Category Archives: c-section

Following In Dr. Biter’s footsteps

A North Carolina physician is being investigated after having presided over 3 home birth fatalities.

In a statement issued through his attorney Friday, Dr. John David Hayes also said families of the babies have continued to support him.

Of course they do, most people choose birth providers specifically because they trust them. It is terrifying to think that someone you trusted hurt you unnecessarily. The article actually notes that the information came from an unnamed source and that details of the deaths will never be released. Someone saw a pattern and spoke up out of concern for other people, and I commend them for doing so. The fear of repercussion or being ignored is very daunting when deciding to report other people for misconduct.

Dr Hayes expects to be cleared of wrongdoing. I do not expect that for him. Most obstetricians lose one full term baby that was otherwise expected to live in their entire careers, and he has lost 3 in 10 years. At least that is if you believe that he was only taking low-risk patients, which seems to be the only possible way for him to excuse taking a patient for home birth to begin with. His arguments are nonsensical in some portions of the article:

“I expect that after a thorough and impartial investigation, all of my home birth practices will be found to be within the standard of care for an obstetrician in North Carolina,” he said.

Home birth is not the standard of care for any obstetrician. The standard of care for obstetrics involves having ready access to blood transfusions and an operating room, something no home birth can offer without an unacceptably long transfer period. That is why ACOG and virtually every obstetrician discourages out of hospital birth for patients. Most pediatricians discourage home birth as well, on the basis of having treated so many brain damaged patients who were hurt by their parent’s decision to home birth.

However, as Dr Hayes and a few notable exceptions prove (Dr. Biter, and non-OBGYNs Aviva Romm, Dr Sears, and the late Marsden Wagner) an adequate education is not always enough to protect doctors from believing in quackery.

For those who are unaware, Dr Biter is another male OB who was dead set on home birth and insisted on its safety. Unlike dr Hayes, Dr Biters patients did complain in the form of a lawsuit. Dr Biter ultimately surrendered his medical license in light of the fact that he botched a home birth and killed someone’s child. He later decided to open a birth center as a non-physician, until social media pressure caused it to close. Dr Biter has also been the subject of sexual complaints, having taken advantage of the dr-patient relationship in order to obtain sexual favors from his patients. He is very scummy.

Many people who are aware of the debate about malpractice reform know that a minority of doctors are usually responsible for the majority of malpractice claims. When your doctor swims against the current in their speciality it is very difficult to know if it is because they are ahead of their time or because they are quacks. This I know for sure- there are far more doctors who succumbed to quackery than those who were ahead of their time. Be careful.

proof that natural child birth advocates don’t care about choice

An article is making the rounds on facebook, it is called “State bans elective inductions and c-sections! victory!”

They don’t give a shit if you don’t want to give birth vaginally for whatever reason. Many women choose elective c-section because of abuse histories, or perhaps because they want the baby to see their father he gets deployed, there are really countless reasons and circumstances which make elective c section or induction completely understandable. They believe its a victory to try and force you to do so.

They believe that legislators are totally correct to restrict the choices of pregnant women, based on the (incorrect) concept that vaginal birth is always preferable to surgical birth in terms of safety. However, the same people will tell you that its incorrect to ban direct entry midwifery because it limits the choices that women have.

Hypocrites. Every last one.

Never Good Enough

I found an article today that made my eye go a bit twitchy. It is called “A family centered cesarean is not a substitute for a fully supported natural birth or VBAC“.

I have no idea why the author thinks they are the authority on what is or isn’t a substitute for a natural birth, I would think that the woman giving birth would have to decide that on her own. I am sure there are mothers that have had a vbac and then a c-section for a later pregnancy. A poll of them would be more useful than just making a blanket statement.

The article is intended to demonize c-sections, as usual. What struck me is that physicians who do not feel comfortable with a “natural” vbac (see: almost none) are still considered bad for offering what is called a family-centered c-section.

And mothers, if when you are discussing your desires for your natural birth with your provider, they immediately start talking about the “family centered cesareans” they offer for mothers like you, please please please recognize this as a red flag, and consider transferring care to a more supportive provider….one whose immediate response is what they can do to facilitate your natural birth and then, only if all other options are exhausted, will perform the most family centered cesarean possible

No matter how much OBGYNs pander to natural child birth advocates, its just never good enough. I think I would do the same thing if I were in the OBGYN’s shoes, just to try and prevent anyone from having a dangerous birth at home.

The reason that most providers require close monitoring and epidural anesthesia for VBAC in the hospital is that the risk of a catastrophic uterine rupture is best managed under those conditions. A life saving c-section can be performed quickly under those conditions. An unmedicated VBAC makes it impossible to catch the problem early, which can result in death for the infant. It can cost the mother her uterus, or her life.

I just wish people like the author of the Birth Blissfully article  had to explain how superior a natural vbac is to women who have suffered a uterine rupture during a vbac. Here is one from baby center:

The room filled with people, they threw the sheet curtain on me, didn’t even have time to hang it up before I heard the doctor say “cutting!”  Thank goodess I had the epidural so there was no time wasted there.  She had my baby out so fast, literally within a minute or so.  DD’s arm and shoulder had went through my rupture into my abdominal cavity.  She was breathing but a little limp – it’s so scary to think that minutes later would’ve been a different story.  They rushed her to the NICU, right by DH who had no idea that she had even been born yet.

It seems that she came pretty close to death, too. She lost 2 pints of blood, had multiple transfusions, and had to stay in the ICU for monitoring. One of the big things people dislike about c-sections is that you may have to spend time away from the baby while getting stitched up, but this mom ended up going days without seeing her daughter because they were both in their respective ICUs and couldn’t visit each other. Here is what she has to say about her decision to vbac:

I spent more time thinking, praying, and researching this vbac decision than any other in my life.  Ironically, it was the worst decision of my life.

I feel the exact same way about my choice to birth out of hospital with direct entry midwives (though luckily I did not have this type of health outcome). I looked into it so much, but sometimes doing research is just assuring yourself that what you want is really what you need. It takes a lot of humility to realize when you are reinforcing your previously held beliefs vs when you are actually trying to get to the truth.

A fully supported VBAC, for this mom, would have meant death or serious injury to mom, baby, or both. A c/section is a fine substitute for that risk, that is probably why the vast majority of moms choose repeat c-section over VBAC when presented with information about risks. It isn’t because women are stupid or uneducated, they just have different priorities than NCB advocates. There is nothing wrong with that.

Gloria Lemay: pre-eclampsia is the mother’s fault

If you are unaware of Gloria Lemay, she was an illegal midwife in Canada who defied court injunctions that deemed her a danger to the public. She was involved in an infant death and subsequently sentenced to serve time in prison for her actions.

She still has quite a following in the world of Natural Child Birth, despite having no real qualifications and a ton of documented fuck ups to her name.

The most recent piece of idiocy can be seen on her facebook page. Here is the initial post:

gloria lemay 1

Gloria Lemay remarks that she would “love to see every baby in N America wearing this little message!” The message is “My mommy refused to induce me”. 

Some people rightly pointed out that there legitimate reasons to induce someone, such as pre-eclampsia, which can have serious health consequences (including death) if improperly managed. Here is Gloria’s reply:

gloria lemay 2“When a baby is at risk with “Pre-e” (pregnancy induced hypertension), what has been done to prevent the situation? Over and over, it has been shown that diet plays a key role.

 

The insistence that diet controls pre-eclampsia has absolutely no evidence behind it. A lot of women at the Pre Eclampsia foundation have a lot of anecdotal accounts of following the brewer diet religiously, and then ended up with the condition anyway. Some of them say they got pregnant again because they were confident they could beat pre eclampsia with diet, and in one case the mother almost died as a result. The idea that pre eclampsia is always a case of eating the “wrong” diet caused a lot of the moms on the forum to feel guilty. Lemay continues:

 

Then, if the situation is really out of control with high liver enzymes, is it a good plan to torture the woman/baby with an induction when you already have two ill patients? How is adding synthetic hormones to the situation going to help anything?

 

If you tell women that they are torturing their babies by inducing, you better have some damn good evidence. But there isn’t any. 

As for women being tortured by induction… that doesn’t seem to be what women actually say if you ask them about it.

 

 

There is a very high risk that the induction will end in c/s anyway. I would advise anyone in my own family to go straight to c/s in this situation, avoiding all the drugs, iv’s, of the induction.

 

C-sections include plenty of drugs and IV lines. I have no idea why she thinks she knows better than a physician about induction vs c/s for a case of pre-eclampsia. It is a complicated condition and the mode of delivery is chosen based on a number of different factors. Lemay talks about how horrible c-sections are all the time- perhaps she thinks a woman “deserves” a c-section for eating poorly? Its hard to know. There does seem to be a certain level of vitriol in her answer to a simple question.

 

Inductions are dangerous. Cesareans are dangerous. Ignoring sound dietary practice in pregnancy is dangerous.

 

Saying “x is dangerous” doesn’t really tell me anything about the danger. How dangerous is it? Are all three of those things equally dangerous? 

Lemay is again suggesting that mothers are to blame for eating poorly. I usually try to find a decent amount of evidence before blaming someone for a negative medical outcome. 

 

Birth is as safe as life gets. Medicine is for medical problems but it should be reserved for states of illness, not normal healthy women who have carried a baby to full term. “

 

“Birth is as safe as life gets” is bullshit. It can be pretty dangerous depending on what resources and technology you have available to you. Women still die all the time from complications of child birth, and women like Lemay are only able to ignore that because she is privileged enough to live in a place where obstetric care is very advanced and widely available. It is the same reason she can ignore the effectiveness of vaccination. 

Someone talked about how guilty this discussion made her feel, because she had been induced.

Here is Gloria Lemay’s response:

gloria lemay 3 After telling women they tortured their babies by inducing, which they obviously caused by poor diet or ignorance anyway, she decides to wash her hands of the obvious consequences of making these (extremely judgmental) statements. I don’t know how women are supposed to feel okay about torturing their babies, if they believe what Gloria Lemay has to say about it. In fact it seems pretty unethical of her to excuse people for baby torture, if she genuinely believes induction is an equivalent. 

The guilt heaped on mothers, regardless of the choices they make, is a symptom of a misogynistic society. It isn’t fair to women to add to that. 

 

Debunking the Business of Being Born: part 8

This is part 8 in a series on debunking The Business of Being born, the popular documentary by Ricki Lake and Abbey Epstein. You can find the other parts of the series here. My descriptions of the movie are in bold. My commentary is in regular text.

Dr Michael Odent says that there are people that claim “that in the future most women will prefer to have an elective cesarean section. But when you talk about that with certain women, [they] still have some sort of intuitive knowledge of the importance of what’s happening when the baby is being born. They cannot accept that cesarean section is the future.” 

It is indeed true that certain women prefer some things and other ones do not. Its almost like we are individuals!

Rickie lake is talking with Abbey Epstein. Ricki Lake says  “I couldn’t get enough information. I was just blown away by what I didn’t know the first time around. I knew, even before I planned a second pregnancy, that I wanted it different. I wanted to do it on my terms. “

That’s fine. The unfortunate part about The Business of Being Born is that they pretend that unmedicated births are the only way to have a child on your own terms. Women who want c-sections, or who do not want assistance at all, are not represented. The contrast between the extremes would make for an interesting movie, but it becomes obvious that this is a movie intended to make home birth look good in the public eye, not to explore any issues surrounding womens preferences during child birth.

Abbey Epstein remarks that she thought it was just an eccentricity for Ricki to prefer home birth. Ricki replies that she loves pain medication and takes it when she has a headache. “But when it came to giving birth, it wasn’t an illness. It wasn’t something that needed to be numbed. It needed to be… experienced, you know?”

Ricki Lake filmed her home birth and footage of it is shown. She has multiple people trying to relieve her pain during contractions.

Rickis voice narrates over the footage “I remember I was in a LOT of pain. I was enduring just about the worst part, almost the worst part. I didn’t lose my sense of humor. I was naked and going ‘uhhh’ and we heard an ambulance go by, and I was like ‘That’s my ride, get me the fuck out of here! I want to go to the hospital, I want my epidural.’ “

Footage is shown of Ricki’s home birth where she is obviously in a lot of pain and says “I don’t think I can do this.” Ricki narrates over the footage saying “My midwife reminded me of all the reasons I was at home, and what I wanted to avoid, and the gift I was giving my baby.” and I thought “yes” and I got through that contraction, and I was one step closer.

This footage would be extremely disturbing if you hadn’t been prepped with natural child birth talk for 40 minutes beforehand. If you had seen the footage without being pummelled with the film’s conclusion (that vaginal unmedicated childbirth is optimal, is an amazing experience, etc) you would have thought it is cruel to deprive a woman of pain relief when she was in intense pain and requested relief. I also have a feeling that when women trust their midwives it is easier to go with their narrative of birth rather than to see their actions for what they are- cruelty. It is cruel to deprive someone of pain relief when they are desperate for it. After all, ricki isn’t experiencing the pain now, so it is easy to look back on it and make light of how horrendously painful it was.

More footage of ricki’s birth. She is in pain and her midwife wispers “this is you having a baby.” 

Ricki says “I feel like pushing.” her midwife responds encouragingly. 

Ricki’s narration over the footage says “At a certain point, I just gave in to the pain. I just let go and surrendered, and that’s when things went really quickly. “

Again, incredibly disturbing to someone who hasn’t been told repeatedly that doing things this way is optimal. It seems so needless to hurt that much. Ricki looks exhausted and dazed by having endured hours and hours of painful contractions. I remember that before I had my baby, I thought that midwives who acted like Ricki’s were acting like they believed in her, but after having been that patient, in tons of pain, with a midwife inadequately prepared to deal with my pain… it seems very cruel. I think that midwives witnessing pain so regularly without the means to solve it can harden them to the pain other women are enduring.

There is footage of ricki pushing her baby out in her bathtub, her midwives encourage her to pick up the baby.  Ricki is crying and saying “My baby” over and over.

This is the bread and butter of the business of being born: birth footage chopped into bits that emphasizes the baby being born and minimizes the labor and pain. I just wish that they would have been forced to show footage in proportion to the time spent on different portions of the actual labor. Women typically labor for hours, and the moment of birth is just that- a moment. There is a disproportionate amount of focus on the end of the birth.

Ricki remarks “That was just…everything to me. I mean, I could start sobbing right now. It was so empowering.”

Statements like this try to establish the objective supremacy of natural birth, when in reality it is just Ricki’s opinion of home vs hospital. Other women with different experiences are not represented.

A Doula is giving a couple lessons in their home on how to deal with contractions and talks about different techniques to provide relief. The woman’s husband is interviewed and talks about how he was on board with home birth from the start. Footage is shown of the midwife providing prenatal appointments in the couples home. 

Eugene Declerq, an MPH says “The research on home birth is pretty consisten in showing that in a supported environment, (he clarifies this to mean well trained attendants with quick hospital transfer), the outcomes of home births are very, very good. Generally better than they would be at a hospital birth.”

The outcome of home birth with nurse midwives with quick transfer are better than the outcomes of home births without those things, but the majority of home birth midwives have none of the things he listed. Regarding the numbers, its quite a stretch to call them “very, very good”, and its an outright lie to say the outcomes are better than hospitals. It is difficult to evaluate what studies he is referencing because they are never named, nor do they tell you what they believe to be a good outcome. I can bet that they care more about the c-section rate than the death rate.  The majority of studies show a decrease in interventions and an increase in perinatal death. MANA’s numbers, which came out this past year, demonstrate the same thing (if you look past their flowerly press release that tries to ignore the obvious conclusion that comes from looking at the numbers and then comparing it to hospital statistics).

The midwife talks about screening out patients for risk and other safe guards in place to protect moms (like preparing for transfer and making the call to do so in time). 

That’s nice and all, but those things only matter if the midwife actually decides to do them. There are so many cases of midwives taking high risk patients, of midwifery publications calling dangerous conditions “variations of normal”, etc. This seems like another attempt to make home birth midwives look like something they are not. Most of them are not nurses, most of them do not have adequate training, most do not have adequately quick transfer, and most of them do not have a good working relationship with hospitals.

OBGYNs express doubt that midwives could adequately manage complications without the equipment available in the hospital. One dr compares it to driving without seat belts using previous safe driving as a justification for the risk. Eugene comes back on the screen to dispel the myth that midwives are using archaic methods to manage labor or pain. He says they bring pitocin, oxygen, etc to births. Home birth midwives are shown packing up this gear.

Once again, this movie tries to make it seem like most midwives are nurse midwives (the only highly trained midwives in the usa), but most home birth midwives aren’t. Most home birth midwives are direct entry or “lay” midwives who do not have adequate training to deliver babies. Direct entry midwives are not allowed to carry medicine in all states, and some don’t do it because they think that complications should be managed by homeopathy or other techniques.

It is worth noting that midwifery is “traditional” or “ancient” when it suits natural child birth advocates, and its contemporary and evidence-based when it suits them.

Eugene continues “Home birth midwives are incredibly skilled at what they do.”

Then why is their death rate so high? Why is it that in many states I can become a home birth midwife simply by calling myself one? I have no skills or training outside of a doula class, but no one can prevent me from attending home births in my state because the standards are non-existent.

An OBGYN says “In a postpartum hemorrhage, you can lose your entire blood supply in about five minutes.” 

The midwife says “if you think a mother has a higher risk of bleeding you have the pitocin drawn up. You have the IV warmed here, right by her side.”

Anyone who has attended codes or traumas knows how hard it is to start an IV on someone who is bleeding heavily.  Having it ready doesn’t mean a lot if it isn’t physically inside the person’s vein. When they get really desperate for a line they jam a huge IV into your bone to provide fluids. Its not pretty. I doubt midwives have the equipment for that. Anyone who has watched the beginning of this movie knows home birth is all about NOT having IVs or other medical interventions, even “just in case”. They only bring it up when safety concerns are being addressed, to make it appear safer than it actually is.  They again they ignore the fact that the majority of american home birth midwives are not nurses and have no real medical training.

My patience for this is wearing thin. There is so, so much deception at this point that it is hard to conclude that it was not intentional. Either that or the film makers are in so deep that they are basically acting as cult members, who believe that it is okay to lie as long as you are serving the cause.  An entire portion of the film is dedicated to talking about how skilled and trained and prepared home birth midwives are, but they take absolutely no time to discuss the difference in training and preparation between the majority of home birth midwives (direct entry midwives) and the majority of hospital midwives (certified nurse midwives). Its a truly glaring omission.

“do nothing”- the official slogan of home birth

With a few exceptions (namely placenta previa) the home birth midwife’s theory of practice is to not do anything. Their strategy of not doing anything (often euphemistically called “trusting birth”) is what patients shell out thousands of dollars for. Home birth midwives seem to believe that active management of risk factors causes deaths, when there are plenty of statistics that evidence the safety of hospital birth when compared to home births. Here are the numbers from Oregon. The midwives have a theory, that doing nothing is better than doing something nearly all of the time, but they ignore all the available data to check and see if their theory is correct. They put peoples lives on the line and do not check ahead of time to see if their idea is true.

The way that midwives come to believe such nonsense is that the majority of the time no one dies when they decide to do nothing. The issue with doing nothing isn’t usually death, its usually brain injury caused by oxygen deprivation. There is not any accountability or tracking of brain injuries in babies by home birth midwives, but a paper by perinatal specialists found an 18 x higher rate of them. Sometimes it takes years before the effects show up.

I began thinking about this matter because of an article on the Thinking Midwife’s page about how nuchal cords (cords wrapped around baby’s neck) are a “scapegoat” for interventions. Heres her advice:

  • During birth DO NOTHING.
  • IF the cord is preventing the baby descending once the head is born (extremely rare) use the ‘somersault technique’ (Schorn & Blanco 1991) – see below.
  • Once the baby is born, unwrap the cord (the mother/family can do this).
  • If the baby is compromised at birth encourage the parents to talk to their baby whilst the placental circulation re-establishes the normal blood volume and oxygen for the baby. if the baby requires further resuscitation do it with the cord intact.

She emphasizes over and over again how rare it is to have to use the somersault technique, but to me that says that american home birth midwives specifically will be unlikely to actually learn this technique during a birth. Would you want to be the first patient a midwife has used this technique on? Would she even know if she were making a mistake? States that actually regulate direct entry midwives require that they fulfill educational criteria that is woefully inadequate, You can take the NARM exam and get certified after attending only 20 births- most non OBGYNs deliver more babies in med school than that.

The thinking midwife’s theory is that compressed cords are providing compromised, but not completely absent, blood and oxygen to the baby. That may or may not be true in any specific case, but there isn’t any electronic fetal monitoring to detect distress at her home births, so midwives are forced to form an opinion based on intermittent Doppler readings.

I sometimes wish I could get midwives together with malpractice attorneys sometime to talk birth injuries. Midwives who do home births attend to far fewer births than physicians, midwives get to pick their patients with more freedom than physicians, and lay midwives are less likely to actually recognize their mistakes. Home birth midwives are less likely to see the impact of their practice choices in any representative way, which probably makes it easy for them to pass around useless advice over and over. Malpractice attorneys deal exclusively in cases where someone died or was injured because critical decisions were made (or not made). They tend to have a much more common sense explanation of the problems caused by nuchal cords because they actually have to see the parents of the injured babies, and file the documents in court, and see the costs associated with the injuries, interview medical experts who explain what went wrong, etc. Malpractice attorneys have to face what these midwives would rather forget or blame on the parents. You will notice that it says in some cases the only way to treat is emergency c-section, and the only way to make sure its not an unduly delayed c-section is to use fetal monitoring. Home births have neither of these things at their disposal, so they have to push the lie that doing nothing is better than doing something that can only be done in a hospital. Admitting that it is more dangerous would lead them to having to obtain actual informed consent, and very few people would be willing to sign on for the risks of homebirth if they were honestly represented ahead of time.

 

The reason the #notburiedtwice campaign exists

The reason the #notburiedtwice campaign exists

I came across a link for a radio show called Progressive Parenting, which decided to discuss the Vickie Sorensen manslaughter case. They had someone from the human rights in childbirth campaign and Katie McCall of Our Sisters in Chains. These women are trying to bury the memory of the baby that died a preventable death in Utah, they are trying to make sure people do nothing in response to the deaths.

The focus of the show was how prosecution of midwives for attending preventable deaths would affect the community. There are a few major claims in the show that are questionable:

Claim #1 is that Doctors are never charged with manslaughter for killing a patient.

It took me one google to debunk that, there are many cases of physicians being charged with manslaughter when they have done something incredibly negligent. The reason that doctors or midwives are charged with manslaughter is that their negligence was so egregious that it could be considered criminal. I think it is safe to say home birth midwives are more likely to do something outrageously negligent because of their dogmatic belief system about the nature of birth combined with paranoia about being persecuted. The women on the show complain that physicians only have to worry about being sued, but are not in favor of mandatory insurance for midwives so that they too could “just” be sued in the case of a death. If midwives want to be sued instead of charged they should carry insurance. The ones with risky practices cannot secure insurance because insurance companies know the risk involved would make for a very high rate for services, and midwives cannot charge prices high enough to justify the insurance cost. Its common sense that if you do a risky job then you open yourself up to these problems, but midwives and natural childbirth advocates believe that they should be exempt from the rules that the rest of us have to play by. They want all the glory of being a physician without any of the responsibility, which leads me to the next claim.

Claim #2 is that home birth midwives are experts in vaginal birth and should be regarded as such by the medical community.

The women on the show praise Utah’s midwifery laws, despite the fact that you need no training or experience to become a home birth midwife in the state. They later refer to Utah as a ‘haven’ for midwives because the law is so lax. I don’t know how they can claim that our laws are great because they require nothing of people who want to practice home birth midwifery, but then demand that untrained or undertrained midwives be regarded as experts in childbirth. Physicians are sick and tired of cleaning up after the mistakes made by lay people and have a negative view of home birth midwives for a reason. I’ve noted before how a non-nurse midwife’s complete ignorance of electronic fetal monitoring makes them unable to detect distress patterns outside of brachycardia, and likely explains the wealth of intrapartum deaths that home birth midwives preside over that are completely unheard of in a hospital setting (the long labor, heart rate was fine, then suddenly the baby is dead story you’ve seen so many times before). The human rights in childbirth rep says that collegiality needs to be in place so that the midwife and hospital can trade info, but if you’ve read From Calling to Courtroom (the guide for home birth midwives to avoid liability) you know the standard advice to avoid liability is to make a chart in your own special code that only you understand.

Do not chart emergency medical procedures. Use a “made up” code that only YOU understand. Don’t ever think it can’t happen to you. I believe I was careful BEFORE I was prosecuted. I am even more careful now.

 

-Chapter 1 of From Calling to Courtroom

It is absolutely impossible to take information from someone in this profession seriously because there have been so many cases where home birth midwives lied to the hospital, EMTs, police, etc.

Claim #3 Anyone working with birth is bound to see a ‘bad outcome’.

Lets assume that by bad outcome they mean a newborn death, since that is the case being discussed on the show. Vickie Sorensen was a midwife for over 30 years, and has delivered ‘over 1000 babies” (according to her fundraiser page). Contrast that with an OBGYN, which would take about six years to get that number of births (delivering 140-180 or so babies a year). OBGYNs still manage to lose significantly fewer babies in the hospital despite taking on cases where newborn death can be expected.  It seems to me that if most OBGYNs were working at the same pace as home birth midwives, and could be as selective in choosing their patients, that they would be extremely unlikely to see an unexpected perinatal death. The culture of home birth has a creepy way of trying to normalize preventable newborn deaths as being unpreventable, but the numbers say something different. The vast majority of home birth deaths can be prevented.

Claim #4 There is an anti-home birth agenda that causes unmerited arrests of midwives and causes the media to falsely report information.

I’ve never actually seen a midwife be exonerated after being accused of manslaughter or homicide, so unless the agenda extends to juries its a bit hard to take seriously. A lot of evidence would need to be produced to support this claim, which is essentially a conspiracy theory to try and excuse the allegations against midwives. I’ve seen no evidence of it anywhere. It seems as though this would be a pretty low priority target, considering the minority of births are taking place out of hospitals. I’ve pointed out why I believe in the charges against VIckie Sorensen, and I talk specifics exactly because I know that these natural child birth advocates won’t. Its a manipulation tactic to keep things vague.

Claim # 5 The right of midwives to practice is about the right of women to choose when and how they give birth.

I find this incredibly dishonest and appropriative of legitimate feminist issues. This is and always has been about letting midwives do whatever they please without accountability. People who are actual feminists think that women deserve to have skilled birth attendants who can actually adequately explain risk vs benefit to them, not a bunch of anti-vaccine nutjobs who idealize the history of human child birth, despite its high mortality rate. Letting midwives get away with being unaccountable and untrained means that we are letting women fall into the trap of charlatans, and many of them are choosing home birth because of fear of hospitals or a lack of finances.

Claim# 6- if midwives have restrictions placed on them, women will have to choose between c-sections and unassisted birth.

Of course this is a false dichotomy, there is a lot of space between those two things. Many hospitals have tried to incorporate as many features of home birth as they can into birth centers attached to hospitals. You could have a vaginal unmedicated birth in a hospital.  Illegal home births attended by midwives happen all the time.

The claim here supposes that going unassisted is much worse than having a midwife, a claim that is false in many cases. Midwives have a mantra of ‘trust birth’, and it means that they are more likely to say that everything is fine when there is a real risk or a real problem happening. There have been many times where home birth midwives prevented transport or insisted it wasn’t needed while the patient knew that they needed urgent help. Midwives have a history of making things much worse than they needed to be.