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Friend's baby died...attempted homebirth then transfer :( Need some encouragement - Page 5

post #81 of 118
Quote:
Originally Posted by Paigekitten View Post


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. wink1.gif

 

 

post #82 of 118
Quote:
Originally Posted by MidwifeErika View Post


I also believe that in all aspects of maternity care we should always, always, always be looking to be improving out outcomes. Regardless of birth location or attendant.


 


,truedat.gif

 

I'm wondering....it there a thread somewhere in the midwives forums addressing this issue? Because if there isn't one yet, I think it definitely would be worth starting one!

 

(Don't worry....I wouldn't post on that one. wink1.gif I figure I lack the qualification to discuss acutal measure to resolve the problem because a) I'm not a midwife and b) I'm not even American)

 

post #83 of 118
Quote:
Originally Posted by Paigekitten View Post



It's not terribly difficult to look up state code for licensure requirements for midwives, or to point blank as a midwife questions about birth outcomes, and experience in emergencies in her practice.  And quite frankly, that IS my responsibility as a parent and a patient.

 

Just as "trust birth" get's thrown around a lot, so does the assumption "trust doctors".  I'm more from the camp of "question everything and make my decisions from there."  And it should be my right to do so and wide-spread sweeping legislation of homebirth isn't the solution.

 


I don't agree. First of all, not all parents are research savvy. Some people don't use the internet and finding out that kind of information with the 'net is work enough. Doing it without, when you know little about where to start and what to look for.....difficult.

 

Second, I did a bit of searching, just to see how well it would go.

 

I found the website of the medical board of california ba googling "state code for licensure requirements for midwives" and what I found on their site was a bit too much on the side of legalese and not very informative on top of that.

 

http://www.medbd.ca.gov/allied/midwives.html

 

The next links weren't much better either:

 

http://www.pacode.com/secure/data/049/chapter18/chap18toc.html 

http://www.azdhs.gov/als/midwife/

 

I tried googling for "good midwife" and the results were equally unsatisfying and un-informative.

 

http://www.associatedcontent.com/article/5661498/choosing_a_midwife_five_qualities_of.html?cat=52

 

http://www.ncbi.nlm.nih.gov/pubmed/17042821

 

This one was the best I found:

 

http://cfmidwifery.org/midwifery/faq.aspx

 

...and it mentions how "The Midwives Model of Care is based on the fact that pregnancy and birth are normal life processes." and that "Your choices are going to be dependent on several criteria: the legal status of midwifery in your state, the kind of midwife you're looking for, and the availability of midwives in your area. Here are some suggestions" and that "The hallmark of the Midwives Model of Care is respect - for the mother and baby, for the family, for the birth process itself."

 

But finding something about the complications that can arise during birth and how different midwives are equipped to handle it and how it's a criteria that should be checked for when looking for a good midwife? As far as I could tell: zilch. Not exactly "informed consent" enabling, is it?

 

....and this one, I found a bit counter-informative if you're trying to check out if your midwife is truly as competent as she claims she is:

 

http://www.mothering.com/community/forum/thread/1265590/austin-faith-beltz-a-good-midwife

 

To quote MDC policy: "Positive healthcare provider reviews are welcome. Please use careful language when responding to or soliciting a review. We do not wish to host negative remarks or comments about practitioners, practices, hospitals or healthcare centers that might cast them in a negative light and which would present liability concerns for you and for Mothering. Negative comments that are verifiable facts of public record or court ruling are acceptable."

 

This kind of policy makes it darn difficult to get a good, critical look at a midwife, will make people reluctant to post about it if they heard stuff went wrong at the midwifes parctice.....and I figure a lot of expecting moms come to MDC for advice about exactly this kind of thing.

 

One more thing: YOU are from the " camp of "question everything and make my decisions from there."" Not everybody is.

Some people are a lot more trusting and if the are told by someone who was introduced to them as a "professional" that there's not reason to worry, then they will rely on that professional's opinion.

Some people are shy and have a difficult time questioning someone they perceive to be of greater authority.

 

It seems callous to me to condemn these people to risking their lives and the lives of their babies in the hands of incompent midwives, because they lack the research skills and are more trusting or shy than you to question what they're being told.

post #84 of 118

Kanna, one quick point before I proceed with my busy day: The EFM study that you referenced makes no mention of a comparison group to auscultation (bolding my own). 

 

Quote:
In the regression analyses, the primary exposure variable was EFM status during labor (yes vs no).

 

Quote:
Additional secondary analyses were conducted. We compared the distribution of having operative vaginal or primary cesarean delivery based on EFM status.

 

I will try to read it more thoroughly during my baby's nap this afternoon (I just briefly perused the section on methodology), but if it's the study I'm thinking of, it was industry-funded and compares EFM to no EFM at all.  In the context of our debate, we'd need to see how it compares to auscultation. I'll post more later on the research supporting auscultation.

 

 

post #85 of 118
Quote:
Originally Posted by Turquesa View Post

Kanna, one quick point before I proceed with my busy day: The EFM study that you referenced makes no mention of a comparison group to auscultation (bolding my own). 

 

 

 

I will try to read it more thoroughly during my baby's nap this afternoon (I just briefly perused the section on methodology), but if it's the study I'm thinking of, it was industry-funded and compares EFM to no EFM at all.  In the context of our debate, we'd need to see how it compares to auscultation. I'll post more later on the research supporting auscultation.

 

 


We definitely need more input before coming to any viable conclusions.


Actually, I was a bit pressed for time myself when I wrote that comment. I had time enough to google for a paper on the subject, to get us started and came across this one, which seemed as good a starting point as any....but nope, I haven't gotten around to looking at it in depth either yet.

 

I'm wondering....maybe this subject is worth starting a new thread over?

post #86 of 118
Quote:
Originally Posted by Kanna View Post




...and are you now going to accuse me of lying, when I tell you that I DON'T have an agenda and that I'm NOT here to preach? Because I've stated that in previous comments that

 

a)

As a mother or a two year old, I'm interested in a wide variety of subjects ranging from from wooden toys, vaxing, drinking water quality, birth, schools, missing breastfeeding, dealing with a kids temper tantrums and recommendations for good baby slings...which, if you've taken a look at my posting history, should be something you've notice.

 

b) The thread might be a year old, but if you're scrolling down a list of topics, it's just a tiny nudge of the mouse away.I didn't even notice the darn thing was a year old when I clicked on the link and only noticed when I was writing my first comment (and trying to figure out when the OP was due). It's similar for other threads.

 

I look for stuff I find interesting, not stuff that is "new".

 

c) There have been other people here in this thread, engaging in a vivid and interesting discussion, adding there own to cents from the other side of the spectrum, with lots of links to information they felt supported their viewpoint (e.g. Turquesa or MidwifeErika), and I don't see you accusing them of "....preaching an agenda".

 

Don't you think that's a bit of a double-standard on your part?

 

d) I'm someone who likes sharing experience and information with others, especially if its information and experiences I haven't come across before, because I feel that ideas and beliefs that I hold have to be put to the trial by others in order for them to be something I can base my decisions and my way of living on. If those ideas and beliefs that I have withstand this "trial of fire", I will keep them. If they don't, then I discard them, for they have proven that they aren't "solid ground to stand on".

 

This is, if I'm not mistaken, perfectly in accordance with the MDC guidelines that state that moms should come here "... with a desire to examine, discuss, and learn".

 

e) In addition to all that, I believe that MDC guidlines state that posts should be "respectful, and courteous".

And somehow, I think that you barging in here only to accuse me of "...preachin an agenda" does NOT fall under the heading of "respectful and courteous".

 

From Turquesa's and MidwifeErika's posts I understand why the "old" MDC'ers might be a bit on the edge, but quite frankly, so going by some of the posts in this forum I'm NOT under the impression that this is a community that deserves to be called fair, repectful or welcoming to newbies.

 

You just charge in, slinging around accusations, without trying to talk to people and find out more first.

 

 



lol... I said five words.  If that makes you feel that I'm "charging in, slinging accusations", I'm sorry.  

 

It's just that MDC is generally supportive of homebirth, as well as the decision to not vax, etc.  I read this entire thread, and it made me go back to look at other threads you had posted in, simply because I found it odd that you dug up this old post.  In doing that, I found that you had gone back to a few older posts, several of which dealt with homebirth and vaccination.  I'm sorry if some of us feel like you may have a bit of an agenda, but it is what it is.  I don't think I'm being rude at all... just pointing out that I noticed you had done that too.

post #87 of 118
Quote:
Originally Posted by Kanna View Post




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. wink1.gif

 

 


My personal experience of informed consent has been signing acknowledgements that by refusing xyz, I put myself at risk.  I have had VERY few experiences where the actual risks of accepting a procedure were adequately explained to me beforehand (actually, I can't think of one in any personal situation with a medical provider).  I know this has been the experience of many many other American women.

 

As for malpractice insurance, it would be nice if midwives were able to protect themselves and still provide affordable care for the women they serve.  If midwives all started carrying malpractice insurance, they would need to start charging more for their services. Already the cost of paying cash for a homebirth makes a qualified birth attendant unattainable for some. It's not always as clear cut as providing quality and protection, you can't provide quality care if no one can afford your care to begin with.

 

And I agree, American's are trigger-happy on lawsuits, and I personally believe it is not in our best interests.



Quote:
Originally Posted by Kanna View Post




I don't agree. First of all, not all parents are research savvy. Some people don't use the internet and finding out that kind of information with the 'net is work enough. Doing it without, when you know little about where to start and what to look for.....difficult.

 

Second, I did a bit of searching, just to see how well it would go.

 

I found the website of the medical board of california ba googling "state code for licensure requirements for midwives" and what I found on their site was a bit too much on the side of legalese and not very informative on top of that.

 

http://www.medbd.ca.gov/allied/midwives.html

 

The next links weren't much better either:

 

http://www.pacode.com/secure/data/049/chapter18/chap18toc.html 

http://www.azdhs.gov/als/midwife/

 

I tried googling for "good midwife" and the results were equally unsatisfying and un-informative.

 

http://www.associatedcontent.com/article/5661498/choosing_a_midwife_five_qualities_of.html?cat=52

 

http://www.ncbi.nlm.nih.gov/pubmed/17042821

 

This one was the best I found:

 

http://cfmidwifery.org/midwifery/faq.aspx

 

...and it mentions how "The Midwives Model of Care is based on the fact that pregnancy and birth are normal life processes." and that "Your choices are going to be dependent on several criteria: the legal status of midwifery in your state, the kind of midwife you're looking for, and the availability of midwives in your area. Here are some suggestions" and that "The hallmark of the Midwives Model of Care is respect - for the mother and baby, for the family, for the birth process itself."

 

But finding something about the complications that can arise during birth and how different midwives are equipped to handle it and how it's a criteria that should be checked for when looking for a good midwife? As far as I could tell: zilch. Not exactly "informed consent" enabling, is it?

 

....and this one, I found a bit counter-informative if you're trying to check out if your midwife is truly as competent as she claims she is:

 

http://www.mothering.com/community/forum/thread/1265590/austin-faith-beltz-a-good-midwife

 

To quote MDC policy: "Positive healthcare provider reviews are welcome. Please use careful language when responding to or soliciting a review. We do not wish to host negative remarks or comments about practitioners, practices, hospitals or healthcare centers that might cast them in a negative light and which would present liability concerns for you and for Mothering. Negative comments that are verifiable facts of public record or court ruling are acceptable."

 

This kind of policy makes it darn difficult to get a good, critical look at a midwife, will make people reluctant to post about it if they heard stuff went wrong at the midwifes parctice.....and I figure a lot of expecting moms come to MDC for advice about exactly this kind of thing.

 

One more thing: YOU are from the " camp of "question everything and make my decisions from there."" Not everybody is.

Some people are a lot more trusting and if the are told by someone who was introduced to them as a "professional" that there's not reason to worry, then they will rely on that professional's opinion.

Some people are shy and have a difficult time questioning someone they perceive to be of greater authority.

 

It seems callous to me to condemn these people to risking their lives and the lives of their babies in the hands of incompent midwives, because they lack the research skills and are more trusting or shy than you to question what they're being told.


I went to the California state website and searched midwives and came up with a list of links, including how to look up licensed midwives in the state.

 

http://www.ca.gov/CaSearch/Default.aspx?type=All&search=midwives

 

On the Oregon.gov site searching for licensed midwife came up with plenty of information including the text of the state code regarding licensure.

 

http://oregon.gov/search_results.shtml?cx=005482606056434223770%3Auq7asij-tbc&cof=FORID%3A10&ie=UTF-8&q=licensed+midwife&siteurl=oregon.gov%2F

 

The U.S. is HUGE.  The way search engines work you aren't going to get state specific and provider specific information with general search terms.

 

I think the barriers you mention to finding a good midwife are true.  I think they apply for every single medical profession in the U.S.  I suspect most people just got to whoever their insurance covers, with little thought to whether or not that provider is a good fit for them or has a history of providing poor care. 

 

Also, I found a couple studies regarding the safety of homebirth in general with a CPM that I figured I'd share, just because I think they are very interesting.

 

http://www.cmaj.ca/content/early/2009/08/31/cmaj.081869.short

 

http://www.bmj.com/content/330/7505/1416.full?ehom

post #88 of 118
Quote:
Originally Posted by xzaviers_mama View Post





lol... I said five words.  If that makes you feel that I'm "charging in, slinging accusations", I'm sorry.  

 

It's just that MDC is generally supportive of homebirth, as well as the decision to not vax, etc.  I read this entire thread, and it made me go back to look at other threads you had posted in, simply because I found it odd that you dug up this old post.  In doing that, I found that you had gone back to a few older posts, several of which dealt with homebirth and vaccination.  I'm sorry if some of us feel like you may have a bit of an agenda, but it is what it is.  I don't think I'm being rude at all... just pointing out that I noticed you had done that too.


*sigh*

 

Yes, it was only 5 words....but you were the 3 person in 2 days implying I was an EBIL doctor kidnapping the thread and holding it for ransom because it was apparently my goal to brainwash everybody with a world-view that differed from mind. And non of you were particularly polite either.

 

But yeah, apology accepted.

 

Hint for the next time something like this happens:

 

Turquesa went about it a whole lot better I feel. She wrote: "I find it interesting that you resurrected this thread after over a year.  You must feel passionate about this topic." See? Non-confrontational, friendly and still she got to ask me whyeverfore I was latching onto this thread.

 

To lay any remaing doubts you might have about me to rest:

 

Yes, homebirth and vaccination are things that interest me.

 

Homebirth because I gave birth to years ago and had to decide on where to do it and to me the decision to do it at the hospital was something I knew I wanted right from the start and I'm curious about what leads other people to make a different choice.

 

Vaccination because our family is vaxed to the max (I traveled abroad and so I'm even immunized against Yellow Fever, Rabies, different forms of meningits rampant in Asia....) and we're doing fine, but I'm aware that that's just anecdata, and since (as a doc) I DO get asked by friends and aquaintances about the pros and cons of vaccination, I felt I needed a more in depth knowledge than the one I already had.

 

Also, if you've taken a look at my posting history, you'll have noted that I posted across a wide range of topics (circing and Montessori got added today to other subjects ranging from how to bf while lying down to recommendations of natural wooden toy producers here in Germany).

 

And yes, I feel that it IS rude to just point at someone and shout "HA!!! I'm fairly certain you're only here because you have an ebil, ebil underlying agenda and on top of that you probably want to talk down to us to bolster your tiny crippled ego".

 

The old saying "Innocent until proven guilty" still holds, and darn it, if you were wondering about my motives, would it have been too much to just plain politely ASK about them, like Turquesa did, instead of jumping to conclusions and wildly pointing fingers first?

 

As for MDC being supportive of HB: Going by the moderators words of "... with a desire to examine, discuss, and learn".I somehow was under the impression that "supportive" did NOT equal "we will not discuss debate the fine points, ever".

post #89 of 118

I just wanted to say to SaveTheWild, you sound like you will be brilliant doctor--I hope if my next delivery goes south I will get someone like you!

post #90 of 118
Quote:
Originally Posted by Kanna View Post



 

And yes, I feel that it IS rude to just point at someone and shout "HA!!! I'm fairly certain you're only here because you have an ebil, ebil underlying agenda and on top of that you probably want to talk down to us to bolster your tiny crippled ego".

 

 


If you read all of that, from my "I noticed this as well"... I'm not really sure what to tell you.  Maybe you're looking to feel attacked?  I don't know... shrug.gif

 

post #91 of 118
Quote:
Originally Posted by Kanna View Post


I don't agree. First of all, not all parents are research savvy. Some people don't use the internet and finding out that kind of information with the 'net is work enough. Doing it without, when you know little about where to start and what to look for.....difficult.

 

While I'm sure there are exceptions, ime, the people you're talking about are far, far more likely to see a doctor than a midwife, for both prenatal care and attending the birth. I do think there are some people in the natural birth community who are overly inclined to "trust birth", even under really extreme circumstances. And, there are some who blame the mom's emotional/psychological state for everything that goes wrong in L&D (although mom blaming certainly isn't limited to natural birth circles - it's a favourite pastime in the medical community, too). But, by and large, the women I see choosing midwives (this may be different in Germany) are very, very likely to have done at least some research ahead of time. Obviously, not every mom-to-be does that, but many do. Personally, I've never met a woman who went with a midwife who hadn't researched pregnancy, prenatal care, potential complications, etc. to a fairly significant degree. I've met many, many, many women who saw doctors for their care and never asked a single question about anything.

 


...and it mentions how "The Midwives Model of Care is based on the fact that pregnancy and birth are normal life processes." and that "Your choices are going to be dependent on several criteria: the legal status of midwifery in your state, the kind of midwife you're looking for, and the availability of midwives in your area. Here are some suggestions" and that "The hallmark of the Midwives Model of Care is respect - for the mother and baby, for the family, for the birth process itself."

 

But finding something about the complications that can arise during birth and how different midwives are equipped to handle it and how it's a criteria that should be checked for when looking for a good midwife? As far as I could tell: zilch. Not exactly "informed consent" enabling, is it?

 

What does informed consent have to do with a general guide to the midwifery model of care, and general guidance about choosing a midwife? Informed consent is between the expectant mom and her care provider, not on a page of the type you're looking at.

 


To quote MDC policy: "Positive healthcare provider reviews are welcome. Please use careful language when responding to or soliciting a review. We do not wish to host negative remarks or comments about practitioners, practices, hospitals or healthcare centers that might cast them in a negative light and which would present liability concerns for you and for Mothering. Negative comments that are verifiable facts of public record or court ruling are acceptable."

 

This kind of policy makes it darn difficult to get a good, critical look at a midwife, will make people reluctant to post about it if they heard stuff went wrong at the midwifes parctice.....and I figure a lot of expecting moms come to MDC for advice about exactly this kind of thing.

 

It also makes it hard to get a good, critiial look at OBs. It's not a model of care specific guideline. Quite honestly, I'd talk to people behind the scenes (by PM or email) if I wanted to discuss a specific midwife or doctor. I've said some negative things about my GP and OB over the years, but I haven't named them by name here on the forums, and I don't intend to do so. If someone local is looking for specifics, I'll address that privately. The fact that MDC doesn't allow flame war instigating reviews to be publicly posted isn't a huge factor in making those choices, imo. When I was looking for someone to attend a HBA3C, I went completely underground, and talked to people I trusted. I didn't look much for online reviews, yk?

 

One more thing: YOU are from the " camp of "question everything and make my decisions from there."" Not everybody is.

Some people are a lot more trusting and if the are told by someone who was introduced to them as a "professional" that there's not reason to worry, then they will rely on that professional's opinion.

Some people are shy and have a difficult time questioning someone they perceive to be of greater authority.

 

It seems callous to me to condemn these people to risking their lives and the lives of their babies in the hands of incompent midwives, because they lack the research skills and are more trusting or shy than you to question what they're being told.

 

As I said above, ime, the kind of person you're talking about is significantly more likely to see a doctor than a midwife in the first place. I don't know what it's like in Germany, but in North America (I'm Canadian, but the syndrome seems even more pronounced in the US, as far as I can tell), the opinions of doctors are given the weight of Holy Writ to an awful lot of people.



 

post #92 of 118

NM

post #93 of 118

Weighing in briefly and frantically trying to keep up with this thread....I'll provide some information on public health data in the U.S. and how it pertains to "other midwife."

 

Every baby must be issued a birth certificate, and providers generally fill out the necessary information.  This information is compiled as public health data by both state health departments and federal agencies such as the Centers for Disease Control.  This is the data that Wisconsin's health department compiles and relies on.

 

Each state gets to choose what kind of form to use.  A boilerplate form was released in 1989, which you can view here: http://upload.wikimedia.org/wikipedia/commons/c/c3/United_States_long_form_birth_certificate.gif

 

In 2003, the federal government issued a new form and encouraged states to adopt it.  Here is an explanation of that changeover process.

http://www.marchofdimes.com/Peristats/calculations.aspx?reg=&top=&id=6

 

And here is the 2003 form: http://www.cdc.gov/nchs/data/dvs/birth11-03final-ACC.pdf

 

You will note that both the 1989 and 2003 forms have the category OTHER MIDWIFE.  There is no category for a CPM.  But here's the important part: The OTHER category on both forms has the words "please specify."    There is room, in other words, to specify CPM.  And apparently, nobody did, or we'd have some concrete data on CPM outcomes.  

 

ETA: I'm not sure if Wisconsin uses the 1989 or 2003 form to compile its data, but either way, we have the "Other Midwife" conundrum.

post #94 of 118

@Xzaviers_mama

 

O.K., since you don't seem to understand why I believe you were being rude, let me try to put this another way. Let's have a look at what was being said first:

 

Paigekitten:

Seems odd for someone to dig up an old thread on the homebirth forum and start pushing pushing pushing to prove that homebirth isn't safe.

 

LittleStar:

Couldn't agree more. And if you look at her posting history, this isn't the only resurrected thread she's preaching her agenda on.

 

You:

I noticed this as well.

 

1. You agreed with Pk and LS.

 

2. LS an Pk were saying that

 

  • I had an "agenda." People that have an "agenda" are not being honest with you and they're trying to push something on you which you don't actually want. In other words, people that have an "agenda" are trying to harm you in order to advance their own goals.

 

  • I was "pushing pushing pushing" and "preaching". People that push and preach are disrespectful of others. They disregard others' rights to their own opinions and thoughts and instead try to force them to give them up and exchange them for the opinions of the one "preaching".

 

  • I deliberately dug up this old thread. If you deliberately go somewhere to "push an agenda", then that's a bit stalkerish and creepy.

 

To sum it up, preachy, pushy people with an agenda that deliberately go hunting for places where they hope they will find people that they can be preach and pushy to are, to use an euphemism "not nice" (=a*******).

 

And since you were basically agreeing that I was someone "preachy, pushy with an agenda" who deliberately came here so I could preach and push my agenda on the people here…..yes, I DO feel that you were being rude.

 

The fact that you're now saying that "Maybe" I'm "looking to feel attacked?" and basically implying that I'm being oversensitive and whiny about your accusations is not exactly helping your case.

 

I don't hesitate to call a spade a spade, and you were being rude and you still ARE being rude.


Edited by Kanna - 8/10/11 at 1:49am
post #95 of 118


 

Quote:
Originally Posted by Storm Bride View Post

While I'm sure there are exceptions, ime, the people you're talking about are far, far more likely to see a doctor than a midwife, ...
What does informed consent have to do with a general guide to the midwifery model of care, and general guidance about choosing a midwife? Informed consent is between the expectant mom and her care provider, not on a page of the type you're looking at.
I went completely underground, and talked to people I trusted. I didn't look much for online reviews, yk
 


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. 

 

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.

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.

 

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.

 

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.

 


Edited by Kanna - 8/10/11 at 12:55am
post #96 of 118

thumb.gif

post #97 of 118

I think it's rude to post a link like this one: http://hurtbyhomebirth.blogspot.com/ in a forum that is meant to be supportive of homebirth.  

post #98 of 118

 

Quote:
Originally Posted by xzaviers_mama View Post

I think it's rude to post a link like this one: http://hurtbyhomebirth.blogspot.com/ in a forum that is meant to be supportive of homebirth.  



First of all, you are taking this out of context.

 

As you can see here:

 

Quote:
Originally Posted by Kanna View Post


Negligence, when it happens, is a terrible thing.

 

The crux is, it's not limited to doctors. Midwives can mess up just as bad. Here are some cases where midwives attending to mothers during a homebirth were the negligent ones:

 

http://hurtbyhomebirth.blogspot.com/

 

Here one from Oregon, just a few days ago: http://special.registerguard.com/web/opinion/26642904-47/midwives-birth-oregon-direct-entry.html.csp

 

Another few, seen from the legal perspective: http://www.slate.com/id/2293389/pagenum/all/#p2

 

Just like you regret your choice to give birth at a hospital, a lot of the baby loss moms in these cases regret giving birth at home with a midwife.

 

 

the link was originally posted to illustrate that there are negligent midwives AS WELL as negligent doctors, and that kids die during homebirths as well as during hospital births.

Please take note that the original post that started this thread was ALSO about a baby dying during homebirth....and I don's see you berating the OP for that, which seems like a double standard on your part.

 

I then proceeded to explain that I DO support homebirth, with a skilled, competend midwife and a good transfer plan for if things go wrong, but that there are unskilled, un-experienced midwives out there that HAVE killed babies with their negligence and that something needs to be done about that.

 

Other posters in this thread agreed with the points I made, and I don't see you berating them either.

 

To illustrate:

Quote:
Originally Posted by Turquesa View Post

It’s funny….everytime somebody here makes the factual statement that babies die in hospitals as well as at home, they get jumped on for lacking compassion.  I don’t think they do, and I don’t think you do.  Yes, agreed.  Babies die at home, babies die in hospitals. 

 

 

 

Quote:
Originally Posted by SaveTheWild View Post

 

Kanna: Also, I'm not worried about the "well-educated skilled midwives". I had wonderful midwives at the hospital that gave excellent care. It's the not-so educated, rather less skilled midwives that don't know how to handle emergencies that I'm worried about, and I believe that is a legitimate worry.

 

I actually agree with this statement.

 

 

 

Quote:

Originally Posted by MidwifeErika View Post


I also believe that in all aspects of maternity care we should always, always, always be looking to be improving out outcomes. Regardless of birth location or attendant.

 

Quote:

Originally Posted by SaveTheWild View Post

 

I do think that midwifery should have more quality control, because an incompetent midwife stains the entire child birthing world. 


Yes, this forum does support homebirth, but it does NOT support incompetence or negligence.

 

The cases found on http://hurtbyhomebirth.blogspot.com/ are cases that illustrate negligence and incompetence by midwives, something that, as can be seen by the comments, is criticized even by other homebirth professionals and homebirthing moms, so yes, I feel it was perfectly legitimate to post that link here.

 

Now, can we get back to the point of you being rude towards me, and (after your most recent post, the third one in a row attacking me) add the question of why you seem compelled to do that?

post #99 of 118

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.

 

 

post #100 of 118

Kanna I mentioned that it seemed odd because it DID seem odd to me.  Since you asserted you didn't know it was old thread and was genuinely interested in intelligent discussion I figured I'd stick around and discuss instead of go back to lurking.  That said, it does make me personally very concerned when people post threads talking about need reassurance about homebirth, in the homebirth forum, and people jump in talking about the risks of homebirths.  When I read the original post it seems to me to be a mother asking LIKE-MINDED mothers for a reminder about why she has made a choice she has already researched and chosen. When a thread title is asking specifically for encouragement, it seems rather rude to me to jump in and start a debate about the risks of homebirth, especially when one of the things the OP was specifically concerned about was how it was going to reflect on the HB community in general.  That said, since you say you don't have an agenda to push, and are here in an effort to discuss and come away with more information then, I'm sorry I doubted your intentions.

 

It seems very easy to say things along the lines of if homebirth and midwives were more regulated, there would be fewer incidences of negligence and incompetence therefore, everyone will be better off with more oversight.  What I am trying to point out is there are many many of us who DON'T WANT more government oversight in our birthing choices.  We simply don't want it.  Those individuals who do want that are going to choose a care provider that is more highly regulated, the OB's, the CNM's, the licensed midwives.  Those of us who don't WANT that, still want the ability to make our own choices regardless of what others think of the risks.  It frankly scares the crap out of me when people want to walk in and start taking away my freedoms in an effort to protect me.  Would I rather be safe, or free?  I choose free.  Others choose safe.  That doesn't mean they should take away MY freedoms by limiting the options of care providers I have.  

 

And it seems to me that you are under the impression that women who have been subjected to poor medical care by the medical establishment have great recourse for retribution. I don't see that.  I suggest you research the deaths from cytotec inductions and the general lack of regard for the families of the women who have died to get a feel for the climate here in the U.S. in regards to medical negligence in the OB community. Here's a link to the Tatia Oden French Memorial Foundation. http://www.tatia.org/id7.html.

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