Whether you are a supporter of homebirth in our tribal area, or simply support families' right to choose their birth care, you may be interested in helping:
First, a link that will take you to the fundraising campaign for legal defense:
http://pledgie.com/campaigns/13728
This is the first news story to emerge about this case:
http://www.news-leader.com/apps/pbcs...D=201010090336
This is the 'probable cause statement' from the police dept as they prepared to levy charges against the mw:
http://www.news-leader.com/assets/pd...25egI0nWKn4%3D
Please remember in reading these things, that 1. The media knows nothing about birth but a LOT about sensationalizing things. 2. The probable cause statement contains the plain facts *as the officer understands them* (which may well leave out other pertinent facts)...including comments he heard made by a doctor involved. Most dr.s know nothing of natural birth, let alone homebirth and apparently, the dr quoted is pretty anti-homebirth.
Some other things--these comments are long, but I hope if you're a supporter of hb or just choice, you will read it anyway
It could help...you, your friends, and midwifery:
Whether or not you would support a non-CPM mw for your own births, remember that this sort of case can and no doubt will be used against MO midwifery in any way possible by those who are already trying to knock down our CPM-legal status. That is just the nature of politics--money and power tend to be strong motivators. We don't know why this mw was not a CPM, because it seems she had a lot of experience--possibly, enough to apply for the CPM exam. But sometimes it is only $$ that prevents a qualified mw from taking the exam, since the whole NARM process costs at least $1400.00. That can be prohibitive for some (or at least delay their CPM application while they save $$). So we should NOT assume that the mw was 'less experienced' than she needed to be to apply for the NARM exam/CPM.
In fact, it is POSSIBLE that she was far more experienced than many mws who are able to afford taking the NARM exam. Remember that achieving CPM status is based on 'minimum numbers of prenatal/birth/newborn/pp experiences'--a number of those elements of birth care that are considered to be enough for 1. Being able to competently work with normal birth and 2. Being able to spot difficulties that are beyond the mw's skills--so she knows when to get help.
So--many a newly-certified CPM has little or even NO experience dealing with complications that can occur with pregnancy/birth/newborns. She may be quite competent when it comes to helping with normal birth--which MOST births are! But it is also likely, especially if a student mw 'fast tracks' her way to a CPM (only gaining the min clinical experiences needed to apply for the NARM, as is becoming more common), that she has not seen much 'deviation from the norm'. But NARM standards do include measuring any mw's ability to spot difficulties best handled by more experienced providers than she may be when first certified. This is very important to know--along with knowing that some difficulities CAN be managed well by a more-experienced mw, and in far fewer cases, only by an OB with hospital/med technology.
Also, it has come to my attention that in MO, anyway, some mws are criticized for having 'too many transfers of care'. It seems to be a belief that ANY transfer from home can too easily be used against mws generally--if she goes to the hospital, then she is open to legal attack, especially if she is not a CPM yet. And this belief makes no sense to me, given my long years watching homebirth, midwifery, prosecutions (nationally), etc. First, some really do need medical care, even if they started pregnancy in the 'lowest-risk category'. 2nd, sometimes it is hard to determine EARLY ENOUGH TO GET HELP, just who truly will need med care. Thus, it may be most prudent to transfer care for some who end up with normal births in the hospital....because of 10 ppl transferred, maybe only 1 really needed it...but it could not be determined EARLY ENOUGH TO GET HELP just which of those moms/babies would truly need med help. Many issues resolve with a mw's help, or just on their own during labor--some get worse. No matter how experienced a mw is, though experience can make a difference, there are scenarios at birth that are impossible to predict.
Know too, that some of a mw's transfers may occur from CLIENT CHOICE--even if the mw believes things are still plenty safe. It is your right to go to the hospital if YOU feel it's best--even if your mw disagrees. While it's a good thing for a mw to give the reasons she feels staying home is still safe (or maybe that she can help you w/pain management well enough, if you're thinking 'epidural'), a mw who is operating with respect for informed consent will support families' wishes about transfer and not argue about it; she will not insist on having her way. Remember that a mw, apart from safety concerns, has a concern for her reputation and 'transfer stat', and possibly will fear for her legal safety--these things should NOT get in the way of your wish to transfer. She will respect your wishes AND YOUR INTUITION, and accompany transfer and help you in every way possible to have the best birth possible.
I would never want a mw or family to think that having the baby at home is THE most important thing. A mw with knowledge of medical protocols, and good communication skills is well-able to help make a hospital transfer a positive experience for families, even if they do need medical help. And if transfer turns out to be 'unneeded', then it is still possible to have a natural birth with little interference in the hospital. A mw's comm skills, and a family's preparedness for this possibility makes all the difference.
So, when you're interviewing a mw, it is important to speak with her about transfer of care. During pregnancy, considering transfer of care is very important for all, even if only few families really need it. You might even ask prospective mws for references from clients with whom she has transferred care, so you can get an idea of how she handles transfer. Know too, that the national 'norm' for hospital transfer is 10%, among licensed or certified mws. THIS IS PRUDENCE IN ACTION, not fear or incompetence. A good mw may well have a lower transfer rate (and many mws say that they transfer more 1st time moms, for exhaustion or pain relief, more than other moms--their stat for FTM's may be over 10%, but for other moms, lower--and the total average is 10%). I myself would be somewhat suspicious of any mw who claims a transfer rate below about 7%....because most likely, she is staying home with some moms in situations where the availability of med care (if not it's actual use) is safest for moms/babies.
Think of it this way: let's say there are 10 transfers of care, but only 1 of those moms/babies really needed (or just wanted) medical care or at least medical oversight/availability. The other 9 can still potentially have ecstatic births in the hospital, at least if they are prepared, and if their mw has good comm/advocacy skills (both factors make ALL the difference in how a transfer goes). While those 9 may be disappointed they lost their hb, they have first, had a safe birth. 2nd, they have made a highly valuable contribution to homebirth and to midwifery on the whole: by being one of the 'needless transfers', they have helped guarantee the safety of the 10th family who really needed med help. They have helped to show a very positive face of homebirth families--that we are sensible, sane and safety minded.
And the mw who transfers these 10 families has MOST LIKELY helped to avert tragedy/difficulty for the 1 family, if that makes sense. Transfer of care, when undertaken prudently, does NOT make midwifery look bad--it makes midwifery look good. Besides, and this is so important to understand: those who hate homebirth are looking for BIG NEWS to use against hb and mws. A 'needless transfer' (which is usually not determined until after the fact, btw) that results in a safe happy birth, is NOT what the anti hb med ppl are going to try to use against hb and mws. There is no 'ammo' in a safe normal birth! The media will not report the dull news of another happy birth. And especially if the mw does have good comm skills, she will not ruffle anyone's feathers at the hospital and create situations where med ppl are mad at her and seek to punish her. Plus, if a birth does lead to a poor outcome (that 1 of 10 'needed transfers'), that outcome is unlikely to be tagged to the mw if the birth occurs in the hospital...at least if transfer occurs before signs get really poor.
Yes, there are occasionally--rarely--surprising emergencies that arise at birth. But for the healthy family with a competent, prudent mw, this is just so extremely rare. Most often, difficulties can be spotted coming during pregnancy, or during labor while there is still plenty of time to transfer care. While this sort of emergency can more often lead to loss or impairment, it is unlikely to lead to charges relating to 'manslaughter'. For the non-CPM, it could lead to prosecution for being uncertified--but that is not nearly so damaging to her or to midwifery, as is a manslaughter or reckless endangerment charge.
Finally--it is the family's job to be their own best advocate. Don't surrender your power to your mw, any more than you would surrender your power to a doctor (except in a true emergency). Your mw SHOULD be listening to you--YOUR INTUITION is every bit as important as your mw's skills and intuition! The mw might feel signs are 'good enough', she may feel she has everything in hand. If YOU don't feel right about staying home, then her assessments are not as important as your intuition.
We can't prevent every difficult birth or loss. That is never going to be possible, no matter where we give birth or with whom. But we can prevent many of them. Prudence is so important! We can't prevent every loss or difficulty--but we can do much to prevent the worst of scenarios from occurring when it comes to the law, and media involvement--factors that burden and complicate matters for families and mws alike so greatly--by considering the things I've said. I didn't invent these points...I've just learned over time how important they can be for families, and for homebirth and mws in general.
Whatever you may think about this case against a mw in Springfield, it can still be used to further homebirth, midwifery, and choice in general. As a famous mw once said long ago to those who did not want to support her (in a case eerily like this one): 'go ahead and use me as a good example of a bad example, if you like--but do use my case to help the cause however you can!' With some savvy, this can be done--and that famous midwife did so. We can't bring back a baby who is gone...we can help homebirth midwifery be safer and more available to families who choose it.
First, a link that will take you to the fundraising campaign for legal defense:
http://pledgie.com/campaigns/13728
This is the first news story to emerge about this case:
http://www.news-leader.com/apps/pbcs...D=201010090336
This is the 'probable cause statement' from the police dept as they prepared to levy charges against the mw:
http://www.news-leader.com/assets/pd...25egI0nWKn4%3D
Please remember in reading these things, that 1. The media knows nothing about birth but a LOT about sensationalizing things. 2. The probable cause statement contains the plain facts *as the officer understands them* (which may well leave out other pertinent facts)...including comments he heard made by a doctor involved. Most dr.s know nothing of natural birth, let alone homebirth and apparently, the dr quoted is pretty anti-homebirth.
Some other things--these comments are long, but I hope if you're a supporter of hb or just choice, you will read it anyway
It could help...you, your friends, and midwifery:Whether or not you would support a non-CPM mw for your own births, remember that this sort of case can and no doubt will be used against MO midwifery in any way possible by those who are already trying to knock down our CPM-legal status. That is just the nature of politics--money and power tend to be strong motivators. We don't know why this mw was not a CPM, because it seems she had a lot of experience--possibly, enough to apply for the CPM exam. But sometimes it is only $$ that prevents a qualified mw from taking the exam, since the whole NARM process costs at least $1400.00. That can be prohibitive for some (or at least delay their CPM application while they save $$). So we should NOT assume that the mw was 'less experienced' than she needed to be to apply for the NARM exam/CPM.
In fact, it is POSSIBLE that she was far more experienced than many mws who are able to afford taking the NARM exam. Remember that achieving CPM status is based on 'minimum numbers of prenatal/birth/newborn/pp experiences'--a number of those elements of birth care that are considered to be enough for 1. Being able to competently work with normal birth and 2. Being able to spot difficulties that are beyond the mw's skills--so she knows when to get help.
So--many a newly-certified CPM has little or even NO experience dealing with complications that can occur with pregnancy/birth/newborns. She may be quite competent when it comes to helping with normal birth--which MOST births are! But it is also likely, especially if a student mw 'fast tracks' her way to a CPM (only gaining the min clinical experiences needed to apply for the NARM, as is becoming more common), that she has not seen much 'deviation from the norm'. But NARM standards do include measuring any mw's ability to spot difficulties best handled by more experienced providers than she may be when first certified. This is very important to know--along with knowing that some difficulities CAN be managed well by a more-experienced mw, and in far fewer cases, only by an OB with hospital/med technology.
Also, it has come to my attention that in MO, anyway, some mws are criticized for having 'too many transfers of care'. It seems to be a belief that ANY transfer from home can too easily be used against mws generally--if she goes to the hospital, then she is open to legal attack, especially if she is not a CPM yet. And this belief makes no sense to me, given my long years watching homebirth, midwifery, prosecutions (nationally), etc. First, some really do need medical care, even if they started pregnancy in the 'lowest-risk category'. 2nd, sometimes it is hard to determine EARLY ENOUGH TO GET HELP, just who truly will need med care. Thus, it may be most prudent to transfer care for some who end up with normal births in the hospital....because of 10 ppl transferred, maybe only 1 really needed it...but it could not be determined EARLY ENOUGH TO GET HELP just which of those moms/babies would truly need med help. Many issues resolve with a mw's help, or just on their own during labor--some get worse. No matter how experienced a mw is, though experience can make a difference, there are scenarios at birth that are impossible to predict.
Know too, that some of a mw's transfers may occur from CLIENT CHOICE--even if the mw believes things are still plenty safe. It is your right to go to the hospital if YOU feel it's best--even if your mw disagrees. While it's a good thing for a mw to give the reasons she feels staying home is still safe (or maybe that she can help you w/pain management well enough, if you're thinking 'epidural'), a mw who is operating with respect for informed consent will support families' wishes about transfer and not argue about it; she will not insist on having her way. Remember that a mw, apart from safety concerns, has a concern for her reputation and 'transfer stat', and possibly will fear for her legal safety--these things should NOT get in the way of your wish to transfer. She will respect your wishes AND YOUR INTUITION, and accompany transfer and help you in every way possible to have the best birth possible.
I would never want a mw or family to think that having the baby at home is THE most important thing. A mw with knowledge of medical protocols, and good communication skills is well-able to help make a hospital transfer a positive experience for families, even if they do need medical help. And if transfer turns out to be 'unneeded', then it is still possible to have a natural birth with little interference in the hospital. A mw's comm skills, and a family's preparedness for this possibility makes all the difference.
So, when you're interviewing a mw, it is important to speak with her about transfer of care. During pregnancy, considering transfer of care is very important for all, even if only few families really need it. You might even ask prospective mws for references from clients with whom she has transferred care, so you can get an idea of how she handles transfer. Know too, that the national 'norm' for hospital transfer is 10%, among licensed or certified mws. THIS IS PRUDENCE IN ACTION, not fear or incompetence. A good mw may well have a lower transfer rate (and many mws say that they transfer more 1st time moms, for exhaustion or pain relief, more than other moms--their stat for FTM's may be over 10%, but for other moms, lower--and the total average is 10%). I myself would be somewhat suspicious of any mw who claims a transfer rate below about 7%....because most likely, she is staying home with some moms in situations where the availability of med care (if not it's actual use) is safest for moms/babies.
Think of it this way: let's say there are 10 transfers of care, but only 1 of those moms/babies really needed (or just wanted) medical care or at least medical oversight/availability. The other 9 can still potentially have ecstatic births in the hospital, at least if they are prepared, and if their mw has good comm/advocacy skills (both factors make ALL the difference in how a transfer goes). While those 9 may be disappointed they lost their hb, they have first, had a safe birth. 2nd, they have made a highly valuable contribution to homebirth and to midwifery on the whole: by being one of the 'needless transfers', they have helped guarantee the safety of the 10th family who really needed med help. They have helped to show a very positive face of homebirth families--that we are sensible, sane and safety minded.
And the mw who transfers these 10 families has MOST LIKELY helped to avert tragedy/difficulty for the 1 family, if that makes sense. Transfer of care, when undertaken prudently, does NOT make midwifery look bad--it makes midwifery look good. Besides, and this is so important to understand: those who hate homebirth are looking for BIG NEWS to use against hb and mws. A 'needless transfer' (which is usually not determined until after the fact, btw) that results in a safe happy birth, is NOT what the anti hb med ppl are going to try to use against hb and mws. There is no 'ammo' in a safe normal birth! The media will not report the dull news of another happy birth. And especially if the mw does have good comm skills, she will not ruffle anyone's feathers at the hospital and create situations where med ppl are mad at her and seek to punish her. Plus, if a birth does lead to a poor outcome (that 1 of 10 'needed transfers'), that outcome is unlikely to be tagged to the mw if the birth occurs in the hospital...at least if transfer occurs before signs get really poor.
Yes, there are occasionally--rarely--surprising emergencies that arise at birth. But for the healthy family with a competent, prudent mw, this is just so extremely rare. Most often, difficulties can be spotted coming during pregnancy, or during labor while there is still plenty of time to transfer care. While this sort of emergency can more often lead to loss or impairment, it is unlikely to lead to charges relating to 'manslaughter'. For the non-CPM, it could lead to prosecution for being uncertified--but that is not nearly so damaging to her or to midwifery, as is a manslaughter or reckless endangerment charge.
Finally--it is the family's job to be their own best advocate. Don't surrender your power to your mw, any more than you would surrender your power to a doctor (except in a true emergency). Your mw SHOULD be listening to you--YOUR INTUITION is every bit as important as your mw's skills and intuition! The mw might feel signs are 'good enough', she may feel she has everything in hand. If YOU don't feel right about staying home, then her assessments are not as important as your intuition.
We can't prevent every difficult birth or loss. That is never going to be possible, no matter where we give birth or with whom. But we can prevent many of them. Prudence is so important! We can't prevent every loss or difficulty--but we can do much to prevent the worst of scenarios from occurring when it comes to the law, and media involvement--factors that burden and complicate matters for families and mws alike so greatly--by considering the things I've said. I didn't invent these points...I've just learned over time how important they can be for families, and for homebirth and mws in general.
Whatever you may think about this case against a mw in Springfield, it can still be used to further homebirth, midwifery, and choice in general. As a famous mw once said long ago to those who did not want to support her (in a case eerily like this one): 'go ahead and use me as a good example of a bad example, if you like--but do use my case to help the cause however you can!' With some savvy, this can be done--and that famous midwife did so. We can't bring back a baby who is gone...we can help homebirth midwifery be safer and more available to families who choose it.
sorry cant help ya, my license wont allow it. go to the hospital or go uc. Breech? 
Do you follow?
I appreciate that.
) most need for OUR safety and satisfaction. Hey if not for birthing families, none of these pesky mws, OBs or med-law experts would even be needed at all!
Follow Mothering