Batshittery Redux: Sisterhood Before Safety

Ever since I wrote the post This is Batshittery, I remain appalled and aghast at the continued support the homebirth community offers to killer midwives. At the time, I received several comments along the lines of, “Don’t lump us together with those extremists!” or “They really aren’t getting THAT much support.” Unfortunately, the more I observe this horrifying phenomenon, the more I believe that it simply isn’t the case. These midwives have large numbers of supporters, including the leaders of the natural birth movement, and these advocates are putting the cause before the lives and health of women and babies.

Lisa Barrett has presided over five deaths in four years. Even if she were attending 100 births a year (which I’m sure she isn’t), this would be a shockingly high and inappropriate death rate. She revels in her maverick status and her website is full of birth stories which showcase her questionable judgment. Is she being called out by members of the homebirth community? No, but there are TWO facebook groups (Including one brilliantly named “I support Lisa Barrett and That’s Final“) with more than 1600 members showing their support and raising money for her. She was also a featured speaker at this year’s Trust Birth conference.

But there are no facebook groups raising money for her victims.

If Lisa Barrett were an isolated incident, maybe I could be convinced it’s just a few supporters showing their cultish devotion. But it isn’t. Not only did she take on a 43-year-old first-time mother (in an of itself a high-risk situation) with a breech presentation, whose baby ultimately died and preside over the death of a twin shortly after birth, Karen Carr also told a hemorrhaging mother who was being transported not to tell the hospital about the drugs she’d administered. This behavior is unconscionable for a midwife. In spite of the behavior, however, Karen Carr has more than 1500 supporters sending her money in the Legal Defense Fund for Karen Carr, CPM Facebook community and a whole bunch of people showed up to protest at her hearings.

But no one is raising money for her victims.

Sara and Jarad Snyder’s son Magnus died at the hands of midwives at the Greenhouse Birth Center in Michigan. In spite of the fact that the midwives carry no malpractice insurance, the Snyders managed to find an attorney to take their case, and they are suing. Are any homebirth advocates raising funds to assist them with their legal bills? Hardly. There are homebirth advocates, however, banding together with the midwives to raise money for their legal assistance. In fact, the leader of the natural birth movement, Ina May Gaskin herself, is lending her support to these midwives. You can’t get more mainstream (when it comes to NCBers, at least) than that. Other supporters include Barbara Harper of Waterbirth International; Peggy O’Mara, former publisher and editor of Mothering magazine and Mothering.com mogul; Jennifer Block, author of Pushed; and Geradine Simkins, president of MANA.

And the latest batshittery? At a birth center in Idaho, there were three infant deaths between October 11, 2010 and August 9, 2011. That’s THREE DEATHS IN LESS THAN A YEAR (side note: 2010 and 2011 are going to be banner years for CPMs. I can hardly wait for the CDC numbers to come out.). In one case, they neglected to clamp the cord before they cut it. In another, they took on a mother with Type 1 diabetes, a situation that many obstetricians will refer to a MFM and then neglected to transfer when the baby’s heart rate dipped dangerously low. When paramedics were eventually called, the midwife delayed them in reaching the mother. And finally, they allowed a woman to push for more than 10 hours after discovering meconium in her amniotic fluid. After these deaths, was there an outcry? Were there facebook groups created to raise money for these stricken families? No, but there was an outcry that the midwives are being investigated.

And we can’t forget Clarebeth Loprinzi, who abandoned a woman for hours with her placenta still in her uterus and who’s license was finally revoked years later after yet another infant death. Midwifery Today, the banner publication for homebirth, is hawking “educational” recordings she made with Anita Rojas, another midwife involved in Oregon infant deaths.

Then there’s Gloria LeMayAlison OsbornEvelyn MulhanAmy Medwin. Diane Goslin. Janet Fraser.

I’m sorry, but it looks like you homebirth supporters who find this bizarre phenomenon distressing are actually in the minority. The people who are supporting these mavericks are making a statement, “It is more important to make homebirth look good than to make it safe for women and babies.” But in reality, this blind devotion isn’t even serving your purpose. As homebirth becomes more mainstream and these bad midwives continue to practice, they will be hurting more and more families. More attorneys will take on civil suits.  More legislators will be appalled. More arrests will be made. Why not pull your support now and throw the bums out?

Beyonce Must Be a Terrible Mother

I personally have no idea what kind of mother Beyonce is. When I first read she was pregnant, I figured she’d be a lot like the rest of us: she would love her child deeply and want the very best for her.

Now that said infant has arrived, however, it has come to light that Beyonce is the Worst Mother In The World ™.  At least it has to many members of the Natural Child Birth Community. How did they figure this out? Well, they read in a few online tabloid articles that she gave birth via c-section. Because her baby was breech. At–somewhere around…maybe…that’s the rumor at least–37 weeks. Now, of course, breech babies are currently (unless you are a real woman, in which case you’ll give birth to your footling breech twins vaginally at home) on the official Approved Reasons for a C-section® list, but it is so very clear to these women that the timing for Beyonce is  inappropriate. We all know that articles about celebrities are the epitome of accuracy in journalism. We also know that certain members of the NCB elite have special powers enabling them to determine whether circumstances surrounding a c-section were appropriate without access to medical records (I have experienced women with these amazing powers firsthand when sharing my own birth story). And there is NO WAY that Beyonce might have released a due date later than her real one in order to throw the paparazzi off. So what does all this mean? Yep, it means that Beyonce is a selfish, horrible mother. And that the birth of her baby is sick. Gross. Ridiculous. Stupid. A real bummer. Worthy of the pronouncement, “Ugh!”

(might I interject here that I find it a little frightening that there’s a woman out there calling herself a midwife who is unaware of the difference between a gut and a uterus…)
But wait, there’s more! I had forgotten that when your baby is extracted through the sunroof, it isn’t really birth.
In reality, the baby was harvested and Beyonce would have been better off using a surrogate if she couldn’t handle a vaginal breech birth.
Yep. Oh, and beware injecting reason into any discussion regarding the issue, lest you find yourself banned!
Ah, warm memories come flooding back of the time I told my birth story in the livejournal [info]pregnant community. How quickly we forget that that mothers — even celebrities — who have c-sections are people, too.
Lest I be accused of taking things out of context, have a gander at the original threads yourself (they’re all currently open for anyone to view):

What OHLA Doesn’t Know Could Hurt You

I heard a nasty rumor for the third time yesterday: that the Legacy hospital system and Legacy Emmanual in particular have an unwritten policy of refusing to report sentinel events resulting from homebirth transfers and that they discourage their nursing and medical staff from doing so as well. Now, the first time I hear a rumor, I can ignore it. The second time it sticks in the back of my mind. And the third time? I start to think there may be something to it. Obviously I haven’t substantiated it, but when I hear something from three different people? Someone with sharper sleuthing skills than me needs to look into this.

Let’s take a step back for a minute. The history of reporting negative outcomes that end up at hospitals in Oregon has been fraught with drama. In 2010, a group of Portland midwives decided they didn’t want their bad outcomes reported and sued OHSU, a large Portland hospital, for reporting and their own licensing agency, OHLA, for investigating the reports.  Apparently these midwives are not big fans of having their inappropriate care of laboring women exposed. And apparently they don’t want to be held accountable for poor outcomes like health care workers in hospitals are.

See, hospitals are overseen by the Joint Commission, which mandates that all sentinel event outcomes (death, severe morbidity, transfusion, hemorrhage, etc.) require an investigation. Any outcome meeting certain criteria triggers intense scrutiny, evaluation, and assessment to determine if it was preventable or if standards need to be changed. The hospital system requires and ensures a thorough investigation to establish if there are systemic problems, problems with a specific practitioner, or problems with a policy or protocol that needs to be changed. ANY sentinel event results in multiple layers of meetings and discussions designed to prevent a recurrence. Not only that, in the hospital, no one works alone — there are many eyes watching each patient, which can seem intrusive, but this is part of what keeps women and babies safe and holds care providers accountable.

Where is that reflection and accountability for licensed midwives in Oregon? It simply doesn’t exist. And the only way that the Board of Direct Entry Midwifery and OHLA know of poor outcomes is if they are reported by hospitals, medical professionals, or other community members.

Back to the lawsuit.  If you google it, you can come up with all sorts of midwifery propaganda alleging that the big bad hospital is trying to put the tiny helpless midwives out of business. In reality,  the case was eventually settled with no wrongdoing found on the part of OHLA or OHSU. In any case, the argument that doctors are reporting for monetary gain is ridiculous. Homebirth accounts for a mere 1% of births overall, and HBACs and home breech births, which were the apparent basis for the lawsuit, account for even less than that. More likely, medical staff report such outcomes for the same reason any sane person would do so: they have a goal to keep  women and babies in the state of Oregon safe.

Not only that, but healthcare workers are mandated by law (Oregon HB 2059) to report “unprofessional conduct,” which means

conduct unbecoming a licensee or detrimental to thebest interests of the public, including conduct contrary to recognized standards of ethics ofthe licensee’s profession or conduct that endangers the health, safety or welfare of a patientor client.

And there are legal repercussions for not reporting! The same house bill requires that

(5) A licensee who fails to report prohibited or unprofessional conduct as required by subsection (2) of this section or the licensees conviction or arrest as required by subsection (3) of this section is subject to discipline by the board responsible for the licensee.

(6) A licensee who fails to report prohibited conduct as required by subsection (2) of this section commits a Class A violation

If this is the case, why would Legacy be declining to report such outcomes to the licensing board? One of my sources gave me a warm and fuzzy reason: if they report, midwives won’t bring potential bad outcomes to the hospital, or they’ll wait until it’s too late to do any good. If they have a policy of non-reporting, it’s actually safer for Portland families. That’s all well and good, though it doesn’t reflect well on Portland homebirth midwives.

Another person I spoke to offered a more sinister explanation. This individual thinks that Legacy is making a lot of money on NICU stays as a result of homebirth transfers, and they’d rather that other area hospitals don’t get that business. It’s true that one stay in the NICU is going to bring in a heck of a lot more money than a whole bunch of successful VBACs. Really? Maybe I’m not cynical enough, but I was shocked to hear that even floated as a scenario. I can’t imagine this could possibly be true.

There’s a third possibility as well: they’re afraid of lawsuits. These midwives have already proven themselves a litigious bunch, and even though no wrongdoing was found in the last lawsuit, I’m sure it cost a pretty penny (In a fantastic irony, legal fees were named as a reason for the need to increase midwifery licensing fees in a recent BDEM meeting. I guess that’s what happens when you sue your own board). No doubt Legacy wants no part of that hot mess.

But does fear absolve them of their duty to their patients and to the public to do the right thing? The LEGAL thing? I don’t think so.

Again, I don’t know if these allegations are true. I’m sure that Legacy has never put such a policy into writing, as it is illegal. However, I just can’t get past the fact that three different people would separately bring it up. If it is true, it is horrifying to me and something needs to change.

 

Whaaat??!? The Danger of Placenta Previa is Really Just “Hospital Drama”

You may remember the Whaaatt? post regarding birthing at home with placenta previa. If you need to refresh your memory, it’s right over here. As it turns out, the original page is the gift that keeps on giving. Birth Without BS posted a link for discussion on her facebook page, and many people were appropriately shocked at the poorhideously awful advice therein.  However, one commentor took it upon herself to educate the masses:

Ahhh, I see, that makes so much sense. If we could all just have a slightly more Traditional — with a capitol “T”! –indigenous paradigm (which has apparently been proven, as opposed to the “unproven male mechanistic medical paradigm”), things like placenta previa just wouldn’t be a problem! We can just keep calm and that placenta will take care of itself. Our reptilian brain will kick into gear and somehow get that baby THROUGH the placenta and out first. Not only that, if you manage to acquire that Traditional, indigenous paradigm, you WILL be able to just read something off the internet and go for it. Change your paradigm, people!!

 

 

WHHAAATT? Formula is a Fate Worse than DEATH?

Yes, that’s right. If that baby needs anything more than skin-to-skin contact and breastmilk, then you should apparently just let him die. I don’t know what’s more disturbing: that someone actually typed this out or that NINE  TWENTY ONE other people said, “Hey! I like that!”

(original post)

Only slightly less disturbing: the woman who thinks it might be reasonable to risk giving a special needs baby pertussis in order to donate breastmilk to him…

Off topic WHAT??!?: Proof that Birth-related Issues Do Not Have the Corner on the Sanctimommy Market!

ETA: In a spectacular twist of irony, it turns out that Mom 1 below is Brenda Scarpino-Newport, whose negligence and anti-hospital rhetoric contributed to the death of Mary Beth Chapman.

 

Happened across this little gem on a blog called “Mothers With Cancer.” Allow me to translate:

Mom 1: “I have cancer and I’m commenting on a site called mothers with cancer. I’m hoping to find some solace with other mothers experiencing the same thing. Here I will tell a bit of my story and say something thoughtful and a little little inspiring. I have an amazing attitude and am listening to my doctors and continuing the treatment they and I have decided is best, even in the face of a poor prognosis.”

Mom 2: “You idiot! How could you possibly be listening to your doctors? You know they’re just in it to make money off of you until you die! Which you are no doubt going to do. And soon, if you keep listening to them. Probably within weeks. Too bad you aren’t as insanely awesome as me, who went to doctors but totally ignored what they had to say, and who is curing herself with diet and exercise. You know that makes me superior!! And I’m cancer free!! Not that it actually had anything to do with my self-prescribed treatment, but na, na, na boo boo, you dumb a$$! Oh, wait. Better throw in a little pseudo-inspiring BS lest I look like a complete jerk.”

 

 

 

 

WHAT?? You would still VBAC with 99% chance of uterine rupture?

 

Oh, and before I get all the comments about how I’m shoving all NCBers in the same box…she may be the only one who would VBAC unassisted with a 99% chance of uterine rupture, but she sure isn’t the only one who thinks scientific evidence is bunk.

The good folk at Unhindered Living

Birth Without Fear

 Jette Clausen

 

All over the forums at MDC 

 

 

 

 

 

 

 

 

WHAT?? Birth at Home With Placenta Previa?

**note** My apologies for the lack of a baby in the picture. None of the ones I drew actually looked like a fetus, so I gave up.

Placenta previa is a very dangerous condition for both the mother and the baby. It occurs when the placenta covers the cervix — causing either complete previa or partial previa (fairly self explanatory) — or when the placenta is very close to the cervix, causing marginal previa. A recent study published in AJOG found that, in cases of marginal previa, at least two-thirds of women with a placenta farther than 10 millimeters were able deliver vaginally without increased risk of hemorrhage. The study is very small, though, and I would have liked to see a third group with normal placentas as a control. In any case, when it comes to complete or partial previa, good outcomes for both infant and mother depend on prenatal diagnosis and cesarean delivery before the membranes rupture. If not, they are at risk for some very nasty complications, including preterm delivery, blood clots, infection, placental abruption, hemorrhage of both the fetus and the mother, shock, and death. Placenta previa is not a joke.

This is why it is unconscionable for Unhindered Living to continue publishing the page Handling Placenta Previa At Home.

A few choice bits:

It seems like she realizes it’s terrible advice, because she’s qualifying every other statement, yet she still gives it! Placenta previa is NOT a “variation of normal,” so if you are diagnosed and it continues late in your pregnancy, please do not consider that page as a justification for a home birth. **Note** An early diagnosis of placenta previa (with the anatomy scan, 20ish weeks) may resolve itself as the uterus grows, and if that is the case, you would not need a c-section for previa. However, this is something that should be taken care of between you and your doctor or midwife, not by taking advice from websites.