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Friend's baby died...attempted homebirth then transfer :( Need some encouragement - Page 6

post #101 of 118
Quote:
Originally Posted by marsbars View Post

It seems the numbers for hospital deaths is higher than of homebirths, I'm sure everyone can read up on the statistics.

 

Watching "Business of Being Born" was really helpful and an eye-opener.

 

There's 7 billion people in this world, I think if homebirths/non-hospital births were dangerous, we wouldn't have gotten this far since hospital births was introduced in the early-mid 1900's.


1. We DID read up on the statistics (if you followed this thread) and sorry, but e.g. in Wisconsin, the death for homebirths is higher than for hospital births. If you have access to statistics indicating otherwise, please feel free to post a link.

 

2. TBOBB certainly gives insights into one side of the argument, but it also is shows a rather incomplete picture of the issue, thus skewing the issue as a whole.

 

3. Evolution doesn't require EVERYBODY to survive. It just requires ENOUGH people to survive. And if you did a little research, then you would quickly find that in the past and even today, the leading cause of maternal and neonatal death is birth.

 

post #102 of 118
Quote:
Originally Posted by Kanna View Post


The thing that started this particular discussion was Paigekitten being of the opinion that parents are responsible for picking a competent, skilled midwife.

 

I thought that there were several factors that hampered parents ability to do so and since this was the case, it would be states' responsibility to make sure as far as possible that ALL midwives that practice are skilled and that it is made transparent for parents exactly what kind of skills a specific type of midwive posessed and what kinds of situations she's able to handle. 

 

Where I live, there are licenses, regulated midwives, so I can choose one that the government and doctors approve of, if that's what I want. However, the final choice is mine, and if I want one who isn't regulated, I have that option, too. This is not an area where I want my responsibilities to be handed over to the state, thakn you very much. Their approach to regulation has hurt me badly over the course of my reproductive life. I agree that, if a midwife is licensed, that should mean she has a certain level of education and experience (or the license is meaningless), and should be held accountable if she fudges that. (Actually, I think an unlicensed midwife should be hit hard if she lies about her experience and education, too. I'd guess that, after the fact, it would be hard to prove what she did or didn't claim, though.)

 

 

I think this should be done because there have been several instances of negligent or at least incompetent midwives being responsible for the deaths of babies.

And while there are incompetent, negligent doctors too (see the story of Lisa1970), if a doctor messes up, you can sue his pants off. It's not possible to do that with midwives, since, amongst other things, they don't usually carry malpractice.

 

Malpractice insurance protects the person being sued. It doesn't enable a lawsuit. If I wanted to sue an unlicensed provider, who didn't carry insurance, I could still do it. It's just that 1) I may not receive as much (as any award is limited to what they actually own), and 2) it would hurt them a lot more than someone with insurance (whose rates go up, but isn't in danger of losing their home, car, etc. etc.). In any case, I have no desire to sue anyone's pants off, unless they do a c-section on me while they're drunk, or something equally egregious. I consider it a simple fact of life that doctors and midwives make mistakes, and those mistakes can be very serious. I don't consider that to be malpractice (no matter how "malpractice" is defined in law) - I consider that to be human.

 

So I feel that if you can't sue if things go wrong, the parents should at least receive help in picking a midwive that WON'T mess up and I think that the current amount and quality of information available (and the lengths you need to go to to find it) make that next to impossible.

 

Help from whom? I know of several midwives that I wouldn't use. I know of several other people who have had bad outcomes with midwives that I can't identify. But, if I were birthing in those people's areas, I'd definitely get in touch and ask for more information.

 

So for starters, there might not be a lot of parents that are not good at doing research, but even if they are few, they deserve to get the information they need in order to make an informed choice. They need to know that if things go south, the midwife will be able to recognize that, recognize it in a timely fashion, that she has made appropriate provisions for transfer to a hopsital where complicaitons can be dealt with and that she will be able to stabilize the situation until they arrive at the hospital. The information you currently find on the internet concerning such a situation is completely insufficient.

 

That's actually more information than I've ever had about a doctor - it's just assumed that they know all those things. In any case, there is no way to have this information, because all births are subjective, and there's no way to know how things will go south, if they do. I lost my son in a hospital (yes, after a homebirth transfer). I had continuous EFM, and was actually waiting for a c-section (not because things had gone south - the only reason I was ever given by hospital staff for needing a c-section was that I'd already had three). Nobody knew things were going south, except that I'd exceeded guidelines on how long I'd been in labour, until his heart simply stopped - no decels. Since I was in a hospital at that point, everything's fine, and the hospital staff are presumed to have done everything right, and "everything they could". If the exact same thing had happened while I was still at home, people would have been screaming for my midwife's head, and accusing her of incompetence. If all the OB's experience, and the L&D nurse's experience, and a decision to incision time of less than 10 minutes (to the best of my recollection, it may have been under 5, but I've misplaced my records and can't check), were insufficient to prevent my son's death, then what "information" from a homebirth midwife could have done so? She could have handled many other situations (I know women she's attended who have had complications, which have been handled well), but there's no way to "stabilize" a stopped heart.

 

FWIW, the hospital staff made one or two minor errors, imo. I have no idea if they'd have been able to save my son if they hadn't, but I'm not out for revenge or payback. The mistakes they made were only human.

 

It's good that you and paigekitten have mad researching skillz....but not everybody does and it shouldn't be a requirement for parents that are looking for ways to have their kids safely.

 

I never said that I have "mad researching skillz". But, any care provider, doctor or midwife, licensed or not, can have skeletons in their closet. Having a license or being regulated doesn't mean you never screw up, or that you can do everything you claim you can.

 

The bottom line is that people can set up whatever licensing or regulation they want to. I can't stop them. But, as a pregnant woman (to be clear, I'm actually not pregnant - I'm done having babies), I also have the right to choose a care provider who suits me, whether or not my pregnancy fits into the guidelines required by a regulatory board. I've never had a baby safely, except for an externally imposed definition of "safe", and that's partly because of the guidelines and regulations put in place to "protect" me. (At least one of my c-sections was done almost entirely to protect the OB from a potential lawsuit, because I was outside guidelines on length of gestation. The really sick aspect of that is that I wouldn't have sued, and that c-section did permanent physical damage to my pelvis...for which I have no legal recourse, because he was "within guidelines". The rules protected him, not me...except that I wouldn't have sued for that, either.) I like the fact that there are unlicensed, "rogue" midwives, because they maintain an element of choice that's utterly absent in the regulated system.

 



 

post #103 of 118
Quote:
Originally Posted by Kanna View Post


1. We DID read up on the statistics (if you followed this thread) and sorry, but e.g. in Wisconsin, the death for homebirths is higher than for hospital births. If you have access to statistics indicating otherwise, please feel free to post a link.

 

I've never seen really good statistics on this. Since the stats so often (I'm tempted to say "always") fail to account for accidental homebirths (you know, the "OMG - the baby was born at home, but it somehow survived, and the heroic dad/sibling/neighbour/random stranger caught it - mom was there, too" headlines), or accurately record attendants, etc., I have trouble taking them seriously.

 

2. TBOBB certainly gives insights into one side of the argument, but it also is shows a rather incomplete picture of the issue, thus skewing the issue as a whole.

 

TBOBB is what skews the issue? Seriously? The issue was already skewed. I'm not sure TBOBB is entirely accurate, but being slightly weighted to the other side of an issue than pretty much everything else in the media doesn't mean that TBOBB is the source of the skew!

 

3. Evolution doesn't require EVERYBODY to survive. It just requires ENOUGH people to survive. And if you did a little research, then you would quickly find that in the past and even today, the leading cause of maternal and neonatal death is birth.

 

While I agree about evolution, I also find the "leading cause of death was/is birth" argument to be overly simplistic. As far as I can tell, we have no data on maternal deaths during childbirth on women having intervention-free births, where the women are adequately nourished, have access to clean water, etc. And, a huge percentage of the drop in deaths in childbed happened when antibiotics were discovered, which is quite separate from modern obstetrics. (Research has also led me to the conclusion that when doctors first took over birth from midwives, and moved pregnant women to hospitals, mortality went up, not down.)



 

post #104 of 118

I really don't think malpractice insurance has much to do with providing safe care. I don't think lawsuits have done much to improve our medical situation here in the US and doctors are sued left and right and up and down. If anything, I believe it destroys good care. Good doctors have left medicine due to inability to keep up with the rising costs of malpractice insurance. Hospitals have brought in policies that are not at all about evidence-based care and are all about avoiding lawsuits and liability.

 

There are doctors who practice without malpractice, but then they cannot accept certain insurances. No problem. They usually make up for it with being quite affordable. This is the same with midwifery care. I disclose in writing and in oral format to all potential clients that I have no malpractice and that I also own nothing. If they want to sue me, they could get a 1998 subaru with 200,000 miles on it. If they enter into a contract with me for care, they go in with it being quite transparent.

 

What I do see about malpractice insurance requirements.... it is a good way to shut down homebirth providers. It is a good way to drive people out of private practice. I would be curious to know what the costs of malpractice insurance in Germany are in comparison to the US for providers who are attending births. It can be absolutely insane here in the US due to people being quite "trigger happy" with lawsuits. For many doctors the cost of insurance goes up with the more experience they have because the insurance company starts to feel their time is coming for a lawsuit. That is insane. One would think the more experience one would have the better as they would be less likely to make mistakes.

post #105 of 118
Quote:
Originally Posted by Kanna View Post




1. We DID read up on the statistics (if you followed this thread) and sorry, but e.g. in Wisconsin, the death for homebirths is higher than for hospital births. If you have access to statistics indicating otherwise, please feel free to post a link.

 

 


I also posted a couple of studies earlier in the thread with statistics indicating that deaths for homebirths were equal to hospitals, but other poor outcomes were lower. 

 

post #106 of 118
Quote:
Originally Posted by Kanna View Post

 

I think that people debating stuff here are not doing it so they can one-up other people. I think people are debating, because they want to be CERTAIN that they are making good choices for themselves and their families, and you can only be sure that your choice is good, if your assumptions have been challenged and have withstood this rigorous test.

 

Concerning the tone:

 

Overall, I perceive the tone here as mostly civil (on both sides), but I'm someone who is used to straightforward, bordering on blunt communication patterns that may also include heated debate, so there might be some undertones that I don't catch. If you consider any phrase in the comments I posted as hitting the wrong notes, please let me know why and I'll go back and edit.

 



I have only read through this thread up to here, but personally, I think the problem is that there really should be no place for "debate" within a thread of this nature.  OP was asking for encouragement, not a heated debate over a tragedy that none of us know the details of.  It would seem much more appropriate to start a new thread debating c-sections and everything else instead of hijacking this thread to "debate."  I find it downright disrespectful and I am in no way a home birth advocate.  Kanna, I have noticed from several posts that you seem to love a good debate, and that is perfectly fine.  Just find a more appropriate thread to have a debate on. 

 

post #107 of 118

 

Quote:
And while there are incompetent, negligent doctors too (see the story of Lisa1970), if a doctor messes up, you can sue his pants off. It's not possible to do that with midwives, since, amongst other things, they don't usually carry malpractice.

Kanna, the research would say otherwise.  http://www.nejm.org/doi/full/10.1056/NEJMsa054479

 

The majority of the 1500 lawsuits studied did not make the legal definitions of frivolous, (debunking the great "hot coffee myth" that permeates the national tort "reform" debate).  Most cases were settle out of court.  Cases that did go to trial resulted in a loss for the plaintiff in 80% of cases. 

 

(Interestingly, the majority of suits (19%) were against obstetricians).

 

What this article doesn't mention as is that most---perhaps all--malpractice settlements include a legal "gag order" forbidding the plaintiff from ever making public mention of the case.  This means that while anti-homebirthers gleefully post dead-baby stories that get published in newspapers in order to score themselves cheap political points (not a slam on you, I just see a lot of it on the Internet), the grieving mothers who lost babies due to hospital negligence have to muffle their voices. 

 

So you see, it's not so simplistic as "suing [a doctor's] pants off."  And as StormBride said, the lack of malpractice insurance doesn't make a person immune to a lawsuit; it just devastates them even more should they be sued.

 

By the way, if MWs had their own separate malpractice program, I'd support it.  What is preposterous is expecting midwives to pay the same medical malpractice insurance as obstetricians, surgical specialist whose work includes high risk cases.  Physicians who push for the latter are trying passive-aggressively to run midwives out of business and secure their control over childbearing women. 

 

post #108 of 118
Quote:
Originally Posted by APToddlerMama View Post





I have only read through this thread up to here, but personally, I think the problem is that there really should be no place for "debate" within a thread of this nature.  OP was asking for encouragement, not a heated debate over a tragedy that none of us know the details of.  It would seem much more appropriate to start a new thread debating c-sections and everything else instead of hijacking this thread to "debate."  I find it downright disrespectful and I am in no way a home birth advocate.  Kanna, I have noticed from several posts that you seem to love a good debate, and that is perfectly fine.  Just find a more appropriate thread to have a debate on. 

 

I'm to blame too, though.  I shouldn't have responded.bag.gif  I would continue this in a different thread. 
 

 

post #109 of 118
Quote:
Originally Posted by Paigekitten View Post




I also posted a couple of studies earlier in the thread with statistics indicating that deaths for homebirths were equal to hospitals, but other poor outcomes were lower. 

 


Kanna-- That's the reason why to me it seems like you are pushing an agenda here. You don't ever refer to the studies posted by others who have shown the outcomes of homebirth to be quite different from what you keep stating. I just read this thread and that was my first impression. Hope that helps you understand why this conversation can strike a bad note for some people.

 

post #110 of 118
Quote:
Originally Posted by APToddlerMama View Post





I have only read through this thread up to here, but personally, I think the problem is that there really should be no place for "debate" within a thread of this nature.  OP was asking for encouragement, not a heated debate over a tragedy that none of us know the details of.  It would seem much more appropriate to start a new thread debating c-sections and everything else instead of hijacking this thread to "debate."  I find it downright disrespectful and I am in no way a home birth advocate.  Kanna, I have noticed from several posts that you seem to love a good debate, and that is perfectly fine.  Just find a more appropriate thread to have a debate on. 

 


bag.gif  I certainly have been perpetuating the debate.  I totally would move to a new thread though.

 

post #111 of 118

I just want to say that, while I agree that this isn't the proper thread for a debate, the question of supporting the OP is somewhat irrelevant at this point, as her baby was due last year, and it looks from her signature as if she had a little girl in October (although I may be reading that wrong).

post #112 of 118
Quote:
Originally Posted by Storm Bride View Post

I just want to say that, while I agree that this isn't the proper thread for a debate, the question of supporting the OP is somewhat irrelevant at this point, as her baby was due last year, and it looks from her signature as if she had a little girl in October (although I may be reading that wrong).



It doesn't change the fact that some mother lost a baby which is what this thread was supposed to be about.   I don't blame anyone for responding to Kanna or think the responses perpetuate the debate really.  To me, it seems more of a defense of the poor mother whose baby died.  Regardless, I find it really tasteless to pull up old threads to push an agenda, especially when the thread involves this sort of tragedy. 

 

post #113 of 118
Quote:
Originally Posted by Storm Bride View Post

I just want to say that, while I agree that this isn't the proper thread for a debate, the question of supporting the OP is somewhat irrelevant at this point, as her baby was due last year, and it looks from her signature as if she had a little girl in October (although I may be reading that wrong).



coolshine.gif Cool! Thanks for sharing that bit of info (=little girl in October) and congrats to the mom!


Edited by Kanna - 8/10/11 at 3:03pm
post #114 of 118
Quote:
Originally Posted by APToddlerMama View Post





It doesn't change the fact that some mother lost a baby which is what this thread was supposed to be about.   I don't blame anyone for responding to Kanna or think the responses perpetuate the debate really.  To me, it seems more of a defense of the poor mother whose baby died.  Regardless, I find it really tasteless to pull up old threads to push an agenda, especially when the thread involves this sort of tragedy. 

 


 

*sigh*  Good thing I WASN'T pulling up old threads to push an agenda then, no?

post #115 of 118

New thread started!!!!!

 

"The price of being the best.....is having to BE the best.

Or: On how to make Homebirth even safer"

 

(Quote at the beginning by Terry Pratchett)

 

Here's the link:

 

http://www.mothering.com/community/forum/thread/1325291/the-price-of-being-the-best-is-having-to-be-the-best-or-on-how-to-make-homebirth-even-safer-initial-quote-by-terry-pratchett#post_16599945

post #116 of 118



 

Quote:
Originally Posted by Kanna View Post




1. We DID read up on the statistics (if you followed this thread) and sorry, but e.g. in Wisconsin, the death for homebirths is higher than for hospital births. If you have access to statistics indicating otherwise, please feel free to post a link.

 

2. TBOBB certainly gives insights into one side of the argument, but it also is shows a rather incomplete picture of the issue, thus skewing the issue as a whole.

 

3. Evolution doesn't require EVERYBODY to survive. It just requires ENOUGH people to survive. And if you did a little research, then you would quickly find that in the past and even today, the leading cause of maternal and neonatal death is birth.

 


 

 

1. No, I did not completely follow this thread. I prefer to keep my replies minimal and without link jumping. There are enough statistics online regarding safety for homebirths vs hospital births...

 

2. To each their own

 

3. You would also know that one of the leading causes of human death is car accidents. So I guess we should avoid all moving vehicles then.. Sorry, but if we don't need medical intervention to eat or have bowel movements in general, I don't see a need why a labouring women would also unless there were complications. As you know, very rarely a person has an impacted bowel and may need help removing it.......Have you read the stats of hospital birth deaths at ALL??? You can't avoid death, you can't avoid fate. It's the reality of it.

 

Think about how many millions of babies die in the hands of a doctor. I've personally known of some people who has lost a baby while labouring, in the hospital. So you can argue two ways.

 

post #117 of 118
Quote:
Originally Posted by marsbars View Post

1. No, I did not completely follow this thread. I prefer to keep my replies minimal and without link jumping. There are enough statistics online regarding safety for homebirths vs hospital births...

 

2. To each their own

 

3. You would also know that one of the leading causes of human death is car accidents. So I guess we should avoid all moving vehicles then.. Sorry, but if we don't need medical intervention to eat or have bowel movements in general, I don't see a need why a labouring women would also unless there were complications. As you know, very rarely a person has an impacted bowel and may need help removing it.......Have you read the stats of hospital birth deaths at ALL??? You can't avoid death, you can't avoid fate. It's the reality of it.

 

Think about how many millions of babies die in the hands of a doctor. I've personally known of some people who has lost a baby while labouring, in the hospital. So you can argue two ways.

 



If you wish to continue this, could you please take it to the new thread? Thank you.  ^_^

post #118 of 118

Midwives (DEMs & CPMs) DO have access to at least two different professional liability policies...

 

Prime Insurance: http://www.primeis.com/product_lines/professional_liability.html

Dean Insurance: http://www.deaninsurance.cc/malpractice.html

 

There may be others, but these are the ones that I am aware of.

 

Kim Mosny, CPM, LM

Home Birth Midwifery Service

Midlothian VA

 

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