My Midwife is Under Investigation - Mothering Forums

Forum Jump: 
Reply
 
Thread Tools
#1 of 50 Old 12-10-2005, 05:48 PM - Thread Starter
 
quelindo's Avatar
 
Join Date: May 2005
Location: On the road to find out
Posts: 3,129
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
(X-posted)

http://www.jsonline.com/news/wauk/dec05/376793.asp

Formerly New Mama to Henry, born August 2005 and Silas, born November 2010.
quelindo is offline  
#2 of 50 Old 12-10-2005, 05:55 PM
 
rmzbm's Avatar
 
Join Date: Jul 2005
Location: NC
Posts: 16,378
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
She wouldn't follow to the hospital, they couldn't use her name & she STOLE the tape?!?!

~Marie : Mom to DS(11), DS(10), DD(8), DD(4), DD(2), & Happily Married to DH 12 yrs.!
rmzbm is offline  
#3 of 50 Old 12-10-2005, 06:54 PM
Zus
 
Zus's Avatar
 
Join Date: Sep 2005
Posts: 78
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
The article is really vague about the circumstances of the death. For some reason they emphasize the fact that the midwife did the epis and gave the pitocin shot, which a midwife is entitled to do, otherwise giving birth at home would not be a safe option IMO.
Babies sometimes die at birth, that's harsh reality. And very often, it was not a matter of malpractice of the caregiver either! You should use your common sense and your gut feeling about this midwife, and not listen too much to stories from the media who like to blow things up.
Zus is offline  
#4 of 50 Old 12-10-2005, 07:01 PM
 
Snowdrift's Avatar
 
Join Date: Oct 2005
Posts: 5,669
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
It is better from a defense strategy point of view not to have a videotape. If/when the prosecutor gets the tape, it will be entered into evidence and twisted around and shown in bits and pieces and commented on by experts (Ob/gyn's). It also mentions that part of her standard agreement was that if transport or some other emergency, she would get the tape.
Snowdrift is offline  
#5 of 50 Old 12-10-2005, 07:03 PM - Thread Starter
 
quelindo's Avatar
 
Join Date: May 2005
Location: On the road to find out
Posts: 3,129
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
I should clarify that I already gave birth with this midwife in attendance. We had a complication right at the end that sounds similar to what happened here, from what I can deduce. My baby's hands were up by his face, and his arms were intertwined. She had to flip me over and rearrange his arms in a hurry. We were very, very happy with the birth and her care, and felt like she totally handled the situation.

She's not going to be able to practice midwifery anymore, and could face jail time. I find it hard to believe that she told the couple she wouldn't go with them to the hospital, or that she ignored the mom's requests to do so, because she's done many hospital transfers and seems very in tune with what she can and can't handle.

And they make it sound like she's only an apprentice midwife. My understanding is that she let her certification lapse in protest because she disagreed with the requirements of being certified (she's very political).

I feel terrible for the family involved, terrible for the midwife, terrible for the other two women who were there (one was a doula), and terrible that this situation will be pointed at by people who think homebirth is unsafe.

Formerly New Mama to Henry, born August 2005 and Silas, born November 2010.
quelindo is offline  
#6 of 50 Old 12-10-2005, 07:41 PM
 
MamaTaraX's Avatar
 
Join Date: Oct 2004
Posts: 9,152
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
I replied to the other thread, I'll copy what I said in case they get combined someday:

------------------------------------
Quote:
Six times in the hours that followed, the midwife performed an episiotomy
SIX TIMES!?!? Pardon me but...WTH!? Who performs an episiotomy SIX TIMES!? That just caught my attention...
It also doesn't sit well with me that the mom asked to go to the hospital and the midwife refused. Women know what they need and should be trusted. Of course, tons of women birthing at home probably get scared and ask to go when all really is well...so that's really a grey area if anything.

I'm sorry to hear of yet another midife under investigation. The article definately doesn't make some things clear though, so I have no real thought either way. What upsets me most is that for every one tragedy there are hundreds of perfectly beautiful outcomes which are overlooked and overshadowed by the one tragedy. Nobody does that to doctors or in-hospital midwives. Such an event places undo scrutiny on other midwives in the area. A similar situation is occurring in mys tate right now. It's sad
MamaTaraX is offline  
#7 of 50 Old 12-10-2005, 07:50 PM
 
onlyboys's Avatar
 
Join Date: Feb 2004
Location: FL
Posts: 3,755
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
I was slightly confused by the article.

She gave SIX episiotomies in the attempt to free an apparently shoulder dystocia-ed baby?

Quote:
Six times in the hours that followed, the midwife performed an episiotomy using scissors, a procedure aimed at widening the birth canal.
She waited 20 minutes after the baby's head was delivered before she called 911?

Quote:
One of the two women who accompanied the midwife told a member of the ambulance crew that the baby's head emerged from the birthing canal about 20 minutes before help was summoned, but the midwife "could not manipulate the shoulders or the rest of the body to allow delivery of the baby."
This sounds like a horribly scary birth. And, from what we have here with the article it does sound like she was negligent, I'm sorry. I'm sure that there's more to the story though, right? I hope?

Homebirth is not unsafe, and SD is a very, very scary situation, and one that is not always reconcilable, but EMS should have been called way before 20 minutes were up.
onlyboys is offline  
#8 of 50 Old 12-10-2005, 08:31 PM
 
liseux's Avatar
 
Join Date: Jul 2004
Location: washington d.c.
Posts: 1,281
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
I am so sorry to read about this baby, this poor family and the midwife.

I`m sorry for speculating b/c I wasn`t there, but a couple things jumped out at me to make me think it was a fatal shoulder dystocia. When the doctor said "they have emergency drills for this in hospitals", s.d. is one of the few things OB`s do have drills for. It sounds to me, with the multiple epis. that the mw was dealing with a very severe case and panicked. There is no guarantee that they could have delivered this baby safely in the hospital. As a mom who lost a baby to s.d. I have read way too much about this. I have heard of many cases of doctors also panicking when dealing with this.

I just feel so badly for all involved. In my case our mw was also a lay mw, but she had 911 called before our son was stuck for even a minute. She had me in the Gaskin maneuver right away and handled everything by the book. Still it wasn`t enough. I feel like I am always talking about this on MDC, but it seems to come up a lot. The media loves stuff like this, but they only get involved with the permission of the family & the hospital. Whatever happened here, I hope its not anyone`s direct fault & I hope for some healing for the family.

Married Catholic mami : to 5 boys, : 9 6 3 : 5 mo. 5/6/02-6/22/02 (HIE)
:
liseux is offline  
#9 of 50 Old 12-11-2005, 11:15 AM
 
onlyboys's Avatar
 
Join Date: Feb 2004
Location: FL
Posts: 3,755
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
liseux, thanks for your perspective, and I am so sorry about your sweet boy.
onlyboys is offline  
#10 of 50 Old 12-11-2005, 02:20 PM
 
mwherbs's Avatar
 
Join Date: Oct 2004
Location: Tucson, AZ
Posts: 5,575
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 1 Post(s)
can't really tell anything by the article- people who know little about birth get details wrong-- and just from my experience with other newspaper articles even with documents/press relases in their hands- reporters have gotten names wrong, comments and quotes wrong.

what are the license laws in WI, if there is no license then it may very well be reasons she did not want a tape to be seen-- hard to say what 6 medical procedures were -- re-read the article at first they say 6 medical procedures in the hours before the birth- which may including checking for dilation , later that info may have been confused with episotomies-- because maybe even the reporter could not think-simple checking was the medical procedure- a head out for 20 minutes before she called-- now no one can be sure of this timing either- could be 20 minutes from when the baby was crowning- or even if it were 20 min after the head was born- it could be that she was a bit preoccupied and who ever was with her was too -- or it could mean the ambulance arrived 20 minutes after the head emerged-- if the 20 minutes is even an accurate number--
as far as the statement about going to the hospital- that is also hard to say was the mom insistent or did she in transition say something in a freak out moment of terror-- I have heard moms say- I'm not doing this any more; can you just cut it out;pull it out; just get it out; can I go get some drugs now; and other things... one mw said during one of her births she was having a fantasy during transition where she visualized the ambulance coming and she was looking on the shelves and finding the pain meds....
I guess if she were only looking out for her interests she would have not given the pit shot in front of the ambulance attendant-- but she was probably doing something to protect the mom from hemorrhage with all this distraction and stuff going on mom is in danger too- ambulance folk have a range of experience and skills birth is not exactly their field of expertise -- the article does sound a bit sensationalistic and has already shown a bit of bias--"In hospitals, doctors actually perform emergency drills for this so that it can be dealt with quickly by trained physicians,"
and the midwife did not do these same procedures? if she did an episotomy it sounds like she was doing the procedures-- more than one baby born with shoulder dystocia has died in the hospital---not every baby can be save no matter what the setting.
mwherbs is offline  
#11 of 50 Old 12-11-2005, 03:54 PM
 
marymom's Avatar
 
Join Date: Nov 2001
Location: Treasure Coast,South Florida
Posts: 536
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
ok,
I have studies SD alot, my son has a permanent injury because of one.
I have been to two births where a dystocia occurred, (interesting statistically) and both were safely managed, one had a transient injury.
first off can I just say that cutting the vagina does not make the actual canal bigger,
the shoulders generally get stuck under the bone.
It does however give the MW room to reach in to dislodge the shoulder. sometimes.

It is my experience that midwives who are under investigation are usaully stressed and under large amounts of pressure. Emergency transfers to a hospital by the midwife under investigation are often not well handled by the hospital because they have formed opinions about the midwife.
Likely you are expecting things to go in perfect divine order and since you have delivered with this midwife before you have faith in her ability. Likely this faith would serve both of you.
Those are two plusses and minuses that I thought about.
May peace be upon us
Mary Rainer
marymom is offline  
#12 of 50 Old 12-11-2005, 04:48 PM
 
mwherbs's Avatar
 
Join Date: Oct 2004
Location: Tucson, AZ
Posts: 5,575
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 1 Post(s)
I agree with you about epis and shoulder dystocia but it is part of the routine and will sometimes allow a hand in when it wouldn't fit before---
the thing with sd is to keep changing and trying something else- don't get stuck on one maneuver if it doesn't work move to something else-
mwherbs is offline  
#13 of 50 Old 12-11-2005, 05:54 PM - Thread Starter
 
quelindo's Avatar
 
Join Date: May 2005
Location: On the road to find out
Posts: 3,129
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
Originally Posted by marymom
Likely you are expecting things to go in perfect divine order and since you have delivered with this midwife before you have faith in her ability. Likely this faith would serve both of you.
Just to clarify -- I had my baby last August and do not plan on having anymore. I don't think my midwife will be allowed to attend births after this.

Formerly New Mama to Henry, born August 2005 and Silas, born November 2010.
quelindo is offline  
#14 of 50 Old 12-11-2005, 05:58 PM
 
doulajen's Avatar
 
Join Date: Oct 2004
Location: Oahu HI
Posts: 164
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
I am this midwife's apprentice. I know that she is beyond qualified to handle a difficult birth. Although I was not at this birth, I can assure you that this story is a bunch of crap and the reporter obviously has no idea what they are talking about. I can't believe that this midwife would refuse to go to the hospital or that she cut 6 episiotomies (I am pretty sure there is not enough skin in that area for this to be possible!) I have seen her handle a difficult birth before (Hi new moma) I know that she is very caring and competent! She would never make a mother stay home if she did not want to. I have also been with her during a transport and know that she has no problem taking a mom in if medical care is needed. Please remember that this story was written to sell papers!!! There is more to this story than what is written. She gave this mom options for her birth. The paper says this "that a certified professional midwife from the Milwaukee area turned the couple down earlier because Bridget *****'s maternity history was considered "too high risk" for a home birth. She declined to specify the risks identified by that midwife." How would you feel if you knew that "high risk" was VBAC??? I don't consider a vbac mom high risk that is for sure! Every midwife has their comfort zone and should not venture outside of that, but does that mean that every other midwife should have to turn away clients because someone else does? I don't think so. I don't know the details of this case because I have chosen not to ask (for my own good in case of trial). I do however know the integrity of this midwife. I am so sad for this family, for the midwife and her family, for all the mothers who will not be served by this wonderful midwife, and for the state of WI. Please try to keep an open mind when you read what is written in the news. Jen
doulajen is offline  
#15 of 50 Old 12-11-2005, 06:15 PM
 
Ruthla's Avatar
 
Join Date: Jun 2004
Location: Long Island, NY
Posts: 47,599
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 3 Post(s)
I used a lay midwife for my first two births. She was also arrested and charged with "practicing medicine without a liscence" after attending a stillbirth, and the last I heard she was in jail.

Whatever the medical details of the case, this is in the news because it's political. It's a "witch hunt" against lay midwives.

Ruth, single mommy to Leah, 19, Hannah, 18, and Jack, 12
Ruthla is offline  
#16 of 50 Old 12-11-2005, 07:00 PM
 
onlyboys's Avatar
 
Join Date: Feb 2004
Location: FL
Posts: 3,755
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
Originally Posted by doulajen
I am this midwife's apprentice. I know that she is beyond qualified to handle a difficult birth. Although I was not at this birth, I can assure you that this story is a bunch of crap and the reporter obviously has no idea what they are talking about. I can't believe that this midwife would refuse to go to the hospital or that she cut 6 episiotomies (I am pretty sure there is not enough skin in that area for this to be possible!) I have seen her handle a difficult birth before (Hi new moma) I know that she is very caring and competent! She would never make a mother stay home if she did not want to. I have also been with her during a transport and know that she has no problem taking a mom in if medical care is needed. Please remember that this story was written to sell papers!!! There is more to this story than what is written. She gave this mom options for her birth. The paper says this "that a certified professional midwife from the Milwaukee area turned the couple down earlier because Bridget *****'s maternity history was considered "too high risk" for a home birth. She declined to specify the risks identified by that midwife." How would you feel if you knew that "high risk" was VBAC??? I don't consider a vbac mom high risk that is for sure! Every midwife has their comfort zone and should not venture outside of that, but does that mean that every other midwife should have to turn away clients because someone else does? I don't think so. I don't know the details of this case because I have chosen not to ask (for my own good in case of trial). I do however know the integrity of this midwife. I am so sad for this family, for the midwife and her family, for all the mothers who will not be served by this wonderful midwife, and for the state of WI. Please try to keep an open mind when you read what is written in the news. Jen
I'm so glad to read this.

I've been thinking of this midwife and the story all day. The reporter obviously has some "facts" mixed up!

I really hope the truth comes out here, for the MWs sake.
onlyboys is offline  
#17 of 50 Old 12-11-2005, 10:04 PM - Thread Starter
 
quelindo's Avatar
 
Join Date: May 2005
Location: On the road to find out
Posts: 3,129
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
Originally Posted by doulajen
I am this midwife's apprentice.
Hi Jen. I hope you think it's okay that I posted a link to the article here. I just feel so sad and awful about what happened -- I can't stop thinking about it -- and just wanted other people's insight and comments to help me process it.

Formerly New Mama to Henry, born August 2005 and Silas, born November 2010.
quelindo is offline  
#18 of 50 Old 12-11-2005, 10:23 PM
 
doulajen's Avatar
 
Join Date: Oct 2004
Location: Oahu HI
Posts: 164
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
I think it is fine. The more people that know that this witch hunt is going on the better! Jen
doulajen is offline  
#19 of 50 Old 12-11-2005, 11:57 PM
 
liseux's Avatar
 
Join Date: Jul 2004
Location: washington d.c.
Posts: 1,281
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
I agree that we don`t know what happened and I hope I didn`t make it sound like I was judging the mw at all. I was just commenting on how the article made it sound and it sounded similar to me situation. Even if she did panic, there is still no way to know that the outcome would have been any better in the hospital. Its annoying the way the article made it sound like the hospital is always prepared for these things. That`s just not true.

Its very hard to keep something like this out of the media and I just wish the best for the family and the midwife.

Married Catholic mami : to 5 boys, : 9 6 3 : 5 mo. 5/6/02-6/22/02 (HIE)
:
liseux is offline  
#20 of 50 Old 12-11-2005, 11:59 PM
 
KariM's Avatar
 
Join Date: Mar 2004
Location: at the sewing machine (in zone 5A)
Posts: 3,375
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
Originally Posted by mwherbs
what are the license laws in WI, if there is no license then it may very well be reasons she did not want a tape to be seen--
Currently, midwives in WI are in that grey area of not being legally regulated but also not prohibited.

AB 709, the Proposal to License Certified Professional Midwives, a bill introduced in the State Assembly, is an attempt to change that situation, though. AB 709 would require midwives to earn the Certified Professional Midwife credential through the North American Registry of Midwives (NARM). NARM is a nationally accredited certifying agency by the National Commission for Certifying Agencies (NCCA) and the National Organization for Competency Assurance (NOCA), the agencies that also authorize the American College of Nurse Midwives Certified Nurse Midwife credential.

More information about the bill can be found at:
http://www.wisconsinguildofmidwives.org/friends.htm

The family mentioned in the referenced news article has my greatest sympathy. I can only imagine the pain they're experiencing from their loss and hold them in my prayers.

I hold the midwife in my prayers as well because the pain and suffering she is experiencing is also great.

Having been a consumer of midwifery services I worry about the damage this sort of media coverage will bring.

I was a "high risk" pregnancy and saw three separate OBs before I finally found my CPM. Without access to Jan I'm convinced my DD's entry into this world would have occured in an OR rather than the safety of our home.

Wisconsin is a very rural state and it is becoming increasingly difficult for women to have access to hospitals permitting a "trial of labor." My only option for a VBAC birth (without a midwife) would have been to travel outside of my county and drive to the nearest large city. I would have had to undergo various protocols (epidural cath, IV, internal fetal monitoring, etc) in order to be permitted a "trial of labor" at a hospital that met ACOG procedural standards.

I only wish the media would give equal coverage to the damage done to mothers and babies by licensed medical providers.

--Kari
KariM is offline  
#21 of 50 Old 12-12-2005, 02:25 AM
 
Zoo Loo Naturals's Avatar
 
Join Date: Sep 2003
Location: rain, headwaters, agate beaches
Posts: 391
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
There were alot of things in that article that were fuzzy, twisted or sensationalized. Good reporting by 3 men.

I wonder who reported her!?!?

There was a birth in my area not long ago, very much like this one. They concluded (without autopsy) that baby died just before delivery. Sometimes babies don't make it. It's VERY sad, mother nature is cruel sometimes. But why are we always looking to "blame" someone? Can't we say the midwife did her best, everything she knew to do? Wouldn't they say that in the hospital? Women midwives just don't have the egos that male doctors have.
Zoo Loo Naturals is offline  
#22 of 50 Old 12-12-2005, 03:37 AM
 
paloma's Avatar
 
Join Date: Feb 2004
Posts: 873
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
"Katie Prown of the Wisconsin Guild of Midwives said Friday that a certified professional midwife from the Milwaukee area turned the couple down earlier because Bridget Stoiber's maternity history was considered "too high risk" for a home birth. She declined to specify the risks identified by that midwife"

HIPAA violation above.
paloma is offline  
#23 of 50 Old 12-12-2005, 03:52 AM
 
hotmom's Avatar
 
Join Date: Jul 2005
Location: Cali
Posts: 486
Mentioned: 1 Post(s)
Tagged: 0 Thread(s)
Quoted: 1 Post(s)
This is just awful.
I feel so sad for the family and the MW. I just want to ask about S.D. my baby had a minor case and the MW was able to get him out quickly with me. I have also heard of doctors just pulling the baby out as well. What "emergency drills" are done for OB's? what else could a hospital have done? If the head is birthed, then what?
I am little confused, thanks.

ELY -Mommy to many

hotmom is offline  
#24 of 50 Old 12-12-2005, 06:23 AM
 
norasmom's Avatar
 
Join Date: Nov 2003
Location: right where I'm supposed to be
Posts: 317
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Paloma- can you expand on the HIPAA violation that you noted?

The midwife didn't need to be reported. 911 was called, the midwife was there, a baby died.
norasmom is offline  
#25 of 50 Old 12-12-2005, 06:27 AM
 
Zoo Loo Naturals's Avatar
 
Join Date: Sep 2003
Location: rain, headwaters, agate beaches
Posts: 391
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
Originally Posted by norasmom
The midwife didn't need to be reported. 911 was called, the midwife was there, a baby died.
If there is to be an investigation it would have been reported. No?
Zoo Loo Naturals is offline  
#26 of 50 Old 12-12-2005, 09:05 AM
 
NavelgazingMidwife's Avatar
 
Join Date: Jun 2005
Location: San Diego, CA
Posts: 63
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
A couple three things:

1. Any death, *someone* looks at it. Almost always, the state is the investigating party when a midwife has reportable events. I felt the article implied it was the parents' choice, but it wasn't very clear.

2. With regards to HIPAA, I can imagine the midwifery organization midwife was asked after the mom's name was already publicized... I can imagine the press could ask, "if a woman was <insert overweight here> pounds, had a history of shoulder dystocia, <blah blah>, would a midwife take her as a client? And that midwife saying, "no, she would be turned down as a potential client." I can also imagine the press got a hold of court records and made it sound like *they* did the interview instead of reading the records.

All that said, IF it came out as reported, that she either said her name to the press OR stated the woman, if *they* used her name and she did not, had previously sought care from someone and was turned down, I agree... yes, that would be a HIPAA violation.

3. With regards to drills about shoulder dystocia, many of us midwives do the same thing. A drill might look like this for a physician/nurse:

(most of the activity happens within the first minute... very, very fast... and depending on experience and learned-instinct, some steps might be in a different order once the head is born)

- slooowwwww head presentation... begin considering calling for help... consider, then do, episiotomy
- head born with turtling (coming out and pulling back in again up to the baby's chin), hit the "panic" button to get enough others in the room
- if episiotomy not done earlier, do it or enlarge the one already cut
- get mom flat in the bed
- push moms legs back into her ears (this is McRobert's Maneuver)
- have mom PUSH while doctor "encourages" rotation with hands (nervous docs pull on the baby's head at this point)
- push hands in to find anterior shoulder to push it in one direction or the other to try to get it unstuck from behind the pubic bone
- try to find an armpit to hook to pull the impinged arm outward (usually breaks the clavicle)
- suprapubic pressure; a technique where someone uses both hands and all of their weight directly on the upper part of the top of the pubic bone (where the shoulder is stuck behind in a true shoulder dystocia) and presses directly downward at the same time as the doctor does the spin and pull down the shoulder trick
- break one or both clavicles to "fold" the baby's wings inward to lessen the width of the shoulders (this sounds horrendous and while it isn't the most fabulous thing to do, nor a first step, it *can* save the baby's life and does not (usually) require anything more than pinning the baby's shirtsleeve to the shirt for a couple of weeks to repair the damage
- if all that fails, push the baby back in and do a cesarean (I have never heard of anyone having this done for shoulder dystocia and suspect it is done incredibly rarely because mortality is almost certain)

note: I know that some women come and ask me why their doctor pulled on their baby's head so hard. When asked if there was a lot of activity in the room, the answer is usually yes, and then I guess what might have happened is this: when a baby is looking like s/he might be a shoulder dystocia... verrrrrry slow descent of the head... very, very long crowning (or crowning, retreating, crowning, retreating)... as the baby's head begins to be born (one eek at a time... oh! there's the top of the ear! oh, there's the earlobe... oh, look, an eyebrow! [I have heard families saying these things - to a care provider, these ever-so-slow presentations are horrifying]... the eyes, the cheeks, the upper lip, the bottom lip... and finally the chin... sometimes, this can take several minutes all on its own), the doctor tries HARD to *not* allow rotation occur (where the head goes from looking down/up to the side) because when the baby rotates, the shoulder also turns and *that* is the absolute impingement point (hypothetically, and to me, probably). So, as the head is being born, the doctor "assists" the head by pressing (often seen as pulling) downward to try and get the shoulder down under the pubic bone before rotation begins or completes. (I could show you so much better in person.) It is probably a combination of both pressing down and pulling, but when I have had to do this, I focus hard to make sure it is more pressure than pulling.

Midwives, who wouldn't typically have to contend with narcotics or epidurals in the mom (unless she is a CNM and if she *is* a CNM in the hospital, she is required to call an OB or ten), can add a couple of other maneuvers including the Gaskin Maneuver - getting the mom onto hands and knees - or something akin to the Gaskin Maneuver, having a woman lunge... and lunge... and lunge... squatting, lunging... flipping from hands and knees to lunge... a variety of movements that sound much easier than it really is with a baby's head between the legs. (I am one who had the thought that the Gaskin Maneuver actually works because the *movement* of getting a woman from her back to her hands and knees was the mechanism, not the hands and knees itself, that dislodged the shoulders - this came after seeing stuck shoulders [not dystocia] become un-stuck as women in pools stepped out and over the side... that swirling-opening the hip motion.

No matter who is doing it, the drill includes tending to rescusitation of the baby and tending to hemorrhage of the mom - both distinct possibilities, if not probabilities. Baby: many true sd babies come out needing serious rescusitation (docs cut the cord, midwives typically would not do that) Mom: unsure until recently why a mom tends to hemorrhage after a sd, Michel Odent reveals the after-effects of surges of adrenalin (which certainly occurs when a dozen or more people converge into the room and onto your body)... it causes the blood vessels to swing wide open and blood to pour out of open "wounds" such as the placental site.

So, with all of that information, it can probably be understood why they call so many people into the room, but folks are also called to *watch* and learn what to do (or NOT to do) during a sd they might be in charge of. Also as witnesses for court. (not kidding)

Sticky shoulders is not the same thing as a true shoulder dystocia. I personally know two people who had their baby die in a shoulder dystocia (one at home, the other in the hospital). The midwife under investigation... I cannot imagine her agony as she tried to free that baby. I cannot imagine it was 20 minutes before calling 911 (time goes FREAKY during sd... it is a VITAL part of the practice we do, too... one person assigned to call out times as every 15 seconds passes)... I believe the press totally screwed what was said up... an episiotomy 6 times over several hours? No way. 6 times to get her hands in the vagina to break the clavicle to try and get the baby out? That I can imagine (although incredibly extreme, but in a panic, I could see someone trying ANYTHING).

I know this was long, but do hope it explains sd a little better.

Barb Herrera
NavelgazingMidwife is offline  
#27 of 50 Old 12-12-2005, 11:15 AM
 
paloma's Avatar
 
Join Date: Feb 2004
Posts: 873
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
"Katie Prown of the Wisconsin Guild of Midwives said Friday that a certified professional midwife from the Milwaukee area turned the couple down earlier because Bridget Stoiber's maternity history was considered "too high risk" for a home birth. She declined to specify the risks identified by that midwife"

1) It was allowed to be known that the woman sought care.
2) It was allowed to be known that the woman was turned down for care.
3) It was allowed to be known that the woman was considered "High-Risk."

Any midwife should know to decline specifics and common-sense should tell her not to jump in bed with reporters when a midwife is being investigated.
paloma is offline  
#28 of 50 Old 12-12-2005, 11:56 AM
 
shay's Avatar
 
Join Date: Oct 2002
Location: Northwest Indiana
Posts: 297
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
This sort of stuff makes me soooo angry!!! If this baby would have died from a hospital birth, you wouldn't be reading about it in the paper. This article is a good example of making homebirth out to be 'unsafe.' Maybe if the states would get there act together, midwives wouldn't have to practice 'within a grey area.' I encourage you all to write a letter to the editor about this.

http://MotheringByNatureCenter.comsaynovax.gifnocirc.gifhomebirth.jpgwaterbirth.jpggoorganic.jpgwinner.jpg

shay is offline  
#29 of 50 Old 12-12-2005, 12:24 PM
 
paloma's Avatar
 
Join Date: Feb 2004
Posts: 873
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
There are state by state listings of hospital outcomes. This sounds like a job for a local person. Anyone want any research or other help writing a letter to the editor about this?
paloma is offline  
#30 of 50 Old 12-12-2005, 01:14 PM - Thread Starter
 
quelindo's Avatar
 
Join Date: May 2005
Location: On the road to find out
Posts: 3,129
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
Originally Posted by paloma
There are state by state listings of hospital outcomes. This sounds like a job for a local person. Anyone want any research or other help writing a letter to the editor about this?
I would love to look into this. Where do I start? I tried doing a google search but am having some trouble.

FWIW, I did just send an e-mail to a columnist for this paper in the hopes that he'll highlight the GOOD aspects of homebirth. I really like him and hope he takes this subject on.

Formerly New Mama to Henry, born August 2005 and Silas, born November 2010.
quelindo is offline  
Reply

Quick Reply
Message:
Drag and Drop File Upload
Drag files here to attach!
Upload Progress: 0
Options

Register Now

In order to be able to post messages on the Mothering Forums forums, you must first register.
Please enter your desired user name, your email address and other required details in the form below.
User Name:
If you do not want to register, fill this field only and the name will be used as user name for your post.
Password
Please enter a password for your user account. Note that passwords are case-sensitive.
Password:
Confirm Password:
Email Address
Please enter a valid email address for yourself.
Email Address:

Log-in

Human Verification

In order to verify that you are a human and not a spam bot, please enter the answer into the following box below based on the instructions contained in the graphic.



User Tag List

Thread Tools
Show Printable Version Show Printable Version
Email this Page Email this Page


Forum Jump: 

Posting Rules  
You may post new threads
You may post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off
Trackbacks are On
Pingbacks are On
Refbacks are Off