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Midwife charged in DC? Karen Carr, CPM...
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Anonymous
| I think sometimes people have a hard time accepting that a low statistical risk does not mean that you will not be the unfortunate person who ends up in the bad outcome category. I would assume that at some point the parents were told the risks. If they risked out of birthcare, I can't imagine that birthcare did not tell them why. While I myself have never used a mid wife, all my friends who have all report similar stories of how their midwives informed them of everything. At the same time, I could imagine that they also heard how the midwife had delivered many successful breech babies without loss, how breech is often vaginal rather than automatic c-section in Europe, and how Dr Tchabo would take them on for an attempt if he was in town and the position was OK. The parents probably knew the risks but knew the risks were small and assumed they would not fall into the small category with a bad outcome. In their grief, they are focusing only on what they heard about positive outcomes and not remembering that even with a 3% risk you could be in that 3%. |
Anonymous
|
So just curious... does everyone here wear a seatbelt while driving or riding in a car?
Overwhelmingly, when riding in a vehicle we can expect that we probably won't get into a car accident. Women ride in vehicles everyday and arrive at their destinations safely. But most of us wear a seatbelt in the event that we do get into an accident. Wearing a seatbelt will vastly improve our chances of survival in an accident. In rare occasions, however, wearing a seatbelt during an accident can be more harmful than going without a seatbelt. But the odds of a seatbelt saving your life overwhelmingly outweighs the risk of a seatbelt harming you in a car accident. So most of us wear seatbelts. I think if someone is so afraid of a seatbelt doing them harm, they should probably not get into a car. Just to be clear I am obviously NOT commenting on this particular case or individuals, just generally. |
Anonymous
What does this have to do with the actual Karen Carr case? |
Anonymous
| What Block fails to mention is that the reason for a C-section delivery is often the cause of the death of the mother, not the c-section itself. |
Anonymous
I pretty much agree with this, BUT I am reserving judgment here because we do NOT know if there were extenuating circumstances here that made C-section a very undesirable option for this mother. There ARE women for whom c-sections are much riskier/traumatic than average. I think everyone has a right to discuss the issues in this thread (and I think it's a good thing), but to sit back and place blame on anyone without knowing all the facts is not fair or just. None of us know what really happened...and if anyone here does, it's not like they're going to actually say...what a breech of trust that would be to this woman and her family. I wouldn't be talking about someone I knew personally like this, would you? |
Anonymous
Bingo. |
Anonymous
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One other point is that the lack of ob/gyns who automatically do c-sections for breech births for any position does not mean that vaginal breech birth is unsafe. Ob/gyns are not being trained how to do this which leads to the lack of trained medical providers. As ob/gyns are trained as surgeons, they are more comfortable that they can control and manage a c-section that they do all the time than a vaginal breech birth. Hospitals would prefer a planned c-section to an unplanned c-section due to position change for logistical reasons.
Its a shame that someone with Karen's skill could not practice in hospital or that more doctors like Dr Tchabo exist in the area. I agree that time counts and having quick access to an available OR is important. The hospital model should support mid wife/physcian partnerships and unplanned c-sections only in emergent situations over planned c-sections. The trend is changing for VBAC now but this has been the case for VBACs too. It took a while but now VBACs are being accepted as safe and more residents are seeing them performed. |
Anonymous
Thank you. Excellent point. |
Anonymous
Then why is the death rate rising? |
Anonymous
What extenuating circumstance on Earth could have possibly made a home birth with an illegal CPM for an unbelievably high risk pregnancy (43 y/o, first time mom, breech baby) more desirable than a more medicalized birth. The fact is that this woman already risked out of a home birth (by Birth Care). Instead, she went midwife shopping, and found an illegal one who would do it, and she found a birth assistant who was looney enough to attend this disaster, when all signs pointed to the fact that it was going to be an dangerous birth. |
Anonymous
Just wanted to point out that this is an OPINION piece, not an article. And a larger point: perhaps if the mom in this horrible case had been able to differentiate between the opinions of the anti-hospital, homebirthing, Bradley, no-c-section-at-all-cost crowd and listen to facts from the professionals such as Tchabo and looked at some real, non-biased statistics, her baby would be alive today. |
Anonymous
Actually, I found the article somewhat sketchy. The c-section rate is rising, and maternal death is rising. Statistically, this does not mean that one is the irreducible cause of the second. One interesting point she made is that the death rate for African-American women is much higher than the overall rate. However, no attempt was made to investigate or discuss the cause of this. |
Anonymous
Actually, I do not think this is true. C-section complications and maternal/fetal death are broken out by infection, surgical error, etc. I dn't think the risk of surgical error or infection is higher for c-section over other abdominal surgeries these are risks that do not occur in vaginal deliveries. The c-section itself can heighten the risk in other conditions. For PE/HELLP vaginal is preferrable because one of the complications is loss of blood clotting ability, not a good condition to be undergoing surgery. However, I have also read/heard that c-sections are a pretty easy surgery in terms of technical skills. Complications for the baby come more from the doctor being poorly trained, trying to make too small an incision, or not being aware if s/he nicked something else in time to control the bleeding. If you are with a very good ob/gyn and a hospital that has good control over its infection rate then your risk for c-section compliactions could be much, much lower than the statistics that do not control for those variances. A c-section with a top ob/gyn in a top rated hospital available in a major metro area could be very different than a c-section in a rural area with only a sub par physcian and small hospital with poor controls. |
Anonymous
Not all people who are Bradley Method class participants view birth this way. Just fyi on your blanket judgement |
Anonymous
Well, I don't know, what if she had a heart condition that made anesthesia very dangerous for her, what if she was the type of patient who would normally risk out of c-section (they exist). She'd have to weigh her options...and maybe they were very limited. Perhaps because vaginal would be less risky for her, and she wasn't able to find a skilled OB to deliver her baby vaginally, she took her chances with a midwife who was experienced in delivering breech babies vaginally. I DON'T KNOW THE FACTS. Do you? Why does this have to be about blaming someone instead of discussing hypothetical situations? The former is just petty (and CRUEL imo), and the latter is actually informative. |