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

[Anonymous]

What is the difference between a midwife and a birth assistant?

[Anonymous]

Anonymous wrote:

If you are concerned, I would call the Bradley cooperate office if you don't feel comfortable asking the teacher directly or calling BirthCare. Do you know any BirthCare moms or people you can ask? Honestly, I know who it is but after that letter to Jeff I am not going to be the one to say it on the Internet. I would discuss it with a friend though.

This is probably what the letter intended to do along with dampening the debate. Regardless, I'm sure that anyone seeking midwives, birth centers, assistants, or home birth will be asking these questions.

This is a tragic situation. Many things involve making a decision between what risks to take. I don't think you can condemn the parents or the midwives. I do believe that they all knew that risks exist but that they also knew that many women have successful vaginal breech births. Many of the medical recommendations that you receive are simply based on generalized statistical risk comparisons.

I think what is truly sad is that Dr Tchabo is the only ob/gyn in the area who will attend a breech vaginal birth. It sounds like the parents would have been open to giving birth with an ob/gyn in a hospital setting if an attempt at vaginal birth was possible.

The birth assistant's lawyer can write all the letters he wants to Jeff. At the end of the end of the day, he cannot successfully sue someone for saying something that is TRUE.

[Anonymous]

Anonymous wrote:I had my first baby in a birth center with midwives. I chose the out of hospital birth setting because studies have shown that even midwives in hospital settings use more interventions and have higher c-section rates than midwives attending home and birthcenter births. I am pretty sure I would have gotten several interventions had I given birth in the hospital because my birth was not easy and I pushed for a very long time. In hospitals both doctors and midwives are much more likely to use interventions rather than allow women to push as long as I did. This is because hospitals allow limited time for the stages of labor before intervention is required. I was able to have the birth I wanted and I am grateful for that.

I also have two children whom I adopted at birth and I was present at both hospital births. It was pretty horrific to see how many things were done to the women and the babies without explanation or consent. The nurses and doctors just did things to them, often without even saying what they were going to do. I was traumatized just watching these sweet young women give birth and both of them chose to give birth with minimal medication, no epidurals. I am sure that some hospital births are not
like the ones that I witnessed but I think the birthcenter should be given some credit for trying to teach women about some of the things that might happen in the hospital and also for offering a safe alternative.

To the bolded statement: This is just plain false and ridiculous, there is no time limit 'before interventions are required'. Every birth is an individual situation. When I read 'how many things were done to the women and the babies without explanation or consent' - it just makes me shake my head - there is no such thing, unless it's a life or death situation that is evolving rapidly, at least not that I've seen it in years and years of practicing.

[Anonymous]

So probably what people are saying on here in previous posts are absolutely not true and would be defined as defamation.

[Anonymous]

Food for thought:

If licensing of CPM's in the state of VA is more administrative versus a skills assessment, and if as a rule the state of VA did not vigorously seek to stop non-licensed midwives from attending births prior to this incident, what is the state's culpability?

If the state of VA midwife licensing does not preclude at-home-midwife-attended vaginal breech births, wouldn't the legal issue here then be not the death of the baby, but the lack of licensing?

Suppose a mother doesn't have health insurance (can't obtain it? can't afford it?), doesn't qualify for safety net benefits, and doesn't have the money for an in-hospital birth (especially if it ends up in surgery)?

[Anonymous]

Anonymous wrote:

Anonymous wrote:I had my first baby in a birth center with midwives. I chose the out of hospital birth setting because studies have shown that even midwives in hospital settings use more interventions and have higher c-section rates than midwives attending home and birthcenter births. I am pretty sure I would have gotten several interventions had I given birth in the hospital because my birth was not easy and I pushed for a very long time. In hospitals both doctors and midwives are much more likely to use interventions rather than allow women to push as long as I did. This is because hospitals allow limited time for the stages of labor before intervention is required. I was able to have the birth I wanted and I am grateful for that.

I also have two children whom I adopted at birth and I was present at both hospital births. It was pretty horrific to see how many things were done to the women and the babies without explanation or consent. The nurses and doctors just did things to them, often without even saying what they were going to do. I was traumatized just watching these sweet young women give birth and both of them chose to give birth with minimal medication, no epidurals. I am sure that some hospital births are not
like the ones that I witnessed but I think the birthcenter should be given some credit for trying to teach women about some of the things that might happen in the hospital and also for offering a safe alternative.

To the bolded statement: This is just plain false and ridiculous, there is no time limit 'before interventions are required'. Every birth is an individual situation. When I read 'how many things were done to the women and the babies without explanation or consent' - it just makes me shake my head - there is no such thing, unless it's a life or death situation that is evolving rapidly, at least not that I've seen it in years and years of practicing.

Not the poster you're responding to, but I'm not really sure what makes you think it's okay to say to this woman "Your actual experience is wrong and did not happen." She said that she witnessed things done to the birth mothers of her adopted children. She was THERE. It's not like she was talking about something she heard from her brother's girlfriend's cousin's cashier at the grocery store.

I'm glad your experiences have been good in the years and years you've been practicing. But recognize that your experiences are not the only experiences a person can have, ever.

[Anonymous]

Anonymous wrote:Food for thought:

If licensing of CPM's in the state of VA is more administrative versus a skills assessment, and if as a rule the state of VA did not vigorously seek to stop non-licensed midwives from attending births prior to this incident, what is the state's culpability?

If the state of VA midwife licensing does not preclude at-home-midwife-attended vaginal breech births, wouldn't the legal issue here then be not the death of the baby, but the lack of licensing?

Suppose a mother doesn't have health insurance (can't obtain it? can't afford it?), doesn't qualify for safety net benefits, and doesn't have the money for an in-hospital birth (especially if it ends up in surgery)?

It is against the law to turn away a woman in labor at the hospital - hospitals are required to attend the birth regardless of a woman's ability to pay. Pregnant women who are citizens also qualify for Medicaid which would cover some of the medical expenses.

[Anonymous]

There is nothing in the regulations that say vbac breech twins cannot be attended to by a cpm. They can be found on the VA BOM websites. Maybe they are trying to set a precedent and dny a mothers right to chose this? Not having a license is a misdemeanor.

[Anonymous]

Suppose a mother doesn't have health insurance (can't obtain it? can't afford it?), doesn't qualify for safety net benefits, and doesn't have the money for an in-hospital birth (especially if it ends up in surgery)?

It is against the law to turn away a woman in labor at the hospital - hospitals are required to attend the birth regardless of a woman's ability to pay. Pregnant women who are citizens also qualify for Medicaid which would cover some of the medical expenses.

True but the hospital would go after every single asset the women had and would bankrupt her family. There are a large number of women who make enough and have enough assets not to qualify for Medicaid but who are uninsured. There are many women who have insurance plans with poor coverage and lack maternity coverage.

There was a recent thread from a woman who wanted children, was over 40 and then found out that in order to add maternity coverage to her health insurance she would not be covered if she conceived before a one year mark. She was struggling with whether to take the risk of complete bankruptcy or the risk of never conceiving because she had to wait an additional year.

One of my friends and her husband were self insured because insurance was not offered where they worked. They did not have a maternity rider. She accidentally became pregnant while using birth control. They needed their salaries and their jobs were hard to find so quitting their jobs to go on welfare to qualify for Medicaid was not a good choice. They hired a midwife and did a home birth because they could not afford the hospital and did not want to abort because of insurance coverage issues. She was young and low risk so everything worked out in the end.

[Anonymous]

Anonymous wrote:If you are concerned, I would call the Bradley cooperate office if you don't feel comfortable asking the teacher directly or calling BirthCare. Do you know any BirthCare moms or people you can ask? Honestly, I know who it is but after that letter to Jeff I am not going to be the one to say it on the Internet. I would discuss it with a friend though.

This is a valid concern...the birth assistant hasn't been charged with anything but at the same time we all as mothers have a right to feel 100% comfortable with our childbirth education and labor support. We want to trust the advice we are given. Many women may still be comfortable with this woman, but others might not, and I don't think we should judge that.

What letter to Jeff? What did I miss? I thought I had read all the posts, but I admittedly was skimming some of them. Can you reference, please? Thanks!

[Anonymous]

Anonymous wrote:

Anonymous wrote:The mom was saying she didn't get enough information from the birth assistant or from Birthcare. But she hasn't said anything publicly yet about Karen Carr. We don't know yet if Karen Carr advised her of the possible risks.

Huh, the way I read it she was referring to both the birth assistant and "the midwife" which are all assuming is Karen.

I don't believe Karen works for BirthCare so when she talks about seeing the midwife at BirthCare, I assumed she mistyped and meant the assistant or the Bradley Teacher. I could be wrong. We also don't know for 100% certainity that this is actually the mother in this case.

In addition, according to earlier postings by people who "seem to be in the know" the parents in this case are not blaming Karen which if true also makes me think that the review was solely about BirthCare.

[Anonymous]

I'm a pro homebirther. Had my 2nd (VBAC) at home with a CPM. 3rd will be in hospital, but with a CNM...

The thing that irritates me about people arguing that the VA licensing is useless, dangerous, etc is that prior to 2005 it was illegal for a midwife to attend any homebirth in the state. CPMs and organizations that represent them lobbied the state very hard to implement a way for midwives to legally attend homebirths. And the state did. And because of that mothers in VA seeking a homebirth have access to hundreds of highly trained, competent CPMs that they didn't have access to just 6 years ago.

If you think there is still something lacking in the VA licensing practice, don't just flout the law and the process, do something to change it.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Why hasn't anyone identified the birth assistant by name?

Because everyone is waiting for someone else to do it. People know who the birth assistant is.

In two previous posts, the instructions for finding out who the birth assistant was were pretty clearly listed.

If people want to find out who it is, they can. And people are free to post it.

Why should they though? As far as I know neither the birth assistant and the doula have been charged with anything. They are entitled to their privacy.

What about other mothers who are considering who need to hire someone?

I would not be comfortable hiring someone like the birth assistant involved.

Other home birth mothers in the community are entitled to this information.

Then you need to ask pointed questions of anyone you are hiring. Take it up with BirthCare if use choose to use them for their birth.

Anonymous people, who weren't present at the birth and do not know the full circumstances shouldn't be posting the BA or doulas name so a bunch of other anonymous people can go around spreading unsubstantiated rumors about them.

Hence the lawyer's letter.

[Anonymous]

Anonymous wrote:

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."

The Hannah study has been largely discredited. It is not an accurate source of information regarding vaginal breech birth. Karen herself has attended many more than 20 breech babies, and this is the first and only one to have this problem. Someone who is interested in learning more about breech birth in the home setting is certainly welcome to start conversations with homebirth midwives who attend breech births, as there are many in the DC area and on the East coast.

Also, some of us believe that we do not want or need the nanny state to determine what is best for us. It is, and hopefully always will be, the woman's choice regarding the risks she is willing to take for herself and her unborn baby. I highly admire the obstetrical community and the amazing advances they have made medically, however it does not erase the fact that if you look through their history you will find cases of neglect, abuse, and harmful treatment of mothers and babies. It is not right to always assume that they hold the best answer for every woman.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Why hasn't anyone identified the birth assistant by name?

Because everyone is waiting for someone else to do it. People know who the birth assistant is.

In two previous posts, the instructions for finding out who the birth assistant was were pretty clearly listed.

If people want to find out who it is, they can. And people are free to post it.

Why should they though? As far as I know neither the birth assistant and the doula have been charged with anything. They are entitled to their privacy.

What about other mothers who are considering who need to hire someone?

I would not be comfortable hiring someone like the birth assistant involved.

Other home birth mothers in the community are entitled to this information.

Then you need to ask pointed questions of anyone you are hiring. Take it up with BirthCare if use choose to use them for their birth.

Anonymous people, who weren't present at the birth and do not know the full circumstances shouldn't be posting the BA or doulas name so a bunch of other anonymous people can go around spreading unsubstantiated rumors about them.

Hence the lawyer's letter.

The lawyer can write all the letters he wants. However, when the birth assistant's name actually gets published, he won't be able to do anything about it, since it really was the birth assistant who was at the birth. Like the lawyer cannot sue someone for slander if what people are saying is actually true, even though it is unflattering. He probably is the same person who got City Search to take down the mom's review of Birth Care.