Another difference between midwives and OBGYNs

…an OBGYN can’t just dump you from care in your third trimester without helping you find a new care provider.  Actual health care professionals have an obligation to do what is best for the patient, and that includes not leaving them to their own devices when they are unlikely to be accepted as a patient by someone else. I found an article about a woman who got abruptly dumped by midwives during her pregnancy, and they refused to help her find a care provider.

The funny thing is, my entire pregnancy had been riddled with series of let-downs and deflated dreams. Getting kicked out by the birthing center was just another hole in the fantasy I’d built about pregnancy. And I did not even end up having the blissful, natural childbirth I assumed I would. In fact almost everything on the well thought-out, seemingly mild birth plan we naively handed to our labor team, went out the window. But interestingly, by the end of it all, I did feel empowered.

 

They knew it was hard to find an OB in the last trimester, but did not do any work to help her.  Could they have dumped her the day before her due date? I’m sure they could have. The problem with this case is compounded by the fact that the mother was suffering from depression and other mood problems. She was extremely vulnerable and the midwives washed their hands of accountability for her care. She was able to stand up for herself and find an OB, but who knows if the next woman will?

vaginal birth complications

Natural child birth advocates constantly push the idea that the risks involved with a vaginal birth are always preferable to the risks involved with a c-section. The risks of a c-section are over stated and the risks of a vaginal delivery are undersold by people advocating ncb. Of course, no one wants any sort of complication, but in reality women have to make a choice and deserve to have accurate information about what can happen in different situations. Here is a story from a mom named Jackie Risnear that had her heart set on a vaginal delivery, and ended up with some serious complications afterwards as a result (shared with permission from the Fed Up With Natural Childbirth group on facebook):

A woman suggested this group to me after refusing about my birth trauma. I’ll post my experience here, not wishing for sympathy, but encouragement.

John Karl was born on October 29th at 9:51 PM, after 16 hours of labor, 3 hours of pushing and a level 4 laceration with vacuum assistance. 

I was induced with a Foley bulb on the night of October 28th. After an hour of the bulb being in place, I could NOT pee and felt like my bladder was going to explode so we went back to the hospital (They wanted me to sleep and come back when it ‘fell’ out) to have my bladder drained. The bulb was sitting on my urethra blocking urine. 

They admitted me, set me up with a catheter and IV fluids and told me I could have pitocin as soon as I wanted to after the bulb came out.

Around 4 am, a nurse came to tug on the bulb and it “Popped” out. 

Contractions were only intolerable around 3 pm, when I asked for the epidural. Around 7, they started to get me set up to push and started to let the meds wear off a bit so that I could feel when to push.

After the second hour of pushing, they called for a surgeon/delivery DR to come and evaluate weather or not I needed aSection. I had my heart set on a vaginal delivery. She said that she would do three sets of three pushes each with a vacuum (knowing I wanted to avoid asec) to get the baby out. 

By the second set of three she told me Johnny was “sunny side up” which meant he was looking out, and his head position was very dangerous. She gave me the option then and there for an episiotomy or asection. I chose the episiotomy, not knowing what future problems would occur.

Four snips and three pushes and my baby was out. I was weeping with gladness from not having to have surgery, and John was put on my chest and began nursing right away. 

In recovery, a nurse told me that I had to have at least 50 stitches because I had been cut vagina to rectum, all the way to my bowels. She called this a vaganus, which made me laugh.

Flash forward to a week later. I felt a rip in the stitches and stool began leaking out of my vagina. To the ER we went, and next afternoon I had it repaired. Three days later, I felt it rip again. The top surgeon in vaginal reconstruction in the DC metropolitan area tore the stitches down, and attempted to repair it again.

For a third time, I felt a rip. This time they admitted me. The DR decided that the only way for this repair to be successful was to open the incision and let the tissue heal completely before reattaching the perineal area. My tissue was tearing away from the stitches “like a wet paper towel”. The pain was so intense that I had an epidural for three days, and a button to push every 6 minutes that shot Diladed into my veins. I was bound to the bed for a week, unable to brush my own teeth, comb my hair, or bathe.

To top it all off, the wound was never going to heal until they stopped my bowels. They did an invasive surgery called an ileostomy that eliminates the entire colon from use and stool is released from a stoma in the front of my abdomen into a bag. Waking up from this operation was horrifying, there was a nurse pressing so hard on my abdomen trying to get the bag to “click” into place. Two days after surgery, I had a blockage and they inserted a tube into the stoma to let my small intestine drain properly. 

I couldn’t take care of my son properly. I couldn’t hold him, because it was too painful. I couldn’t nurse him because my milk dried up after the second operation. (They hadn’t allowed me to eat or drink anything for three days prior to surgery) I developed deep depression and I could barely look at him. 

I was diagnosed with PPD and PTSD during my month long hospital stay. I have to go back in March to have my perineum reattatched and my rectum reconstructed. After that heals I will have my ileostomy reversed and hopefully will be functioning as somewhat normal again.

I have my first therapy appointment on the 15th and have been on anti-depressants for a month. 

I still manage to find joy in my son, however hard it still is to hold him. I planned on breast feeding for the first year of his life but am unable to satiate his hunger and only nurse to comfort him.

The Midwife From Hell

The Midwife From Hell

Another example of midwives worried more about themselves and their fees than moms and babies. Another mom who has so little recourse that she has to name and shame her midwife online to warn others. Another woman who has an indescribable hole in her life and tons of out of pocket expenses that will never be paid. This profession desperately needs legislation.

For every woman who is strong enough to come forward and tell everyone about their ordeal in public, I am willing to bet there are ten more who are too heartbroken or disempowered to do anything about it. 

I offered all kinds of help to the mom before noticing that she has been working hard on getting justice on her own, and has likely done all the things I offered to help with. 

six reasons you shouldn’t listen to the healthy home economist

I was linked to this article today, titled Six Reasons To Say NO to Vaccination. Its a stretch to call these ‘reasons’, but they are great examples of the kind of emotional decision making that is rampant in Natural Child Birth circles. Reason number one:

#1:   Pharmaceutical Companies Can’t Be Trusted

She goes on to list a bunch of things that pharmaceutical companies have done wrong. I agree that there are many problems with the pharmaceutical industry. That is not as evidence that vaccines are problematic.

Last time I went to Ikea I noticed a recall notice for a tea cup. Apparently it can explode if you put something too hot inside the cup.  It would not be reasonable to believe that the entire company makes dangerous products based off the recall of the cup. It would be even less reasonable to assume the entire industry was guilty by association, or that I should be fearful of teacups in general. Each claim and product can be evaluated on its own merit.

#2:   ALL Vaccines are Loaded with Chemicals and other Poisons 

Everything is a chemical. Literally. Its a meaningless descriptor in this context, so is the use of the word ‘poisons’.  She lists ingredients in vaccines, then lists a non-vaccine usage of the ingredient to prey on the fears of people who are ignorant of chemistry.  An ingredient having multiple uses does not prove that it is harmful or poisonous. She also ignores the issue of dosage- the ingredients she is describing are in extremely tiny quantities.

#3:   Fully Vaccinated Children are the Unhealthiest, Most Chronically Ill Children I Know

I don’t really care if the healthiest people I know are vaccinated or not, because it proves nothing about the truth of the matter. I care about finding tangible evidence of vaccines causing ill-health. That is why studies are performed on large numbers of people and with accountability for results and peer review- its what people do when they are interested in finding out the truth.

#4:   Other Countries Are Waking Up to the Dangers of Vaccines – 

If Other Countries jumped off a bridge, would you???

#5:   A Number of Vaccines Have Already Had Problems/Been Removed from the Market 

Again, every vaccine can be evaluated on its own merit. A problem with vaccine A does not mean vaccine B, C, D, etc have the same problem. There is a lot of black and white thinking going on in the post.

#6   You Can Always Get Vaccinated, But You Can Never Undo a Vaccination 

…but vaccines are a preventative measure, so you can’t always get vaccinated in time. There is also the fact that a lot of vaccines wear off and have to be given repeatedly to offer protection. That is a vaccine being ‘undone’ in the sense that it is no longer effective.

 

These are the same people who are constantly telling women to ignore their doctors advice, calling it ‘scare mongering’. Believing that there is a vast corporate and government conspiracy in place to sicken children for profit is seen as a legitimate fear, but contracting a preventable disease is not.  There is considerable overlap between people who are anti-vaccine and pro-natural child birth. This should be a huge red flag to anyone considering using direct entry midwives for their birth. They may believe that vaccines are poison and that they don’t need to be vaccinated (despite working around pregnant women and infants, who could be severely negatively impacted by contracting a disease like influenza or measles).  A midwife at the birth center I went to was not informed about vaccines and seemed to be against them, it was a nagging doubt that I should not have ignored.  It is further evidence that lay midwives are not medical professionals because they are ignorant of and in opposition to preventative medical care. Some will outright tell their patients not to vaccinate their children. Recommendations about vaccines are way outside the scope of practice for a direct entry midwife, so they should really stop.

one difference midwives aren’t willing to sell you

I remember being totally sold on using a midwife for my birth. A direct entry midwive, specifically. They are very eager to tell you about how they are different from the hospital and other health care providers (in terms of philosophy, not safety- they claim they are just as safe). There are some differences that they never alerted me to that I believe all pregnant women should be made aware of.

What midwives won’t tell you is that they do not want to be accountable for mistakes, and that they regard any attempt at making midwives accountable as ‘persecution‘.  They only want their own midwife-run organizations to be in charge of accountability, mainly so that there will be no harsh consequences. Midwives with clearly dangerous practices can simply move from place to place, preying on vulnerable women who would otherwise never be candidates for a home birth.  MANA (midwives association of north america) isn’t even willing to define what “low risk” means, they prefer to let individual midwives decide what that means. Why would individual midwives be better at deciding ‘low risk’ than a panel of experts (even other midwives), based on proper research?

This maverick do-whatever-you-want type of practicing was the norm in medicine for a long time. This documentary is about that era in medicine, specifically about a doctor who was performing hundreds of ethically questionable lobotomies in the 1940s. One patient died because he wasn’t paying attention to what he was doing, he was trying to pose for a picture during the lobotomy. He invented an ice pick technique to simplify the surgery (you can guess that there were no controlled trials in the development of the technique, and that results were mixed).  In those days doctors did not publicly discuss negligence with non-doctors and there were not any real consequences for malpractice.  Luckily, outside organizations and legislators got involved to hold physicians accountable for the outcome of their practices.  Midwifery today is in the era of 1940’s physician accountability: the public has to fight for it, because midwives are unwilling to regulate themselves.

When professional colleagues work together there is a natural tendency to feel loyalty and assume good faith. I understand that, completely. No situation illustrates the tendency of professional colleagues to excuse the inexcusable more than sexual abuse scandals. The catholic church (and countless other religious groups). Jerry Sandusky (and other educational facilities). Teachers and doctors are often defended by colleagues when accused of abuse. And yes, midwives, too.  The dynamic can happen in groups as small as individual families, with one parent ignoring the sexual abuse of their child by another family member. This is why outside accountability needs to exist in professional organizations.

If you need more evidence of midwives banding together when they should be condemning negligence, just look for what midwives have to say about it:

The reality is that if Rowan Bailey is found guilty of murder in North Carolina, then a precedent will be set that a death in a midwife attended birth was found to be WILLFUL murder of a baby.

Don’t talk to me about “But she wasn’t legal” because we all know that midwives hedge their bets on legal. They all do some small thing that is maybe crossing a line or helping someone they shouldn’t “legally” because frankly, the legal system is full of discrimination against healthy women and we all know it.

She is saying that all midwives break the law. They all determine their own guidelines and if they kill a baby or a mother because of the line they decided to cross- oh well. The midwifery community will be there to support the midwife instead of the patient with a dead infant.

For the record, the midwife in question let a woman labor for four days without obtaining any help. Gloria Lemay had this to say:

Shannon, thanks for this important post. I’m always reminded of the words by Angela Davis, “If they come for you in the morning, they’ll be back for me in the afternoon.” We’re all in this together. If one midwife is being bullied, all midwives are being bullied. The bright light of overblown charges is that, of course, they will be reduced. The tragic thing is that it’s akin to taking a baseball bat to a butterfly.

Please everyone, no matter how small, donate as a show of solidarity.

Everyone seems to be ignoring that a baby is dead, and their parents are very much alive and still dealing with the loss caused by negligence.  They forget pregnant women completely when their colleagues are threatened with legal action. When the state is (understandably) angry about a needless death it is “bullying” to use the harshest possible charge against the midwife. What will a midwife call it if you have to pick up a phone and report her?

In defense of midwifery compels people to give money to the legal defense of the clearly negligent midwife. Midwives talk very differently on websites intended only for other midwives. The author has a warning that when YOU (a midwife) attend a perinatal death you don’t want a DA breathing down your neck, right? I mean, unless you have a sense of ethical responsibility and believe perinatal deaths should be investigated!  This is what midwives do when there is negligence- they help each other pay their legal fees, and prioritize each other over patients.

Valerie ElHalta is one of the worst cases I’ve ever seen. When she caused death or injury and the state found out, she simply moved to a state with fewer regulations. She went to oregon, and then to Utah, where she used cytotec and a vaccuum extractor without adequate training. A preventable infant death occurred as a result. The midwifery community did nothing to stop her or warn other people that she had a history of poor judgment. When she was arrested in Utah the community here decided it was persecution, and that a political watchdog committee needed to be formed. defending killer midwves

Midwives will talk your ear off about woman centered care, about respecting choice, and whatever you want to hear… but they won’t tell you that if someone hurts you or your child they will be donating money and time to help the person who wronged you. Its perverse. I am lucky to have ended up on the wrong side of Direct Entry Midwives with my baby alive, but it doesn’t make seeing the defense of needless suffering and death any less infuriating to me.

Leaving NCB

I’ve had absolutely horrible experiences with childbirth, and midwives in particular. (here is a link to the story for anyone who is interested). Luckily my child and I made it out alive, though I was very damaged psychologically by the experience. I may have been damaged physically too, I don’t know for sure because I am too afraid of medical examinations to obtain follow up care. I don’t know when I will be ready.

I’ve had a lot of time to reflect on the Natural Childbirth/Home Birth movement, and what could have been done to spare me from making such a horrible mistake. I wasn’t open to talking about my choice to use a birth center and direct entry midwives, and I was very sensitive about it during my pregnancy. I felt that a lot of the anti NCB/homebirth websites were cruel, and I still have that impression from time to time. Midwives and NCB advocates have their own cruelties in their communities as well, though I did not recognize them as cruelties until later on. Hindsight is 20/20.

People who used to be a part of NCB and left aren’t visible in anti-NCB circles (unless of course they lost their child). People like me can offer understanding and perspective to mothers considering midwives or NCB. I don’t judge anyone for picking homebirth or midwives, I have an intimate understanding of the reasons women choose NCB because I chose it. This blog will be a safe place for mothers or moms to be to explore their feelings and options. I hope I spare someone else the trouble that I ended up going through as a result of the natural childbirth movement.