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

[Anonymous]

" it's not like csection is totally without risk either. There are risks at the time if the csection, risks afterwards, risks to baby such as breastfeeding potetially not going as well, risks for subsequent pregnancies, etc,"

Putting breastfeeding on your list is deeply silly. Brain injury or breastfeeding going well, let's make a choice!

I guess I see a whole cluster of risky behaviors around those who choose CPM midwife assisted birth that makes me call the whole thing into question. The people who choose CPMs frequently seem to also be the people who decide not to get tested/treated for GBS, think you can change your Rh factor by diet and avoid Rhogam, decide to have no prenatal care (after all -- they eat organic!), don't get ultrasounds to determine if there are significant birth defects that could be assisted by surgery in utero, or would require immediate medical care after birth, etc., etc.

[Anonymous]

I chose a CPM (Karen Carr) as my midwife and was also tested for GBS, had multiple ultrasounds (due to some complications during pregnancy), followed the "standard" schedule for prenatal care. Please stop making assumptions about people. Your only correct assumption is that I do try to eat organic, but I'm not dumb and I do not believe that would exempt me from prenatal care. Come on.

[Anonymous]

Anonymous wrote:" it's not like csection is totally without risk either. There are risks at the time if the csection, risks afterwards, risks to baby such as breastfeeding potetially not going as well, risks for subsequent pregnancies, etc,"

Putting breastfeeding on your list is deeply silly. Brain injury or breastfeeding going well, let's make a choice!

I guess I see a whole cluster of risky behaviors around those who choose CPM midwife assisted birth that makes me call the whole thing into question. The people who choose CPMs frequently seem to also be the people who decide not to get tested/treated for GBS, think you can change your Rh factor by diet and avoid Rhogam, decide to have no prenatal care (after all -- they eat organic!), don't get ultrasounds to determine if there are significant birth defects that could be assisted by surgery in utero, or would require immediate medical care after birth, etc., etc.

I agree with the previous poster about the breastfeeding being on this list as silly. I had a c/s for a footling breech baby and successfully breastfed for a year without an issue. Often times breastfeeding issues have nothing to do with how the child was delivered rather a latch issue that if not corrected has the mother choosing formula. Some mothers find formula easier because for a new mom the first weeks of breastfeeding is a huge adjustment and can be extremely difficult. I have several friends who had a vaginal birth who did not breastfeed for one reason or another.

I think those who have not had to have a c/s are horribly misinformed of how things happen- they make it seem like you're cut open and chopped up the way a butcher cuts stew meat. I thought the OR would look like something I've seen on TV since I had never had surgery previously, wow was I in shock to see how it really is! Please don't make assumptions that you have no facts to back up.

[Anonymous]

Anonymous wrote:" it's not like csection is totally without risk either. There are risks at the time if the csection, risks afterwards, risks to baby such as breastfeeding potetially not going as well, risks for subsequent pregnancies, etc,"

Putting breastfeeding on your list is deeply silly. Brain injury or breastfeeding going well, let's make a choice!

I guess I see a whole cluster of risky behaviors around those who choose CPM midwife assisted birth that makes me call the whole thing into question. The people who choose CPMs frequently seem to also be the people who decide not to get tested/treated for GBS, think you can change your Rh factor by diet and avoid Rhogam, decide to have no prenatal care (after all -- they eat organic!), don't get ultrasounds to determine if there are significant birth defects that could be assisted by surgery in utero, or would require immediate medical care after birth, etc., etc.

I do know that Karen attended a large number of births in the Amish community. I believe they shun some (or all - I really don't know) of the things you mentioned because of their cultural beliefs around technology. I personally believe it is important to respect people's choices of what they want to have done to themselves and their bodies during pregnancy and otherwise (like Jehova's Witnesses who refuse blood transfusions).

[Anonymous]

Anonymous wrote:

Anonymous wrote:" it's not like csection is totally without risk either. There are risks at the time if the csection, risks afterwards, risks to baby such as breastfeeding potetially not going as well, risks for subsequent pregnancies, etc,"

Putting breastfeeding on your list is deeply silly. Brain injury or breastfeeding going well, let's make a choice!

I guess I see a whole cluster of risky behaviors around those who choose CPM midwife assisted birth that makes me call the whole thing into question. The people who choose CPMs frequently seem to also be the people who decide not to get tested/treated for GBS, think you can change your Rh factor by diet and avoid Rhogam, decide to have no prenatal care (after all -- they eat organic!), don't get ultrasounds to determine if there are significant birth defects that could be assisted by surgery in utero, or would require immediate medical care after birth, etc., etc.

I agree with the previous poster about the breastfeeding being on this list as silly. I had a c/s for a footling breech baby and successfully breastfed for a year without an issue. Often times breastfeeding issues have nothing to do with how the child was delivered rather a latch issue that if not corrected has the mother choosing formula. Some mothers find formula easier because for a new mom the first weeks of breastfeeding is a huge adjustment and can be extremely difficult. I have several friends who had a vaginal birth who did not breastfeed for one reason or another.

I think those who have not had to have a c/s are horribly misinformed of how things happen- they make it seem like you're cut open and chopped up the way a butcher cuts stew meat. I thought the OR would look like something I've seen on TV since I had never had surgery previously, wow was I in shock to see how it really is! Please don't make assumptions that you have no facts to back up.

And the same goes for many of you who have never had an out of hospital birth. Horribly misinformed and inconceivably judgmental about things you know nothing about. Home birth people are not all free love hippies who live on communes and drink wheatgrass juice all day. (Not that I have anything against those people either.) They are intelligent people who want to do the best thing for their babies. The birth in question was a mistake and it makes me very sad but it is not proof that our rights to birth as we choose should be taken away from us.

[Anonymous]

This is yet another example of a CPM practicing illegally, beyond her scope of practice, exercising poor judgement as well as not having an appropriate risk-out criteria for her clientele. A 43 year old primip with a breech pregnancy is NOT low risk and should have been referred to an OB for care. How unfortunate for all involved.

Deb O'Connell CNM, CPM, MS (homebirth midwife)

[Anonymous]

My second child was in the breech position when I went into labor. While I did (and still do) believe that a vaginal birth is a viable option for a breech presenting baby, I also would never trust any care provider (OB or otherwise) who does not have vaginal breech birth training and experience. As my OB at the time did not, I agreed to a c/s. Unfortunately, while being extracted from my uterus, my baby's head became *entrapped*. After several minutes, the OB finally had to slice my uterus vertically in order to free my baby. He was blue and lifeless.

An entrapped head can happen in BOTH a vaginal and a c/s birth. The myth that a c/s is always the safe alternative to a vaginal birth for a breech presenting baby is just that...a myth. I've had 2 c/s for breech presentation....not once did any OB ever mention this as a possibility.

Thankfully, my son survived. However, had he not, I doubt any police would have shown up to arrest the OB despite the fact that this injuries were a *direct* result of the c/s which had been essentially forced/coerced (I've left out many details leading up to the c/s). It wouldn't have mattered that the OB had less experience than Karen. It wouldn't have mattered that both situations are perfectly *legal* under VA law.

Really, enough with the falsehood that a c/s would have guaranteed a different outcome.

Your story doesn't really make sense. If your baby's head became *entrapped* during a c/s the doctor wouldn't wait several minutes before freeing the baby. And if the head was entrapped - that wasn't the direct result of the c/s, it was the result of contractions. A c/s doesn't cause entrapment. If you hadn't been in surgery when the head became entrapped would your child have survived? Chances are - no.

[Anonymous]

Anonymous wrote:

My second child was in the breech position when I went into labor. While I did (and still do) believe that a vaginal birth is a viable option for a breech presenting baby, I also would never trust any care provider (OB or otherwise) who does not have vaginal breech birth training and experience. As my OB at the time did not, I agreed to a c/s. Unfortunately, while being extracted from my uterus, my baby's head became *entrapped*. After several minutes, the OB finally had to slice my uterus vertically in order to free my baby. He was blue and lifeless.

An entrapped head can happen in BOTH a vaginal and a c/s birth. The myth that a c/s is always the safe alternative to a vaginal birth for a breech presenting baby is just that...a myth. I've had 2 c/s for breech presentation....not once did any OB ever mention this as a possibility.

Thankfully, my son survived. However, had he not, I doubt any police would have shown up to arrest the OB despite the fact that this injuries were a *direct* result of the c/s which had been essentially forced/coerced (I've left out many details leading up to the c/s). It wouldn't have mattered that the OB had less experience than Karen. It wouldn't have mattered that both situations are perfectly *legal* under VA law.

Really, enough with the falsehood that a c/s would have guaranteed a different outcome.

Your story doesn't really make sense. If your baby's head became *entrapped* during a c/s the doctor wouldn't wait several minutes before freeing the baby. And if the head was entrapped - that wasn't the direct result of the c/s, it was the result of contractions. A c/s doesn't cause entrapment. If you hadn't been in surgery when the head became entrapped would your child have survived? Chances are - no.

exactly. Had you had a scheduled c/s for a breech it would have been an entirely different story. Now of course, you can't predict labor but the vast majority of breech c/s are scheduled at around 39 weeks. Voila, no head entrapment.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

My second child was in the breech position when I went into labor. While I did (and still do) believe that a vaginal birth is a viable option for a breech presenting baby, I also would never trust any care provider (OB or otherwise) who does not have vaginal breech birth training and experience. As my OB at the time did not, I agreed to a c/s. Unfortunately, while being extracted from my uterus, my baby's head became *entrapped*. After several minutes, the OB finally had to slice my uterus vertically in order to free my baby. He was blue and lifeless.

An entrapped head can happen in BOTH a vaginal and a c/s birth. The myth that a c/s is always the safe alternative to a vaginal birth for a breech presenting baby is just that...a myth. I've had 2 c/s for breech presentation....not once did any OB ever mention this as a possibility.

Thankfully, my son survived. However, had he not, I doubt any police would have shown up to arrest the OB despite the fact that this injuries were a *direct* result of the c/s which had been essentially forced/coerced (I've left out many details leading up to the c/s). It wouldn't have mattered that the OB had less experience than Karen. It wouldn't have mattered that both situations are perfectly *legal* under VA law.

Really, enough with the falsehood that a c/s would have guaranteed a different outcome.

Your story doesn't really make sense. If your baby's head became *entrapped* during a c/s the doctor wouldn't wait several minutes before freeing the baby. And if the head was entrapped - that wasn't the direct result of the c/s, it was the result of contractions. A c/s doesn't cause entrapment. If you hadn't been in surgery when the head became entrapped would your child have survived? Chances are - no.
exactly. Had you had a scheduled c/s for a breech it would have been an entirely different story. Now of course, you can't predict labor but the vast majority of breech c/s are scheduled at around 39 weeks. Voila, no head entrapment.
Not the poster, but read her post again. The baby's head was entrapped in the uterus, not in the birth canal. The entrapment was from the c-section - it could not have occurred with a vaginal birth, because babies don't come out directly through the uterus in a vaginal birth. Now the baby's head might have been entrapped in the birth canal during a vaginal birth, but that is a totally different complication, and there is no reason to think it would have occurred. So point is, yes it is possible to have a breech baby die due to a c-section that would have lived if they had done a vaginal birth. And yes, a surgeon might have to wait a few minutes while getting the baby out - they don't just start crazily cutting if they can't get the baby out right away, they do have to be a little bit careful if they want the mother to survive.

[Anonymous]

Anonymous wrote:This is yet another example of a CPM practicing illegally, beyond her scope of practice, exercising poor judgement as well as not having an appropriate risk-out criteria for her clientele. A 43 year old primip with a breech pregnancy is NOT low risk and should have been referred to an OB for care. How unfortunate for all involved.

Deb O'Connell CNM, CPM, MS (homebirth midwife)

Wow, Deb, way to bring down your sister midwife without personally knowing any of the details of this birth. That is terrible. As a CPM, I would hope that understand the concept of informed consent and the fact that some women will have extenuating circumstances which lead them to make a particular choice. How exactly was Karen practicing beyond her scope of practice? What makes you think that you can determine that she was exercising poor judgement?

Very disappointing to see this coming from another CPM.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

My second child was in the breech position when I went into labor. While I did (and still do) believe that a vaginal birth is a viable option for a breech presenting baby, I also would never trust any care provider (OB or otherwise) who does not have vaginal breech birth training and experience. As my OB at the time did not, I agreed to a c/s. Unfortunately, while being extracted from my uterus, my baby's head became *entrapped*. After several minutes, the OB finally had to slice my uterus vertically in order to free my baby. He was blue and lifeless.

An entrapped head can happen in BOTH a vaginal and a c/s birth. The myth that a c/s is always the safe alternative to a vaginal birth for a breech presenting baby is just that...a myth. I've had 2 c/s for breech presentation....not once did any OB ever mention this as a possibility.

Thankfully, my son survived. However, had he not, I doubt any police would have shown up to arrest the OB despite the fact that this injuries were a *direct* result of the c/s which had been essentially forced/coerced (I've left out many details leading up to the c/s). It wouldn't have mattered that the OB had less experience than Karen. It wouldn't have mattered that both situations are perfectly *legal* under VA law.

Really, enough with the falsehood that a c/s would have guaranteed a different outcome.

Your story doesn't really make sense. If your baby's head became *entrapped* during a c/s the doctor wouldn't wait several minutes before freeing the baby. And if the head was entrapped - that wasn't the direct result of the c/s, it was the result of contractions. A c/s doesn't cause entrapment. If you hadn't been in surgery when the head became entrapped would your child have survived? Chances are - no.

exactly. Had you had a scheduled c/s for a breech it would have been an entirely different story. Now of course, you can't predict labor but the vast majority of breech c/s are scheduled at around 39 weeks. Voila, no head entrapment.

Oh my God! The arrogance of some people on here is absolutely amazing. I am glad you have such a deep and profound faith in the medical model of birth, but you need to take your blinders off and remember that it does not always offer the perfect outcome. There is literally no way that you can possibly know that this woman would have had a different result. Talk about rose-colored glasses.

[Anonymous]

Anonymous wrote:

Anonymous wrote:This is yet another example of a CPM practicing illegally, beyond her scope of practice, exercising poor judgement as well as not having an appropriate risk-out criteria for her clientele. A 43 year old primip with a breech pregnancy is NOT low risk and should have been referred to an OB for care. How unfortunate for all involved.

Deb O'Connell CNM, CPM, MS (homebirth midwife)

Wow, Deb, way to bring down your sister midwife without personally knowing any of the details of this birth. That is terrible. As a CPM, I would hope that understand the concept of informed consent and the fact that some women will have extenuating circumstances which lead them to make a particular choice. How exactly was Karen practicing beyond her scope of practice? What makes you think that you can determine that she was exercising poor judgement?

Very disappointing to see this coming from another CPM.

Cool it, lady. Deb had the courage to go on record and post her name.

I think any sane person thinks that this woman should have delivered in a hopsital.

This client delivering at home was almost certainly going to have issues. True, she *might* have had issues at the hospital with a surgical birth, but the chance of that happening is probably very low COMPARED to doing it at home with an illegal CPM.

I say this as a woman who gave birth at home and plans to again, if I am low risk.

[Anonymous]

The fact that certain posters can't seem to understand that the risks (c-section risks versus head entrapment risks) were in no way comparable in terms of the likelihood of them happening is extremely frustrating.

Its the old planes versus cars saw -- more likely to die in a car crash than a plane crash, but some people still can't get over their perceived fears and recognize that they assume more risk every time they take a drive than when they fly.

And thank God that there are some people (thanks Deb) who are more concerned about ensuring the ethical behavior of their co-professionals than about closing ranks and pretending that there are no concerns about Karen Carr's course of action.

[Anonymous]

Anonymous wrote:The fact that certain posters can't seem to understand that the risks (c-section risks versus head entrapment risks) were in no way comparable in terms of the likelihood of them happening is extremely frustrating.

Its the old planes versus cars saw -- more likely to die in a car crash than a plane crash, but some people still can't get over their perceived fears and recognize that they assume more risk every time they take a drive than when they fly.

And thank God that there are some people (thanks Deb) who are more concerned about ensuring the ethical behavior of their co-professionals than about closing ranks and pretending that there are no concerns about Karen Carr's course of action.

13:16 here. You hit the nail on the head.

[Anonymous]

This article points out that the death rate for women in childbirth is steadily rising along with C-section rates. How many of those deaths could have been prevented if doctors hadn't been so quick to perform unnecessary surgeries? I am not saying that all C-sections are unnecessary- they do save lives. But what about the ones that end lives? Those of you who are so quick to blame this woman who did her best to make the right choice and who lost her baby, might want to consider the women who listened to their doctors and lost their lives.

http://articles.latimes.com/2007/sep/24/opinion/oe-block24