HIPPA violation by local midwife??

[completebeginnings]

I had a poor birth experience (no really it was an assault and traumatic birth) with my 3rd child. Because I work in the same community as this midwife I have been very careful to not step on any toes. She was linked to my personal birth story on my blog where she was identified only by a first name initial (she doesn't even go by that name). She then wrote a letter to me identifying me by my first name initial and posted it on her website. The letter was quite slanderous and awful calling me a liar and a jealous midwife. I never attacked her personally. The story I put on my blog was just that, the story of my birth( all of my other births are there as well). It has caused quite a problem in our small community. I have received several emails stating that they think what she posted is a violation of our HIPPA agreement. Do you ladies believe it is? And this brings to mind another question. Is it appropriate to post on face book etc. when you have attended a birth even with out the parents being identified?

[HariB]

I don't know if she violated HIPPA, but it sure sounds like she's awful darn close to the line.  Seems to me that confidentiality is not just about names but various potentially-identifying factors--such as calling you a 'jealous mw'--that can help others identify you.  I mean, how many of her clients went on to become mws...and mws with the same first initial as yours???  If it were me, I'd make a complaint about it--seems the worst that can happen is that you will discover that while she was close to the line, she didn't step over it.  And the best that could happen is some kind of sanction against her.  I will only add that personally, I *hope* a complaint leads to a sanction against her... 

[momto9kidlets]

I would say if someone was able to identify you then yes she is in violation of your privacy, and I would report her or at least have a very frank discussion with her telling her that she is violating your privacy.  

As far as your question about writing on FB - I think it is okay to say you attended a birth, but not okay to say boy, girl, names, weight, etc - no identifying markers.  I will admit I often wonder how people can post names and weights on their FB page - I always wondered if they got permission or not.  

[mothercat]

I am a midwife and after the birth I wait for the parents to announce the birth on FB or MDC and then I post just the baby's name and sex on the business FB page. The parents know that I will do this with their permission. At the same time if they have signed up for mealbaby.com I will post the link for that so others of our families can sign up to bring meals.

But, no, I don't write details of the birth. Not my story to tell.

If that midwife posted things on her blog then the following is how you decide if it was a violation:

Medical Information: What Does HIPAA Cover?

HIPAA covers any information about your past, present or future mental or physical health including information about payment for your care. To be covered by HIPAA, information has to be kept by a covered entity - a health care provider, health care plan, or health care clearinghouse. This, combined with some fact that identifies you (your name, address, telephone number, Social Security number) is called "protected health information" or PHI. PHI can be oral, handwritten, or entered into a computer. This means a conversation between a doctor and nurse about your condition has the same general protections as information written on your records.

This site seems pretty comprehensive in the details of HIPAA

http://www.privacyrights.org/fs/fs8a-hipaa.htm#4

[completebeginnings]

Thanks ladies for the insight. I am going to contact her by email and ask her to remove it if not I will look into more choices. Good thing my dh is an attorney. It is really a sad situation and the reason that so many women who have had similar experiences to mine are afraid to speak out. The bullying is out of control and needs to stop.

[Charmie981]

Yes, it's a violation of your privacy and a really awful thing to do, to boot.

Re: posting on FB.  Gosh, I just don't think it's a good idea, most times.  I do it sometimes.  I like people knowing why I'm out of commission and posting "baby day" or something on FB makes it easy for everyone to know.

There are many times when I won't do it, though.  For example, the only client I'm currently on call for is active in her local LLL (not my local LLL...she lives pretty far from me).  Her local LLL leader and a few other members of that LLL (former clients of mine) are on my FB.  If I post "baby day" on my FB, I'll effectively be telling her entire LLL that she's in labor, or that there's a very good chance she's in labor.  If I say something today about "gotta get one more baby born and then I'm off call" and two days later I post "baby day" then yes, everyone on my FB who knows her will know she's in labor.  I try pretty hard to keep my personal and business separate on FB, but it just doesn't seem to happen that way.  First, it's a convenient way to keep up with former clients and their cute little babies (!!) and second, if a LLL leader or CBE or doula or LC friends me, it's a networking thing.  I don't want to offend people who could potentially send me clients, ya know?  It makes my FB have to be pretty anonymous.  And it makes me cringe when DH posts things like a picture of me 8-9-10 OUT sleeping on the couch with a sick baby.  But ya know, I think it's probably mostly good for my clients to see the human side of me, too.

SO, if I post something about a birth, I only do it knowing that no one who knows the mama is on my FB.  I missed a birth recently (the only birth I've ever missed!) for a mama who lives so rurally that she doesn't have internet and who is new to the area she lives in (again, not my area, but not one that I've ever served before either).  I posted about that on FB..."first time in four years as a midwife that a baby has beat me to a birth."  I also posted a little more of the story in the comments (dad caught the baby, was thrilled, etc).  I felt fairly comfortable with that.

[mothercat]

You may also want to check out the sticky in the Birth Trauma forum.

Midwifery Today had published 4 articles about bullying  from a midwife. The articles are about midwives bullying each other, but it also applies to midwives bullying their clients.

[mothercat]

Originally Posted by Charmie981 
  If I post "baby day" on my FB, I'll effectively be telling her entire LLL that she's in labor, or that there's a very good chance she's in labor.  If I say something today about "gotta get one more baby born and then I'm off call" and two days later I post "baby day" then yes, everyone on my FB who knows her will know she's in labor.  I

This is precisely why I tell my birth assistants that they may not post that they are going to a birth or have been at a birth until after the family announces.

Had a BA post that she was going to a birth and the BA's friend also knew the laboring woman. The friend put 2 and 2 together and proceeded to tell everyone she could get to listen that so and so was in labor. The poor mom had a transport rather than her planned home birth and by the time she got back on the computer there were a lot of "Are you and the baby all right?" messages. She had to explain a lot of things she didn't want to go into, and everyone already knew she'd had the baby.

[mntnmom]

At the very least, it's horribly unprofessional and speaks poorly for her character. IMO slandering a client in a public way is never okay, regardless of identifying information. I'm so sorry you have to deal with this at all. :(

[Charmie981]

Originally Posted by mntnmom 

At the very least, it's horribly unprofessional and speaks poorly for her character. IMO slandering a client in a public way is never okay, regardless of identifying information. I'm so sorry you have to deal with this at all. :(

I agree with this.  I've had a client who saw things about her birth differently than I did and said it on the net.  Obviously if I'd felt the way she did about it, I wouldn't have made the decisions I made.  I still feel that in the circumstances the choices I made were the right ones and stand by my decisions.  But it was HER birth and she saw it the way she did and I have never (will never) defend my choices to her and tell her she is wrong about how she saw things unless she asks me about it directly.  And I certainly wouldn't jump onto a website or a public forum and defend my choices.  The mother has ownership of her birth story.  The fact that we were there as providers ABSOLUTELY DOES NOT make it our story to tell with our personal spin on the events.  Not okay.  Nope.

[completebeginnings]

I contacted her and after some major insistance on my behalf she pulled down my story and replaced it with ANOTHER attack on a different client with a similar experience. So obviously she doesn't get it. It is not ok. She is a bully to her clients and everyone in the midwifery community.

[BabyBearsMummy]

Originally Posted by completebeginnings 

I contacted her and after some major insistance on my behalf she pulled down my story and replaced it with ANOTHER attack on a different client with a similar experience. So obviously she doesn't get it. It is not ok. She is a bully to her clients and everyone in the midwifery community.

WOW hopefully the other client takes action. However if this midwife is bullying clients word will get out and business will begin to dry up. If I saw a nasty attack story on my midwife's blog or website I couldn't run away faster. She is only shooting herself in the foot.