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Our midwife lost a breech baby-questions? - Page 2

post #21 of 94

Wow.  Well, not everyone is privileged enough to get to choose WHERE and HOW their breech babies come into this world.  As someone who was the recipient of a scheduled breech c-section b/c no hospital or birthing center professional would assist w/ my baby's vaginal birth, I can tell you 100% that if I have another breech, it will be born at home w/ a midwife who I have since found who has experience and would assist.  And I would expect to find support for that here on MDC, but, I guess as they say, the times, they are a changing.  Sad, sad, sad.  Disrespect towards the choices of the way other women birth, especially those looking to avoid c-sections, *shaking my head*

post #22 of 94
Quote:
Originally Posted by dogretro View Post

Wow.  Well, not everyone is privileged enough to get to choose WHERE and HOW their breech babies come into this world.  As someone who was the recipient of a scheduled breech c-section b/c no hospital or birthing center professional would assist w/ my baby's vaginal birth, I can tell you 100% that if I have another breech, it will be born at home w/ a midwife who I have since found who has experience and would assist.  And I would expect to find support for that here on MDC, but, I guess as they say, the times, they are a changing.  Sad, sad, sad.  Disrespect towards the choices of the way other women birth, especially those looking to avoid c-sections, *shaking my head*



But it's not disrespecting anyone's choice to state the fact that breech vaginal births are riskier than cephalic vaginal births. Even the Johnson and Daviss study that looked at a huge number of homebirths to try to figure out safety statistics found that 2/80 breech babies died. If you know that it's riskier but still want a homebirth, that's all your choice; it's the mother's job to balance the risks and benefits in her particular situation. I just wouldn't want anyone to think that breech is as easy on babies as cephalic. 

post #23 of 94
I would ask these questions:
Have you done breech births in the past? If so, how many?
The first time you did a breech birth, what type of preparation/training did you have?
Were there any complications during this delivery that were unexpected?
What types of recessitation did you attempt?
How soon did you call 911?
What do you think happened to cause the baby to die? Looking back, do you think there was anything different you could have done to alter the outcome? (assuming still a home birth and not c-section)
Have they determined an official cause of death?
Will this death put your legal status in doubt? (attending breech birth in my state is illegal. Doing so regardless of outcome would cost a MW her liscence.)
How many babies have you lost? What happened in each case?
Walk me through several emergencies (life/death) that you have handled at a labor.
How many times in your practice have you had to dial 911?

I would not automatically DQ this MW and run for someone else. But I will say that if she went into this without loads of experience with breech babies, I would run. Vaginal delivery of breech is both possible and reasonably safe with proper care. But it is high risk, and treating it like it is not would be a red flag for me. If this is the first time she has ever had an emergency, I would run. If, however, she is highly trained, dealt well with a small number of emergencies, and displays a feeling of responsibility and regret for what happened, I would consider keeping her on.

You didn't say, but is your baby breech at this time? Or flipping around a lot? Good luck and I hope the conversation you have with your MW gives you some answers.
post #24 of 94
Quote:
Originally Posted by dogretro View Post

Wow.  Well, not everyone is privileged enough to get to choose WHERE and HOW their breech babies come into this world.  As someone who was the recipient of a scheduled breech c-section b/c no hospital or birthing center professional would assist w/ my baby's vaginal birth, I can tell you 100% that if I have another breech, it will be born at home w/ a midwife who I have since found who has experience and would assist.  And I would expect to find support for that here on MDC, but, I guess as they say, the times, they are a changing.  Sad, sad, sad.  Disrespect towards the choices of the way other women birth, especially those looking to avoid c-sections, *shaking my head*


No, not everyone is able to choose where and how they deliver a breech baby, so many variables are in play with labor and delivery. But all women can certainly plan those things. And I don't feel like anyone isn't supporting the OP, she asked for opinions. I think we are all trying to be helpful. But if being supportive means encouraging a home birth at all costs, I simply can not for I would have the feeling of blood on my hands if something happened to the mother or baby, and that would break my heart. And I don't think anyone is saying she needs to have a c/s either. I, personally, would just deliver with my midwife in a hospital or find an ob willing to deliver a breech.

 

post #25 of 94

I would also ask why she feels she doesn't need a "break" from practice or some time to recover for the experience.

 

For example, with the case of Karen Carr, she had a baby death in September of 2010, a major morbidity in October of 2010, and then another baby death (trapped head/breech birth) in December of 2010 (the birth on which she was convicted of 2 felonies).  I do think her outcomes would have been different if she had paused in September of 2010 and maybe gave some thought to her practices, her willingness to taken on risk, etc.


 

post #26 of 94
Quote:
Originally Posted by dogretro View Post

Wow.  Well, not everyone is privileged enough to get to choose WHERE and HOW their breech babies come into this world.  As someone who was the recipient of a scheduled breech c-section b/c no hospital or birthing center professional would assist w/ my baby's vaginal birth, I can tell you 100% that if I have another breech, it will be born at home w/ a midwife who I have since found who has experience and would assist.  And I would expect to find support for that here on MDC, but, I guess as they say, the times, they are a changing.  Sad, sad, sad.  Disrespect towards the choices of the way other women birth, especially those looking to avoid c-sections, *shaking my head*

 

There have been a few extremely hard-learned lessons around the birthing boards here at MDC lately. I don't think it is at all unsupportive to have a realistic discussion about both risks in general, and providers in specific.

 

post #27 of 94
Thread Starter 
Hi everyone, it's me the OP.
I want to thank everyone who gave thought to my original request for questions to ask my midwife. DH and I are compiling a list to bring up at our next appointment. I, also, appreciate the facts that some of you have supplied. I think with a combination of good questions then facts to base our choices on we will be able to make a wise and informed decision.
If anyone has more facts about breech birth at home and hospital I would be interested... links or references to studies are great, too.
Also, if anyone can think of questions that havent been listed yet please keep them coming.
I don't know the facts surrounding this birth and have only heard 3rd hand about what happened so it is very important for me to sort this out without bothering the mother and her family during this difficult time.
post #28 of 94

I appreciate the discussion here. I feel this has been particularly enlightening, and I appreciate the diversity of views and opinions. I understand the desire and wish for the family to grieve privately, and I wish them all good thoughts. I also think, however; for the sake of openness and disclosure, it would be helpful to let others know who the midwife is or what the practice is called. This is something worthy of discussion for all future clients and certainly the present ones. 

post #29 of 94
Quote:
Originally Posted by calldeville View Post

I appreciate the discussion here. I feel this has been particularly enlightening, and I appreciate the diversity of views and opinions. I understand the desire and wish for the family to grieve privately, and I wish them all good thoughts. I also think, however; for the sake of openness and disclosure, it would be helpful to let others know who the midwife is or what the practice is called. This is something worthy of discussion for all future clients and certainly the present ones. 



And what, exactly, would be your particular motivation for asking for these details?  Forgive me for being skeptical, but there has been a tremendous amount of trolling on MDC.  A user with only 5 posts and a question like this, seems to give me pause.

 

Again, if indeed you are a mom interested in or planning a homebirth, you can understand why the skepticism about sharing this type of information on the internet, that it just *might* be injurious to some.

post #30 of 94

Please also keep in mind that while you have questions you may want to ask the midwife, she may not actually be at liberty to discuss the situation with you. HIPAA and all that good stuff.

post #31 of 94
Thread Starter 
Quote:
Originally Posted by calldeville View Post

I appreciate the discussion here. I feel this has been particularly enlightening, and I appreciate the diversity of views and opinions. I understand the desire and wish for the family to grieve privately, and I wish them all good thoughts. I also think, however; for the sake of openness and disclosure, it would be helpful to let others know who the midwife is or what the practice is called. This is something worthy of discussion for all future clients and certainly the present ones. 


I can understand your concern, but this is not the time or place to request this information. If you have concerns about a specific midwife or even opinions of midwives you are considering there are places on MDC to ask those questions. As I said in the pm yesterday do your research....
"now back to our original programming..."
post #32 of 94
Thread Starter 
Yes, I was hoping to ask the questions in a way that wasn't situation specific, but specific enough to get reasonable information.
Thanks for the thought on the subject- there is so much swirling around in my head right now that help getting it sorted is fabulous.
post #33 of 94

Hi OP -

 

From your original post it wasn't clear to me if you are also breech.  However, if you are or have a high likelihood of having a breech baby (from some reading I have been doing, breech does seem to run in some families), I woud be asking some serious questions about how she is topping off her skill set in the intervening time. 

 

Even if her performance was *perfect* in the prior breech birth, I would have serious concerns about the mindset of someone who could step away from such an incident WITHOUT serious self-reflection, a desire for reviewing and honing of skills and a commitment to doing what they could to perform at their best to avoid a repeat experience.

post #34 of 94
Quote:
Originally Posted by 19spitfire View Post

Hi everyone, it's me the OP.
I want to thank everyone who gave thought to my original request for questions to ask my midwife. DH and I are compiling a list to bring up at our next appointment. I, also, appreciate the facts that some of you have supplied. I think with a combination of good questions then facts to base our choices on we will be able to make a wise and informed decision.
If anyone has more facts about breech birth at home and hospital I would be interested... links or references to studies are great, too.
Also, if anyone can think of questions that havent been listed yet please keep them coming.
I don't know the facts surrounding this birth and have only heard 3rd hand about what happened so it is very important for me to sort this out without bothering the mother and her family during this difficult time.



Well I don't know how useful to you this will be but I had this discussion in my last pregnancy as my son was breech until 35 w 4 d (and I had several rounds of pre-term labour, two hospitalizations) when he flipped. I gave birth at 36 w 0 d so go him.

 

My OB is known for breech deliveries as well as turning babies; he is foreign-trained and did breech vaginal deliveries in his training.  He only does breech vaginal deliveries with low-risk, proven pelvis mums and for the pushing phase, he does them in the OR. He did not consider me a candidate for a breech delivery because my daughter died due to a cord accident. He does this both 'cause some mums want to, but also as a teaching opportunity.

 

I share that although it's not a study because he's really experienced and that's the conclusion he's come to - he'll do it, but only with surgical backup literally right there. He is definitely not c-section happy; he convinced me with my elder son to go for a vaginal delivery even though, after losing my daughter, I wanted a c-section.

 

Best in your decision and hope everything goes well in the pregnancy and at delivery. :)

post #35 of 94

Since you are neighbors could your DH ask her DH if they feel the midwife was at fault?  He could explain you're planning to use her again but with their loss you wanted to, without prying into details, just get their opinion on her skills.  Has the birth/death been investigated?

 

I lost my second son due to birth trauma and doubts formed as all the alarms were sounding and all hell broke loose in the delivery room.  When I got pregnant again I could not use my midwife again and I will not recommend her and her group - too many questions unanswered. 

 

I'm sure she'll have answers for you, but if she has any fault she won't admit it.

 

 

post #36 of 94

i agree to run far far away.

post #37 of 94

I think that you are taking the right approach of gathering as much information as you can.

 

If you are neighbors with the family, I would likely be all quaker and make them food and go over and do laundry and whatever else to help, and simply assert your condolences as best you can. Leave them at that -- they will share or they won't. It's ok, that's on their timing.

 

But asking the midwife all sorts of questions is great. In addition, you might consider how you evaluate these various risks that you think might be real possibilities for you, and what her normal processes are for risking people out and what that process would involve for you (eg, how the dialoguing and decision works, etc).

 

You'll find what you need, no doubt. :)

post #38 of 94

I don't want to speak for anyone, especially since I have no expertise in this area and really just randomly happened upon this thread.

 

However, I think that what people mean when they say that the fact is, babies die, is that the death might have nothing to do with the midwife, and might have happened regardless of the healthcare professional/location of the birth.  It's not necessarily constructive to say that this death is, unequivocally, the fault of the midwife.

 

However, I echo the statements that even if the death was not the fault of the midwife, and there is nothing she would have done differently, she may not be in a stable enough state of mind to deliver your baby.  I am not personally strong enough to ever even consider midwivery because of situations like this one, but if I was a midwife and this had happened to me, I would imagine I would have something similar to PTSD and might be at risk of a breakdown during my next few deliveries.  Hopefully that makes sense without being incendiary.

 

Regardless--and depending on when you are due--you would probably best be suited to arrange for a backup if you don't already have one in place.  Your midwife might believe herself to be just fine and then find out she is not in a matter of days or weeks, due to shock.

post #39 of 94

You know, as to fault, I think it is legitimate to consider whether the midwife was negligent in attending a breech homebirth at all.  In other words, is the fact she was willing to attend that birth mean that her practices are too loosey goosey for you right off the top?

 

I know that is not a popular position around here, but any safety claims made about homebirth (if you accept their validity) are based on a "low risk" pregnancy, and I do not believe that a breech can be considered low risk (the very reason that, for example, as a prior poster noted, it is specifically out of the scope of practice for CPMs in some states).

post #40 of 94

Does anyone know what KIND of breech the baby was? A midwife who was willing to deliver, say, a footling breech would be a big red flag for me, personally.

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