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

[Anonymous]

Anonymous wrote:

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.

Because if a woman has real choices about how and where to birth, then she also has choices about who to hire to attend her birth. I had an out of hospital birth and I chose a CNM rather than a CPM. But if the law makes it difficult or maybe even impossible for a doctor or certified nurse midwife to attend your "high risk" birth, and you can't hire a layperson, then you actually do NOT have the choice to have the birth that you want.

[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?

I gave birth both at the hospital and at home and all of my kids go to the pediatrician and follow the regular schedule for vaccinations. I know plenty of moms who would never even think to deliver outside a hospital who either don't vaccinate or follow a alternate schedule. As someone said there is no one "homebirth community" just as there is no "hospital birth community". We are people who bring our own experiences, ideas and knowledge into both birth and raising children.

[Anonymous]

Anonymous wrote:Wow... I've read this entire thread since the beginning and I don't remember anyone other than Karen being mentioned specifically. In fact, many have asked who the other attendants were and no one answered.

\

BirthCare has been named, Tcahbo has been named, there have been several posting that while not naming the Bradley teacher have come pretty close. There has also been a lot of "stating facts" on both sides with no way to back up the "facts".

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

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.

I think that view might be a little warped. My midwife was very soothing, quiet and loving. When I said I was scared to start the pushing because I knew how hard it would be, she listened and helped me move past the fear. At no point was I ever told suck it up.

[Anonymous]

Anonymous wrote:

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.

The bolded part above is simply untrue! There are many situations where a women would not be able to deliver vaginally, no matter how hard she tries. For example, transverse lie, IDM who is LGA , or CPD to name just a few.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

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.

The bolded part above is simply untrue! There are many situations where a women would not be able to deliver vaginally, no matter how hard she tries. For example, transverse lie, IDM who is LGA , or CPD to name just a few.

So a cesarean is not a birth? Read it again, she said "Her body is going to birth her baby." When a woman gives birth via cesarean, she is still giving birth with her body. She can choose who she wants and how she wants to give birth, no matter how it happens. There's another thread on here where women are shopping around for the best c-section doctor based on the amount of scarring! Why can't everyone have that same luxury?

[Anonymous]

Anonymous wrote:

Anonymous wrote:Wow... I've read this entire thread since the beginning and I don't remember anyone other than Karen being mentioned specifically. In fact, many have asked who the other attendants were and no one answered.

\

BirthCare has been named, Tcahbo has been named, there have been several posting that while not naming the Bradley teacher have come pretty close. There has also been a lot of "stating facts" on both sides with no way to back up the "facts".

Birth Care is in Old Town Alexandria.

Go to the Bradley website and check to see who teaches in Old Town. Run that list up against who is a birth assistant for Birth Care.

Old town has three people who teach Bradley. I'm not sure which of those are birth assistants for Birth Care.

[Anonymous]

Anonymous wrote:Birth assistants are different from doulas. A birth assistant is a monitrice or someone who can carry out clinical tasks such as checking fetal heart tones, palpation, and cervical exams.

This is not across-the-board. If a midwife is having her "birth assistant" do cervical checks and palpation, the birth assistant is probably a student the midwife is overseeing. Birth Care doesn't allow that, except for their Student Nurse Midwives who are not the birth assistant for that birth.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Wow... I've read this entire thread since the beginning and I don't remember anyone other than Karen being mentioned specifically. In fact, many have asked who the other attendants were and no one answered.

\

BirthCare has been named, Tcahbo has been named, there have been several posting that while not naming the Bradley teacher have come pretty close. There has also been a lot of "stating facts" on both sides with no way to back up the "facts".

Birth Care is in Old Town Alexandria.

Go to the Bradley website and check to see who teaches in Old Town. Run that list up against who is a birth assistant for Birth Care.

Old town has three people who teach Bradley. I'm not sure which of those are birth assistants for Birth Care.

Sorry - I forgot to add that this is based off of what appears to be the mother's review of Birth Care, which has been taken down from city search, but the text of it is as follows:

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]

"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."

I really believe this is what everyone in this thread is reacting to with justifiable concern. Aren't these the things that any woman would expect from ANY caregiver? Perhaps not counseling against an option, but at least a risk/benefit discussion. Shouldn't this be the standard of care for any midwife, lay midwife, or OB? Or, am I wrong? Should lay midwives not be held to this standard? If so, it seems like it would be very important for women who might be considering hiring a lay midwife to know that. Again, it's a mother's choice to birth with whomever and wherever, but she should also know what she's getting into...

[Anonymous]

Anonymous wrote:"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."

I really believe this is what everyone in this thread is reacting to with justifiable concern. Aren't these the things that any woman would expect from ANY caregiver? Perhaps not counseling against an option, but at least a risk/benefit discussion. Shouldn't this be the standard of care for any midwife, lay midwife, or OB? Or, am I wrong? Should lay midwives not be held to this standard? If so, it seems like it would be very important for women who might be considering hiring a lay midwife to know that. Again, it's a mother's choice to birth with whomever and wherever, but she should also know what she's getting into...

Do you really think this is the case though? This mother clearly has written a review that she is so emotionally attached to and who's to say how clearly she can remember what was said. Her life was destroyed because of the events of her birth and she needs to place blame somewhere (human nature). When someone is describing details of an event that there are emotional about and personal ties to, it is easy to make things sound like they didn't happen or confuse what did happen.

Informed consent is HUGE in the natural birth world as is discussing benefits/risks. I find that women who chose the midwife/birth center/homebirth route are so into the research, being an informed consumer, asking a lot of questions, and understanding the risk/benefits that I find it hard to believe this mom a.) didn't know b.) her care providers didn't counsel her.

[Anonymous]

Anonymous wrote:

Anonymous wrote:"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."

I really believe this is what everyone in this thread is reacting to with justifiable concern. Aren't these the things that any woman would expect from ANY caregiver? Perhaps not counseling against an option, but at least a risk/benefit discussion. Shouldn't this be the standard of care for any midwife, lay midwife, or OB? Or, am I wrong? Should lay midwives not be held to this standard? If so, it seems like it would be very important for women who might be considering hiring a lay midwife to know that. Again, it's a mother's choice to birth with whomever and wherever, but she should also know what she's getting into...

Do you really think this is the case though? This mother clearly has written a review that she is so emotionally attached to and who's to say how clearly she can remember what was said. Her life was destroyed because of the events of her birth and she needs to place blame somewhere (human nature). When someone is describing details of an event that there are emotional about and personal ties to, it is easy to make things sound like they didn't happen or confuse what did happen.

Informed consent is HUGE in the natural birth world as is discussing benefits/risks. I find that women who chose the midwife/birth center/homebirth route are so into the research, being an informed consumer, asking a lot of questions, and understanding the risk/benefits that I find it hard to believe this mom a.) didn't know b.) her care providers didn't counsel her.

I'm just going off of what the mom said. It is reasonable to ask the questions I asked given her reaction. I'm not going to question the truth of what she's said. I'm just saying, if what she has said IS true, it would be very concerning and is very concerning to a lot of moms. Just because you find it hard to believe, doesn't mean it isn't true, or that people shouldn't have concerns about it being a widespread issue in the lay midwife community. They aren't medical providers, they can't provide medical advice...where do they draw the line and do they make sure their clients know where that line is? Are they even qualified to give clients advice on medical risks and benefits given their lack of medical training? I'm a lawyer, I have a license, if I didn't have one I could be held criminally liable for practicing law without a license and then personally liable for any harm I caused someone by giving bad legal advice. Should lay midwives be held to the same standard? These are fair questions I think, and they're questions I know I'd want answers to if I were considering hiring a lay midwife, no?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:"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."

I really believe this is what everyone in this thread is reacting to with justifiable concern. Aren't these the things that any woman would expect from ANY caregiver? Perhaps not counseling against an option, but at least a risk/benefit discussion. Shouldn't this be the standard of care for any midwife, lay midwife, or OB? Or, am I wrong? Should lay midwives not be held to this standard? If so, it seems like it would be very important for women who might be considering hiring a lay midwife to know that. Again, it's a mother's choice to birth with whomever and wherever, but she should also know what she's getting into...

Do you really think this is the case though? This mother clearly has written a review that she is so emotionally attached to and who's to say how clearly she can remember what was said. Her life was destroyed because of the events of her birth and she needs to place blame somewhere (human nature). When someone is describing details of an event that there are emotional about and personal ties to, it is easy to make things sound like they didn't happen or confuse what did happen.

Informed consent is HUGE in the natural birth world as is discussing benefits/risks. I find that women who chose the midwife/birth center/homebirth route are so into the research, being an informed consumer, asking a lot of questions, and understanding the risk/benefits that I find it hard to believe this mom a.) didn't know b.) her care providers didn't counsel her.

I'm just going off of what the mom said. It is reasonable to ask the questions I asked given her reaction. I'm not going to question the truth of what she's said. I'm just saying, if what she has said IS true, it would be very concerning and is very concerning to a lot of moms. Just because you find it hard to believe, doesn't mean it isn't true, or that people shouldn't have concerns about it being a widespread issue in the lay midwife community. They aren't medical providers, they can't provide medical advice...where do they draw the line and do they make sure their clients know where that line is? Are they even qualified to give clients advice on medical risks and benefits given their lack of medical training? I'm a lawyer, I have a license, if I didn't have one I could be held criminally liable for practicing law without a license and then personally liable for any harm I caused someone by giving bad legal advice. Should lay midwives be held to the same standard? These are fair questions I think, and they're questions I know I'd want answers to if I were considering hiring a lay midwife, no?

I wasn't responding to be snarky I was just saying given the typical profile of a homebirther, I would be surprised that she wouldn't understand risks and benefits but who's to say this particular midwife (Karen), seeing as she takes higher risk patients, is very upfront about those risks. It would be nice to hear from someone on the board that has used Karen and BirthCare in the past.

[Anonymous]

That letter to Jeff is just silly. No one has been named here besides people who were listed in public court documents. I can't imagine a lawyer doing a slew of John Doe lawsuits to reveal identities on DCUM when you can look at any number of sites (Washingtopost.com, SkepticalOB.com, Facebook group) and see thousands of messages being posted.

I have read every message here, learned a lot but still don't know anyone besides Karen Carr who was at the birth. Not the parents, not the assistant, nothing.

*waves to lawyer who has time to read all this*

[Anonymous]

I used Karen for a homebirth and was at risk for post partum hemorrhage due to uterine fibroids. I was definitely informed about this risk by Karen as well as counseled on the treatments she would have available at the birth and we had a plan for hospital transfer, if necessary. I didn't hemorrhage so we didn't have to go there, but the risks were discussed.

All the people who think midwifery is all "kumbaya and candles" may not realize that midwives and clients have serious conversations about risks, treatments, plans, etc.