OBs and Midwives: The Double Standard

We can blame OBs but we cannot blame midwives.

In a hospital: interventions, inductions, c-sections --> fault of the OB

Yes, a mother must give consent for an epidural. Yes, a mother has to give consent for an induction. Yes, a mother has to give consent for a c-section. But it's still the OB's fault. They offered. They unrightfully scared the mother. And so on.

On the flip side....

At a home birth: death, brain damage, injury --> fault of the PARENT

Yes, you read that correctly.

Sorry, parents, but this is something you need to understand up front. You need to take responsibility for your decision to have a home birth if something goes wrong. Regardless of the details, people in the home birth community will ban together and bail out the midwife and do whatever they need to do to protect her. It has happened and continues to happen over and over and over again. Expecting accountability = persecution or a witch hunt!

If you have a home birth loss and if it was due to negligence on your midwife's behalf, you may be met with comments such as these... these are actual comments made to (or referring to) home birth loss moms. I have cut and pasted them. These are, sadly, just a very small sampling of the types of parent-blaming comments I have read!!

"at any time she felt it was needed, she could tell them she wanted to be transferred... I am sorry for the parents who lost their precious child, but they made the choice to have the child there (at a free-standing birth center), and they made the choice to stay even when complications arose."  (the mom she is referring to actually had no idea complications had come up… so much for informed consent!)

"What's abhorrent is the need to carry malpractice insurance because we are such a sue happy country because no one can take responsibility for their choices. There is NEVER any guarantee that things would have turned out differently if other choices had been made no matter what the "professional" people claim."

"They weren't hostages. They could have called an ambulance themselves, right? Just asking."

"I find it disheartening that the parents are not accepting any accountability themselves for the decision they made."

"I truly feel bad for the [family]. However, with all the resources we have at our finger tips, doing research on something so important only after a tragedy happens is somewhat negligent in itself."

"When we can let go of the blame in a child's death, we heal!"

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So let’s turn those comments around for mom’s who have had what they believe to be an unnecessary c-section:

“When we can let go of the blame in a c-section, we heal!”

"I truly feel bad for the [family]. However, with all the resources we have at our finger tips, doing research on something so important only after a c-section happens is somewhat negligent in itself."

"I find it disheartening that the parents are not accepting any accountability themselves for the decision they made to consent to have a c-section."

"They weren't hostages. They could have told the OB that they will not consent to a c-section, right? Just asking."

"What's abhorrent is the need to carry malpractice insurance because we are such a sue happy country because no one can take responsibility for their choices. There is NEVER any guarantee that things would have turned out differently if other choices had been made no matter what the "professional" people claim."  (sweet!! OB’s, just ask your patients to own up to the outcome 100% and you no longer need to pay thousands and thousands of dollars for your malpractice insurance!!)

"at any time she felt it was needed, she could tell them she refused a c-section... I am sorry for the mom that she had to have a c-section, but they made the choice to sign the form.”

Harsh, huh?

B/c most home birth midwives do not carry malpractice insurance and b/c they really don't have a governing body (like a medical board), there really is no recourse if a midwife practices negligently here in the USA. Even if she does so multiple times. She can keep right on practicing. So your chances of being able to have any justice in the shape of a lawsuit or such is slim to none. And to top it off, you have people that will back your midwife regardless of her actions and tell you to basically suck it up and take responsibility. 

I cannot even imagine what it would feel like to not only lose your baby due to a negligent care provider, but then on top of it, having to read about how people are blaming them - the parents. The PARENTS are negligent when death happens at a home birth. The PARENTS didn't do enough research. The PARENTS didn't speak up. The PARENTS should know when things become dangerous - even if they are being assured by their PROFESSIONAL CARE PROVIDER that it is not dangerous.

You can only complain about informed consent in a hospital setting. Not at a home birth. A midwife is infallible, basically. Parents - be prepared to 100% own your home birth outcome!!

Does this sound fair? No. But it’s the sad reality of the situation and something that was so shocking/horrifying/heartbreaking for me to see in the home birth community. Blame your OB and you'll find an entire community that has your back, that will share in that blame you cast on your OB, that will coddle you and love on you and "empower" you by telling you "it's not your fault, shame on that doctor of yours!!" But if things go wrong at your home birth and you again want to blame your care provider - your home birth midwife - well, don't expect that same community to stand behind you. B/c they are behind the midwife.

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Please note: The point of this blog post is not to say that OBs are never at fault and that women are never mistreated in a hospital. The point is, if negligence happens on behalf of  a care provider, there should be recourse and accountability. A woman is not expected to know as much as her professional care giver, no matter where she chooses to give birth. Responsibility falls on the care giver to act ethically, in the best interest of the patient. This is why every health care professional in the United States is required to have malpractice insurance… except home birth midwives.