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Midwife charged in DC? Karen Carr, CPM...
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Anonymous
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I posted upthread about my experience with Dr. Tchabo. I risked out ultimately due to size of baby and the baby shifting to a footling position. He WILL consider FTMs as candidates but a lot of conditions need to be met. I was 35 at the time. Of course, he delivers in hospitals where going to a c-section as plan B is immediately available. Actually I think if it had happened that I would have delivered in the room closest to the OR.
The whole issue of head entrapment gives me chills, I was happy to have my healthy baby via c-section, with my midwife literally holding my hand. I was also happy to have a VBAC in a hospital with midwives. A friend did have a rupture VBACing in a hospital and both she and her daughter came very close to death. IMHO way too risky to do at home, there is no time to transfer. She had been considered an excellent candidate and was being monitored closely. Having preferences about the birth is one thing, a healthy baby and mom need to be the overriding priorities. It is so easy to get caught up in trappings of birth. If my first had not been a c-section I would have liked to have had a home birth. It didn't work out that way. I think in part that emotions become so heightened due to hormones and the intensity of the experience of being pregnant and giving birth that a less desired birth experience can take on a lot of emotional weight afterwards. I do think that a lot in the homebirth movement do use fear to motivate others to make the same choices, thus validating them. I can't imagine that if the parents had read the text bolded above and had not heard lots of anecdotes to the contrary from people they had an emotional bond with that they would have made the choice they did. |
Anonymous
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Anonymous
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I think that many people commenting have not had a breech child. While I see an OB who I think is outstanding, with a breech (especially a footling like I had) they tell you the risks time and time again. Mine did not recommend intervention and after reading more up on breech now than I had before I had my first, I see why. With my second, they are open to a VBAC so long as I meet strict criteria- they are not willing to put me or the baby at risk and honestly I want a healthy baby no matter how they're delivered. I find it selfish to put a birth experience over a healthy child. While death is an unfortunate part of life, why take risks that are unecessary.
Many have argued what their grandmothers have done- my grandmother delivered my father breech...and over 60 years later she still complains about how painful and awful it was. We aren't putting our children in the same lead painted homes, non-existent car seats and leaving them to raise themselves so why are you trying to do what they did? I wanted the "normal" birth experience of going into labor and pushing out my baby but my path was different and I accepted that. I have a beautiful child as a result. I think once you have a breech baby your persepective changes-if you haven't had one it's hard to say what you really would do. |
Anonymous
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Anonymous
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Anonymous
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I am a supporter of home births, but Ms. Carr better hope I am not on the jury. This was negligent homicide. A classic case.
Geez. Where was her judgment. She clearly can't be relied on to provide sound advice when a home birth v. hospital birth is required. The poor mother. |
Anonymous
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Anonymous
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My understanding is that Dr. Tchabo also uses ultrasound to determine the position of the baby while in labor since it can shift more easily in a breech presentation. That info helps determine whether the attempt at a breech delivery goes forward. Someone pls. correct me if I am wrong.
I don't feel nearly as sorry for the parents as I do for the poor baby. |
Anonymous
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As a mom of two, the first born in a hospital where I was literally treated like a cow giving birth to a calf in the barn, I planned a midwife/birth center birth with my second.
Imagine my surprise when I got to the birth center in labor to learn that my baby had flipped from the perfect head down position to a footling breech position during the last week of my pregnancy. I was sent to the hospital where I was whisked away to the OR for my c-section. Everyone told me that it was what was best, and that there's a reason we have these medical options, to save babies like mine. Unfortunately no one could tell me why it took me two years to not be in pain every single day at the surgical site. No one could tell me why I was physically unable to be the mom my kids deserved, and the only option I was given was exploratory surgery to figure it out. No one explained to me what the RISKS of my c-section were or how drastically they could affect my family. Clearly if my choices are a dead child or a life of pain for me, I'd choose the life of pain for me. However, if I had known that Karen Carr would have helped me through a breech home birth, it may have saved me a lot of pain. Karen was on my (very short) list of home birth midwives I wanted to consult with when we decided it was time for our next child. I can only hope that I am able to find someone as talented and caring as Karen when the time comes. |
Anonymous
I can't correct or confirm, but it sounds like another good argument for hospital birth with breeches -- I just don't think the quote about placenta problems likely referred to access to ultrasound in labor. |
Anonymous
Ultrasound is always used in the hospital setting with a breech delivery. Also during an external version. I'm curious if mom attempted a version to correct the malpresentation? |
Anonymous
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"they are not willing to put me or the baby at risk and honestly I want a healthy baby no matter how they're delivered. I find it selfish to put a birth experience over a healthy child. While death is an unfortunate part of life, why take risks that are unecessary."
To carry on from the post a few up, it bothers me when women assume that not wanting to have a c-section is because the mother is persueing some birthing outdoors in the rain fantasy. I don't know how I feel about this situation (too few facts), but I do know that c-section scares the hell out me. No one ever seems to talk about the risks of THAT option. It's always, oh other options are too risky, let's just make the safe choice. There are many many complications that range from death (babies still die from c-section births and breech heads still get stuck in c-section incisions), to lifelong injury to mom or baby (remember that thread a few weeks back with the mom who was in a vegetative state after being nicked in the uterus?), to complications from just having had surgery, higher risk of issues with subsequent pregnancies (and not just with subsequent births themselves), higher risk of lung and other issues with baby (I firmly believe that vaginal birth and the processes the baby goes through are beneficial to the baby), problems with breastfeeding, longer recovery time, and all the way down to mom having to have a scar and possibly not feeling like her belly returns to it's previous flatness (which I get doesn't matter if your baby is dead, but it's the most minor of concerns so I thought I'd include it). Anyway, I just don't want to hear that it should be an easy decision to have a c-section if you really care about a healthy baby. It's not and it should not be. |
Anonymous
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The situation must be devastating for the family, and I totally feel for them and for the mother who probably had large part in deciding her prenatal care and delivery options.
I also had breech and it never occured to me to even try vaginally, I guess I'm one of those strong believers in the medical establishment that I couldn't imagine giving birth outside the hospital and when it came out that baby is breech, I just took it for granted that I would be going undergoing surgery. Now that I have underwent surgery, and keeping in mind that I am beyond grateful for a healthy outcome for me and baby, and now that we are planning a second child, I am already - and i'm not even pregnant with no. 2 yet - terrified about my pregnancy (and the possible complications due to my earlier c-section), terrified about a 2nd c-section and terrified about VBAC. Probably more from the c-section than the VBAC - and I had a 'good' c-section. The way I feel now is that there is no 'guessing' the right answer: what if I try VBAC and there is complication and i / baby are injured / die or what if I go with the c-section and there are complications and I or baby die. I read the statistics, I read the risks, but still. At the end of the day, i feel it is a guessing game where it comes to deciding for ME rather than for the average statistical woman. In some way, it's like flying: we all know the low risk of death flying on commercial arilines, but nobody wants to take that plane which will end up crashing and nobody of those who have been on a crashing plane boarded it knowing that it would crash. So, in some way, I understand the family in terms of how easy it is to get confused about the different messages that are sent. If I did not have such 'almost blind' trust in modern medicine, back with DC birth, I also may have considered alternatives and chosen something else. |
Anonymous
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Well, I'd rather a head gets stuck briefly in an incision that can easily be enlarged than get stuck in a pelvis at home. The mom could have died too.
And if you google, you can find pix of folks giving birth to breech babies in waterbirths, in, wait for it, the rain on a summer night. I kid you not. One may have been footling There are always risks. With a c-section for breech delivery the risk is more to the mom and the risk to the baby is lessened. Do you really think if that mom could go back and have a c-section now she wouldn't do it? Tchabo is a great option but if he's not available, the riskier setting if something goes wrong IS prioritizing birth experience (romanticized no less) over the safest choice for the baby. Mom is still here, baby never got a chance to live. According to the story in the Post she shopped around for other home delivery midwives in VA and couldn't find one. I really think that the birth assistant/class teacher bears a lot of responsibility here for their "homebirth at any cost" stance. I would have liked a home birth but was also risked out of Birthcare by the footling position. Tchabo wasn't an option due to presentation. I also believe that the birth process is beneficial to babies. But in this case, the risk skewed the other way and to be in a home setting if entrapment occurred left no viable plan B. |
Anonymous
A version is not without its own risks, though. They were risks that I was willing to take, but not all moms are, even those that are OK with a c-section for breech. My footling breech turned vertex at 36 weeks so I ended up not needing the version, but my midwives had the referral all written up. We learned my kidlet was head down at the ultrasound that was going to be used to schedule the version. There are a couple schools of thought about versions and the timing of them. Some feel that it's better to do them before 36 weeks because there's more room for the baby to turn. Of course that also means there's more room for the baby to flip back to breech. Others believe it's better to wait until around 36 weeks because if the version is successful, there's less chance for the baby to flip back. Also, when doing the version, there are risks that things can go "wrong" that would necessitate an emergency c-section, so waiting until later in the pregnancy is probably a better option to limit poor outcomes from premature birth. And many OBs prefer to use epidural anesthetic when doing a version on a FTM; there are some studies that show a better chance of success this way. If the mom in this case felt very strongly about an epidural, and worried that by attempting a version she was increasing her risk of an emergency c-section, a version may not have been very appealing to her. |