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

[Anonymous]

11:42 here, in response to 11:45:

No, I would rather have a C-section than die.

However, I also believe (and my belief is informed by a lot of medical literature reading, and speaking to OBGYNs and midwives and health statisticians) that C-section versus death is not the usual choice in a home birth. In most home birth situations where a C-section will be necessary, the trained midwife sees trouble coming a long way off and insists on transferring to a hospital. Thank goodness we have trained surgeons when we need them.

BUT there are other situations when mothers can die, and they are going to die at home or in the hospital. Look up Amniotic Fluid Embolism (AFE) as an example. And there are situations when babies can die or be severely damaged. And there is precious little evidence that the current hospital doctrine of continuous fetal monitoring prevents that. That is to say, periodic monitoring of fetal heart tones, as can be done by any L&D nurse, midwife or OBGYN worth their salt - assuming they are not terribly overworked and forced to care for too many patients simultaneously - has just as good outcomes as the type of continuous monitoring that can only be done in the hospital, usually with the mom stationary. And etc.

My views on life and death just mean that I do not regard being in a hospital "just in case" the terrible 1:20,000 situation occurs as preferable to birthing at home. The attitude of the hospital is to prepare for awful, unlikely events. And the terrible side effect of that preparation and mindset is that lots of unnecessary interventions and surgical treatments happen, and a lot of inhumane treatment of mothers...

So that's where I'm coming from. And many of the other people who birth at home whom I know. Not everyone, of course, and views vary widely.

I know a little of Karen Carr's background and I think she believes very strongly in a woman's right to dignified treatment and to birth in the location of her choice. (She herself had a traumatic first birth when her child was unexpectedly breech and she was sectioned without her consent.) This belief may have blinded her to whatever was going on with this particular family, though. Whatever happened, the situation is tragic and I feel for everyone involved.

[Anonymous]

Anonymous wrote:

Many of us who choose to birth at home feel this way also. The way that many OBGYNs and other doctors are trained, to fend of death at all costs with extreme measures, is repellent to some people.

Genuinely curious - you feel that death is preferable to a C-section? I know that the question sounds flamey, but I found this statement to be odd.

Yes, because it wouldn't be her death, after all.

[Anonymous]

13:46, go back and read my comment above. And then STHU.

[Anonymous]

Anonymous wrote:Where have folks read that this breech birth was in the footling position? Or is that an assumption?

Unfortunately, I think people jumped to that because we were talking about what kind of breech babies Dr. Tchabo and others would and wouldn't consider.

I don't think it was necessarily a footling breech, at least not to begin with. The reviewer on the link a couple pages back (if it is this mother) mentions that the baby moved during labor to no longer being in optimum position for breech delivery. From that I infer the baby probably started out frank or complete breech and then moved to footling. I've read in other places that complete breech babies can often shift to footling breech during labor.

[Anonymous]

Anonymous wrote:13:46, go back and read my comment above. And then STHU.

I've read it. Nothing there about the risk of the BABY's death.

[Anonymous]

Anonymous wrote:

Anonymous wrote:13:46, go back and read my comment above. And then STHU.

I've read it. Nothing there about the risk of the BABY's death.

She said she'd get the c-section. Let it go.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:13:46, go back and read my comment above. And then STHU.

I've read it. Nothing there about the risk of the BABY's death.

She said she'd get the c-section. Let it go.

Not the PP you are responding to, but she said she would get the c-section rather than put her own life at risk.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:13:46, go back and read my comment above. And then STHU.

I've read it. Nothing there about the risk of the BABY's death.

She said she'd get the c-section. Let it go.

Not the PP you are responding to, but she said she would get the c-section rather than put her own life at risk.

Your implication is really sickening. Seriously, STFU.

[Anonymous]

MOVING ON.

Does anyone know who is pressing the charges against Karen? Is it the state or the parents or both?

[Anonymous]

It is the state bringing criminal charges -- Commonwealth v. Karen Carr. Grand jury indictment on 3/14, trial set for 6/7-6/9. Whether there will be a separate civil lawsuit against her by the parents, I don't know. Not sure what the point of that would be, as you can't get blood from a stone and there is no malpractice insurance involved here.

[Anonymous]

Anonymous wrote:MOVING ON.

Does anyone know who is pressing the charges against Karen? Is it the state or the parents or both?

\

From what I gathered, she is facing criminal charges. I'm assuming a civil suit from the family will follow.

[Anonymous]

Anonymous wrote:It is the state bringing criminal charges -- Commonwealth v. Karen Carr. Grand jury indictment on 3/14, trial set for 6/7-6/9. Whether there will be a separate civil lawsuit against her by the parents, I don't know. Not sure what the point of that would be, as you can't get blood from a stone and there is no malpractice insurance involved here.

Actually, it looks like the family is setting up to sue Birth Care as well, if that "review" linked upthread is truly from the mother. Also, there's a chance that they could sue any other medical professional they consulted if it can be shown they were given poor advice. This is a big old mess.

[Anonymous]

Anonymous wrote:

Anonymous wrote:It is the state bringing criminal charges -- Commonwealth v. Karen Carr. Grand jury indictment on 3/14, trial set for 6/7-6/9. Whether there will be a separate civil lawsuit against her by the parents, I don't know. Not sure what the point of that would be, as you can't get blood from a stone and there is no malpractice insurance involved here.

Actually, it looks like the family is setting up to sue Birth Care as well, if that "review" linked upthread is truly from the mother. Also, there's a chance that they could sue any other medical professional they consulted if it can be shown they were given poor advice. This is a big old mess.

I was just getting ready to post the same thing. They really place a lot of blame on BirthCare if that review is hers. I see a big civil suit coming.

[Anonymous]

Anonymous wrote:11:42 here, in response to 11:45:

No, I would rather have a C-section than die.

However, I also believe (and my belief is informed by a lot of medical literature reading, and speaking to OBGYNs and midwives and health statisticians) that C-section versus death is not the usual choice in a home birth. In most home birth situations where a C-section will be necessary, the trained midwife sees trouble coming a long way off and insists on transferring to a hospital. Thank goodness we have trained surgeons when we need them.

BUT there are other situations when mothers can die, and they are going to die at home or in the hospital. Look up Amniotic Fluid Embolism (AFE) as an example. And there are situations when babies can die or be severely damaged. And there is precious little evidence that the current hospital doctrine of continuous fetal monitoring prevents that. That is to say, periodic monitoring of fetal heart tones, as can be done by any L&D nurse, midwife or OBGYN worth their salt - assuming they are not terribly overworked and forced to care for too many patients simultaneously - has just as good outcomes as the type of continuous monitoring that can only be done in the hospital, usually with the mom stationary. And etc.

My views on life and death just mean that I do not regard being in a hospital "just in case" the terrible 1:20,000 situation occurs as preferable to birthing at home. The attitude of the hospital is to prepare for awful, unlikely events. And the terrible side effect of that preparation and mindset is that lots of unnecessary interventions and surgical treatments happen, and a lot of inhumane treatment of mothers...

So that's where I'm coming from. And many of the other people who birth at home whom I know. Not everyone, of course, and views vary widely.

I know a little of Karen Carr's background and I think she believes very strongly in a woman's right to dignified treatment and to birth in the location of her choice. (She herself had a traumatic first birth when her child was unexpectedly breech and she was sectioned without her consent.) This belief may have blinded her to whatever was going on with this particular family, though. Whatever happened, the situation is tragic and I feel for everyone involved.

I'm aware of amniotic fluid embolism and of situations in which a baby and/or a mother would have died regardless of place of birth. However, to make a blanket statement that if a baby is going to die, he's going to die no matter where he is born is not accurate. It is a case by case basis. But I basically agree with most of what you say above re continuous monitoring, unnecessary interventions, and the like -- we're not as far apart as you think. But in the three years I've been immersed in birth stuff, I do hear some women say things like "death happens" and "there are no guarantees" and that's all well and good for people to say until it is their baby that dies. At that point I think 99% would have a hard time maintaining such a sanguine attitude and would have deep regrets if they believed that being in a hospital could/would have meant a different outcome. I know I would. So that's where I'm coming from. Of course it is a case by case basis too whether being in a hospital could have meant a different outcome, but I've definitely read stories (one in particular about a baby who died after an abruption) where it would have. And it is true that hospital overreach can cause deaths that wouldn't have occurred at home (though from my research, more likely deaths of mothers than of babies). That's why I support choice, because there is no one place for birth that is the safest for every mother and baby. We have a long way to go in improving maternity care in this country.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:It is the state bringing criminal charges -- Commonwealth v. Karen Carr. Grand jury indictment on 3/14, trial set for 6/7-6/9. Whether there will be a separate civil lawsuit against her by the parents, I don't know. Not sure what the point of that would be, as you can't get blood from a stone and there is no malpractice insurance involved here.

Actually, it looks like the family is setting up to sue Birth Care as well, if that "review" linked upthread is truly from the mother. Also, there's a chance that they could sue any other medical professional they consulted if it can be shown they were given poor advice. This is a big old mess.

I was just getting ready to post the same thing. They really place a lot of blame on BirthCare if that review is hers. I see a big civil suit coming.

Sigh. I hope not. I think BirthCare *does* have malpractice insurance (please correct me if I am wrong on this) so it makes sense they would sue them because that's a deep pocket. If they get sued and end up having to shut down it will really impact the choices women in this area have for their care. Even if BirthCare is ultimately exonerated, it will probably still drive up their premiums or get them dropped by their insurer.