I know we are clearly coming from a place of sorrow and grief, which often includes anger. We feel we have investigated our birth in depth with many sources, including the lead midwife at our birth center, our doula, fellow friends who are doula's, nurses, or midwives, and then of course our families. Many seem to be of the mind that our midwife was negligent at the least, and whether or not she could have prevented our eventual still birth is still up in the air. Our doula is still very angry at the care we received from this midwife. We also believe there were signs that our daughter was having cord compression, not only during labor but in the weeks leading up to delivery, and they were all missed by our midwife.
We were seeing a group practice where you essentially are followed and covered by all three. They are all CNM's and the owner has rights to deliver at two local hospitals as well. Due to my husband's work schedule, we often had appt's on Tuesdays, and as a result we often saw who I will refer to as Midwife C. C appeared "hands off", but we experienced very little education. Our visits were often 10 minutes, a quick listen on the doppler, a measurement, and then to ask if we had questions. There was little direction on any holistic things to prepare my body that I know about from mothering forums, including RRL tea, EPO and other items that some mother's try and some do not. We were also planning a home birth. This midwife NEVER remembered that we were a homebirth couple and this birth center only schedules two a month, so we were only one of two for March. Each visit she could never remember this.
I had consistently had a baby that didn't move. We had started doing NST's weekly and each week it took longer and longer for her to respond on the heart monitor within the time frame. The last one took over an hour. We know now this is a sign of cord entanglement and compression. I told them constantly that I rarely felt her. When they sent me at 37 weeks for a BPP, no color doppler was done or ordered. This would have shown and detected the cord. It was not ordered and when the results were sent to C, she did not send me back over for a color doppler. During the last few weeks, she increased her amount of violent hiccups. I know now this is cord compression as well. I had lower blood pressure. This is a risk factor if there is already cord compression present.
When we called her in labor, yet again she asked if we were going to meet her at the birth center. We had to remind her, not even 6 days after our last appointment, that we were at home. She discouraged us from having her come out and kept dropping hints that she was busy. She also said she would need to go by the birth center to get my chart before coming to our house. Friends who are midwives have commented that was unusual and that they typically have copies with them when they are on weekend rotation on call.
For her first visit, she did an internal and did not ask consent to do a sweep. I remember thinking that I was "testing" her to see if she would ask first or just do it. She did and commented 'you aren't really dialated, you were barely a 1 and I probably made you a 1 just doing the sweep".
I was having contractions every 3-6 minutes often lasting up to 2 minutes, which obviously little dilation, and hours of diarhhea. So we're looking at some atypical labor here. She instantly suggested nubain, I consented. She did not listen to the heart beat of the baby DURING a contraction or through a contraction, and she listened for around 10 seconds. She did not evaluate me after administering nubain and did not take my blood pressure to see if I might have had a decrease and needed naloxone.
She leaves, I sleep for around 2 hours, and wake up to begin vomiting. I continue this throughout the night and I know this is another sign of my body preparing. I also start losing my plug. I cannot keep liquids down and feel very dehydrated. Midwife C is called to come back approx 10 hours after she left to administer fluids. It takes over 2 bags before I even feel the urge to pee. She does not take my blood pressure. She listens to the baby, again a quick listen, not through a contraction. We commented the heart rate was lower than normal, much lower, around 110 instead of her usual 160. We were told this was fine. We know now this could have been a sign that my decreased blood pressure was impacting hers.
She does not ask about fetal movement. She again administers nubain and now phenergan. Does not evaluate and watch for blood pressure, and she leaves. She does not call or check in with us for the rest of the day. She leaves around 2pm and we do not hear from her. She does not indicate that I might need to be checked at the hospital after dehydration. She does not offer any signs or follow up care to my husband to watch.
The next morning at 5am we call and tell her that I've had excrutiating contractions all night that made me begin to demand a c-section, come hell or high water. We know now that my daughter had died and was essentially sitting in my pelvis, placing constant pressure and obviously cannot move or respond to contractions. When we call, instead of even listening to our question, she answers with "Hi, I'm not on call anymore, Call Midwife A". And hangs up.
3 hours later we discover at the birth center that there is no heart beat. We had heard it less than 24 hours before.
When I was induced later that day, when I was on pitocin and had reached 9 centimeters, I remember telling my doula and my husband that what I had been feeling the night before was 10x worse than unmedicated, ready to push, pitocin induced labor.