Tragic Death of Baby

Something happened on Friday that definitely deserves a lot of attention: A baby died a preventable death because the midwife did not understand the risks involved in the particular situation.

This was broadcast for everyone to see on Facebook. It started with this initial question, sent via private message to Jan Trittan, the editor of Midwifery Today, who then posted it on her page:

As you can clearly see, the midwife did not fully understand the risks of the situation ("what do we truly feel are the risks"). You can also clearly see that she has not transferred care to a physician ("we're in a state with full autonomy for midwives and no transfer of care regulations past 42 weeks").

If a pregnant woman's hired professional care giver is unaware of the risks, how does the pregnant woman know the risks? This midwife clearly doesn't want to acknowledge that this mother is in any danger at all, even saying "technology isn't perfect" as if a BPP done on two separate occasions, both indicating ZERO amniotic fluid, would be incorrect (again... this is not a matter of a BPP indicating LOW amniotic fluid, it indicated ZERO amniotic fluid BOTH times). Can we honestly believe this mother has any idea of the risks involved in her situation?

At 42 weeks 3 days, the baby died:

The baby died from meconium aspiration. How does that happen? There are factors that each individually increase the chances of meconium aspiration and sadly this mother had several factors:

Postterm
Low amniotic fluid (and in this case, even worse, she had NO amniotic fluid)
Placental insufficiency

Based on current research, an induction at 41 weeks (or shortly after) not only would have greatly increased the chances that this baby would have survived, but it also would have decreased the chances that this mother would end up with a c-section.

An immediate transfer of care at 42 weeks 1 day when it was initially known that there was no amniotic fluid would have also yielded a live baby. Or at 42 weeks 2 days. Clearly, going in at 42 weeks 3 days proved to be one day too long.

I have had a pit in my stomach since I watched this all unfold on Friday on Facebook. It almost seemed a like an awful prank. What midwife would do such a thing? What professional wouldn't understand the risks? What professional would seek advice on Facebook and ask others to share "opinions/stories" to help them make their decisions?

A petition has been started and I have already signed it, and I hope you will as well. Sign for this mother, because she was not given true informed consent and is now left with the loss of her child. Sign for this baby, because he or she was not given the best chance at life. Sign for the family of the mother/baby, who will also forever grieve this loss. Sign for this midwife, because her actions were beyond negligent and she should be held accountable. Sign for the current and future clients of this midwife, who deserve to know who they are hiring.

Please Sign This Petition

Update your Facebook and/or Twitter status with this hashtag: #notburiedtwice to raise awareness for the loss of this baby.... another preventable loss at the hands of a negligent midwife.

The thread was, of course, deleted. I took over 65 screen shots (including the two posted here) as I was participating in the discussion but did not get all of the comments. However, they were all captured. To view the full Facebook thread, it is available here: The Internet Never Forgets

What Drew Me To Home Birth and What Turned Me Away, Part 4

I feel so conflicted with how to wrap this up… I have so much to say, so much that was going on, so much that I was thinking about… hopefully I can get it out in a way that makes sense outside of my head...

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So here I was pregnant with baby #2… and go figure, options were wide open for a home birth, insurance is all set to cover it… and now I was actually leaning toward hospital birth. But I didn’t know. I still wanted a home birth – and partially for my pride at this point.

But the questions and concerns…. Oh so many…

I talked to my two good friends (doula friend and childbirth ed friend) about everything I was going through… I felt so conflicted… and now, to add more confusion for me, a recent birth of a dear family friend had me even more confused and conflicted. At dinner with them one evening, I told them as much as I could about what I was thinking and concerned about and what I had recently learned about that birth: "our family friends just had a baby with a diaphragmatic hernia, perfect low risk pregnancy, she would have been considered a perfect home birth candidate, this was her third vaginal birth with no previous issues in other pregnancies/children. The hernia developed after the 20 week scan so they had no clue their baby would be born with this huge issue. The baby couldn't breathe when born… she couldn’t get enough air… and oxygen wasn’t enough, she needed a ventilator to breathe/stay alive until surgery.... what if that baby were born at home?" I looked at them desperately wanting an answer as I was crying to them… and doula friend said nothing and childbirth ed friend hopelessly said “I don’t know…”

I knew the answer. The chance of that baby surviving had she not been born at a hospital was slim to none.

(On a side note, I was recently reading the Birth Center study that came out in 2013 and one of the babies that died had this exact issue: diaphragmatic hernia. Very similar circumstance as our family friend. It developed after the 20 week scan so they were unaware this would be an issue at birth. The baby in the Birth Center study did not survive. I couldn’t believe it when I read it.)

I went into my search for information on home birth and its safety coming from the perspective of someone who was already sold on home birth. I wanted to believe. I wanted everything to point toward home birth. Sometimes when your searching for the answers to something, the results you find can be tainted by your own personal desires... what I mean is, if you want to believe in something badly enough, sometimes you can find a reason to believe because your desire is so strong. I thought my search would bring me to the conclusion - an even more well-informed, well-rounded conclusion - that home birth is safe. As I felt before. But that's not where I ended up.

By now, I felt so... turned off by the home birth system as a whole in our country. It all felt like it was based off of misleading information, protection of the reputation of midwifery at nearly all costs, a stunning lack of accountability, and stifling those who brought up their concerns.

I had read too many stories of negligent midwives, home birth losses that were very likely preventable... and I realized I had no way of knowing who I'd be hiring as a midwife. It made me sick to my stomach over it... I loved and felt I could trust our midwives implicitly and I believed in their skills... but I have yet to hear a home birth loss story where the mother didn't feel the same about her midwives... midwives who later betrayed the trust by taking chances or with flat out negligence. I felt more confident going the CNM route because I know they have their nursing board to hold them accountable. But even then, there's no guarantee... even if they are completely ethical and do everything right, what if I am that small statistic that faces an issue that can only be resolved in a hospital..... my house isn't that close to a hospital. It would take quite a bit of time, especially if it were during rush hour. It just..... it felt like a gamble.

And I realize in the hospital, it is also a gamble. You never know the doctor or nurse you will get. You never know what kind of day they are having. You never know what their philosophy is. You never know how outdated their standards of care may be. To a certain extent, you have to put blind faith in a care giver. But at least in a hospital, you have accountability. Accountability is crucial. And I've looked at the numbers... vital statistics, hospital stats, studies, etc... our hospitals in the USA do a very good job of making sure our babies are born alive and safe and healthy.

I believe there is a certain element of childbirth that is mental. I, personally, wanted to take this into consideration as well. It's mental in that.... it's the woman feeling comfortable and safe and letting her body do what it needs to do. In that mode, that safe space, a woman's body functions at 100%, the hormones, the labor, everything... it just functions better. I think that there is a lot of propaganda out there in the home birth world that leads women (or maybe just me) to believe that being at home, in that familiar place, that that is where birth needs to happen to allow the woman to feel that way.

My own hospital experience was quite nice with our first. And I understand that it may not be the norm. I have experienced other hospital settings as a doula where things weren't as nice and where there was some fight needed by a mother/couple to get evidence based care. And like I said in my first post, I read many, many stories of hospital experiences that were not as nice at all. 

The childbirth ed midwife said to me once, during my first pregnancy: “you have to decide: where do you place your risk?” So that’s what I had to do. I had to decide where I would place my risk. I had to think about my options…

What are the true, unbiased risks?

What risks could happen at home that could only be remedied in a hospital?

What risks could happen at a hospital that could only be avoided by being at home?

I took everything into account that I could... infections that can be caught at home and/or in water (water birth), infections that can be caught in a hospital, childbirth risks that can happen to anyone/anywhere...

I had my answer.

In a hospital is where I needed to have our baby.

I felt I had the best of both worlds in the hospital, with my birth team: my husband and my doula. I can hope for another fantastic nurse, I can hope for another lovely doctor... but there is no guarantee. But there is a guarantee that my birth team that I trust will help me ask questions, help me ask for options, help protect my space, help me feel uninhibited and unembarrassed and safe and able to surrender to the process, help my experience to be as close to my desired experience as possible. The doctor and nurse(s) may add to that team or may make it a challenge for that team but regardless, they will be there to keep us safe. They will have the interventions and equipment if needed or wanted readily available.

This is what worked for us. I felt that while home birth can sometimes be a safe option (and I wrote a blog post where I put together a list of things, based on my fairly extensive research, of what makes for a safe home birth option). But it wasn't going to be the right fit for us.

By Spring/Summer (ish) of 2012, I was 100% confident in my choice to have another hospital birth. But not only that, I felt compelled to share my journey, through my blog, shared the things I learned along the way, to process it all, and to maybe even help others that may be in the same boat I found myself in.

I knew publishing my first blog post would change certain things for me in my life. Specifically, it would change certain relationships. And it has. As you can imagine, it ended certain friendships. Our doula backed out of being with us for our birth. I was told by a birth world friend that my blog was "too negative, too extreme, I was advocating that women live life in fear." But that's not what it was about for me at all. I had so many "what ifs" running through my head when I was in the process of making the decision of where to have our 2nd baby... so much fear that I'd make the wrong choice (and other fears, too)... I had to hash it out. I wanted to make an informed decision. I wanted to feel confident in my choice. This is how my blog earned it's name... it's not about living life in fear or in a constant state of being bogged down by "what ifs." It was about allowing those "what ifs and fears" to guide me to gathering more information so I could feel confident in my choice; feel empowered and well-informed.

My blog started me down the path of advocating for change.

I believe education and standards and insurance and transparency are so incredibly important for home birth midwifery. My advocacy comes from a place of not trying to limit options -- it's from a place of believing that women deserve the best options.

**If you'd like to read more about home birth in our country, birth centers, studies and statistics, and more, click here. 

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You are reading Part 4 of "What Drew Me To Home Birth And What Turned Me Away." Click to view:

Part 1

Part 2

Part 3

Part 4 (currently reading)