Do we have any update on Evelyn's hearing?
Evelyn Muhlhan's website - Page 2
Apparently so, my conversation with her was just a week or so ago and she said she'd have no problem traveling to my home as long as I had no problem traveling to WV for prenatals. She was also totally supportive of HBAC, but I only spoke to Nannette, not the other partner midwives in the practice.
So is Nanette a CNM? How does it work if you live in another state and practice here? We are TTC #3 (may be a while though with #2's nursing so much), but we are concerned about our options for homebirth, as we will absolutely not deliver in a hospital.
Small Rant to Follow:
We HBAC'd with Evelyn a while back. I finally got a chance to read that nursing board document. And while there were definitely items in there where she may not have followed "accepted procedure" to a T. I question whether many of those rules are even in the best interest of the patient or the best interest preventing potential litigation.
But the most important thing I noticed what how they chastised her for being such a "risk to the health and survival of local women and babies," WHILE simultaneously stating that her Infant mortality rate was LESS THAN HALF of the Maryland average for full term infants.
She has an IMR of 1.25/1000, Maryland is 7.8/1000 and if you look at just full term babies, its over 2/1000.
And since we know that Evelyn was treating women traditionally considered "high risk" by many OB's the population being served was likely extremely similar medically speaking. That rate cannot be explained away by saying 'oh the OBs have a high risk population.'
SO... how DARE the nursing board insinuate that EVELYN is the risk to women and babies, when it is CLEAR her methods have resulted in SIGNIFICANTLY LOWER negative outcome rates than this areas hospitals. They should be ashamed of themselves for this witch hunt. Truly ashamed.
I also wanted to add, that Evelyn absolutely tells you the statistical risk for VBACs! She gave me a whole sheet on it, listing the rate of uterine rupture. I knew there was a small chance I or my baby could die delivering at home and a HIGHER chance I or my baby could die delivering in a hospital! Women choosing this option do not need the Board of Nursing to protect us!! We need to be given INFORMATION AND CHOICES and left ALONE to decide what WE THINK is best for us. Despite whatever evidence they think they have to the contrary.
Our bodies, Our Choice.
Okay, rant over. But seriously. Those nurses are a disgrace to health care. How dare they. I want to go through every one of their birth histories to see how many times a women and baby was compromised due to OVER INTERVENTION and that led to infant morbidity and mortality! Lets suspend all their licenses!
I agree with you completely about Evelyn's situation - what makes me the most angry about what they've done to her is not only that it wasn't the women or the families who demanded an investigation but the medical staff at the hospital, who have been disrespectful toward her for years despite her absolute talent for midwifery and the level of trust her clients have in her (jealous? I think so!) and the fact that they suspended her prior to investigating as though she's a terrible danger to ANYONE, when in fact she's delivered more babies safely in their own homes than most doctors have in 20+ year careers in hospitals in this state. I agree that the nursing board should be ashamed for removing a person who is so clearly dedicated to preserving the natural process of birth from the lives of so many women and infants who would be safer in her care, whether high risk or not; it's just one more way the medical structure in Maryland confines women to their standards and limits their rights to choose the birth options that best suit them. How many women has Evelyn created choices for who would have otherwise been forced into interventions and surgeries at the hands of doctors who feared "allowing" them to even attempt to have a natural birth? Hundreds? Maddening.
And yes, Nanette CNM. She travels into MD to perform prenatal check-ups and asks her clients to travel to WV for them as well. Best of luck in creating miracle #3 :)
"She has an IMR of 1.25/1000, Maryland is 7.8/1000 and if you look at just full term babies, its over 2/1000."
You have not read the information provided in the filing closely enough -- I believe the statistics provided in the filing for her are ONLY for the dates between January 1, 2011 and September 25, 2011 and ONLY cover the described 80 patients. So her listed "infant mortality" rate is not 1.25 per 1000, but rather 1.25 per 80.
Thus, if you multiply out her number so that it is measured over 1000 (rather than 80) she actually has an infant mortality rate more like 15/1000.
HB 1056 did not make it through the Maryland House of Delegates, and it was not introduced to the senate this year. We had hoped and dreamed that we would be the lucky grassroots group that succeeded on our first try; however, we are not disappointed in our efforts and accomplishments and all that we have learned.
We are confident that our bill will pass the house next session and will work hard over the summer to make senate connections so that we have a chance in that arena as well.
We will also be involved in the informal work group that HGO chair, Delegate Peter Hammen, has ordered. The work group will consist of MFSB, the DHMH and a variety of other stakeholders. We have been assigned the task of determining how to license CPMs in Maryland. We are excited about the opportunities to educate the opposition and create common ground which will help form the 2013 bill.
So Evelyn is not practicing, we have no other CNMs, and there is no urgency to legalize CPMs, leaving us mothers who refuse to go to the hospital for a routine birth to do things unassisted or under the radar still (and paying out of pocket).
Except that her rate of infant mortality rate for the previous 5 years of ABC's clients was zero. So that is how extracting data can be misleading. And over a 26 year career, you are looking at a less than 1% IMR in over 2000 births. She is just a wonderful, capable, amazing midwife. I knew it just from working with her clients as a CBE and doula and after working as her assistant I absolutely know it to be true.
Evelyn also referred several clients to local area hospitals for emergency treatment during home births that still resulted in infant mortality, which makes it difficult to blame her for the the death of the baby since it could easily have been as much the fault of the hospital staff or no one's fault at all. You can't take a rate based on a 7 month period and extrapolate that throughout a person's career that has spanned two decades with the expectation that each year consistently she has lost 1 child per 80 live births. There would have to be a much longer term of study, or at least an investigation conducted based on factual data from previous years, to be able to determine what the actual rate is.
Sad that HB 1056 has been shot down.. As a person who has struggled to plan a natural, low-intervention VBAC birth 3 times I am very disappointed that we haven't been able to take a real stride in the direction of licensing people who, if licensed, represent that low-intervention option so pointedly. Maybe one day women who don't feel that giving birth in a place like a hospital that represents illness and death will be forced to take matters into their own hands. Or, like me, won't be forced to drive for almost 2 hours out of state to find a birth experience that isn't dehumanizing and unnecessarily feared. I'll be the first in line to sign the next petition!!
Does anyone know how to get our medical records from Alternative Birth Choices, so we can have our records with our new midwife? I called the office number, and it is no longer in service. Is there a mailing address to request them, to be forwarded to our new midwife?
Any help is greatly appreciated.
What a troll.
So Evelyn was the midwife in that case, and that's why she's having all these problems? Wow. Poor Evelyn and poor Maryland. From what I read in the legal papers about this case, it was homebirth done right. Evelyn correctly noticed a problem and got the mother to the hospital in plenty of time to get the care she needed.
This one is all on the hospital, which is why the verdict is high. Not to compensate the family, that can't be done. But to teach the hospital that there are consequences for poor care.
The mother waited an hour and 55 minutes for her emergency c/s. And the damage to the baby all occured in the last 18 minutes of that wait.
Blaming homebirth for this is frightening and ignoring the problem. Our hospitals are not mother-friendly. Why anyone would birth at Johns Hopkins after this is beyond me.
Shocking case, and couldn't be more clear where the fault lies. I hope they pay a good chunk of that verdict and are forced to re-examine their policies. An hour and 55 minutes. Criminal.
You have no idea what you are talking about.
This case is one of the reasons that Evelyn lost her license.
Here are at least 4 ways that Evelyn committed malpractice in this case:
I.Utilizing Intramuscular Oxytocin to stimulate labor in a term pregnancy;
II. Using fundal pressure in the second stage of labor to attempt to cause descent ofthe fetus;
III. Using vaginal chlorhexadrine, rather than intravenous penicillin, in labor to treata known group B beta hemolytic strep vaginal carrier to prevent early onset GBS neonatal sepsis;
IV. Misdiagnosing fetal station resulting in an unnecessary episiotomy. The physical exam on admission to Hospital B was a fetus impacted in the vagina at + 1 station which was incompatible with the report that the fetus had been crowning when the episiotomy was performed...
In addition to the above, Evelyn let the mother labor for 20 hours prior to calling an ambulance.
Finally, the assertion that the damage was done in the last 18 minutes is patently false. That was just the plaintiff's allegation. The science said otherwise, but the jury disregardrd the evidence.
Are you taking the position that those actions fall within the standard of care?
All parties (defense, plantiff, experts on both sides) in the Martinez case acknowledged that the NMW committed blatant malpractice in the case. She was not named as a party in the law suit since she did not have any insurance. Even if she did have coverage, Hopkins would have been on the hook due to Joint and Several liability.
Look at your statement and tell me how anything Evelyn did lead to Johns Hopkins with-holding critical care for nearly 2 hours. A 10 minute decision to incision time is emergency care. 30 minutes is the standard. 75 is the limit of the safe from the study I read in a quick search. 115 is JH's record in this case. Nobody is saying why.
Johns Hopkins was the place of birth, and that they waited a criminally negligent amount of time to deliver this baby. I don't care if the herbs Evelyn waved over the mom caused the baby to grow three heads. That's not the issue. The issue is that these parents went to one of the most famous and respected medical institutions in our country with plenty of time to get the care they needed. And for some UNEXPLAINED reason, they didn't get it. Pointing fingers at what happened at home is totally irrelevant in this case. OK, if they had gotten prompt and appropriate medical attention and the baby was injured, then let's talk about what Evelyn did or didn't do. That's not this case.
Johns Hopkins got slammed with a huge verdict because what they did was absolutely appalling. This poor family should be compensated by the hospital that did harm (by accepting the ambulance and not sending them to another facility which could have given prompt care).
Anyone that supports healthcare in Maryland should be demanding that Hopkins make some major changes. This was not about Evelyn. It's about first doing no harm. And $55 million is hopefully the wake-up call they need. No, JH will not pay even half that amount when the appellate courts apply the state's cap on damages. It's a symbolic amount, but should be a clear message.