Midwife goes to jail after stillborn birth

So... why didn't the parents check her licensure? It's also suspicious that they didn't start working with her until a month before the due date. What were they doing before then? Were they seeing an OB or another midwife? The story seems incomplete in its description of the parents' efforts to ensure that their child was delivered in the safest way possible.

I'm not necessarily against home births, but it seems very risky after having had 3 c-sections. I wonder what caused her to have the c-sections? If she had already had prolonged labors or breech babies, common sense seems to dictate that she wasn't exactly taking the safest route by not being at a hospital.

All of that said, what quack runs around injecting women with drugs and no type of licensure?

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Everyone involved in this situation are just so disgusting. I'm pregnant with my 2nd, my 1st was c-section and doctors only allow a vbac after 1 c-section, and you have to have had a bikini cut on your uterus. There are risks involved and the mother and father have to make that call but they are only done in a hospital with doctors and nurses around in a controlled environment incase there is a complication. These parents were obviously negligent as well, and after already having had 3 children through c-section you'd think that they would be better informed and more responsible. The midwife definately deserves what she got but what about people that go through with using a "midwife" who tells them that if anything "went amiss during the procedure, she wouldn't stick around to answer questions and that they were to withhold her true identity." These people deserve some punishment as well for the life that was lost due to their negligence.

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Personally, I think this lady got a really good deal with only 6 months in jail. She shouldn't be practicing without a license or administering drugs that she isn't authorized to administer! The harshest sentence would have been appropriate, for the death of this baby and for all of the other births she assisted on! Ladies, think about your unborn baby's life!! It sounds selfish to me to say "I" want to deliver at home. I bet you wouldn't be thinking that if god forbid, something horrible happened!

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If I remember correctly, other midwives had said she was too high risk to do a homebirth, so she kept shopping around until she found someone who would do it.

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Wow, I hope the other of the dead baby thinks it was "worth it" to shop around until she found someone willing to do something that the vast majority of medical practitioners consider unsafe, so she could have the home birth of her dreams. I'm sorry if that sounds harsh, but why take the risk to your child's life just so you can have "an experience".

I had an unplanned c-section, I didn't care how my daughter got here, I just cared that she was safe and healthy. If we are fortunate to conceive a second child, he or she will be delivered by scheduled c-section. So I don't get to experience pushing a baby out vaginally, so what.

I think the midwife is certainly at fault, but so are the parents.

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I've read about this before, but I'm afraid I may confuse the details with those of another, similar story.

I think they were all - parents and midwife - to blame in this. I'm an advocate for homebirth - my 3rd was born in a pefect, beautiful homebirth - but think all parties involved need to be very informed and ready for all situations that could arise. And I can't imagine attempting a HBA3C, and don't know anyone who would.

The problem with a blanket criticsm of the midwife for "practicing without a license" or "giving drugs she wasn't authorized to give" is that in many states it is very difficult or impossible to become licensed to perform homebirths. Quite frankly, I think it was illegal in my situation for my midwives to assist in my birth. The laws are very often flat our wrong, and written not to protect the safety or choices of moms and babies, but only to protect the interests of hospitals and OB/GYNs.

Without knowing all the details, I imagine it's possible that this was a mother who was going to have a homebirth no matter what, and would have done it unassisted if no one had helped her. Maybe this midwife recognized that it was better to have a trained assistant with her than for her to do it alone. In that case, the sentence is more than fair (if not too harsh).

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Death of the baby or mother (or both) is a risk of both homebirth *and* hospital birth.

This case is bad news and is in no way representative of a typical homebirth.

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How tragic. I agree that the parents made so many bad choices. They didn't deserve for their baby to die tho. That is so sad.

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I believe in homebirth VBACs, because I know they are possible--I know many women who had them, and were perfectly safe. The data on VBACs after multiple c/secs isn't really very clear, mostly because so few of them are done; it's assumed they are risky, but more data definitely needs to be gathered. But I do know women that have had them sucessfully. That said:

1. First of all, the articles do NOT make clear the stillbirth had anything to do with it being a VBAC. That might actually be a red herring in this case (stillbirth might have happened even if there were no previous c/secs). Though if there were complications that led to the previous three c/secs that this midwife knew of and did not take into account, that was wrong of her.

2. Licensing for midwives varies from state to state--in another state, Dentice might have been considered perfectly legal, esp. given her apparent long career in midwifery. That does not justify her taking this client on, but it does point out the difficulties that come with trying to find a good caregiver who also respects your rights and beliefs to make choices about birth. There is no such thing as a risk free birth, even in a hospital. Perhaps this couple and midwife should have known what to do; perhaps it was far less clear than it seems.

3. OBs, who generally oppose homebirth and midwives as competition, are quick to seize on cases like this, and yet very quiet about the many peaceful successful homebirths and midwife births (even VBACs) that happen every year. And OBs get sued for negligence and abuse quite often, as well. Once a baby dies, there will almost always be a lawsuit, no matter what the cause was or what precautions were taken.

The hostility between midwives and OBs, and the lack of understanding of natural birth processes in general in the medical community are what lead to these kinds of cases. Ideally this woman would have been allowed to labor at a birth center with OB backup and watched for problems. But she knew the second she walked into a hospital she would be sectioned right away, probably before her due date. If the hospitals were less rigid, perhaps she would have been more willing to let them be part of her birth, and would have had a better outcome.

The problem with telling women "do what the hospital tells you, no matter what, or your baby will die" is that birth outcomes are seldom that predictable, and lots of women end up with c/secs they didn't need. This creates mistrust and a lack of good choices.

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I agree that it is such a shame when these things happen. Midwife attended deliveries are a safe choice for women who have a noncomplicated "normal" pregnancy. Having previous c/sections does not really make someone high risk. They were done all the time until very recently. As a labor & delivery RN and Student Nurse Midwife (which is a masters degree program) here is what one of my teachers told us about the current state of VBACs:

"You'll actually learn about this in your IP class, but I'll give you my two cents on the issue. For many years VBACs were the recommended course of action because the risk of uterine rupture was believed to be no higher after C-section. All of that changed when a study came out over a year ago that identified a greater risk for uterine rupture following VBAC. The study actually identified that much of this risk was related to all the induction and cervical ripening (particularly with cervadil) that was going on with women who had a uterine scar. The recommendation of the study was NOT to stop doing VBACs but to do them only in places where you had access to emergency c-section if needed (the risk for rupture is STILL very low). What that meant for midwives, is that there is now enough evidence to support doing VBAC only in the hospital setting (and not outside of the hospital). However, many physicians - in response to the study - just stopped doing them altogether. There are still many places, however, where women are still allowed to VBAC. I would encourage the woman you describe here Michelle to look around and find someone who will care for her and plan a VBAC."

As I said, I am a labor & delivery RN and Student Nurse Midwife, and I can tell you that I had my last baby at home and would not have a baby in the hospital unless it was absolutely necessary. But that is because I feel safest at home. One should definitely have their birth wherever they feel the safest. That being said, the reason that I believe home birth is safest is because I see every day how many things we do in the hospital that set the stage for things to go wrong in a delivery. We know through research that many of the interventions done in a hospital on a regular basis interfere with the outcome. Many of these interventions are useful in an emergency but not on each and every patient. To be able to labor in any position that feels comfortable to you is going to contribute toward a better outcome. Lying in a hospital bed (dead cockroach position) is only convenient to the Dr catching the baby (who incidently has a time watch going and if you do not deliver by such and such time you will end up in an unnecessary c/section (c/s). To eat and drink in labor is not only a right, it is when you need more energy than ever!! You are working so hard and you don't have energy because in the hospital you can't eat. For fear if you have a c/s you will have eaten before surgery. Hello, I'm sure the car accident victim coming from dinner wasn't able to not eat before surgery. This practice is based on a study done in the 50s warning agains aspiration risks, and is still in practice today. My point is, not everything we do in the hospital is because it is the best thing for the patient. Most of the things done are because of fear of liability!
To not have anyone take your baby away from you after the birth - even 10 feet to the warmer - is what is best for you and your baby. Skin to Skin contact with Mom is exacly enough. Oh, I can go on and on. If anyone is interested I would suggest reading some of Dr. Michel Odent's research also. Fascinating stuff if you're into childbirth.
Sorry, I work night shift and am writing in a fog but my point here is that the problems between midwives and Drs is all financial. They feel threatened by midwives because they don't know how to divide up the dollar. But it is documented fact that midwife attended deliveries have better statistical outcomes than docs do. And with all this science here in the U.S. you would think that we would be #1 with lowest mortality and morbidy rates, right? Wrong we are way way down there like #27. The countries that use Midwife centered care are #1 like the Netherlands, Sweden and Germany. The reason is because Midwives don't interfere with the perfect process of pregnancy and labor until there is a need to. We don't try to control it. Drs try to "manage" and "control" it and that sets the mother up for things to go wrong in the hospital all the time. Anyway, I could rant on and on. Rickie Lake is someone who is very pro-midwife and is now making a Documentary about midwives that you should keep your eyes open for. Education is key.

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I actually do know of more than a few women who have had HBA3C and had a perfect outcome as well as a few women who had no prior history of c/s who had some very bad outcomes at the hands of OBs in hospitals. My 2 were born in hospitals, one by c/s and the next a vbac because in my state of residence it is illegal for licensed midwives to do vbacs. However the next will be an unassisted pregnancy and a home delivery which means no prenatal (s)care and I will deliver my own baby, not some (S)OB.

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Midwives are one thing and they are great for some people. But this one that ISN'T licenced sounds like someone that should NOT have been doing this in the first place. This makes TWO midwives that I have heard of that were quacks! The first was the one that delivered a friend's wife's baby. The wife was no friend of mine because she NEVER saw a doctor during her pregnancy and this midwife only saw her twice. Once before the delivery and during the delivery and thanks to this quack AND the stupid mother the baby almost DIED! The doctor that worked with the baby while in the NICU said that the mother should have be labeled high risk and the baby should have been delivered in a hospital and monitored from the time of birth! The baby had a STROKE before she was born! She was in the NICU for 5 months and she wasn't put there until the FATHER (who isn't very smart either, he should have taken the baby LONG before then) took the baby to the hospital almost two weeks later when she has a SEIZURE and the baby was dehydrated too!! THe horrible part was she didn't learn from her screaw up and did it AGAIN with the second baby and the SAME QUACK delivered the baby AGAIN and this time didn't see her until the delivery!! LUCKLY the second baby was HEALTHY!!

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I think the parens made a very bad judgement call...a SERIOUS error on their part which cost them the life of their child.

K.

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My wife is a licensed Nurse-Midwife and has attended to several VBAC's in a hospital setting. She has also had our two children at home and I wouldn't have it any other way unless it was absolutely necessary. By osmosis, I have learned at how the OB model of birthing really doesn't always take the patient's needs into account, even from a health standpoint. Too many women have unnecessary c-sections because of the fear that the OB will be sued.

I feel sorry for all involved in this story. What makes me sad as well is the lack of balanced coverage in the mainstream media about midwifery. Too often, you only hear about the bad things (how many unlicensed doctors have gone to jail for botched deliveries? Alot more I bet!)

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In my opinion not getting proper medical care during pregnancy and during birth (at least doing it on PURPOSE) should be considered child abuse! I wish the doctor that cared for the baby in my previous post had done more then maybe the mother wouldn't have been STUPID enough to do it again. But that didn't happen and she was that STUPID!!!!

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Also if I remember correctly, you can have a MIDWIFE deliver at the HOSPITAL!! My doctor asked if he will be delivering my baby or am I going to have a midwife present? I said it was him delivering because I didn't know if medicaid would cover a midwife or where to even LOOK for one.

I just know with my next baby things are going to be done RIGHT! With my daughter I was sent to a general practioner who told me all my pain was "normal". I had cramps until I was 4 months pregnant and at 6 month braxton hicks started. Or so I thought. At 8 months I FINALLY was sent to an OB to be seen by him and he put me on a monitor and I had a few "braxton hicks" while I was there, he asked me how long have I been having this "pain. When I told him since I was 6 month he got MAD that the general practioner didn't send me sooner because they said they were REAL contractions. He monitored me for a few more hours before he was satisfied enough to send me home (I didn't want to stay if I didn't HAVE to) and put me on VERY light duty at work (which meant I sat down on a stool my entire work shift dating products and wrapping finished orders, I worked in seafood).

The worst part was medicaid didn't give a choice on changing the first doctor and that was my daughter's doctor. I was SO GLAD when she decided to LEAVE! I have an EXCELLENT doctor for my daughter now that REALLY listens to me and doesn't LAUGH AT ME when I bring my daughter in for something like a BAD cold (I had brought my daughter in for thrush and the first doctor LAUGHED AT ME). If I have to go to a general practioner again for my next pregnancy first then I will go to my daughter's doctor and I will MAKE SURE she refers me to the OB BEFORE I am 8 months pregnant, buit I know this one will listen when I tell her I am in PAIN!

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the whole things sounds funny ( not haha way). Licensed midwives here will not do a home birth if your previouse prenancy was a c-section. They will do a hospital birth though. @nd if you wnat a midwife you pretty much have to have one lined up before getting pregnant because the waiting list is so long. I have never heard of midwife taking one during the last month. And if anything goes wrong hifde my identity. That should heve sent off alarm bells right away!

Why didn't the father call 911? I agree with the sentenceing she gave real midwives a bad name. A real midwife would have called 911 herself and insisted the birth be done in a hospital. Even if the Dr's were there the midwife would have done everything she could to make it a natural bith as long as both mother and baby are safe. If the hospital doesn't allow midwives there are usually birthing centers somewhere.
I think the mother and father should be charged with something as well.

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Rachel -

In some states, you can't easily find a Certified Nurse Midwife who still does homebirths, thanks to the cost of the malpractice insurance. If they wanted a homebirth, they may have had not choice but to find a "direct entry midwife" who is without a license. She could also have training that is recognized in other states, but not in the state where she lives. (We had a case like this in our area this past year.) This doesn't mean that these women don't know what they are doing.....it just means that their state doesn't recognize them.

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Last April Governor Doyle signed a law requiring out-of-hospital midwives in Wisconsin to undergo the training necessary to become credentialed by the North American Registry of Midwives or the American Midwifery Credentialing Board and to become licensed by the state. The new law also requires midwives to practice according to the guidelines recently developed by the Department of Regulation and Licensing, which require physician consultation and referral for mothers with various risk factors. The guidelines also include a detailed informed consent provision that requires midwives to disclose their training, experience and birth outcomes.

Katie Prown
Legislative Chair
Wisconsin Guild of Midwives

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