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Midwife charged in DC? Karen Carr, CPM...
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Anonymous
I am honestly sorry that you had a scary, bad experience with your c-section. I'm also saddened that you feel it was forced upon you/or that you were coerced, and whether that was the case or not, unfortunately you feel that way, and that's what matters in the end. Nonetheless, my question is: Is your son NOW completely healthy, of normal intelligence, or did he suffer anoxic brain injury? If he is healthy, I assure you - several minutes did not pass, to get your son's head out! I have seen this happen in the operating room and it takes only seconds to widen the incision. Were you in direct view of your abdomen? During an awake surgery you are in a scary helpless situation, seconds may seem like minutes. Your baby would not have survived several minutes without oxygen (did he have to have CPR?), and it does not nearly take that long to widen the incision- it should never take that long to widen the incision! Of course I wasn't there ... but I think your overall unhappiness about feeling forced in to a c-section you never wanted may have made this a worse memory than it was if recounted by someone else who was in the room at at that time. But what may have happened if you had been at home and the head had become entrapped as happens with 8-10% of vaginal breech deliveries? I am also saddened how much you hate your OB years after, with you and your child both healthy - I presume?-, so much that you would like him/her arrested and thrown into jail it appears?? I hope that is not really how you feel?? Not pertaining to you, but the general sense I get from many discussing here..: When even patients who have a great outcome after a difficult situation have so much hatred, mistrust and ill-will towards OBs and other in-hospital providers, requesting statistically more risky courses of action, yet ready to sue in a heartbeat, who wants to be in those professions for years to come? In an era where medical malpractice premiums for OBs range between $50,000 and $200,000 per year depending on state and where many counties in other states have OBs leaving their practices altogether, and you can hardly find any, I can't help but express my gratitude towards those professionals I have encountered over the years that were kind, and highly skilled, still practicing in this demanding profession. |
Anonymous
It's not an opinion that a lot more women die from C sections than from vaginal birth. It's a fact. |
Anonymous
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"Informed consent" is not a black-and-white matter. The risks are often downplayed by homebirth advocates and other natural birth advocates, of which I generally consider myself one. When risks are mentioned, statistics may not be given, or inaccurate or cherry-picked statistics may be given (an un-favorite inaccurate stat: that the risk of uterine rupture is the same in a VBAC as in a first-time mother; this is likely based on one or more studies that showed the risk of fetal/neonatal death as statistically equivalent in VBAC attempts and first-time mothers.) Or statistics may be given but risk characterized as "small" or "tiny." No one is an island and our perspectives usually are colored by one thing or another. Is there an "objective" way to view a risk percentage? Perception of acceptable risk will vary from person to person and can also be colored by what you're hearing from people who otherwise seem understanding and knowledgeable -- and sympathetic to your concerns.
No one really believes that we must choose the circumstance with the least acute risk of death in every instance, including for our children. We take higher risks sometimes for the sake of a normal life. The mother who wants badly to avoid a c-section even at a "slightly" increased risk to her baby's life might see herself as no different from the mother who allows her child to take various small risks in sports and recreation in order to pursue a more normal life. The c-section has a certainty of some negative consequences and an increased risk for others, and even if most of those are to the mother, what happens to the mother affects her newborn and growing child. I do happen to disagree with the level of risk that many homebirth and natural childbirth advocates are comfortable with, and I don't tend to trust them to give accurate facts. I found KC's unwillingness to be licensed under Virginia's very liberal provisions not a sign of prudence which is an incredibly important characteristic for what she set out to do for a living, and I've become increasingly hesitant to recommend CPM birth attendants in general. but the selfishness and lack of concern for babies is not nearly as overwhelming as it's been portrayed. Many or most mothers and probably the midwives themselves make the choices they do out of a perception that a c-section (which even if not planned is more likely to arise from following a more mainstream birth model) in order to avoid a truly or perceived as small or even "tiny" risk to the child's life is misguided in light of the certain or likely consequences of c-section. I think more people may agree with the underlying idea more of the time than they realize even when it comes to birth. But the disciples of extremists who push appealing possibilities become more and more comfortable with risks of death as "just part of life" and more and more distrustful of nearly every caution proceeding from those within the medical system that conflicts with their ideology and/or personal hopes. |
Anonymous
First, they don't even put you under full anesthesia for a c-section. Second, if she would normally risk out of a c-section, don't you think that a really top-notch high-risk OB would be able to control for this? Or make better attempts to control for this than an illegal, rogue CPM delivering high-risk babies at home? I mean seriously? You sound like a buffoon. Some of these hypotheticals people are discussing are just ridiculous. The decision to just take your chances on your kitchen floor in this situation just seems absolutely nuts. |
Anonymous
No PP, YOU are ridiculous. Are you an OB, a doctor, or any other type of birth professional? Do you know more than the rest of us about this case? No? Then take a pill. There are all kinds of reasons docs advise against c-sections for certain women, like I said: I don't know what really happened here, you don't either. When you assume, you only make and ass of yourself. Perhaps a medical professional could actually shed some light on this discussion instead of us having to listen to you flame. |
Anonymous
Agree with the PP that the earlier poster is nothing short of a moron. Women with heart conditions are more likely than not advised to deliver BY C/S so as to avoid the stress of labor. Not the opposite. Really, stop pulling out crap out of your ass to defend your home-birth-at-any-cost view. I ask (as a previous poster did) and many of us genuinely want to know, what "extenuating circumstances" would make a c section a highly undesirable option for a 43 year old primip with a breech fetus?" Really, what medical circumstance(s) are you thinking of? |
Anonymous
There is nothing diificult to understand about this - for some women the statistical risk from a c-section, for whatever reason, is higher than the statistical risk from a vaginal frank breech birth. So to make up numbers, lets say because you have a bleeding disorder, you have a 1% risk of dying from a c-section. Not inconcievable - major surgery is very dangerous for some people. The risk of the baby dying from a vaginal frank breech birth (over a c-section) is .5% (also made that up, don't know what it is). If you make the fairly logical decision that you want to do what carries the lowest risk of death period, then you choose the vaginal breech. But because there are no OBs who know how to do this, your only option is a CPM. Do you still judge the mother so harshly? Or is she not allowed to value her own life at all? Just because she had a bad outcome does not mean she made the illogical choice - WE DON'T KNOW THE FACTS. |
Anonymous
Name one. name one medical reason why a 43 year old primip breech should deliver at home rather than have a c/s in the hospital. |
Anonymous
so you are suggesting the better option for a woman with a bleeding condition and breech fetus is a home birth with a CPM?? *Bangs head against wall*. |
Anonymous
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[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.
First, they don't even put you under full anesthesia for a c-section. Second, if she would normally risk out of a c-section, don't you think that a really top-notch high-risk OB would be able to control for this? Or make better attempts to control for this than an illegal, rogue CPM delivering high-risk babies at home? I mean seriously? You sound like a buffoon. Some of these hypotheticals people are discussing are just ridiculous. The decision to just take your chances on your kitchen floor in this situation just seems absolutely nuts. No PP, YOU are ridiculous. Are you an OB, a doctor, or any other type of birth professional? Do you know more than the rest of us about this case? No? Then take a pill. There are all kinds of reasons docs advise against c-sections for certain women, like I said: I don't know what really happened here, you don't either. When you assume, you only make and ass of yourself. Perhaps a medical professional could actually shed some light on this discussion instead of us having to listen to you flame. When is a patient not a candidate for a Spinal or Epidural ? The patient may not be a candidate for these techniques if one is 1) allergic to certain local anesthetics or narcotics, 2) have disease of the nervous system, 3) have a bleeding tendency or coagulation disorder, 4) have an infection of the lower back area, 5) have had previous lower back surgery, 6) have a Spinal deformity, 7) are morbidly obese (very overweight), 8) cannot cooperate or get into the proper position. Any of these things would have ruled out epidural anesthesia for this mom...just something to consider. Any of these factors combined with any number of other factors might have made a c-section very risky for mom here. Unless you were her caregiver how would you know the truth? She did consult a very well respected OB, maybe she got information there regarding her risk level that made her decide the way she did. Really, who knows? |
Anonymous
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. ******* Exactly...it does not always offer the perfect outcome. Nobody has a crystal ball which is the point here. FTR...he was born at 38 weeks which, according to the ACOG, would have been too early to schedule a c/s. Voila...the "no head entrapment" statement is wrong. There are *no* absolutes and no guarantees. I wish people would stop making such statements. |
Anonymous
First, they don't even put you under full anesthesia for a c-section. Second, if she would normally risk out of a c-section, don't you think that a really top-notch high-risk OB would be able to control for this? Or make better attempts to control for this than an illegal, rogue CPM delivering high-risk babies at home? I mean seriously? You sound like a buffoon. Some of these hypotheticals people are discussing are just ridiculous. The decision to just take your chances on your kitchen floor in this situation just seems absolutely nuts. No PP, YOU are ridiculous. Are you an OB, a doctor, or any other type of birth professional? Do you know more than the rest of us about this case? No? Then take a pill. There are all kinds of reasons docs advise against c-sections for certain women, like I said: I don't know what really happened here, you don't either. When you assume, you only make and ass of yourself. Perhaps a medical professional could actually shed some light on this discussion instead of us having to listen to you flame. When is a patient not a candidate for a Spinal or Epidural ? The patient may not be a candidate for these techniques if one is 1) allergic to certain local anesthetics or narcotics, 2) have disease of the nervous system, 3) have a bleeding tendency or coagulation disorder, 4) have an infection of the lower back area, 5) have had previous lower back surgery, 6) have a Spinal deformity, 7) are morbidly obese (very overweight), 8) cannot cooperate or get into the proper position. Any of these things would have ruled out epidural anesthesia for this mom...just something to consider. Any of these factors combined with any number of other factors might have made a c-section very risky for mom here. Unless you were her caregiver how would you know the truth? She did consult a very well respected OB, maybe she got information there regarding her risk level that made her decide the way she did. Really, who knows? but which of these circumstances would make a home birth (with one of these high risk complications) less medically risky than a hospital c/s? As a CNM I would never want to be AT HOME with a patient with an active infection of the lower back, or a bleeding disorder, or a spinal/pelvic deformity, or someone who is morbidly obese, etc. |
Anonymous
Really doubt that both BirthCare and medical community would both have recommended a C-Section if it represented a particular danger to the mother, or one superior to the benefits of the baby. I do agree that chasing after very specific definitions of "ideal" births CAN lend itself to losing sight of the baby's safety. It won't be magical, it won't be painless, it won't be miraculous. The feeling of holding your child is - hospital or not. Very different. |
Anonymous
I'm not a big fan of c-sections, but I think what you are missing is the fact that more high risk women have c-sections than vaginal births, so it would make sense for more women who have had c-sections to die than women who birth vaginally. When you have no problems with the pregnancy and no problems during delivery (I've had 3 such low risk pregnancies and deliveries), a c-section isn't even muttered. Why would it? Things progress as planned (i.e., spontaneous labor, some pushing, healthy baby). While many people don't want to admit it, OBs generally do NOT push c-sections on low-risk women. While reasonable people can debate whether things like frank breech should automatically mean a c-section, posters like the one I'm quoting seem to be missing the reality that many high-risk women (rightly or not) have c-sections. These women may be high risk for reasons totally unrelated to the baby, but due to simply being pregnant (e.g., overweight women, gestational diabetes, etc.). I have to admit, I really don't get the argument from people - knowing what we do from press reports - that either this women or her baby were just as likely to die from a c-section. I think arguments like that don't help the home birth movement any b/c it does make you seem totally irrational and more interested in the birth experience than in the outcome of such experience. |
Anonymous
What the article is suggesting is that the US could lower their death rates surrounding birth by: -Adopting universal health care - thus lowering and better managing chronic problems and free prenatal care for all lowering mother's and baby's morbidity and mortality -Improving public health - lowering rates of obesity and access to medical care for all to manage diabetes, hypertension etc. that can lead to pregnancy problems needing c-sections, and increasing overall perinatal mortality. -Doing away with the US malpractice system and adopting the European malpractice system: Only true negligence etc is taken on by lawyers and allowed to go forward, no frivolous lawsuits allowed and payout caps, thus drastically lowering malpractice premiums, and allowing hospitals, doctors, and other providers a more diversified approach, take on more risk, and lower c-section rates, therefore also lowering repeat c-section rates and VBAC rates, each with their own set of problems Their comparison is Sweden. Ahhh, the LA Times, such a liberal paper... (not that there's anything wrong with that). Dear fellow Americans: You can't have your cake and eat it, too. Do you want to live where your OB or other provider will attempt statistically riskier maneuvers and courses of action (and thus be better trained at it through volume performance and demand) in a friendly environment or do you want to be able to easily sue your provider? Do you want access to good free medical care and prenatal care for *everyone*, but accept that every once in a while your tumor may be found later or your appendix may burst occasionally -with or without a bad outcome-, because not every abdominal pain and headache get a CT or an MRI immediately, and no, you will not get a multimillion dollar payout for that? Please vote accordingly at your next chance! Disclaimer: I have exaggerated here on purpose. But it's something to think about, is it not? |