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

Anonymous
Anonymous wrote:Shouldn't we judge and blame? Shouldn't we try to get other pregnant women in this forum to think twice before recklessly ignoring their doctor and taking needless risks?


Doctors and hospitals, while having access to some life-saving techniques, can also introduce certain other risks to women, especially during childbirth. No maternity care provider can ever guarantee a perfect outcome, which is why it is important to let every woman make decisions about her birth based on her own research, without assuming that there is an objective right answer for EVERY woman. Where have you been for the past 90 pages? Next, please......
Anonymous
Anonymous wrote:People are making huge assumptions about the "type of breech". I would like even one link to a reliable source where the type of breech presentation is stated. One poster even said something along the lines of "when the baby turned footling" where there is NO EVIDENCE that it ever occurred.


Well the evidence comes for the horse's mouth, my dear. This is what the mother wrote about her experience with Birth Care, etc. on Citysearch. While we cannot ascertain that mom indeed wrote this, pretty much everything points to this being THE case at hand.

The founders of this organization have some integrity issues
Provided by Citysearch Posted by by MDawn at… on 01/09/2011
The founders of this organization have some integrity issues they need to resolve.

"When I asked about birthing my breech baby vaginally, they gave me the names of 5 midwives who were experienced birthing breech babies. And she went on to tell me how she had only delivered one, because they, BC, hadn't realized it was breech until delivery. Note: when she learned the baby was breech, she chose to birth the baby (at home or in the birth center) instead of transferring the mother to the hospital.

It was the birth assistant I hired from Birth Care’s list of approved birth assistants, who suggested I birth my baby vaginally. During labor, after the midwife learned that the baby had changed position and was no longer in the optimal breech position for vaginal delivery, my husband asked her, the birth assistant, what we should do and she refused to answer. (This is someone we thought we had a good relationship with because we took her Bradley class at Birth Care.) After my baby died, I kept going back to Birth Care for postpartum checkups because I felt comfortable with them. Yet, each time I saw the midwife she seemed to be blaming me for my child’s death. When I confronted her about this she denied ever condoning birthing my baby vaginally.

She probably did tell me to go to have a hospital birth but the conversation that day was overwhelmingly pro vaginal breech birth. These ladies are both grandmothers and they’re still operating under do as I say not as I do. How am I to figure that out when I’m a scared first time mother staring down abdominal surgery? They never asked why I wanted to birth my baby vaginally. Nor did they counsel against it. Furthermore, they did not explain or discuss the benefits of a c-section in my circumstance.

Everyone I paid to help bring my baby safely into this world failed me - including the founders of Birth Care. I'm devastated by the loss of my child. My pain is compounded by callous display of BC’s tremendous lack of responsibility toward my care.

Now that they’ve destroyed a life and are being investigated by the local authorities they will probably be more careful with you."


Anonymous
Anonymous wrote:
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.

I'm not the poster you are responding to, but YOU are letting your lack of surgical knowledge (you are obviously NOT an OB) getting the better of you!
The OR 3 doors down WILL be able to do the best to save the baby, and you can do a Duehrssen incision into the cervix and get the baby out. You can also try a maneuver to push the baby back in, and go surgically into the uterus. Bottom line: there are a few different options, none of them doable by a midwife at home.

And let's be clear: a speedy 911 call is always appropriate! The paramedics can assist with the resuscitation and have meds and medical control backup, not to mention oxygen (I assume she had that, but after what we've heard so far, who knows?) - it's the right thing to do, and there is no downside to it!!!
... Unless of course, you have an ego the size of Alaska - or you are hiding something, because you are committing a crime?!



AND......here we go again folks with the name calling, assumptions, and utter lack of comprehension of an alternate viewpoint - despite 90 pages of some very thoughtful and rational posts countering these exact points.


Significantly, this original post on city search was taken down. One can only be left to ponder why. Maybe this grieving mom isn't remembering exactly how it happened? Who knows. City search and the author took it down.


I know. There's another thread that formed in the Off-Topic forum for the people who want to judge, blame, insult, and declare their own superiority. I wish they would just stay over there and leave this discussion alone.
Anonymous
Anonymous wrote:
Anonymous wrote:People are making huge assumptions about the "type of breech". I would like even one link to a reliable source where the type of breech presentation is stated. One poster even said something along the lines of "when the baby turned footling" where there is NO EVIDENCE that it ever occurred.


Well the evidence comes for the horse's mouth, my dear. This is what the mother wrote about her experience with Birth Care, etc. on Citysearch. While we cannot ascertain that mom indeed wrote this, pretty much everything points to this being THE case at hand.

The founders of this organization have some integrity issues
Provided by Citysearch Posted by by MDawn at… on 01/09/2011
The founders of this organization have some integrity issues they need to resolve.

"When I asked about birthing my breech baby vaginally, they gave me the names of 5 midwives who were experienced birthing breech babies. And she went on to tell me how she had only delivered one, because they.....


Significantly, this original post on city search was taken down. One can only be left to ponder why. Maybe this grieving mom isn't remembering exactly how it happened? Who knows. City search and the author took it down.
Anonymous
Either way, it is a searing indictment of the Bradley instructor.
Anonymous
Meant to add to my above post, BUYER BEWARE.
Anonymous
Anonymous wrote:Either way, it is a searing indictment of the Bradley instructor.


How so? What if what she said was not truthful or the whole truth. She took it down. She takes back her words. Unfortunately what has been written cannot be taken back so easily. You are being hateful based on a piece that was retracted. Shame on you.
Anonymous
Anonymous wrote:
Anonymous wrote:Either way, it is a searing indictment of the Bradley instructor.


How so? What if what she said was not truthful or the whole truth. She took it down. She takes back her words. Unfortunately what has been written cannot be taken back so easily. You are being hateful based on a piece that was retracted. Shame on you.


How does the fact that the comment was taken down mean that the mother "takes back her words"? She certainly didn't print a retraction!

There are other more likely reasons the comment was removed.

Anonymous
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:Either way, it is a searing indictment of the Bradley instructor.


How so? What if what she said was not truthful or the whole truth. She took it down. She takes back her words. Unfortunately what has been written cannot be taken back so easily. You arde being hateful based on a piece that was retracted. Shame on you.


How does the fact that the comment was taken down mean that the mother "takes back her words"? She certainly didn't print a retraction!

There are other more likely reasons the comment was removed.



I think it's been made pretty clear throughout all of the posts that at the end of the day the Bradley instructor, doula and/or parents were not the "experts" in this case. They were not hired as "providers" and should not bear responsibility for the clinical outcome, so to speak. Granted, I think it's bizarre that no one called 911 during those 33 minutes, but being that I wasn't there, I don't really know what went on and can't speak to the situation. My re-quoting mom's words was merely to point out that she did infact state that the baby turned from the "favorable" breech position to an unfavorable one. Since footling breech is pretty much regarded as the "unfavorable" one, I'm assuming (again, could be wrong here) that baby went from frank or complete breech to footling. It is regarded as highly risky to attempt a footling breech delivery since the risks of head entrapment are far greater. If this is the case, the call should have been made to transfer for a c-section. Maybe mom refused transfer, but gathering from what we've learned about the court proceedings + mom's interpretation of the delivery from CitySearch, there was no mention that a trasnfer should be made after the footling presentation was discovered. One can only speculate but I'll take mom's words over anyone else's
Anonymous
If indeed the baby turned during labor from frank breech to footling breech, the whole thing makes more sense from the perspective of the mother. Vaginal delivery of frank breech is not particularly risky *with a trained provider*. OBs are no longer trained in breech vaginal delivery. KC -- by all accounts -- was. Footling breech is very dangerous. It seems, then, that the big mistake was not calling 911/otherwise going directly to the hospital when it turned footling. And the responsibility for that lies directly with KC. A laboring mom is not thinking coherently enough to make that call and it was not the birth assistant's place or job to do it either. It was KC's job, and she failed.

That said, if a doctor had been similarly negligent, he would have been sued for everything he had, but not threatened with jail/felonies.
Anonymous
It could have gone from frank to complete.
Anonymous
Anonymous wrote:That said, if a doctor had been similarly negligent, he would have been sued for everything he had, but not threatened with jail/felonies.


KC had every opportunity to get licensed in VA and chose not to. That's on her. She likely would have avoided this whole fiasco if she's been licensed - then similiar to another licensed provider she would have been deemed negligent and maybe had her license revoked, etc., but NOT charged with involuntary manslaughter. Now, as it stands, she risks going to jail if she chooses to practice anywhere in the DC/MD/VA region before her 8 year probationary period is up. She maybe would have lost the ability to practice in VA, but she would have done herself a service by getting licensed in the ONE state that does allow CPMs. Bad call, KC, bad call.
Anonymous
Anonymous wrote:It could have gone from frank to complete.


True, but frank and complete could be safely delivered by an experienced practitioner (as KC has stated she is in breech delivery). For all practical purposes, both frank and complete breech deliveries require the body and legs to be delivered together before the skull, the body and legs together are infact larger than the skull, allowing for more cervical dilation and a greater chance that the skull can be delivered w/out difficulty. In a footling, the feet first, then body delivery means the largest part left to be delivered is the skull, hence the greater risk of head entrapment. Delivery of a footling breech in a first time mom is just a bad gamble on all accounts.
Anonymous
Anonymous wrote:It could have gone from frank to complete.


Or kneeling or a stargazer, which would be more dramatic increases in risk than frank to complete. Footling, kneeling, stargazing, any of the above would be a massive increase in risk.
Anonymous
Anonymous wrote:
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.


Sadly, that's not how things often pan out in our legal system. I have zero doubt that she agreed to this deal in order to avoid jail time.
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