Unlicensed Midwife Epidemic in my town

Parentberries
1

I live in a very “granola” town and midwifery/natural birth is a HUGE deal here. The biggest local Women’s clinic has almost as many midwives on staff than doctors. Anyway, one of these unlicensed “midwives” was arrested for murder recently after a baby she was delivering died en route to the hospital. Local licensed midwiferies are “saddened” and are saying it could have been prevented if she were properly trained. But the community as a whole is actually rallying behind this woman and trying to raise $15k for her bail. A Midwife in the USA needs our help

I don’t think murder/life in prison is appropriate, but this woman (and others like her) should be stopped, and she should be held accountable. Here’s a link to the original news story: http://www.wyff4.com/news/north-carolina-news/APD-Unlicensed-midwife-faces-murder-charges/-/9695846/19509302/-/ehbxpn/-/index.html

What are your thoughts on this?

2

My thoughts on this could fill oceans. I have been following the [name]Rowan[/name] [name]Bailey[/name] scenario with mute horror (even by pathetic CPM standards the woman was completely untrained, and she also worked as a prostitute). Succinctly, I hope they are prosecuted into oblivion. Nurse-midwifery, college degrees, hospital experience, prescribing privileges, malpractice insurance, transfer protocols and accountability or bust!

3

In the interest of full disclosure for my bias, I am a student midwife with intentions of beginning a homebirth practice after my certification and licensure.

There are several states in the US that full-on prohibit direct-entry (read: non-nurse) midwives from practice. [name]North[/name] [name]Carolina[/name] is among the most notorious. Direct-entry midwives are illegal there, and as such, no regulations or statutes are in place to ensure that women seeking the care of a DEM are getting any kind of quality care. In other words, even after I’m done with five years of midwifery school, assist at 150 births, and pass certifying exams by the [name]North[/name] American Registry of Midwives, I will still be deemed to have inadequate training to receive a license to practice midwifery in [name]North[/name] [name]Carolina[/name] because I am not a registered nurse.

Any midwife worth her salt, DEM or nurse-midwife, must have appropriate training, certification, and licensure. [name]Non[/name]-negotiable. You do not screw around with the lives of mothers and babies. Any midwife who doesn’t think that’s necessary is, frankly, an idiot. But if legislation is not passed that (a) legalizes the practice of direct-entry midwifery in the first place, and (b) provides oversight of DEMs training, credentials, certification, and licensure, then inadequately trained, unlicensed DEMs are going to keep practicing underground. We have ample evidence from history to support that, when women are desperate enough to keep within their control anything relating to their reproduction, they’re going to seek out whatever avenues they can to get it, legal or not. If a woman wants badly enough to have her baby with a midwife at home, she’s going to, and if that means she’s got to use an unlicensed midwife, many will. The fewer trained hands there are to catch these babies, the more this is going to happen.

I don’t know enough about the circumstances of this birth to make a judgment call on whether the midwife acted improperly or if this was a circumstance that would not have been able to be helped no matter what. There are more scenarios that point to the midwife’s culpability in this death than not, but I don’t have enough data to say so or not. If she did contribute to the baby’s death in any way, I would love nothing more than for her to fry for it. The death of any newborn is horrific, though, no matter the cause.

At an absolute minimum, this woman needs to go down for unlicensed practice of midwifery and never. Lay. Her. Hands. On. Another. Laboring. Mother. Or. Infant. Again.

4

She was a prostitute? I actually met her at some natural birth event I stumbled into once, I remember because I was 7 months pregnant and her name was [name]Rowan[/name] (well, not her real name)

It’s apparently a huge issue here… and it’s very frustrating how many people are rallying behind her and acting like it wasn’t her fault. I love my city, but sometimes I feel like I’m living in a bad Portlandia episode. :frowning:

5

We had a similar situation in Australia recently (in [name]Adelaide[/name], where I live). A midwife named [name]Lisa[/name] [name]Barrett[/name] was present at three home births where babies died. As far as I’m aware, she has never been charged and she claimed to be working as a “birth advocate” rather than a midwife. Coronial inquests found that all three deaths were preventable. Two of the births were high risk - one was breech and the other was twins (one of the twins survived).

Here’s a link to the most recent news headline (from February 1, 2013):

http://www.adelaidenow.com.au/news/south-australia/no-charges-against-midwife-lisa-barrett-over-homebirth-death/story-e6frea83-1226566712748

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post redacted

7

@sarahmezz [name]Lisa[/name] [name]Barrett[/name]'s case is particularly brazen. This is a common defense when criminal charges are being brought, that the ‘midwife’ was actually working as a doula, not a midwife, and the mother was attempting an Unassisted Childbirth. Completely disgusting and shocking patient abandonment and frank perjury.

@RGE, yes, she was arrested for prostitution a few times in Asheville, when she didn’t have enough paying midwifery clients to foot the bills.

8

Too awful. Apparently she allowed the woman (at 42 weeks) to labor for 4 days, and advised her not to transfer to the hospital because she was uninsured. Any one of these things is reprehensible. On top of it she was practicing medicine without a license? I don’t understand why CPMs are rallying around her. Doulas who assist free-births and call themselves midwives are arrogant fools, and sully the waters for legit midwives.

Shutterbug, thanks for weighing in here. You’re studying to be a direct-entry midwife? Wow, your training has been 5 years? That sounds like some serious schooling! Most nurse-midwifery trainings are 3 or 4 years, as far as I know. I’m curious about your route.

9

I don’t claim any great political savvy or insight and I don’t understand all the details of this case, but if she’s required to be licensed and is practicing without one, then yes, that’s a major legal issue. I would infer that the mother bears some responsibility in allowing an unlicensed midwife to oversee her delivery, but again, I don’t know the details there.

This would be a different story in my state, where midwives are simply not allowed to attend births, regardless of training or certification. That I’m opposed to. While I wouldn’t opt for a midwife, that’s a personal choice based on my age, medical history and the fact that both my sisters experienced medical emergencies when they gave birth. But I believe that other women who don’t have reason to expect a difficult delivery should be allowed the option of a certified, licensed midwife to attend their delivery.

Edited for grammar. Oopsy! :wink:

10

@emms I would bet shutterbug is part of the program at Bastyr University on the outskirts of Seattle. They are leading an experiment in making DEM rigorous, requiring college degrees for entry, 2 years of foundational study plus three years of practica, etc. It’s grounded in a naturopathic model of medical care as that’s Bastyr’s thing.

11

^^ Thanks [name]Sherlock[/name]. :slight_smile:
I like that [name]Penny[/name] Simkin!

12

Really? She scares me. She is a physical therapist without a day’s formal training in anything birth-related-- not lay midwifery, nothing. She is a ‘childbirth educator’ [which, I kid you not, is a ‘credential’ that can be achieved in a morning], and I think it’s ludicrous for her to purport to write a book on the management of labor.

13

Huh. I assumed she was a midwife, since Bastyr’s program is named after her. I read her Labor Progress Handbook a long time ago, and found it interesting. She’s not too keen on epidurals - I know you disagree with that. She gives a lot of recommendations for positioning and low-tech comfort measures, remaining active while using an electric fetal monitor, doula stuff that strikes me as harmless and possibly quite useful. But now that I remember, there was a whole section about maneuvers for managing shoulder-dystocia and diagrams explaining pelvic exams and clinical interventions. This certainly does seem outside the scope of a PT/doula!

14

Crazy. It didn’t specify whether or not the parents of the baby knew she was unlicensed. If she told them she wasn’t licensed, they probably should have known better. Most pregnant women who are uninsured qualify for Medicaid, and most OB/GYN’s here have certified, licensed midwives on staff. All of it is such a sad situation.

15

This is so upsetting . I can’t comprehend how anyone could have the sheer arrogance to think they are capable of delivering babies without sufficient training. It is beyond my comprehension as to why any mother (or father , as they have an equal say) would put the life of their child in danger. Obviously they are sucked in by the philosophy, but natural homebirths are completely possible - but you need a qualified person there to assess the risks and make ‘that’ call. A friend of a friend had a baby a few years back, birthed by an unqualified midwife , the baby was born brain damaged and died a few years later - horrendous. These people need stopping. [name]How[/name] can they life with the guilt? Or are they that narcissistic or deluded that there is none?

16

apologies for the terrible spelling and grammar, I was in ‘Rant’ mode :wink:

17

I am no expert on this subject but I did spend some time looking at a few studies. [name]Friend[/name] of mine got all cuckoo for home birth after seeing the [name]Ricki[/name] [name]Lake[/name] documentary and after 3 hospital births that produce beautiful healthy babies decided to go all natural home birth for #4. [name]Long[/name] story short: midwife was very late arriving, baby was footling breech, baby was born safely, thank God, on the floor of her living room surrounded by several burly paramedics.

My friend said when the midwife realized the baby was footling, she yelled, “I can’t do this!”

The whole thing made me wonder: why didn’t they know the baby was footling? Is that something that happens during birth? At the very least, shouldn’t she have known the baby was breech? And isn’t that presentation contraindicated for a home birth?

My friend was very shaken up. Her husband described the baby’s blue foot dangling out of her, and thought when he saw it that he was dead. For a few days she questioned her decision. Then she forgot the fear, like one does, and decided home birth was awesome and magical.

I don’t know if her midwife was a CPM or not. And again, no expert. But from what I know about my friend’s birth experience, the situation feels really hinky to me.

So I started researching home birth. I started with the Skeptical OB. Interesting website. But I have a rule where if I’m serious about learning about something I go beyond opinions. I don’t want to be sold anything, or if I am sold I want to make the decision to buy.

I looked at a lot of the source material. I am not a physician or a medical professional but I can more or less ascertain whether the data supports the opinion. More or less.

I came away from my several months or so of interest in this topic feeling really disillusioned with home birth. Of course I think it’s anyone’s right. It’s just such a first world problem to me. I think of the poor women around the world who’d give their right arms to labor in hospitals with first class doctors and medicine and machines that go “bing!” (Sorry, [name]Monty[/name] Python reference!) And I sort of scratch my head at how we have swung from the 50s and 60s, when we were so enamored with our ability to make childbearing pleasant that women were all but unconscious, and fed their new babies from bottles wearing rubber gloves, to the opposite end of that pendulum arc: giving birth at home, our dreadlocks dangling in the patchouli scented water of our birthing tub, nursing little [name]Indigo[/name] right away, eating our placentas.

I’m exaggerating a little of course, to make a point. And I think there is a lot to be said for respecting natural processes in many different areas of our lives. I am just concerned that too many women choose home birth without knowing the risks, and worst of all, without understanding their midwife might be a total quack.

My friend and I have kind of tacitly agreed not to discuss the issue. I’m
33 and struggling with infertility, and she’s 29 and had 4 kids without trying. So it’s hard for me to listen to her bitch about not having the right kind of birth experience, when all I want is a parenting experience. I don’t care if the baby is dragged out of me with a team of oxen. As long as we come through it safe and healthy, I will be happy. And in my - I have to say, at this point - pretty informed opinion, a hospital birth is the best way to achieve a safe birth.

There should definitely be licensing requirements for midwifes. Rigorous ones. In every state. Too many women and children have been injured or died due to lack of information and gross incompetence. The blog Hurt by Home Birth is full of their stories, and they are nightmarish.

18

Missus, that hurtbyhomebirth website is really disturbing. I had to force myself to keep reading, because it made me feel so queasy. I don’t know that home birth was the culprit in most of those cases, but negligent and pernicious midwives, who in many cases lacked proper training. I’m sorry to hear about your friend’s experience. I wonder why her midwife didn’t know the baby was breech! There are some midwives who advise against ultrasounds, but even then, she should have been able to tell the position from the fetal heartbeat I’d imagine. Either way, it sounds like she handled it horribly. So glad that the baby was unharmed after all that.

19

Holy crap, Mrs. H., you made me spew green tea all over my computer monitor. That was hilarious.

20

I live in PA and all the MW 's I personally have used fir each of my 3 HB’s are properly trained, have a liscense, and back up ObGyn’s when needed. I do know many who choose what I would call “a glorified doula who read 2 [name]Ina[/name] [name]Mae[/name] books and thinks she is qualified” and until something goes wrong, this handfull of “glorified doulas” will continue to practice, its all supply and demand, sadly. I paid out of pocket almost 3 grand for my one HB and the other 2 were covered by our insurance (Aetna one time, [name]Blue[/name] [name]Cross[/name] the other). The problem I see is that where I live you can either drive well over an hour to a birth center or deliver in one of the several hospitals and fight the whole time for a natural birth. (And while I may choise natural birth formyself, I am not suggesting this is how all are to givebirth) But I also hear of friends from around the country who are able to have “hands off unless it becomes an issue” labors and births in the hospital. So, that is where we are at here in my little pocket of the USA. We also have a high % of Amish and Mennonite folks who can and do support both industries (liscenced and non). While I have obviously chosen HB several times with providers who had what I felt the know how and experience to back them up, and I also did prenatal testing, US etc, I know others who either did not have the insurance or finances to do so.