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

[Anonymous]

Does anyone know who the doula and birth assistant were?

[Anonymous]

Anonymous wrote:
I agree that no one would be talking about a "disheartening" investigation from a bad medical outcome, but then again the medical profession is rife with conflicting interests AND that medical professional would not be facing criminal charges. Babies die all the time in our local hospitals, yet where is the criminal prosecution of the doctors who were involved?

Doctors are licensed and acting within accepted safety protocols or they are sued for malpractice and damages. There is also a review each and every time a baby dies of a suspicious/preventable cause in the hospital, and steps are taken to ensure it doesn't happen again.

Why isn't this the standard for CPMs?

[Anonymous]

Anonymous wrote:

Anonymous wrote:
I agree that no one would be talking about a "disheartening" investigation from a bad medical outcome, but then again the medical profession is rife with conflicting interests AND that medical professional would not be facing criminal charges. Babies die all the time in our local hospitals, yet where is the criminal prosecution of the doctors who were involved?

Doctors are licensed and acting within accepted safety protocols or they are sued for malpractice and damages. There is also a review each and every time a baby dies of a suspicious/preventable cause in the hospital, and steps are taken to ensure it doesn't happen again.

Why isn't this the standard for CPMs?

It seems to me that you are having a particularly difficult time releasing yourself from the commonly held belief that birth is driven by someone other than the mother herself - not that I blame you, as this belief system has a strangle-hold on our culture. The reality is that birth, by its design, happens regardless of who is present or whoever might want to manage it. This is not about what the government should do to assure that the right people say and do the right things to women during pregnancy or birth to keep her safe. Turn the whole thing inside out. It is driven by the WOMAN. Her body is going to birth this baby no matter what, and she deserves to choose who she wants to assist her with the process, regardless of what anyone else (especially the state!) believes about the safety of her choice. When you start introducing high tech procedures and pharmaceuticals, it is proper that there are licensing bodies to oversee this, since there are many, many layers of people, equipment and drugs involved. And yes, there are situations where I personally believe it would be prudent to make use of that system, but this MUST be left to every individual woman to decide.

A homebirth is extremely straightforward, with a minimum of players, and seeks to grant women the right to make the choices which they deem best for them and their family. There is no mystery to this case and it certainly isn't suspicious. There is not even much to speculate on. Breech is not a medical complication; it is something that happens spontaneously in about 4% of pregnancies. Unfortunately, with it comes a very small risk of head entrapment. Again, the mindset that birth is a process to be managed by someone else, leads us to believe that with enough research or planning, we can eliminate every single risk associated with birth. The truth is that this is one risk that will never be eliminated, so your idea of stamping it out with enough review or oversight, while noble, is not realistic.

[Anonymous]

Thank you for posting that message, Jeff. I think reasonable people can infer that message boards are a place for discussion, and not all discussion has to be filtered through attorneys and spell checkers.

To paraphrase the logic of home birthers, we want to talk about this issue and if we don't do it here, we'll find another place to do it. I personally find this thread very informative and I have learned a great deal about this specific circumstance, but more so about this larger issue of lay midwives, dangers, reality, and personal decisions. I find this discussion to be fairly balanced and I believe it has been diverse and enlightening.

[Anonymous]

Anonymous wrote:Breech is not a medical complication; it is something that happens spontaneously in about 4% of pregnancies. Unfortunately, with it comes a very small risk of head entrapment. Again, the mindset that birth is a process to be managed by someone else, leads us to believe that with enough research or planning, we can eliminate every single risk associated with birth. The truth is that this is one risk that will never be eliminated, so your idea of stamping it out with enough review or oversight, while noble, is not realistic.

Breech is also something that kills or severely injures more than 1 in 20 babies delivered vaginally, while via CS the number drops to below 1% (Hannah, 2000). I don't think we can eliminate the risk from anything. I do think that mothers and babies deserve real healthcare, not the placid assurance that "babies have always died, he would have died anyway, there was nothing anyone could have done."

[Anonymous]

Anonymous wrote:

Anonymous wrote:

It's worth noting that midwives in Canada have university degrees, and that homebirths are only offered to women that meet certain criteria, ie, no breech, no diabetes, no heart disease.

I haven't followed the whole thread, but midwives in the US don't have to have at minimum a university degree?

Yes, lay midwives in the U.S. do not have to have a high school education. The requirements by NARM to become a Certified Professional Midwife do not require the applicant to have a high school degree much less a college degree.

[Anonymous]

Anonymous wrote:

Anonymous wrote:This is because if a baby dies during a homebirth and the baby was breech, then things can go wrong that the midwife has no control over. So what this comes down to (most likely) is not negligence or malpractice but a question of whether or not it should be legal for a parent to decide to have a breech baby or any other baby at home with the assistance of a CPM. My opinion is that it should be legal for pregnant women to make these choices for themselves. Personally, I wouldn't do it but the government should not dictate our birth choices or our medical choices.

Of course a pregnant woman can do whatever she wants with her body. The FBI isn't storming in to force her to go to the hospital. At the same time, I can't set up a cardiac catheterization lab in my living room and offer services to people, and then say that it's not my fault when I have a bad outcome. Why wasn't Karen licensed? Why can a midwife act with zero oversight from a licensing body when professionals with much less risky jobs (hair sylists...) must be licensed? Why is it such a horrible thing to figure out which types of births are safe at home and which aren't? Are the 45-year-old GBS+ mom of triplets and the 26-year-old who's already had a successful vaginal delivery really both good candidates for homebirth? Why is the mere mention of standards and guidelines so scary?

If you send me $3,200, I'll send you a embossed certificate that certifies you as a Cardiac Professional Monitor. If you call yourself a Cardiac Professional Monitor, then you are one. After all, people need cardiac catheterization and if they don't get it from the convenience of your living room, just think of all of the other scary places they may go to get that service.

[Anonymous]

Just curious, not trying to flame but I've learned a lot of information about midwives, homebirths, etc. through this thread.

How does the homebirthing community feel about pediatricians and things such as vaccinations?

[Anonymous]

Birth has gone on since the dawn of the race and women have died birthing babies who may have died or been I juried since then. We have found ways to lessen or manage the risk, but don't blather on to mean out how womens bodies know how to birth. They know how to die, too.

[Anonymous]

Anonymous wrote:Just curious, not trying to flame but I've learned a lot of information about midwives, homebirths, etc. through this thread.

How does the homebirthing community feel about pediatricians and things such as vaccinations?

The "homebirting community" is a diverse group of people. There is no answer to your question.

[Anonymous]

I'm finding it hard to support Karen but I am wondering what everyone feels the responsibility of the parents is? I have read every single thread here and have been truly impressed with the calm "debate" (which is hard to come by on this board sometimes). I am pro homebirth if there are no high rosk factors and if mom is healthy and active. I think it is careless for a midwife to take any client because they can. But I also have to say that if I had received the advice of two care providers (BirthCare and Tchabo, assuming this did happen) and their advice was the same, I would probably have followed it so I could have a safe baby (keeping in mind this mom's age). No one knows what mom's mental state was when it came to hospitals, no one knows if they said to Karen "if you don't show up, we will still attempt a home birth" (and if this was the case, would a care provider be obligated or at least persuaded into attending?)

I am just really interested in where the percentage of fault lies with the parents vs. the midwife? or the birth assistant for that matter...

[Anonymous]

Anonymous wrote:Birth has gone on since the dawn of the race and women have died birthing babies who may have died or been I juried since then. We have found ways to lessen or manage the risk, but don't blather on to mean out how womens bodies know how to birth. They know how to die, too.

And if they get very ill, and do not want to be treated, then they have a right to do so without going to the hospital or hiring medical professionals.

[Anonymous]

The reality is that birth, by its design, happens regardless of who is present or whoever might want to manage it. This is not about what the government should do to assure that the right people say and do the right things to women during pregnancy or birth to keep her safe. Turn the whole thing inside out. It is driven by the WOMAN. Her body is going to birth this baby no matter what, and she deserves to choose who she wants to assist her with the process, regardless of what anyone else (especially the state!) believes about the safety of her choice.

Again, the mindset that birth is a process to be managed by someone else, leads us to believe that with enough research or planning, we can eliminate every single risk associated with birth. The truth is that this is one risk that will never be eliminated, so your idea of stamping it out with enough review or oversight, while noble, is not realistic.

This is true, however when you, the woman, choose to hire someone to attend your homebirth, the argument changes. Shouldn't this person be licensed? Credentialed? Board certified? SOMETHING that documents education and practice, holds him or her accountable, and weeds out skilled practitioners from inexperienced ones? Heck, when you hire a HAIRDRESSER they are licensed! Why not your midwife, lay or otherwise?

I don't think people are arguing that review and oversight stamp out risk (if only it were that easy!), but that review and oversight enhance safety and increase accountability. In any profession.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

It's worth noting that midwives in Canada have university degrees, and that homebirths are only offered to women that meet certain criteria, ie, no breech, no diabetes, no heart disease.

I haven't followed the whole thread, but midwives in the US don't have to have at minimum a university degree?

Yes, lay midwives in the U.S. do not have to have a high school education. The requirements by NARM to become a Certified Professional Midwife do not require the applicant to have a high school degree much less a college degree.

wow, is that really true? If so, that's pretty scary and I would hope anyone who hires a midwife really finds out their credentials. I realize a high school diploma is no guarantee of the ability to read but what if the midwife can't. What if she dropped out of school? What if she never even took something like basic biology or can't read a book and understnad basic anatomy?

My view of midwives is admittedly from the media and personal stories posted by others online. I have always thought of them as somewhat mean and brusque and the type that would yell at a woman to "suck it up" and the pain is good and that she should be elated to be in pain giving birth, etc.

I personally had no fear of having a c-section though and while I don't like hospitals I was ok with having to be in one for a couple days to give birth.

[Anonymous]

Anonymous wrote:I'm finding it hard to support Karen but I am wondering what everyone feels the responsibility of the parents is? I have read every single thread here and have been truly impressed with the calm "debate" (which is hard to come by on this board sometimes). I am pro homebirth if there are no high rosk factors and if mom is healthy and active. I think it is careless for a midwife to take any client because they can. But I also have to say that if I had received the advice of two care providers (BirthCare and Tchabo, assuming this did happen) and their advice was the same, I would probably have followed it so I could have a safe baby (keeping in mind this mom's age). No one knows what mom's mental state was when it came to hospitals, no one knows if they said to Karen "if you don't show up, we will still attempt a home birth" (and if this was the case, would a care provider be obligated or at least persuaded into attending?)

I am just really interested in where the percentage of fault lies with the parents vs. the midwife? or the birth assistant for that matter...

Many on this board and on the Washington Post are blaming the parents or at least saying that they share the responsibility in the death. As I've stated many times, most of us posting don't have the slightest clue as to what really happened prior to the delivery, with the birth assistant and at the delivery. So really how can we sit in judgment of Karne, the parents, or anyone else involved.

From what others have posted, the mom did talk to Tchabo and he said he woudl do the delivery but couldn't guarantee that he would be in town when she went into labor. This is when she went for the homebirth with Karen.