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

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:!!!! This is awful. Would love more details.

Why is it awful if it is illegal?

Because women have a right to choose whatever care provider they want. They have a right to choose anyone or a right to choose no one. Should they choose someone to tend to their homebirth they should not have to worry that the provider will hesitate to transfer if necessary due to being afraid of prosecution.

If this is what you want then you should go to a state where this is legal. Just because you think you are entitled to everything you want doesn't mean that you are. She knew that she was breaking the law and now she can reap the consequences.

[Anonymous]

Anonymous wrote:When I was planning for a birth center birth, I had to sign a document stating that I was aware of the risks (some of which were spelled out in the document itself). I assumed that this would lessen the midwives' liability in the event that something did go wrong.

CPMs are the only licensees in Virginia required to disclose their malpractice insurance status, hence that in your paperwork.

[Anonymous]

Anonymous wrote:

Anonymous wrote:When I was planning for a birth center birth, I had to sign a document stating that I was aware of the risks (some of which were spelled out in the document itself). I assumed that this would lessen the midwives' liability in the event that something did go wrong.

CPMs are the only licensees in Virginia required to disclose their malpractice insurance status, hence that in your paperwork.

These were CNMs, not CPMs, and there was nothing in the document about malpractice insurance--just a statement that I understood the risks.

[Anonymous]

I feel this discussion has been all over the place but overall very helpful and informative. There more I learn, the more I realize that I didn't know.

People interested to learn more about this issue should check out a blog operated by a former OB:

http://skepticalob.blogspot.com/

[Anonymous]

Dr. Amy Tuteur is an anti home birth zealot. I would take all of her postings with a grain of salt.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Practicing midwifery with no insurance is putting her own family's financial well-being on the line - not a decision which makes her look very responsible. Carrying insurance doesn't mean you're expecting to be sued, it means you're protecting your family.

At an extra $1-2K/birth? When people are already calling around to other midwives for the cheapest fee? It would put the midwives out of business.

Do people really choose midwives because they are cheaper than OB's? It might add to the price of the birth, but it's the responsible thing to do.

I could be mistaken as I only see an OB and deliver at the hospital but my insurance does NOT pay for homebirth. From my understanding, a homebirth can cost around $5,000-$6,000 which I don't believe qualifies for HSA spending so it's purely out of pocket. According to the paperwork I signed at the OBs office, their service including delivery is around $3300 which does not include the hospital stay or epidural. I don't think if you're having a homebirth it's because of cost, it's more for the birth journey.

[Anonymous]

Anonymous wrote:Dr. Amy Tuteur is an anti home birth zealot. I would take all of her postings with a grain of salt.

Amen. Going to Dr. Amy for unbiased information is as futile as watching Fox News for the same.

Although, there was a very interesting discussion in which she participated on The Unnecesarean a few months ago. It, like the discussion we have been having here, centers around what is an acceptable level of risk when it comes to birth, and how we perceive risk. These are very individual questions, and I believe we should, in a free society, have the right to make these decisions for ourselves. Dr. Amy's contention was essentially that our society has decided for OBs that the level of acceptable risk is zero, e.g. that any number, no matter how high, of unnecessary c-sections is acceptable in order to save one baby. Which is why most of them err on the side of surgery if faced with an ambiguous situation. Many people disagree with this approach, however.

Some women will always choose to give birth at home. Some will choose to give birth unassisted. Even though these may not be decisions that I personally would be willing to make, I think it is very important that we as a society maintain the freedom to make those decisions, and to individually take responsibility for them. People can decide what they consider "safe enough" for them and their families ... we do this every day in many contexts. There is great diversity of opinion on the issue of safety in general (e.g., how long do you keep your child rear-facing? do you let your child ride a bike or skate without a helmet? would you leave your child alone in the car for any length of time?). It is tempting to want to impose my view of the world on everyone, but it's probably not a good idea to do so.

[Anonymous]

Anonymous wrote:I could be mistaken as I only see an OB and deliver at the hospital but my insurance does NOT pay for homebirth. From my understanding, a homebirth can cost around $5,000-$6,000 which I don't believe qualifies for HSA spending so it's purely out of pocket. According to the paperwork I signed at the OBs office, their service including delivery is around $3300 which does not include the hospital stay or epidural. I don't think if you're having a homebirth it's because of cost, it's more for the birth journey.

Homebirth is a medical expense that is indeed eligible for HSA dollars.

Regarding the costs of a hospital stay, note that insurance companies get huge price breaks from hospitals. If you're paying out of pocket, you're usually paying list price, which can be a lot higher. (I looked for estimates but found ranges between $420 and $2500 per day, so I won't attempt to generalize.)

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Practicing midwifery with no insurance is putting her own family's financial well-being on the line - not a decision which makes her look very responsible. Carrying insurance doesn't mean you're expecting to be sued, it means you're protecting your family.

At an extra $1-2K/birth? When people are already calling around to other midwives for the cheapest fee? It would put the midwives out of business.

Do people really choose midwives because they are cheaper than OB's? It might add to the price of the birth, but it's the responsible thing to do.

I could be mistaken as I only see an OB and deliver at the hospital but my insurance does NOT pay for homebirth. From my understanding, a homebirth can cost around $5,000-$6,000 which I don't believe qualifies for HSA spending so it's purely out of pocket. According to the paperwork I signed at the OBs office, their service including delivery is around $3300 which does not include the hospital stay or epidural. I don't think if you're having a homebirth it's because of cost, it's more for the birth journey.

Many health insurance policies will pay for homebirth services as an out of network provider. Some do have an exclusion -- it depends on the company and the policy. Home birth in this area is more like $2500 to $4000 if you pay for it entirely out of pocket. The hospital stay is the most expensive part of an OB-attended birth, so even though the OB's fee is similar to a midwife's fee, the total cost is still much higher. If you have no insurance and are paying entirely out of pocket, home birth is absolutely less expensive. That is not why most people choose it, though. For anyone with insurance, home birth will likely cost more than hospital birth unless you have a very high deductible. The snarky comment about the "birth journey" is unnecessary. People have many reasons for choosing to give birth at home with a midwife. This article can provide some insight. http://www.medscape.com/viewarticle/589062

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Practicing midwifery with no insurance is putting her own family's financial well-being on the line - not a decision which makes her look very responsible. Carrying insurance doesn't mean you're expecting to be sued, it means you're protecting your family.

At an extra $1-2K/birth? When people are already calling around to other midwives for the cheapest fee? It would put the midwives out of business.

Do people really choose midwives because they are cheaper than OB's? It might add to the price of the birth, but it's the responsible thing to do.

I could be mistaken as I only see an OB and deliver at the hospital but my insurance does NOT pay for homebirth. From my understanding, a homebirth can cost around $5,000-$6,000 which I don't believe qualifies for HSA spending so it's purely out of pocket. According to the paperwork I signed at the OBs office, their service including delivery is around $3300 which does not include the hospital stay or epidural. I don't think if you're having a homebirth it's because of cost, it's more for the birth journey.

Many health insurance policies will pay for homebirth services as an out of network provider. Some do have an exclusion -- it depends on the company and the policy. Home birth in this area is more like $2500 to $4000 if you pay for it entirely out of pocket. The hospital stay is the most expensive part of an OB-attended birth, so even though the OB's fee is similar to a midwife's fee, the total cost is still much higher. If you have no insurance and are paying entirely out of pocket, home birth is absolutely less expensive. That is not why most people choose it, though. For anyone with insurance, home birth will likely cost more than hospital birth unless you have a very high deductible. The snarky comment about the "birth journey" is unnecessary. People have many reasons for choosing to give birth at home with a midwife. This article can provide some insight. http://www.medscape.com/viewarticle/589062

My comment on the birth journey was not intended t be snarky. Sorry if I offfended!

[Anonymous]

I could be mistaken as I only see an OB and deliver at the hospital but my insurance does NOT pay for homebirth.

Mine does, and they are generally cheap about paying for things. All of the Birthcare providers are covered.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Dr. Amy Tuteur is an anti home birth zealot. I would take all of her postings with a grain of salt.

Amen. Going to Dr. Amy for unbiased information is as futile as watching Fox News for the same.

Although, there was a very interesting discussion in which she participated on The Unnecesarean a few months ago. It, like the discussion we have been having here, centers around what is an acceptable level of risk when it comes to birth, and how we perceive risk. These are very individual questions, and I believe we should, in a free society, have the right to make these decisions for ourselves. Dr. Amy's contention was essentially that our society has decided for OBs that the level of acceptable risk is zero, e.g. that any number, no matter how high, of unnecessary c-sections is acceptable in order to save one baby. Which is why most of them err on the side of surgery if faced with an ambiguous situation. Many people disagree with this approach, however.

Some women will always choose to give birth at home. Some will choose to give birth unassisted. Even though these may not be decisions that I personally would be willing to make, I think it is very important that we as a society maintain the freedom to make those decisions, and to individually take responsibility for them. People can decide what they consider "safe enough" for them and their families ... we do this every day in many contexts. There is great diversity of opinion on the issue of safety in general (e.g., how long do you keep your child rear-facing? do you let your child ride a bike or skate without a helmet? would you leave your child alone in the car for any length of time?). It is tempting to want to impose my view of the world on everyone, but it's probably not a good idea to do so.

I have said it before in this discussion (30 something pages ago) and this is exactly how I see it. I would not try breech birth at home myself but I would not take away another woman's right to do so. This includes the right to choose the birth attendant that she wants. Also, I don't see it as an unreasonable risk although there was a very sad outcome in this particular case. The chance of dying or being seriously injured in a car accident during your lifetime is much higher than the chance of losing a singleton baby or seriously injuring a baby during a vaginal breech birth. I do not believe in allowing our government to micromanage us to the point where they make important medical decisions for us. I do feel awful about the baby who passed away. It makes me so sad but that doesn't change the fact that it would be wrong to take away a mother's right to make the decision to have a homebirth if she finds the risk level acceptable for her own family.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Dr. Amy Tuteur is an anti home birth zealot. I would take all of her postings with a grain of salt.

Amen. Going to Dr. Amy for unbiased information is as futile as watching Fox News for the same.

Although, there was a very interesting discussion in which she participated on The Unnecesarean a few months ago. It, like the discussion we have been having here, centers around what is an acceptable level of risk when it comes to birth, and how we perceive risk. These are very individual questions, and I believe we should, in a free society, have the right to make these decisions for ourselves. Dr. Amy's contention was essentially that our society has decided for OBs that the level of acceptable risk is zero, e.g. that any number, no matter how high, of unnecessary c-sections is acceptable in order to save one baby. Which is why most of them err on the side of surgery if faced with an ambiguous situation. Many people disagree with this approach, however.

Some women will always choose to give birth at home. Some will choose to give birth unassisted. Even though these may not be decisions that I personally would be willing to make, I think it is very important that we as a society maintain the freedom to make those decisions, and to individually take responsibility for them. People can decide what they consider "safe enough" for them and their families ... we do this every day in many contexts. There is great diversity of opinion on the issue of safety in general (e.g., how long do you keep your child rear-facing? do you let your child ride a bike or skate without a helmet? would you leave your child alone in the car for any length of time?). It is tempting to want to impose my view of the world on everyone, but it's probably not a good idea to do so.

I have said it before in this discussion (30 something pages ago) and this is exactly how I see it. I would not try breech birth at home myself but I would not take away another woman's right to do so. This includes the right to choose the birth attendant that she wants. Also, I don't see it as an unreasonable risk although there was a very sad outcome in this particular case. The chance of dying or being seriously injured in a car accident during your lifetime is much higher than the chance of losing a singleton baby or seriously injuring a baby during a vaginal breech birth. I do not believe in allowing our government to micromanage us to the point where they make important medical decisions for us. I do feel awful about the baby who passed away. It makes me so sad but that doesn't change the fact that it would be wrong to take away a mother's right to make the decision to have a homebirth if she finds the risk level acceptable for her own family.

Someone once said that "Your right to swing a fist ends at the tip of my nose." We have the right to own guns too. But when someone is reckless with their gun and someone innocent ends up dead, someone must pay the price.

[Anonymous]

Anonymous wrote: I have said it before in this discussion (30 something pages ago) and this is exactly how I see it. I would not try breech birth at home myself but I would not take away another woman's right to do so. This includes the right to choose the birth attendant that she wants. Also, I don't see it as an unreasonable risk although there was a very sad outcome in this particular case. The chance of dying or being seriously injured in a car accident during your lifetime is much higher than the chance of losing a singleton baby or seriously injuring a baby during a vaginal breech birth. I do not believe in allowing our government to micromanage us to the point where they make important medical decisions for us. I do feel awful about the baby who passed away. It makes me so sad but that doesn't change the fact that it would be wrong to take away a mother's right to make the decision to have a homebirth if she finds the risk level acceptable for her own family.

What if groups decided othorped surgeons as a whole were a biased group like the OBs are painted to be by many Home Birth advocates here, who base their decision on a generalization of the profession itself? Would it sound reasonable for "specialists" who are not doctors to suddenly perform "home amputations"? No, right? B/c we draw a line somewhere between a natural act (birth) and surgery. The problem is "where do you draw the line", and as a free but REGULATED society where laws are meant to protect people, many won't agree with where to draw that line, and laws can only protect the dumbest via the most educated. Also, your own post suggests an argument. You compare chances of a deadly carwreck with a singleton birth. Since you specified "singleton", I assume you accept the medical stance that any multiples represent increased risk and you'd draw a certain line there. Many would have drawn it with this woman's advanced age / breech baby / first-time birth.

[Anonymous]

What if groups decided othorped surgeons as a whole were a biased group like the OBs are painted to be by many Home Birth advocates here, who base their decision on a generalization of the profession itself? Would it sound reasonable for "specialists" who are not doctors to suddenly perform "home amputations"?

Midwives do not perform home c-sections so the analogy with "home amputations" does not find. Many people seek out physical therapists or even chiropractors instead of orthopods all the time.