Evelyn Muhlhan - another homebirth midwife bites the dust?

[Anonymous]

Anonymous wrote:

Anonymous wrote:Right, so 16:13 holds true to her stated belief that the full term baby has no rights of its own.

Do you really believe that the unborn baby's rights should be protected over the rights of the mother who carries that baby? Do you really believe the government should be making decisions about our medical care?

They make decisions about our medical care all the time, even when we are the only ones involved. What drugs we can use, how we can get them, etc. Whether a certain procedure is permitted or will be paid for by government-involved healthcare plans.

But, yes, I do think that women do not have 100% control over medical decisions that affect whether a full term baby lives or dies.

Look, I'm even libertarian. I have to assume I am less interested in government regulation than you are or most people on this board. But I also think the full term baby is a person, a person with rights. This has some implications somewhere on the margin; there must be some things that a pregnant mother is not allowed to do to the infant. Your position is that the full term infant has zero rights because the mother must have 100% control.

[Anonymous]

The problem with the argument is that even if the mother has the right to refuse treatment, she does not have the right to demand that someone else violate professional codes of conduct. You have the right to stay out of the hospital, but not to demand that the government enable midwives to attend you.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Right, so 16:13 holds true to her stated belief that the full term baby has no rights of its own.

Do you really believe that the unborn baby's rights should be protected over the rights of the mother who carries that baby? Do you really believe the government should be making decisions about our medical care?

absolutely--the right of a term/viable baby to have a reasonable chance of surviving delivery should absolutely, 100% trump the rights of a woman to decide what type of delivery she has.
Just as the rights of an newborn to survive/thrive should trump the rights of parents to abuse that child.

Also, yes I absolutely believe that the government should be making decisions about our medical care---is as much as these "decisions" entail licensing practitioners and holding them to standards of care that protect patients. Do you not believe in the state licensing doctors?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Right, so 16:13 holds true to her stated belief that the full term baby has no rights of its own.

Do you really believe that the unborn baby's rights should be protected over the rights of the mother who carries that baby? Do you really believe the government should be making decisions about our medical care?

absolutely--the right of a term/viable baby to have a reasonable chance of surviving delivery should absolutely, 100% trump the rights of a woman to decide what type of delivery she has.
Just as the rights of an newborn to survive/thrive should trump the rights of parents to abuse that child.

Also, yes I absolutely believe that the government should be making decisions about our medical care---is as much as these "decisions" entail licensing practitioners and holding them to standards of care that protect patients. Do you not believe in the state licensing doctors?

So what are you suggesting? Having police come arrest women in labor and handcuff them to a hospital bed?

[Anonymous]

Parents have been prosecuted for failing to give minor children life saving treatments or keeping them from live saving measures. I suppose this could go the same way but most prosecutors would stay far away.

Licensing and regulating the health professionals who assist women might sound better to you now?

[Anonymous]

Anonymous wrote:

Anonymous wrote:Fair enough, 11:30, but when people point out that a midwife has been questioned for home birth practices, the immediate reaction on this board seems to be that we shouldn't license or control midwives in any way because it interferes with the freedom of choice of the mother.

I'm not advocating that we jail women who home birth under dangerous circumstances but I wonder if you think we should have licensing requirements.

I support 11:24.

I actually don't believe in licensing requirements for homebirth midwives. Midwifery is truly one of the oldest professions, and seeks to assist in a natural stage of life which will occur regardless of who is watching or assisting. It is also an event that in a few very rare cases - no matter who is assisting - will result in some tragedy. That said, I would like to see a greater society acceptance for the normal life-process that birth is. The only control I would like to see is one which requires homebirth midwives to be clear about their background and training. If homebirth midwives want to be able to use a (very few, specific types of) medication, then I think they need to have passed a course or examination which ensures they use these things correctly. That is truly the extent that I want the government involved in what my homebirth midwife is allowed to do.

To the person who doesn't think midwives ought to be regulated:

Suppose a woman has a pretty uneventful homebirth with a midwife. At some point the midwife neglects to wash her hands or disinfect properly, and the woman ends up with a bad infection and dies. Do you think in this case the government still shouldn't be able to say that the midwife has done something wrong, and hold her responsible? Should there still not be standards about how midwives go about their work?

[Anonymous]

Anonymous wrote:absolutely--the right of a term/viable baby to have a reasonable chance of surviving delivery should absolutely, 100% trump the rights of a woman to decide what type of delivery she has.
Just as the rights of an newborn to survive/thrive should trump the rights of parents to abuse that child.

No no no! The two situations you present are completely different. The government cannot force any person to undergo a medical procedure against their express wishes, not even for the benefit of another person. For example, you can't be forced to donate a kidney to your dying child if it's against your religious beliefs, even if you are the only viable donor. Thus, the government also cannot force a woman to give birth in a hospital / under certain conditions (a medical procedure) against her wishes, even for the benefit of the child. TOTALLY different from laws against abuse or withholding medical treatment from children (laws which I fully support).

However, this absolute right to personal control over your own medical treatment does NOT extend to a right to force medical professionals to provide assistance. Medical professionals should absolutely be able to refuse to treat patients who are asking them to violate professional standards of care or codes of conduct.

[Anonymous]

Anonymous wrote:

Anonymous wrote:absolutely--the right of a term/viable baby to have a reasonable chance of surviving delivery should absolutely, 100% trump the rights of a woman to decide what type of delivery she has.
Just as the rights of an newborn to survive/thrive should trump the rights of parents to abuse that child.

No no no! The two situations you present are completely different. The government cannot force any person to undergo a medical procedure against their express wishes, not even for the benefit of another person. For example, you can't be forced to donate a kidney to your dying child if it's against your religious beliefs, even if you are the only viable donor. Thus, the government also cannot force a woman to give birth in a hospital / under certain conditions (a medical procedure) against her wishes, even for the benefit of the child. TOTALLY different from laws against abuse or withholding medical treatment from children (laws which I fully support).

However, this absolute right to personal control over your own medical treatment does NOT extend to a right to force medical professionals to provide assistance. Medical professionals should absolutely be able to refuse to treat patients who are asking them to violate professional standards of care or codes of conduct.

I'm not saying that the government should handcuff women to beds against their will or force them to deliver in hospitals. However, I am saying that the government should license practitioners based on clinical standards that protect the rights of the term fetus and the mother. Practitioners who violate these standards should potentially have their licenses revoked and they should be prosecuted (in cases of gross negligence).

Interestingly, I say this all as a CNM. I believe STRONGLY in a woman's right to birth outside of the hospital. But I also believe very strongly in there being a SAFE standard of nurse midwifery care that all midwifery clients (women and their babies) can be assured of having when they chose a midwife. Many midwifery clients are poor (a huge percentage of midwifery clients are Medicaid births) and many are uneducated and don't have the ability to evaluate whether a midwife is competent. They are very vulnerable health care consumers.

In an ideal world, we as midwives would all provide excellent care every time. In actuality there are some reckless midwives, there are under trained midwives and there are some plain dumb midwives. Bearing the title of midwife does not make one clinically infallible like many (most) in the natural birth community would want to believe. Hence my strong, strong support of government involvement in the form of licensing and and in upholding clinical standards.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:absolutely--the right of a term/viable baby to have a reasonable chance of surviving delivery should absolutely, 100% trump the rights of a woman to decide what type of delivery she has.
Just as the rights of an newborn to survive/thrive should trump the rights of parents to abuse that child.

No no no! The two situations you present are completely different. The government cannot force any person to undergo a medical procedure against their express wishes, not even for the benefit of another person. For example, you can't be forced to donate a kidney to your dying child if it's against your religious beliefs, even if you are the only viable donor. Thus, the government also cannot force a woman to give birth in a hospital / under certain conditions (a medical procedure) against her wishes, even for the benefit of the child. TOTALLY different from laws against abuse or withholding medical treatment from children (laws which I fully support).

However, this absolute right to personal control over your own medical treatment does NOT extend to a right to force medical professionals to provide assistance. Medical professionals should absolutely be able to refuse to treat patients who are asking them to violate professional standards of care or codes of conduct.

I'm not saying that the government should handcuff women to beds against their will or force them to deliver in hospitals. However, I am saying that the government should license practitioners based on clinical standards that protect the rights of the term fetus and the mother. Practitioners who violate these standards should potentially have their licenses revoked and they should be prosecuted (in cases of gross negligence).

Interestingly, I say this all as a CNM. I believe STRONGLY in a woman's right to birth outside of the hospital. But I also believe very strongly in there being a SAFE standard of nurse midwifery care that all midwifery clients (women and their babies) can be assured of having when they chose a midwife. Many midwifery clients are poor (a huge percentage of midwifery clients are Medicaid births) and many are uneducated and don't have the ability to evaluate whether a midwife is competent. They are very vulnerable health care consumers.

In an ideal world, we as midwives would all provide excellent care every time. In actuality there are some reckless midwives, there are under trained midwives and there are some plain dumb midwives. Bearing the title of midwife does not make one clinically infallible like many (most) in the natural birth community would want to believe. Hence my strong, strong support of government involvement in the form of licensing and and in upholding clinical standards.

Yes, but saying that the rights of the fetus 100% trump the rights of the mother, and saying that midwives should be licensed and held to clinical standards are two *completely* different things! I wholeheartedly agree that midwives should be licensed, but that should have no bearing on whether a mother chooses to give birth in a way that doesn't follow those standards. Such a mother won't be able to find a licensed midwife to support her, but it should still be her decision, just as it is a cancer patient's decision to stop chemo and start herbal therapy of they choose.

[Anonymous]

Anonymous wrote:How do you get "preeclampsia is overdiagnosed"? There are clear diagnostic criteria: BP over 140/90 and 24hr protein over 300. This is not subjective. Every obstetrician I have ever met (and as a 2x PE survivor, I've met a lot) has used these criteria. Meanwhile, the PE forums have multiple stories from midwives who FAILED to diagnose. Please tell me, what is "true" preeclampsia, according to midwives? Do they only believe it's real when you're on the verge of stroke or seizure? 140/90 with a 2+ dip and followup of 300+ on 24hr collection IS preeclampsia. Period. Preeclampsia can progress rapidly to HELLP or eclampsia and put baby in distress.

NP here so I don't know what the PP you quote meant, but I had to transfer during labor from a birth center to the hospital for borderline BP. My CNMs are very conservative about this, and it was absolutely the right call, because as you say PE can progress very rapidly. For me during labor at the birth center BP was right at 140 and there was protein in my urine, although it was only one sample and I had a lot of bloody show at that point so no way for the birth center to really know for sure. BP continued to rise during labor, and at one point, according to my medical records from the hospital, I was diagnosed with PE based solely on continually rising BP. There remains some debate among my care providers as to whether I really had PIH or PE since my BP came down into normal range fairly soon after getting an epidural.

[Anonymous]

Anonymous wrote:
No no no! The two situations you present are completely different. The government cannot force any person to undergo a medical procedure against their express wishes, not even for the benefit of another person. For example, you can't be forced to donate a kidney to your dying child if it's against your religious beliefs, even if you are the only viable donor. Thus, the government also cannot force a woman to give birth in a hospital / under certain conditions (a medical procedure) against her wishes, even for the benefit of the child. TOTALLY different from laws against abuse or withholding medical treatment from children (laws which I fully support).

However, this absolute right to personal control over your own medical treatment does NOT extend to a right to force medical professionals to provide assistance. Medical professionals should absolutely be able to refuse to treat patients who are asking them to violate professional standards of care or codes of conduct.

There are quite a few underage people who have been forced by court order to undergo chemo.

Here is one:

http://articles.cnn.com/2009-05-29/us/minnesota.forced.chemo_1_chemotherapy-alternative-medicine-minnesota-boy?_s=PM:US

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:absolutely--the right of a term/viable baby to have a reasonable chance of surviving delivery should absolutely, 100% trump the rights of a woman to decide what type of delivery she has.
Just as the rights of an newborn to survive/thrive should trump the rights of parents to abuse that child.

No no no! The two situations you present are completely different. The government cannot force any person to undergo a medical procedure against their express wishes, not even for the benefit of another person. For example, you can't be forced to donate a kidney to your dying child if it's against your religious beliefs, even if you are the only viable donor. Thus, the government also cannot force a woman to give birth in a hospital / under certain conditions (a medical procedure) against her wishes, even for the benefit of the child. TOTALLY different from laws against abuse or withholding medical treatment from children (laws which I fully support).

However, this absolute right to personal control over your own medical treatment does NOT extend to a right to force medical professionals to provide assistance. Medical professionals should absolutely be able to refuse to treat patients who are asking them to violate professional standards of care or codes of conduct.

I'm not saying that the government should handcuff women to beds against their will or force them to deliver in hospitals. However, I am saying that the government should license practitioners based on clinical standards that protect the rights of the term fetus and the mother. Practitioners who violate these standards should potentially have their licenses revoked and they should be prosecuted (in cases of gross negligence).

Interestingly, I say this all as a CNM. I believe STRONGLY in a woman's right to birth outside of the hospital. But I also believe very strongly in there being a SAFE standard of nurse midwifery care that all midwifery clients (women and their babies) can be assured of having when they chose a midwife. Many midwifery clients are poor (a huge percentage of midwifery clients are Medicaid births) and many are uneducated and don't have the ability to evaluate whether a midwife is competent. They are very vulnerable health care consumers.

In an ideal world, we as midwives would all provide excellent care every time. In actuality there are some reckless midwives, there are under trained midwives and there are some plain dumb midwives. Bearing the title of midwife does not make one clinically infallible like many (most) in the natural birth community would want to believe. Hence my strong, strong support of government involvement in the form of licensing and and in upholding clinical standards.

You mean reckless like Evelyn?

I wonder how you feel about CPMs?

I also wonder how you feel about women choosing vaginal breech birth at home? What about VBAC at home? What about twins at home? Very curious to hear about your thoughts and feelings on those.

I'm also going to go back to what I said earlier: since OBs and homebirth midwives alike have similar outcomes yet (in some cases) vastly different protocols, we have to ultimately allow the woman herself choose how to proceed with her birth, even if she is doing something that the doctor thinks is dangerous. The medical system should not have the final say on what is "right" and "wrong" when it comes to childbirth.

[Anonymous]

So, what's a "term" baby? 37 weeks? Under your logic, babies could be allowed to be born at home at 36 weeks and 6 days then? That would make sense? Or would they have the "right" to hospital care at earlier points of gestation? If so, how early are you suggesting we give fetuses these "rights"? Where do you draw the line? Conception? Potential for conception? Oral contraceptives should therefore be illegal because babies have the "right" to potentially be born, but only in hospitals, huh?

Again, this is about women's rights. Stripping them of options and making certain things "illegal" because of the opinions (read: pocketbooks) of obstetricians is insane. The woman should be the only decider when it comes to decisions about her reproductive health, whether she wants to give birth with an OB or if she wants her mom to catch the baby in the comfort of her own bedroom. If you start giving "term babies" the "right" to a hospital birth, you're going down a slippery slope.

[Anonymous]

Give birth where you want. Use unlicensed midwives if you want. If midwives want licenses to practice, they should be held to a standard of care.

[Anonymous]

Anonymous wrote:So, what's a "term" baby? 37 weeks? Under your logic, babies could be allowed to be born at home at 36 weeks and 6 days then? That would make sense? Or would they have the "right" to hospital care at earlier points of gestation? If so, how early are you suggesting we give fetuses these "rights"? Where do you draw the line? Conception? Potential for conception? Oral contraceptives should therefore be illegal because babies have the "right" to potentially be born, but only in hospitals, huh?

Again, this is about women's rights. Stripping them of options and making certain things "illegal" because of the opinions (read: pocketbooks) of obstetricians is insane. The woman should be the only decider when it comes to decisions about her reproductive health, whether she wants to give birth with an OB or if she wants her mom to catch the baby in the comfort of her own bedroom. If you start giving "term babies" the "right" to a hospital birth, you're going down a slippery slope.

This continuum of reproductive rights, to include complete control from the moment of conception to a completed birth, is not necessary.

A woman's right to an abortion involves an overt, intentional act to end the life of her child. A woman's right to birth as she so chooses involves the sanctity of a bodily function, which is not a medical procedure, and always involves an uncontrollable degree of risk.

So a woman who pays a doctor to deliver her full term baby feet first and sever its spinal cord before the head is delivered is intentionally and overtly participating in a series of actions that will definitely result in a dead baby. In contrast, a woman who pays a doctor to deliver her full term baby feet first, whose head then is not delivered quickly enough and who dies, has NOT intentionally caused the death of her child.

Abortion is a deliberate action that intends the death of a child. Birth is an involuntary action that intends the life of a child, but cannot guarantee it under any circumstances, with any attendant, in any location.

So a mother who delivers in her bathtub at home and leaves her baby underwater to drown because she intends for the child to die is a murderer, while a mother who has a precipitous labor and delivers unattended and does not clear her newborn's airways effectively does not intend for the child to die and is the tragic victim of an accident.

The book Pushed also attempted to link the right to abort with the right to birth, but the link does not hold. Women can advocate for birth choice while respecting the personhood of the child.