Midwifery in our Region
A midwife in our region recently pled guilty to two felony counts in the death of a baby delivered at home. The case re-ignited a longstanding debate about "natural" versus "medicalized" birth. The American College of Obstetricians and Gynecologists note increased risks for both baby and mother in home deliveries. Natural birth proponents point to complications from hospital interventions that are often avoidable. We'll explore the debate.
Guests
Certified Nurse Midwife (CNM), co-founder of the Metro Area Midwives and Allied Services
Attending OB-GYN physician at Washington Hospital Center.
Certified Professional Midwife; Public Relations director for the “Commonwealth Midwives Alliance." On Board of the North American Registry of Midwives (NARM).
chairman of the committee on obstetrical practice at the American College of Obstetricians and Gynecologists [ACOG];Professor and Chairman, Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis
Comments
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My heart goes out to the parents whose baby died. I am a mother of two children both born safely at home (in San Francisco) with the assistance of a midwife, and am also a certified nurse-midwife currently practicing in the metro area.
Typically after an event like this, there is a predictable debate about studies that show home birth is not safe. The fact is that studies and statistics, none of which are perfect, will not make women who want to give birth in a non-hospital environment suddenly change their minds. I see first hand that sometimes women's choices about birth are not always made on a strictly rational basis.
There are two ways to maximize a baby's chances for a safe, normal birth: support local birth centers staffed by midwives who are trained to recognize emergencies and have access to hospitals when they need them, and offer care by midwives inside hospitals, where over 95% of babies are born, so that women who want support for birth without unnecessary interventions can be attended to by midwives, who are experts in normal birth.
For some families, a good option is a freestanding birth center. At Family Health and Birth Center, we have many of the advantages of a home birth: our midwives are skilled in natural childbirth, including water birth, our cesarean rate last year was 3.8% for women initially admitted at the birth center, and we are on call 24/7. We provide birth center services to women who have participated in our education program and have been found to be good candidates for out-of-hospital birth. On the other hand, our Certified Nurse-Midwives also have hospital privileges at Washington Hospital Center, so we can provide total care for many women who are in the hospital, either because they choose to birth in the hospital in the first place, or because they don't qualify for the birth center (e.g. labor before 37 weeks), or because they are transported during labor. In addition, we have ready access to a team of excellent physicians should the need arise. With this combination of services, the goal of our programs is to create birthing choices for healthy women with healthy babies, but also to provide additional support where necessary. Although we do not offer home birth ourselves, we do accept transfers from some home birth practices and also from another birth center. Unlike many areas of the country, the District is fortunate to have many good choices for childbearing women.
Cynthia B. Flynn, CNM, PhD
General Director, Family Health and Birth Center
I was a homebirth transfer, ended up with a c-section, in one of our wonderful area hospitals, so this is a big issue with me. Luckily both me and my son are doing very well, but I would never try this again.
In my reading since, I found that Dr Amy Tuteur brings up some good points about safety statistics gathered by MANA (Midwives Alliance of North America). This large database was supposed to show comprehensive safety statistics for homebirth, but now they won't release the data unless you sign a confidentiality agreement and promise to use the statistics only for the advancement of midwifery.
This is alarming to me. I believe in informed choices, and I question that the homebirth community is really being completely honest and forthright with women. I would think if the data confirmed the safety of homebirth, the midwives would be issuing press releases, so I can only imagine what they found.
http://skepticalob.blogspot.com/2009/11/homebirth-midwives-dont-want-you...
I've been lucky to have had three healthy children. Two were born in the UK with midwives at hospitals/birth centers (doctors are part of the process only if a problem arises); and one right here in my home in Maryland. My BEST experience was the last. Had any complications shown up, I'd have been the first to go to hospital, and I'm 100% sure that my midwives would have supported me and perhaps even held my hand as I walked through the doors.
For those home birth naysayers, imagine not having to trek into a doctor's office for a five-minute, rushed appointment. Instead, someone comes to your home, checks on you and baby, sits to discuss, at length, your health, baby's health, your thoughts, your concerns, and to answer your questions. In which parent-carer situation are you more likely to catch a potential problem? And once baby is born, does your doctor make house calls to check on baby, on breastfeeding, on mom's/family's well being? Of course not. But your midwife will. She'll even trek out after a family dinner in the evening! And yet all that caring and healing will cost far less money than my doctor might have.
To any shareholders of major US health insurance companies I ask: did you get a dividend last year? Was it enough? My provider (aetna) would have covered 100% (no copay) of a birth at Sibley, where I stood a very HIGH chance of a c-section (total costs ranging from $9-20,000+). When I presented them with a cheaper ($4,000) home birth receipt, they covered a mere 60%. Are insurance companies making smart business and caring choices? I'd say no.
Mica in Maryland
Wonderful comments Mica. My homebirth was my best birth as well. My children were born at a birth center (1st one) at AAMC (c-section 2nd child) and at home (VBAC by the midwife in question). My homebirth by far was the BEST all around. Peaceful, calm,spectacular - words that come to mind whenever I think about it. I LOVED it! The cost was MUCH less than with a hospital. My midwife was awesome. She worked with us and made us feel confident that we could have our VBAC at home. Karen projects a calm presence as a midwife and she just has a "way" that words cannot describe. I remeber her saying, quite calmly-yet sternly, after I'd jerked forward after a contraction as the baby was coming out of the birth canal "don't let her do that again" (addressing my doula) I heard it and knew I had to remain still for my baby's safe "landing" (I was on hands and knees), that was enough to calm me and bring me back to focus on the task at hand. My homebirth VBAC felt like the greatest accomplishment I'd ever made in my life and I have Karen to thank for that feeling for the rest of my days.
My heart goes out to the parents and the midwife involved in this case.
Midwifery care for prenatal, labor and delivery, and postpartum is a safe way for a low risk woman to birth her baby in the US. It should be legal and made available in this country to anyone who chooses it.
In most countries OBGYNs are used for high risk pregnancies, not low risk pregnancies. The US is ranked 50th for maternal mortality. That means 49 other countries in the world have better out comes than the US with lower maternal mortality rates, less women dying during or after childbirth. 13 per 100,000 women die during childbirth in this country and most of those births are in a hospital. The US spends the most money of any country for pregnancy care. Most hospitals make most of their money from the labor and delivery section of their facilitiy. It brings them the most money.
In this country many OBs never even have the experience of a vaginal breech birth and don't know how to assist during one. Many of these mothers don't want c-sections and want to delivery vaginally. Studies show that in many cases vaginal birth is safe for breech and twin deliveries, and outcomes are better for mother and baby. However, in the US this is rare. All trained birth assistants need more training to offer women alternatives to c-sections for breech presentations and twin deliveries, whether at the hospital or at home. There are very few Doctors who offer vaginal delivery options for women with twins or breech presentations.
In Northern Virginia, some hopsitals have c-section rates as high as 42%. In my opinion, this is outrageous. Studies recently showed VBAC is safe for most women. Why are doctors not offering this to women and better yet changing their protocals and telling women that it is the safer way to birth their babies? Ask a doctor what the charge is for a c-section in this area. It is around $20,000-$30,000.
I personally had my baby with a midwife out of hospital. The care I received for my 17 hour labor was superb and the support and love I received helped me labor naturally and birth a beautiful healthy baby. I knew I would not receive the same care in a hospital nor with a my prior OBGYN who mocked my choice to birth with a midwife out of hospital. His visits were 15 mins in length and he had little time for my questions. When I asked him what was his c-section rate, he was put off and when I asked him how many natural childbirths statistically his patients had he said 5%. 95% received epidurals! This was unacceptable care for my. He wasn't skilled nor trained in asssiting me in natural childbirth. My prenatal visits with my midwife were an hour long and sometimes longer if I had many questions. I was never rushed nor doubted of my abilities to birth naturally.
Drugs during labor: Are they really safe? Where are the studies that prove all of these drugs during labor are safe for the baby?
My birth cost $3,950 including all prenatal appointments. Some women are choosing not to succomb to the scare tactics and ways of the world of obstectrics. We are fighting through the fear propaganda that the OBs are spreading and we are choosing to go back to the way women were meant to birth their babies, naturally with the support of trained and skilled birth attendants and the love of our families. We are choosing not to have the Obstectric way of care because it often creates more complications than natural childbirth.
Here are 80 sources of studies showing the safety and benefits of homebirth and out of hospital births from MANA (Midwives Alliance of North America). For most women, out of hospital birth with a trained skilled midwife is a safe alternative. All women should have this option. OBs and Midwives in the US should learn to work together to offer everyone these options to the women who want it. OBs need to stop being threatened by out of hospital birth and start looking at their numbers and the numbers of women who are dying in the hospital not from birth but from the massive complciations due to the many procedures, surgeries and drugs the hospitals use as "routine" care.
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I feel terrible for the parent who lost their child. It is a sad and painful experience that no one should have to go through.
I just gave birth last week and used a midwife at a local Va hospital. I must say that throughout the pregnancy, my midwife gave me more information than the doctors. When the doc office said I was going to have a 11 pound frank breach baby, and had to schedule surgery, the midwife gave me techniques to turn the baby and to birth the baby in the hospital med free. And the baby was not 11 pounds but 9 pounds.
Midwives tend to share more info to woman and treat pregnancy as a usual biological routine procedure while docs consider pregnancy a medical procedure that needs lots of interference.
If the the homebirth community was serious, that they'd be investigating cases of midwife misconduct to ensure that homebirth was as safe as possible. Instead, they rally behind the charged midwife and the truth doesn't matter. Their attitude, when it suits them, is babies die.
I find it hard to believe that they feel Karen Carr delivered 1200 babies fine and only caused the death of one so she's a hero. If you drive drunk 1200 times and only kill someone on the 1201'st time, you're still a drunk driver.
Doctors, not Midwives, are responsible for the growing homebirth movement. The time of labor and birth are the most vulnerable times in a woman's life, and too often in a hospital they are emotionally bullied into unnecessary c-sections - because their Doctor is impatient, is afraid of a lawsuit, or is just unaware of natural ways to resolve common situations, such as "failure to progress" that arise during labor without resorting to medical interventions. If women could receive the same respectful, caring treatment from the medical establishment that they do from midwives, so many of them would not go "underground."
This issue at hand is far more than the issue of safety. Stats can be made to look any way you want.
The issues is if a woman has a right to decide where her child is born and who is there to catch the baby. If a women has the right to have her birth where she wants and with who she wants then it really doesnt matter what Doctors or Homebirthers say or what studies they quote.
However if a doctor has the right to force a woman to have her birth in the hosptial either thru Laws or the lack of legal safe options... then what medical rights do any of us really have.
My wife had our son at home, with two midwives and myself. We had the most amazing experience and I cant imagine we will ever have a baby at a hosptial unless there is a high risk that occurs or the Midwives suggest it.
Maryland for Midwives would like to see Certified Professional Midwives licensed in Maryland to provide a safe option for women who want to have a birth in a birth center or in their home.
For women who feel more comfortable in a hospital... I would hope you have a safe and wonderful birth experience. Midwives are only going to make hospitals better and more accomidating for you by providing competition to Hospitals... Something ACOG, and OB's dont like and will never support.
Jeremy Galvan
Maryland For Midwives
md4midwives@yahoo.com
Waiting 33 minutes to call 911 after the delivery went wrong is criminal. The midwife industry scares women away from qualified medical care. Karen Carr made $3,200 per birth and delivered over 140 babies last year. This is for-profit health care with no education and no regulation.
Waiting 33 minutes to call 911 after the delivery went wrong is criminal. The midwife industry scares women away from qualified medical care. Karen Carr made $3,200 per birth and delivered over 140 babies last year. This is for-profit health care with no education and no regulation.
I had three children with Physicians and Midwives Associates practice out of Alexandria, VA. They were wonderful, and because I had 3 low-risk pregnancies, that worked for me, also, as I was there for basically 5 years, I created a relationship with them, that made it worth the 40 minute drive to get there. I also liked that I gave birth in a hospital, and in case of emergency, there was a doctor nearby, who could help, who was familiar with me and my history. And, thankfully, I never needed them.
That aside, some women don't have problems in pregnancy, and for those women, they should have the opportunity to opt-out, so to say of the medical establishment and leave the doctors for those who need them. My heart goes out to the family who lost their baby, but, I also have multiple friends who successfully were able to deliver at home, and deliver healthy babies.
I had three children with Physicians and Midwives Associates practice out of Alexandria, VA. They were wonderful, and because I had 3 low-risk pregnancies, that worked for me, also, as I was there for basically 5 years, I created a relationship with them, that made it worth the 40 minute drive to get there. I also liked that I gave birth in a hospital, and in case of emergency, there was a doctor nearby, who could help, who was familiar with me and my history. And, thankfully, I never needed them.
That aside, some women don't have problems in pregnancy, and for those women, they should have the opportunity to opt-out, so to say of the medical establishment and leave the doctors for those who need them. My heart goes out to the family who lost their baby, but, I also have multiple friends who successfully were able to deliver at home, and deliver healthy babies.
This isn't about women's bodies....this is about a woman who killed a baby. Why can't people separate the two? She's now being investgated for the death of another baby. She administered drugs without a license. Per the Washington Post article she left the baby stuck for 20 minutes and then tried to revive the baby for 13 minutes before calling 911.
I love that the lady on the show supports women having choices for their births. This is not about that. It's about one woman who over sold her abilities for profit and killed a child.
This is like gun rights people who support guns no matter how many people die when someone uses one. This women are the NRA of the birthing community.
Bad things happen? Bad things like waiting 33 minutes to call 911? Really? Saying bad things happen excuses the inaction at a time of crisis. And to say you bring everything in your car that would be in a hospital implies you have a doctor in your car.
So this woman delivered a baby with a midwife with no training? I hope you put your child in a school where the teacher has no training. That your child take swimming leasons from a person who can't swim. This is just absurd!!
I had a baby die due to homebirth. I later found out that the midwife had gotten in trouble MULTIPLE times and I had no idea, none. My baby is dead because nobody would hold her accountable. Midwife organizations don't care about outcomes, at all. Check out the site Hurt By Homebirth.
This discussion isn't solely about the sad death of a baby in Virginia. It's about childbirth in this area. No one in the studio is able to comment on the specifics of the Karen Carr case.
Mairi didn't say that she brings everything in her car that would be in a hospital but everything that would be in a BIRTHING CENTER. ACOG says birthing centers are okay but not birthing at home. The point that was being made was that when a woman has a birth at home with a midwife the circumstances are THE SAME as in a birthing center so ACOG is not being consistent in its policies.
When you have something going wrong and you need access to medical techonlogy...YES, that's great. In this case Karen Carr waited 33 minutes to access that medical care.
I just wanted to mention that the ACOG Dr. has stated several times that women need choices for labor and delivery. However, one problem with hospital births is that women have so few choices once they are checked in at the hospital. Women do not get to choose in the hospital how their labor is monitored or the positions used for birthing. If a woman has had a previous c-section, or has a breech presentation, or is deemed too old, or the labor continues for what a doctor considers to be too long, then women are not given a choice to avoid c-section -- even when a vaginal birth is possible or perhaps even preferable for the individual.
Our country seems far removed from the idea that women's bodies are designed to give birth. It is disappointing that the medical communitiy continues to call women "patients" when arriving in a hospital for a birth. That assumes there is something WRONG that needs medical intervention from the outset. The role of the medical staff should be to assist a mother in helping to have a safe and healthy birth, not to dictate the process. The process of interventions is a very slippy slope that leads to our excessively high Cesarean section rate.
Part of the conversation that seems to be missing is providing the medical community with familiarity with natural births that have NO interventions. Sad that you can graduate and become an obstetrician without witnessing a natural birth during those years. The fact that we TRAIN doctors that they MUST intervene is a huge part of the problem.
My mother naturally delivered 3 of her 14 children as breech deliveries. Nowadays WHO in the medical community (beyond midwives) has witnessed a natural BREECH birth successfully delivered?? We need communciation both ways- the medical community needs to BE TRAINED IN HOW TO ASSIST MOTHERS WITH NATURAL BIRTH AND TO WITNESS BREECH BIRTHS BORN NATURALLY...and midwives need thorough awareness of medical processes that can be implemented in emergency situations.
It is long overdue for our nation to honor woman by empowering them to birth babies naturally when possible.
Christina - proud mom of 2 children born naturally outside of hospital settings
We should start a group for families who lose babies because of bad midwives and hold them accountable
Concerned, we are reaching out to other families going through what we have. As for having midwives held accountable, we speak out about them. Until organizations are willing to hold them accountable or prosecutors (along with police) are willing to do more, there isn't much we can do aside from sharing names and experiences. We also have to fight the homebirth community. It's a battle.
This is an industry. $3,200 per birth times 150 births a year. That's a lot of money. This whole who is about protecting this industry. So what if this poor baby died because she waited 33 mintues to call real medical care. Don't worry about that, just protect this midwife industry. SAD
ConcernedForTheBaby,
You have the choice to call a midwife or go to the hosptial. This couple in VA made a decision. THEY MADE A DECISION. The midwife used her training and her experience to serve them as they wanted. She did not force them to do anything.
Women should have a choice to either go to the hospital or have their baby at a birth center or at home. Parents should have a choice.
If you disagree with that then go to the hospital and let the Doctors deliver your baby. But that is your choice...
Legalizing Midwives in MD will allow women who want homebirth and birth center birth to have that option. It wont affect those who want to go to the hospital. In fact it will only make it better in Hospitals because the 1% of us who have babies outside of the hospital wont be the hospital taking up your doctors time.
It is always hard to comment on something sad when we were not there and hence we cannot use our own instincts and experience to inform our judgments. As a researcher, I know that throughout medicine sad and tragic things sometimes happen. (If they did not, there would not be the debate raging over medical malpractice insurance). Most of us can think of horror stories, but that does not mean we do not go to trained professionals for help.
Of course, these tragedies have gone down over the years, but if we are being realistic at all, we know there will always be some. Rarely, but sometimes, they are the result of human error. As elsewhere in medicine, through professional peer review professional home birth midwives determine if human error has been made. In short, within their scope of practice, the professionalism and quality of home birth midwives is no different than elsewhere in the medical profession, nor is their approach to self-policing their profession.
The takeaway for all of us is that from a care and public policy standpoint, there are very strong reasons to encourage more use of home birth midwives for normal birth. Outcomes are excellent in industrial countries like ours. Costs are dramatically lower than in-hospital care. Transport is a viable solution for problems and certified midwifes are trained to known when to transport. Certified midwifes also are trained to not take cases which are outside their scope of practice. This does not mean babies will not sometimes die. It does mean that as with physicans as a profession, the profession of midwifry acts responsibly and competently.
If you think this is an industry, you should consider how much the hospitals are profitting by charging WAY more and having WAY more births. It is incredibly sad that this poor baby died. It is always a tragedy when a baby dies. Babies die in hospitals, too, but you don't hear about it. The only reason you're hearing about this case is because it's extremely rare. And this midwife is extremely qualified, attending over 1200 births! She will definitely be held accountable for any misjudgements she made, although the bulk of the responsibility lies with the parents. Everyone was well aware of the risks. Sadly, all people involved will be scarred for the rest of their lives and I feel for all of them. The parents, who may never have a baby now, and the midwife, who may be severely punished for trying to help, will never get over this experience. I suggest you read up on midwifery, watch "The Business of Being Born", etc. I think you will change your mind about the practice as a whole. It might not be for you, but other women should have this choice. I had a homebirth in Nov that went extrememly well. I probably wouldn't have chosen a homebirth if my baby was breech, but most people who do have good outcomes.
Not only did a family lose their child but I fear that this case and the backlash will result in women and families in the DC area having even fewer birth options than they currently do. Based on my own experience in a large OB practice and my background in health policy, I knew that I did not want to be treated like a number and that I did not want my pregnancy and my son's birth treated as a medical illness. I was extremely fortunate to have had an uncomplicated pregnancy but also fortunate to have been introduced to an amazing midwife, Whitney Pinger, who had extremely compelling birth statistics, a large following of happy mothers and fathers and an outstanding professional reputation among fellow midwives and OB's alike. Choosing Whitney, a CNM, meant that I would be delivering in a hospital and to me, that gave me the best of both worlds - a seasoned evidence-based practicioner to help guide me through my pregnancy, to support my husband and I during the birth of our son and a seasoned medical professional whom I was confident would not push unneccessary medical interventions on me and who carried with her all of the resources that come with delivering in a well-equipped hospital in the event that interventions were necessary. My pregnancy and the delivery were some of my best experiences in my life. As my care provider, Whitney provided many things, the most important of which was the feeling of empowerment and knowledge that women intuitively know how to give birth to their babies and that health care providers need to be there as resources for the mother and the baby. So much of the medical profession is about moving quickly from patient to patient, scheduling procedures to make outcomes more predictable and the preverse financial incentives that make more tests and more interventions more lucrative for providers. Just as all physicians are not of the same calibur, there is a huge range of the quality of services that midwives are capable of providing. My hope is that the family can find their way through this devastating loss and that the DC region explores how to offer more options for personalized birth experiences safe and accessible to all women. I'm so fortunate to have people like Whitney Pinger to help guide me through the journey of pregnancy and delivery - if there were more resources like her, DC birth outcomes and experiences would be greatly enhanced.
maryland for mi --- That's right. This couple had a choice. The chose someone who promised to deliver the baby knowing it was breach. Someone who promised that she would call 911 if there was a problem. Someone who took $3000 for that service and then DIDN'T perform. The baby came out butt first. She should have called right then! Karen Carr played God and a baby died. And she admitted her guilt in court.
I support the right to choose. You seem to be ignoring that this midwife acted disgracefully becuase you want to protect the midwife practice. You can't protect the industry without standards and removing those who are harming others.
jdub57 -- Why does the bulk of the responsibilty lie with the parents? They were sold a bill of goods. Even in today's show there was discussion of how many breach births are done by midwives. You evenn say "but most people have good outcomes." So with all this selling of breach births done by midwives, why shouldn't the parents have believed that? You cant sell a product and then blame people for buying it....unless you're the gun lobby or the cigarette folks.
The midwive is the person in the room making the decisions. She decided not to call 911. The mother can't make decisions right then. The father isn't a doctor. The midwife was the qualified "professional" who took money to make these decisions. She waited 33 minutes to call 911 and wasn't concerned when the baby changed positions during the birth. So tell me why the parents bear the bulk of the responsibilty. I'd really like to see how you're excusing a midwife causing a baby's death.
You can't protect this industry by protecting those in it who are causing harm.
By licensing Midwives in Maryland which is our goal... We aim to establish standards for Midwives in Maryland. Which is the best option for families who want a Midwife for their birth. Unless you were at the home and witnessed the actions of the Midwife I would with hold your judgement.
As someone who has had to work on Babies in Cardiac Arrest in the field I can tell you until you do it you have no business commenting on how a midwife or I conduct ourselves or how long it takes. Midwives like Karen are highly trained and very experienced. Which was why the family contacted her in the first place. If my family needed a midwife I would feel 100% confident in Karens abilities. Her National Certification and years of experience speak volumes.
No midwife makes any kind of promise that there wont be any problems.
And you should make sure your facts are correct before you make a fool of yourself. Speak the truth so that women can be educated about the options they have.
Babies in cardiac arrest or babies in respiratory arrest? As someone who has had to work on babies after the CPMs are done with them, I will not withhold my judgment. What is all of this talk about having to withhold judgment? She made a series of errors, a baby died, and I doubt she will even have to take any remedial training to avoid repeating her errors, much less lose her CPM credential. THAT'S the problem with the CPM credential- there's no accountability to anyone. No matter how many bad outcomes a CPM has, she can just keep on doing things the exact same way, sure in her belief in herself and her skills. If CPMs want to be taken seriously, they need to start policing themselves. Require reeducation when mistakes are made, and revoke the credential of midwives who repeatly injure babies.
I was originally indifferent to homebirth vs. hospital. Then I was a high-risk pregnancy case. Yet, I am healthy and confident in my body’s abilities. I was high-risk but not convinced that I should be terrified, despite the best efforts of doctors to scare me. Knowing that there must be someone out there who could talk reasonably with me, I looked and looked for a practice whose first suggestion was not a c-section, scheduled or otherwise. After a couple of months, I gave up on finding a physician whose focus was in support of vaginal delivery for me (I know you are out there, but at some point I had to stop looking and focus on myself and my babies). I became desperate and turned to homebirth despite pleas from friends and family. The experience was amazing. We came out of it easily and happily and healthily.
I agree that delivery in a hospital with a CNM or delivery in a birth center with access to a hospital provides the best of both worlds. However, when you risk out of these options and you are not convinced that c-section should be the only option, you get desperate. I am now a supporter of homebirth for those who want it. I still would prefer that truly high-risk pregnancies should not opt for homebirth. But I question who is defining “high-risk”. I had twins. Never did I have any indications of a complication or any risky symptoms. Simply because the twin check-box was checked, I was on track for an unnecessary c-section with an OB. I know there are those of you out there who consider me selfish and reckless for not following doctors orders and just agreeing to the c-section given my “high-risk” label.
On a different note, I would hardly call midwifery an “industry”. For my home birth, prenatal care included, it cost $3,200. In the best case, my hospital c-section for twins with three of us staying in the hospital for a minimum of three days would have cost on the order of $50,000 of which I would have had to pay 10%. I ask, who is in this for the money? Not the midwives.
Some things to add to these wonderful comments:
Babies also die in the hospital. It will always eventually happen. Fetal mortality rate is never 0.
Please look into Karen Carr's life before sharing your judgements. She has devoted her entire life to helping women give birth. She has statistically saved hundreds of women from unnecessary cesareans. She was ironically forced to plead guilty to child endangerment when she has tirelessly given and given to support babies coming into this world in the gentlest and safest way possible for many many years. She was highly trained for her job and her retiring is a sad loss to the midwifery world.
There are thousands of horror stories from woman that gave birth in a hospital, and there is never a show done about it.
Yes, women should have the right to choose where and with whom they birth their children. What is wrong with this picture is that MD does not have a licensing program, and when it does get one, it needs to support non-nurse midwives to get the training they will need and to be allowed to carry the safety equipment they need and to be treated like other types of practitioners.
Yes, there are more midwives in hospitals now, however, these CNM's are only allowed to practice under an OB and are subject to all of the OB's rules and regulations, ie early induction, episiotomies, EFM, IV's, etc. They are not allowed to practice a midwifery model of care.
The best benefit to society (however not OB or insurance companies wallets) is for homebirth midwives and hospital OB's to work and collaborate together. When low-risk women go to the hospital all sorts of problems are created for them. However, these facilities and their specialists are needed for high-risk women. An OB is a surgeon. Low-risk women do not need surgeons.
We as a society should be examining why this team work is not allowed to be developed in this country.
La Piranha,
Your right... We need to license CPM's so that there is consistancy and accountability. That is exactly what Maryland for Midwives is working to achieve. If you or anyone else would like to support Legalizing Certified Professional Midwives in Maryland we'd love your help. I will personally answer any questions you have. You can contact me at
md4midwives@yahoo.com
Our organization is working to allow Certified Professional Midwives as an option for women who would like to use them during birth. We believe that by licensing Midwives in Maryland there will be more of them available, there will be accountability, and there will be a standard of care.
Nothing will replace a parents responsibility to research the risks of out of hospital birth vs hospital birth, and to find an experienced Midwife. Just like when you look for a doctor you have to do your homework.
As with anything in the medical world we are judged by the last patient we see. As is happening in VA an experienced Midwife who has served women in the area for years is being judged by one call. One call out of over a thousand. And those judging her were not there at the scene and did not see what happend. We should seek solutions to this problem not thru hanging a midwife... but thru licensing them so that women who wish to have one at their birth can get one who's training has been verified by the state.
If you have any interest in helping to license Midwives in MD contact me at
md4midwives@yahoo.com
Have a great Day,
Jeremy Galvan
Maryland For Midwives
I recently gave birth to my first child at the ripe old age of 39. I hadn't really thought much of how I would give birth until later in the pregnancy when I realized that I was not even being given any choice in the process. As active duty military, I had no choice in where I would have my baby and from the moment I walked into L & D the doctors start trying to herd you into their pipeline which inevitably leads to a C-section. They don't care how YOU, the mother, wants to have her baby, it's all about their convenience and getting themselves a surgery if they can. It was so disappointing to experience first hand what birth has come to in the United States, a miserable, medicalized procedure instead of a natural process that (in most cases) needs very little assistance to be successful.
I am not sure I would be brave enough to try a home birth, but I certainly understand why some women choose to do so. I had an overwhelming sense during labor of just wanting to be left alone to labor in peace, but the doctors and nurses would not allow that. I was constantly being messed with, disrupting my focus on birthing, and making the process very unpleasant. I'm sure many women would choose to birth in a hospital-accessible environment if they could be assured of having their desires respected. Of course no one wants to suffer the kind of tragedy that happened, but I do believe the medical profession is, in part, responsible for this backlash against hospital births. By not respecting the desires of patients, they have created the environment that causes women to choose home birth.
PennyD: Dr Amy Tuteur is not at all an unbiased information source. She's an arrogant, self-rightous bully and well known internet troll, who insults mothers (and indeed Motherhood itself) and states clearly that she hates natural birth. HATES IT! What a peach of an OB she must have been in practice. In case you were at all considering thinking for yourself or believing in your natural abilities, don't worry, she'll set you straight by calling you an f* idiot and reminding you that only an MD is qualified to make health decisions for that disfunctional and pathetic ticking time bomb you call a body.