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what make a hb midwife "not safe" to you? - Page 3

post #41 of 66

 


Quote:
Originally Posted by carrieb26 View Post

 

So, for you, what makes a MW "not safe"?

 

Carrie



I want a midwife who networks with other birth professionals, has other midwives she can call if she has two clients in labor or is stuck at a really long labor, and keeps up with continuing education.  I want to know she has experience with some complications such as hemorrhage, shoulder dystocia, etc.  I realize some complications are so rare that she might not have seen them, but I would want to know she has a plan for how to manage them.

A back-up OB or hospital based CNM is a plus.

 

Those are things I considered when choosing a midwife.  :)

post #42 of 66

I want a midwife who networks with other birth professionals, has other midwives she can call if she has two clients in labor or is stuck at a really long labor, and keeps up with continuing education.  I want to know she has experience with some complications such as hemorrhage, shoulder dystocia, etc.  I realize some complications are so rare that she might not have seen them, but I would want to know she has a plan for how to manage them.

A back-up OB or hospital based CNM is a plus.

 

Those are things I looked for when choosing a midwife... :)

post #43 of 66
Quote:
Originally Posted by carrieb26 View Post

She wasn't actually at my last birth - was too fast, and she didn't make it, so I can't speak to her abilities while in labor.  Mostly my wondering of "safe" comes from thinking back on things in preparation for this birth.

 

Things like

- few prenatal check ups, no postpartum follow up

- comments like "I went to some seminars and read some about breech birth, and have now done a few, so I'm okay with them"

- I contacted an out of area mw I'd seen before about mw in my area, and she said that she would refer people to other mw's before my current one, since she felt others had more trainng and experience, and she'd heard other handle care with a little more attention.

 

It's just got me wondering.

 

Oh goodness....this sadly describes a dangerous midwife in my area.  I've had so many calls from her clients, telling me that they "haven't been able to get in touch with her for weeks," asking me to fill in the gaps for prenatal care.  It is so sad, but even more, makes me angry.  Those poor families, depending on a woman who is a master of manipulation and lures many into her craziness.  Most do not have the means to dump her once they realize that she is so unreliable, and so they terrifyingly approach labor, wondering if their baby is ok because the prenatal care has been lacking or non-existent, and are unsure if she will answer the phone when labor begins.  And the chatter amongst the birth community, including OBs and CNMs who might be supportive, turns very ugly.  They, rightfully, have a hard time separating those of us who are excellent clinical providers and transfer/transport when appropriate, from the midwives who will only send in the train wrecks for them to clean up.  Licensure does NOT mean a midwife is safe, competent, or professional.  It helps, but does not eliminate.

 

If you have red, or even pink, flags, keep looking.  You are interviewing a professional for one of the most important jobs on the planet.  Keep asking questions until you get answers that satisfy.  Best wishes in your pregnancy...
 

 

post #44 of 66

Yes, you DO sound like a bad mid-wife. You should know your limitations and realize that both the lives of mother and child are in your hands. God forbid anything should happen, I hope you carry mal-practice insurance. 

post #45 of 66

sparkl600, I see you are a new member and just registered today. Please review our User Agreement and our Web Statement of Purpose before you post again.

 

Your post here is highly inappropriate. We do not allow attacks and accusations against members in discussions. Please edit your post to state what you have to say in a civil and respectful manner. 

 

 

post #46 of 66
Quote:
Originally Posted by homebirthing View Post


Wow! I must be an unsafe midwife. As someone who also birthed her twins at home as well. Been to twin homebirths, HBA2C, postdates (carried one myself to 17 days past EDD) and a breech!
 


Yes, at first that sounds a bit reckless.

 

But hey:

 

Maybe you had a good set of safety measures in place to catch complications early?

 

And you also had detailed procedures and plans of action in case things did go south?

 

If those were solid, maybe you're not as reckless as you make yourself sound. ^_~

 

post #47 of 66


To me this is an  unsafe midwife.  The guidlines are there for a reason.

 

To me, I would add another itme "Treating GBS with anything but antibiotics".

Quote:
Originally Posted by homebirthing View Post


Wow! I must be an unsafe midwife. As someone who also birthed her twins at home as well. Been to twin homebirths, HBA2C, postdates (carried one myself to 17 days past EDD) and a breech!
 



 



 

post #48 of 66

Seriously?  I think the oxygen thing  is just..I wonder.if she confusing it with studies on ventilators pressures in NICU babies?
 

Quote:
Originally Posted by Youngfrankenstein View Post

I have met an un-safe midwife (IMO)  Here are the highlights:

 

Me: How many births have you attended?

Her: So many I lost count.

 

Me: Do you carry pitocin in case of PPH?

Her: No, herbs are better. (that's all she said)

 

Me:  Do you carry oxygen if needed?

Her: Some studies have shown that too much oxygen can actually damage the baby. (again, all she said)

 

Me: Who is your back up mw?

Her: I have never missed a birth.

 

Me: Who is your back up mw?

Her: I have a doula who is almost off maternity leave.

 

I could go on and on.  It was bizarre.  This was the first mw interview we had while I was trying to convince DH to have a homebirth.  I was annoyed and upset.  We smiled and left.  Then we met our mw and were so blown away all of her "perfect" responses to all of our questions. 

 

Another thing is that my mw and I talked and talked at each pre-natal appointment.  It let me get to know her as a person and she expounded on many things in the local birthing community that showed me she was very involved and kept her fingers on the pulse of the birthing community.  And even though HB isn't legal in Ohio, she was fully ready to come to the hospital in case of transfer.  I know that's not always in the mw's control so it was more of a blessing.

 

 



 

post #49 of 66
Quote:
Originally Posted by Alenushka View Post

Seriously?  I think the oxygen thing  is just..I wonder.if she confusing it with studies on ventilators pressures in NICU babies?
 


Actually, oxygen in high doses, given over long periods of time, is actually toxic. http://en.wikipedia.org/wiki/Oxygen_toxicity

 

HOWEVER, this is NOT a concern in a medical emergency, since the patient needs lots of oxygen to balance the deficit and the period during which it is given is rather brief.

 

post #50 of 66

Come to think off it, h2O overdose happens too....better to stay away from it

post #51 of 66
Quote:
Originally Posted by Alenushka View Post

Come to think off it, h2O overdose happens too....better to stay away from it



Quote by Paracelsus:

 

"Poison is in everything, and no thing is without poison. The dosage makes it either a poison or a remedy. "

 

Here's a recent case of water poisoning:

 

http://www.msnbc.msn.com/id/16614865/ns/us_news-life/t/woman-dies-after-water-drinking-contest/#.Tk4tumG0OcM

 

and here's an explanation of why she died:

 

http://en.wikipedia.org/wiki/Water_intoxication

post #52 of 66



There is actually debate about whether it is more advantageous to resuscitate with room air vs. 100% O2.

 

http://www.ncbi.nlm.nih.gov/pubmed/15325530

http://www.ncbi.nlm.nih.gov/pubmed/15846632


 

Quote:
Originally Posted by Alenushka View Post

Seriously?  I think the oxygen thing  is just..I wonder.if she confusing it with studies on ventilators pressures in NICU babies?
 



 



 

post #53 of 66
Quote:
Originally Posted by Alenushka View Post

 

To me, I would add another itme "Treating GBS with anything but antibiotics".

 

 

I'm curious as to your reasoning behind this - I thought treating GBS with antibiotics wasn't shown to reduce mortality?
 

 

post #54 of 66

Screening and antibiotic treatment for GBS saves lives. According to the CBC here:

 

 Universal screening at 35-37 weeks' gestation for maternal GBS colonization and use of intrapartum antibiotic prophylaxis has resulted in substantial reductions in the burden of early-onset GBS disease among newborns.

 

 

post #55 of 66

From a study done in Croatia:

 

"Our results documented that intrapartum chemo-prophylaxis for GBS infection significantly reduces perinatal mortality due to neonatal infection and sepsis."

 

Chemoprophylaxis is a fancy term for "preventative medication" and intrapartum means "during birth".

post #56 of 66

Another journal article:

 

"In the 1960s, early onset neonatal sepsis caused by group B Streptococcus (GBS) had an attack rate of 2 per 1000 live births and a 50% fatality rate. Early treatment and then antibiotic prophylaxis were shown to reduce morbidity and mortality rates; however, GBS remains a leading cause of perinatal infection. "

post #57 of 66

I am in Florida, where midwives are regulated I was shocked at how many midwives sounded just like the the midwife conversation posted above.

 

Another thing I would add to the unsafe list would be answering the question, "What do you do for a PPH and retained placenta?" with "Call 911, I would not be comfortable trying to do anything else." I really don't want to bleed out while waiting for the paramedics.

 

I would also feel unsafe working with a midwife that did not carry basic supplies (pit, oxygen, masks, antibiotics, suturing supplies, doppler, etc...)

 

I would not feel safe hearing the words, "Don't worry about it." or "That's not likely to happen." or anything about God and prayer as a solution.

post #58 of 66


twin birth, breech, past due dates are not neccessarily what I would consider dangerous situations to be birthing. The sad fact of the matter is that OBs decided long ago that the small risk that these situations raise are not worth the time and possible litigation and so they would just section them. Thus ended training in handling vaginal breech birth and twins. Not saying that they are without complication because they can be, but they are not neccessarily something that needs to be done in hospital IMO. There are other factors at play that need to be looked into.
 

Quote:
Originally Posted by Kanna View Post




Yes, at first that sounds a bit reckless.

 

But hey:

 

Maybe you had a good set of safety measures in place to catch complications early?

 

And you also had detailed procedures and plans of action in case things did go south?

 

If those were solid, maybe you're not as reckless as you make yourself sound. ^_~

 



 

post #59 of 66
So now thanks to intrapartum antibiotics ecoli and antibiotic resistant ecoli and other infections are now the leading cause of death. So although gbs deaths are down there are the same amout of deaths due to infections. Balancing vaginal flora should be the primary approach. Trouble is GBS is considered to be normal flora, by most medical folks cus 1/5-1/3 of the birthing population are colonized. Peroxide producing lactobacillus has been show to be good at colonizing the vagina and is healthier than GBS

As for oxygen the resuscitation protocols have changed for the majority of resuscitations room air is recommended for use. Part of this is that they have figured out through pulse ox that newborns transition they dont have high oxygen levels to start with. Also they dont know exactly when 90-100% oxygen becomes dammaging . So although I have carried oxygen for years I am less and less likely to turn it on.
The simplest way to make midwifery safer is to legalize it in every state and to allow those midwives to carry and use what is considered normal meds not that they should have to use them but so they could if need be.
post #60 of 66
Quote:
Originally Posted by carrieb26 View Post

She wasn't actually at my last birth - was too fast, and she didn't make it, so I can't speak to her abilities while in labor.  Mostly my wondering of "safe" comes from thinking back on things in preparation for this birth.

 

Things like

- few prenatal check ups, no postpartum follow up

- comments like "I went to some seminars and read some about breech birth, and have now done a few, so I'm okay with them"

- I contacted an out of area mw I'd seen before about mw in my area, and she said that she would refer people to other mw's before my current one, since she felt others had more trainng and experience, and she'd heard other handle care with a little more attention.

 

It's just got me wondering.

 

I wouldn't feel safe with a midwife who didn't do many prenatals. When I had a homebirth midwife, she had me on basically the same prenatal schedule as my doctors/OBs have in my other pregnancies....except that my visits were about 45 minutes long. She definitely followed up post-partum. In fact, when I told her that I'd had dd2 (scheduled c/s, almost two years after my HBA3C went bad), she came by to visit me, make me a meal, and basically give a me a post-partum/post-op break, even though I was no longer her client!

 

The comments about breech would worry me. It's not even because I'd necessarily insist on extensive experience with breech. Those remarks just sound really cavlier, yk? It's like she's just brushing it off.

 

And, the fact that the other midwife wouldn't recommend her is just another flag, imo.

 

In your shoes, I wouldn't go back to this one. I don't have a set list of reasons why I wouldn't find a particular midwife to be a safe choice...but I wouldn't feel safe with the one you're talking about.
 

 

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