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

[Anonymous]

Anonymous wrote: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.

I would assume to do an external version.

[Anonymous]

Anonymous wrote: 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.

Holy hell... so "give me $3K so I can give you questionable advice based on questionable training supported by limited experience, while calling myself a professional but absolving myself of anything going wrong when it was preventable b/c i'm just here to cheer you on"????? Unreal. Mere participation as a professional in the complex medical act that is BIRTH assumes and presumes the responsibility to know what the hell you're doing and are able to transfer care when you no longer do. Nowhere did I read that Carr's defense included "I disagreed with this obviously overly risky approach but feared that the patient would opt for even riskier unassisted birth without me" or "I wanted to call 911 at many points but was bound to respect the patient's wishes that I would not" or "Due to my protest over the approach i felt obligated to participate in, i had the parents sign a waiver stating I'd informed them of the probable unsuccessful outcome of this endeavor if they chose to ignore my advice". No dice. You participate, you're responsible and YES, convincing someone that death is likely when you're the professional and they're not IS your job.

[Anonymous]

Anonymous wrote:

Anonymous wrote: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.

I would assume to do an external version.

Plenty of OBs do this. Tchabo is the only one who will do to a breech vaginal delivery.

[Anonymous]

Anonymous wrote:

Anonymous wrote: 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.

Holy hell... so "give me $3K so I can give you questionable advice based on questionable training supported by limited experience, while calling myself a professional but absolving myself of anything going wrong when it was preventable b/c i'm just here to cheer you on"????? Unreal. Mere participation as a professional in the complex medical act that is BIRTH assumes and presumes the responsibility to know what the hell you're doing and are able to transfer care when you no longer do. Nowhere did I read that Carr's defense included "I disagreed with this obviously overly risky approach but feared that the patient would opt for even riskier unassisted birth without me" or "I wanted to call 911 at many points but was bound to respect the patient's wishes that I would not" or "Due to my protest over the approach i felt obligated to participate in, i had the parents sign a waiver stating I'd informed them of the probable unsuccessful outcome of this endeavor if they chose to ignore my advice". No dice. You participate, you're responsible and YES, convincing someone that death is likely when you're the professional and they're not IS your job.

That's because there was no trial...you never heard her defense. The only thing you, and everyone else here, has heard has been one sided. The prosecutor is not exactly going to build a case that makes the defendant, KC, look good. A fact that seems to have escapes so many here.

[Anonymous]

Anonymous wrote:

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.

That may be true, but I doubt that spiting it by taking on dangerous situations in unsafe home-births that predictibaly end this way will only strengthen their credibility and hurt yours. Plus, dead baby. This was not a case of automatic c-section due to breeched position. There were multiple factors leading to the c-section stance. Carr should have known better. OBs may no longer cultivate their experience with breech births (which is wrong), but perhaps the morbid outcomes of these over the years has something to do with that (not JUST liability). And to see this case as limited to only the breech risk is very nearsighted. Way to go.

[Anonymous]

Anonymous wrote:

Anonymous wrote: 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.

Holy hell... so "give me $3K so I can give you questionable advice based on questionable training supported by limited experience, while calling myself a professional but absolving myself of anything going wrong when it was preventable b/c i'm just here to cheer you on"????? Unreal. Mere participation as a professional in the complex medical act that is BIRTH assumes and presumes the responsibility to know what the hell you're doing and are able to transfer care when you no longer do. Nowhere did I read that Carr's defense included "I disagreed with this obviously overly risky approach but feared that the patient would opt for even riskier unassisted birth without me" or "I wanted to call 911 at many points but was bound to respect the patient's wishes that I would not" or "Due to my protest over the approach i felt obligated to participate in, i had the parents sign a waiver stating I'd informed them of the probable unsuccessful outcome of this endeavor if they chose to ignore my advice". No dice. You participate, you're responsible and YES, convincing someone that death is likely when you're the professional and they're not IS your job.

Sure, except that death was NOT likely in this scenario. There was a high chance that this birth would proceed just fine. The mother chose to assume the small risk that it wouldn't, and obviously she lost.

And I believe that you are completely wrong in your assessment that birth is a medical act. It most certainly isn't.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote: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.

I would assume to do an external version.

Plenty of OBs do this. Tchabo is the only one who will do to a breech vaginal delivery.

He was the midwife back-up physican. Breech are referred to him for version, if that is what mom would like to have done. Mom was supposedly an informed consumer. I think this mom would ask for his guidance while there doing a version?

[Anonymous]

Anonymous wrote:

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?

There are several reasons why Tchabo could have been on the witness list. She may have consulted with him for a version, for a c/s, or for a vaginal breech birth. She could have called him and he refused to talk to her. Or, it could be simply because he is a vaginal breech expert in this area. Who knows. I agree with the poster who said everyone needs to stick to the facts.

[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.

Actually, there were quite a few who did. Remember the prize who claimed she could not treat her children gently and without contempt (something like it) if the experience wasn't itself gentle and happy? And this poster wasn't me, but I fail to see how he/she is rude, condescending, manipulative, mean, or trying to be a pain in the ass. Seriously? For disagreeing with you? For drawing the line of "acceptable v. unacceptable" at a different place than you? ok....

[Anonymous]

Anonymous wrote:

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.

Actually, there were quite a few who did. Remember the prize who claimed she could not treat her children gently and without contempt (something like it) if the experience wasn't itself gentle and happy? And this poster wasn't me, but I fail to see how he/she is rude, condescending, manipulative, mean, or trying to be a pain in the ass. Seriously? For disagreeing with you? For drawing the line of "acceptable v. unacceptable" at a different place than you? ok....[/quote

There were not a few. That was one mom's expression.

[Anonymous]

Anonymous wrote: 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.

I have not seen many posts here saying that home birth should be illegal. I have, however, seen plenty that say midwifery should be formally regulated for the title to represent commonly known / validated / standardized education, experience, expertise, and competence. I have also seen plenty of calls for the rhetoric on each side to be objective to each case (not just to one's general belief system) so that researching mothers' info can be more reliable. If the movement is truly dedicated to changing how it's done, then it would take on doing that through improved medical knowledge of midwives and improved open-mindedness of OBs, and better collaboration between the 2 - not just snubbing it as a pissing contest which only drifts the two apart further and reduces the home-birthers' ability since they currently hold no cards while the medical community holds them all.

[Anonymous]

Anonymous wrote:

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.

People here who defended her decision to birth at home said that she was limited in calling the shots in a hospital since no local doctor was willing to take on a vaginal birth in her case except for ONE, who would not be available. It was also stated in the article that she had to refer to Carr b/c no one locally licensed that she’d reached out to wanted to take on the homebirth plan considering all her factors. So apparently, “chatter” is good when used to defend one side, but not when used to defend the other.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote: 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.

Holy hell... so "give me $3K so I can give you questionable advice based on questionable training supported by limited experience, while calling myself a professional but absolving myself of anything going wrong when it was preventable b/c i'm just here to cheer you on"????? Unreal. Mere participation as a professional in the complex medical act that is BIRTH assumes and presumes the responsibility to know what the hell you're doing and are able to transfer care when you no longer do. Nowhere did I read that Carr's defense included "I disagreed with this obviously overly risky approach but feared that the patient would opt for even riskier unassisted birth without me" or "I wanted to call 911 at many points but was bound to respect the patient's wishes that I would not" or "Due to my protest over the approach i felt obligated to participate in, i had the parents sign a waiver stating I'd informed them of the probable unsuccessful outcome of this endeavor if they chose to ignore my advice". No dice. You participate, you're responsible and YES, convincing someone that death is likely when you're the professional and they're not IS your job.

That's because there was no trial...you never heard her defense. The only thing you, and everyone else here, has heard has been one sided. The prosecutor is not exactly going to build a case that makes the defendant, KC, look good. A fact that seems to have escapes so many here.

Um... Pure speculation here, but if there'd been anything like that to defend her with, she probably would not have pleaded to anything.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote: 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.

Holy hell... so "give me $3K so I can give you questionable advice based on questionable training supported by limited experience, while calling myself a professional but absolving myself of anything going wrong when it was preventable b/c i'm just here to cheer you on"????? Unreal. Mere participation as a professional in the complex medical act that is BIRTH assumes and presumes the responsibility to know what the hell you're doing and are able to transfer care when you no longer do. Nowhere did I read that Carr's defense included "I disagreed with this obviously overly risky approach but feared that the patient would opt for even riskier unassisted birth without me" or "I wanted to call 911 at many points but was bound to respect the patient's wishes that I would not" or "Due to my protest over the approach i felt obligated to participate in, i had the parents sign a waiver stating I'd informed them of the probable unsuccessful outcome of this endeavor if they chose to ignore my advice". No dice. You participate, you're responsible and YES, convincing someone that death is likely when you're the professional and they're not IS your job.

Sure, except that death was NOT likely in this scenario. There was a high chance that this birth would proceed just fine. The mother chose to assume the small risk that it wouldn't, and obviously she lost.

And I believe that you are completely wrong in your assessment that birth is a medical act. It most certainly isn't.

Fine. Birth is a purely natural act that should be taken on with only instinct and self-sustainment. No need for knowledge, experience, assistance, anything. Let mom do it as it naturally comes. Oh wait... all the stuff midwives do at one point WAS considered pure medicine... from which modern medicine evolved.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

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.

People here who defended her decision to birth at home said that she was limited in calling the shots in a hospital since no local doctor was willing to take on a vaginal birth in her case except for ONE, who would not be available. It was also stated in the article that she had to refer to Carr b/c no one locally licensed that she’d reached out to wanted to take on the homebirth plan considering all her factors. So apparently, “chatter” is good when used to defend one side, but not when used to defend the other.

How do you know she contacted only one physician?
How do you know that all the licensed providers that she reached out to her said they couldn't help her because they thought it was risky. She was seeking a provider when she was late in her pregnancy. At such late date it may be because they were FULL, not because they didn't want to help her. Nope - you are assuming that they didn't want to help her. There are other assumptions that are equally valid. The couldn't help her. The reason is not stated anywhere. Sorry, stick to the facts.