Informed consent in the U.S is a HUGE joke, and women are subjected to emergency c-sections, sometimes caused by the actions of doctors themselves. It's the very argument that performing a c-section is the safer option against potential lawsuits that has c-section rates in this country so crazy high.
And the exorbitant cost of malpractice insurance is the very thing putting qualified midwives out of business!
As for the link about Andulaz, I was fully aware they had deaths from negligence in their practice when researching my birth choices in 2007, so once again, the information is there, even in the blog they give the contact information for OHLA. That link was certainly nothing new.
If we are going to talk about quality control, how about more increased accountability from the OB's for the poor outcomes from unnecessary interventions? Why single out midwives?
As far as my experience goes (anecdata, I know) informed consent is taken seriously here in Germany. You have to talk to the patient, draw pictures if necessary, there are information sheets for every little thing that you have to go through with the patient, you tell patients if you're about to do something and explain why if they ask and if they say no (and nobody's life is threatened) you're not allowed to do it.
Are there any initiatives yet in the US that work on improving informed consent? And on educating doctors, patients, etc.?
As for malpractice: overseas, american citizens (including patients) are known to be unbelievably trigger-happy when it comes to suing others. In order to change that, you'd need to change american culture....which is basically feasible (after all, suffragettes got the public to accept women's vote), but a VERY tough job.
Geman midwives have to carry malpractice insurance (though their starting situation is a bit different than yours) and they're still in business.
I feel that american midwives have a strong lobby amongst american women and if they can improve safety for mothers and babies to rates that are equal or better than those of OBs, and if they ALL carry insurance (reducing the likelihood that the insurance will have to pay since the risk is lower than it is now and spread over more people, lowering it further) then they should be able to pressure insurances to lower premiums into an acceptable range.
Also, carrying malpractice insurance is about providing quality and customer protection to clients and since I'm under the impression that midwives are a VERY patient-centristic, protecting their patients and seeing to it that they're cared for even if something goes wrong should be in their interest.
As for Andaluz, this is not about the information of their negligence being new to the midwife community.
This is about the question if they got off too lightly. I certainly think so.
The civil penalty seems like a pittance to me, considering that we're talking about the death of a baby and instead of having her licensed revoked or at least suspended for a REALLY long time, after being responsible for the death of not one but TWO dead babies within just two years, instead she goes on to expand her practice and opens another birth centre. If that had been my child that died, it would have felt like a slap in the face to see the culprit get off with nothing more than a small fine and some additional "homework". I'd certainly wouldn't feel like OHLA was actually doing something serious to hold negligent midwives accountable.
Concerning accountability of OBs for the negative consequences of unnecessary interventions, that's certainly something that needs to be done. I'm not familiar enough with the american system though to know how something like that would be done.....but I highly suspect that it'll involves suing someone.