the procedure, doesn't mean that there won't be providers offering this service and there won't be women for their own psycho-social reasons seeking them out. You are not the boss of another woman's choices on what to do with her body.

Informing someone of medical facts and risks is NOT coercion. The hospitals (OBs – all but ONE who wouldn’t be in town and obviously didn’t care enough to help her via someone else) recommended c-section, which no, she would not have been FORCED into (you have to sign). The local midwife services recommended the hospital, despite the c-section probability (so they must not have disagreed!). This woman was set against hospitals and no one – ESPECIALLY CARR – seemed to consider that what this poor lady needed was help in accepting her reality before someone got hurt. Saying a baby getting stuck at a hospital has no better chance than at home just proves the OBs and midwives right about their c-section stance. And had she attempted the vaginal birth at the hospital, she might have eventually yielded to the c-section BEFORE the head got trapped, when things weren’t looking good. I’m not saying the law should have dealt with this – I’m saying midwives failed her in making her choices which were probably fueled by extreme rhetoric against hospitals, OBs, and medical intervention. If this particular case still doesn’t sound like one where the home-birth and natural route may not be wise, then you (proverbial “you”) are not objective in your home-birth safety stance, and you are part of the reasons why so many distrust the approach as it currently is in the USA.

I don't think anyone here has tried to argue that there is no risk to vaginal breech birth. In fact, after reading through all these pages, I don't think anyone else - even the homebirthers - have claimed that they would have pursued a homebirth in this situation. What I have read is countless people trying to explain that they support the mother's right to do her own research and choose her own path.

In your expert opinion, when exactly is it during the labor that an OB would have called off the vaginal attempt? What information are you using to decide that something happened which would have changed the course?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

The best answer: let the mother decide for herself without coercion. Period.

The best answer: Let the mother make the decision understanding what the risks are. Period.

for the midwife - the best answer is: Don't bite off more than you can chew. Unless she told the mother than she had a nearly 10% chance of this outcome (a dead child) she misled her terribly.

I understand that the glitter and rainbow homebirth contingency believes that this risk is part of the circle of life, and therefore acceptable - but why? Why take the risk when modern medicine can reduce that risk?

What on earth is wrong with you? You are rude, condescending, manipulative and mean. There isn't one homebirth supporter in this entire thread who has said they would put the "experience" above the health of the baby. You are making shit up to be a pain in the ass. And, I do not buy your 10% risk. Another thing you are making up, or skewing statistics to say what you want them to say.

Not the poster you quoted but of course no one says they would put the experience over the childs health...its insinuated in doing a home birth. A home is not a hospital which is inherently risky in general. So yes, you put your child at risk eventhough you may not see it that way bc you want to have a birth at home. Hosiptals are here for tending to unexpected emergency care and no one can be promised or promise they will have a safe birth no one. So to do it at home is a risk that mother is willing to take.

[Anonymous]

Anonymous wrote:

Anonymous wrote: Actually you are just making that up. Who exactly is saying a C-section is required?

And other thing, just because you take away mom's options for vaginal breech birth by saying you won't provide that service, doesn't mean that she won't just go out of state or do it herself. All we have to do is look at the abortion issue to see that this is true. Just because somebody determines say that abortion is wrong and that we will outlaw the procedure, doesn't mean that there won't be providers offering this service and there won't be women for their own psycho-social reasons seeking them out. You are not the boss of another woman's choices on what to do with her body.

Informing someone of medical facts and risks is NOT coercion. The hospitals (OBs – all but ONE who wouldn’t be in town and obviously didn’t care enough to help her via someone else) recommended c-section, which no, she would not have been FORCED into (you have to sign). The local midwife services recommended the hospital, despite the c-section probability (so they must not have disagreed!). This woman was set against hospitals and no one – ESPECIALLY CARR – seemed to consider that what this poor lady needed was help in accepting her reality before someone got hurt. Saying a baby getting stuck at a hospital has no better chance than at home just proves the OBs and midwives right about their c-section stance. And had she attempted the vaginal birth at the hospital, she might have eventually yielded to the c-section BEFORE the head got trapped, when things weren’t looking good. I’m not saying the law should have dealt with this – I’m saying midwives failed her in making her choices which were probably fueled by extreme rhetoric against hospitals, OBs, and medical intervention. If this particular case still doesn’t sound like one where the home-birth and natural route may not be wise, then you (proverbial “you”) are not objective in your home-birth safety stance, and you are part of the reasons why so many distrust the approach as it currently is in the USA.

Sorry, mom came to the birth distrustful of doctors and hospitals. She was never going to give birth in hospital based on her history, and not based on home birth rhetoric. Again, you are assuming that the Dr. said he suggested a C and would be out of town. Where are you getting that information? That was just chatter. The midwives suggested that she see their back-up physician that does breech, not that she birth there. They said that they cannot serve her and per their protocol, referred to somebody that could, their back-up physician. Who knows what he said? Again, stick with the facts.

[Anonymous]

If the mother was so against hospitals, why did she seek out Dr. Tchabo? If he deliverd her baby, it would have been in a hospital.

Sounds like the prosecutor's statement was misleading.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

The best answer: let the mother decide for herself without coercion. Period.

The best answer: Let the mother make the decision understanding what the risks are. Period.

for the midwife - the best answer is: Don't bite off more than you can chew. Unless she told the mother than she had a nearly 10% chance of this outcome (a dead child) she misled her terribly.

I understand that the glitter and rainbow homebirth contingency believes that this risk is part of the circle of life, and therefore acceptable - but why? Why take the risk when modern medicine can reduce that risk?

What on earth is wrong with you? You are rude, condescending, manipulative and mean. There isn't one homebirth supporter in this entire thread who has said they would put the "experience" above the health of the baby. You are making shit up to be a pain in the ass. And, I do not buy your 10% risk. Another thing you are making up, or skewing statistics to say what you want them to say.

not the PP you are responding to, but I think maybe you could point that finger right back at yourself.

[Anonymous]

Anonymous wrote: Sorry, mom came to the birth distrustful of doctors and hospitals. She was never going to give birth in hospital based on her history, and not based on home birth rhetoric. Again, you are assuming that the Dr. said he suggested a C and would be out of town. Where are you getting that information? That was just chatter. The midwives suggested that she see their back-up physician that does breech, not that she birth there. They said that they cannot serve her and per their protocol, referred to somebody that could, their back-up physician. Who knows what he said? Again, stick with the facts.

If it's not true, why was Tchabo on the prosecution's witness list?