The reform homebirth needs

Sebastian, at birth Oct 2006


well after living my life for the last year and two months i have been hard pressed to re examine many things that i held as facts. Death challenged many "facts" i thought i knew, and rocked me to my core. In the rubble left i have been carefully and painstakingly reconstructing something of worth from the pieces. i want, i need my daughter's name to matter. i need the world to change in some way because of her.
i know without a shadow of a doubt Aquila would be alive had i chosen a hospital birth from the beginning with her. i am pretty sure that my daughter would also be alive had i chosen a better educated, more competent midwife, and had thus transferred in a timely matter.
I cannot change the past however... i can only attempt to change the future. I believe that homebirth in America needs a serious revamp. Homebirth is not going anywhere. even though many people seem to think i want it to go away, they would be wrong. i do not. i fully grasp what is good and what potential for benefit lies in midwifery care and even in homebirth.
BUT
first off , until some major changes happen people need real information on what is up with the midwifery system, and what risks there are in homebirth. they need to know that study after study shows that homebirth has 3 times the neonatal death rate
here
over hospital birth. They need to know that homebirth should only be for low-risk woman - Currently every midwife i know will take a woman carrying twins and breeches, moms with histories of shoulder dystocia, diabetes, pre-eclampsia, GBS positive etc, etc, etc......
People need to understand that a CPM is nothing close to a CNM in training and skills.

I think ultimately we need three things-
#1 to create a uniform, nation wide standard for what is a midwife , what they can and can not do and how they must be governed.
#2 to abolish the title of CPM and have only midwives with a CMN or like degree.
#3 to integrate midwifery care into the health care system by covering midwifery care on all insurances (like Florida), and on Medicaid. But in the same token- require midwives to be just as well trained and as responsible as other providers who are- by upping the training to CNM level and by requiring malpractice insurance (also like Florida).


as i tell my children , if you want to be treated like an adult (professional), then act like one

some of you are now saying, 'why malpractice insurance?'
and some of are even saying things like this " malpractice insurance requirements will run midwives out of business and cause unnecessary lawsuits!"
really?
i guess you have never met a baby with extensive brain damage caused by a providers negligence...i have.
why should the parents have to pay what they in no way can afford so that midwives can practice without any liability?
because, sure a parent could try to sue a midwife with no insurance...but good luck finding a lawyer..and if she does? well the lawsuit will never get paid out, so the parent will still not get the money needed to care for the damaged child. how fair is that? you say that a midwife should not have to pay to protect her clients? don't most small business carry liability insurance? Aren't you and i and every other driver legally required to carry driver insurance?
If malpractice insurance runs midwives and home births out of business, than why is Florida's homebirth/midwifery community still alive and kicking?
Florida law requires all midwives to carry a certain level of liability insurance.
Florida law also requires all insurance providers to cover homebirth.
sounds like a win for both 'sides" doesn't it?


what do you think?

negative homebirth experiences?

have you had a negative homebirth experience? would you be willing to share your story in a place that many people will see it? if so, please email me at kirynspiscesmama@gmail.com

choices

As soon as i chime in on a thread about what happened to Aquila at my homebirth, inevitably i receive the same sentiments over and over from Crunchier-than-thou homebirth activists. things like these:

bcblondie wrote:
I'm sorry for your loss. But this is not a fair comparison. We all know that being in a carseat is 1000 times safer than not being in one. You can'T really compare the recklessness of not using a carseat, to homebirths.

All they are trying to say is that homebirthers HAVE made an informed choice. They reduced the risk of their baby needing emergency intervention simply by being at home, not having pitocin or an epidural. Being able to relax and not be confined to a bed with IV's and monitors. The labour is much more likely to go smoothly.
But yes. On the other hand. Sometimes things still go wrong. And if that's something you fear or couldn't live with, you should have a hospital birth.
But for me. If my baby had died at my homebirth, I would have STILL KNOWN that I made an informed choice. I would not regret my homebirth. And I would be quite mad at anyone who implied/said outright that I should.


Amber De Sosa Seber 5:26 am
Sadly, a hospital cannot guarantee or even increase the likelihood of a live mom or baby.

Lorna Doone 12:39 pm
I have never had a horrible birth anywhere EXCEPT a hospital (first time) and then two ridiculously simple, easy, rubber-ball-and-eyeball-injury-free births on my own.
And most normal, healthy, mentally stable, physically fit etc., women do NOT need to be sold a surgeon-attended medically and pharmaceutically assisted hospital birth.

LadyJennifer wrote:
As for the original post; babies and mothers die in hospitals too, often because of interventions rather than natural causes.

Also, it is important to take responsibility for your own birth, know the signs of complications like abruption, etc. Mothers are the only ones who really know what's going on in their own bodies (if they listen), and even the most knowledgeable and experienced hcp can make mistakes. The US has some of the highest maternal and neonatal mortality rates in the developed world - and some of the lowest homebirth rates. "

there are so many more "wonderful things" that have been said to me, but they always center on the same themes-

#1 - baby's die in the hospital too, you know!

yes, brilliant! where else do people dismiss a child's death by bringing up other children's deaths than in homebirth loss?
Hospitals are safer. Transporting takes much longer than you would think. I am not "anti-homebirth" because i want people to face the facts. Have a homebirth- fine with me! I also don't care if you want to turn your 8 month old forward facing in his car seat- BUT i DO want you to be aware of the risks. Of course it is your choice, but what kind of choice is one made with half the information?
Me telling my story does not limit your choices. You stifling my story or deleting it, or dismissing it limits everyone's choices, and pushes your agenda!

#2 Yours was a rare tragedy- homebirths are safer . If someone is healthy enough, strong enough, "crunchy" enough, and thinks positively (woo) than this (probably) won't wont happen to them!

OUCH .
SO which was i? Not healthy enough? Not Crunchy enough?
I know why woman gravitate to this response. Reading my story scares the piss out of them, and they need to do what is so very human, scramble around to figure out what i did wrong to prove to themselves that it could not happen to them.
Well, it could. If you understand that homebirth carries 3 times the risk of death to your unborn baby, then you are making an informed choice.

#3 Well your midwife was negligent.My midwife is well trained/ has great references/ answered all my questions well about what she would do in an emergency!

OK, granted- Faith Beltz was very negligent. but why/how was she negligent?
She was not well trained.she was trained under ATM's curriculum

The Texas Department of Health requires midwifery students to have a high school diploma or GED certificate, and current certification in Infant and Adult CPR.

Then, for ATM's curriculum one must read these books. my personal favorites are the two books on homeopathy. don't get me started there.
then the clinical requirements are as follows:

ATMMTP students must complete the following minimum clinical requirements:

1. 10 observations of births, 2 of which must be in an out-of-hospital setting
2. 20 births as an active participant
3. Functioning in the role of Primary Midwife under Supervision:
1. 20 births, including a minimum of the following Continuity of Care requirements:
* 10 births must be with women for whom the student has provided primary care during at least four prenatal visits, birth, newborn exam, and one postpartum exam
* 3 births must be with women for whom the student has provided primary care continuously under the supervision of one preceptor for each woman, beginning no later than 15 weeks GA and to include all prenatal care, birth, newborn exam and at least two postpartum exams at 36hrs.-6weeks (Continuous Continuity of Care)

A maximum of two transports as active participant and two as Primary Midwife under supervision may be included in the above 50 births

4. Functioning in the role of Primary Midwife under Supervision:
1. 20 initial physical exams and 20 histories
2. 75 prenatal exams
3. 20 newborn exams
4. 40 postpartum exams

so, lets compare that with a CNM's training and also an OB's:

CNM: They have gone through 4 years of nursing school plus an additional 2 years for their masters degree which earned them their CNM certification.

OB: goes to medical school and completes residency.

So, w\how knowledgeable is your midwife really?? Faith beltz failed to recognize two very obvious and major complications in my labor, Chorio and Abruption. And here is the kicker----
Faith was and still is an ATM preceptor-meaning she is a teacher for other midwives. this is the training the next generation of CPMs is receiving!

Also My midwife is regulated by a board comprised of her friends. Th ATM board is one in which Faith Beltz holds 3 seats. The Texas midwifery board (who grants licenses and regulates CPMs in Texas) has midwives sitting on its board , who out number all other members. All these midwives have sat or do sit on the ATM board with Faith, or are in high positions at ATM .
so, how do you know that your midwife is well regulated? what do you think will happen if she kills your baby? Does she carry malpractice insurance? If she is a CPM she does not.

and finally, Faith Beltz had all the right things to say . But when the shit hit the fan, she froze.
How are you so sure your midwife will make the right call?
In the hospital there is a TEAM of people caring for you. at home you are in ONE person's hands. Better be sure she is ready for anything that may go wrong!





and about your choices being limited----
sometimes the government regulates things to protect the consumer.like the
USDA and the FDA.
homebirth midwives need more training, more regulation, required ob backup relationships and the requirement to carry malpractice insurance And consumers need more information about homebirth-not just just Woo-filled fantasies.

oh feel the love- insert sarcasm

warning- grumpy post aheadd- read at your own risk!

i had hits, many hits, coming to my blog from some crunchy birth group on babycenter- so head on over to read this

BabyChappell'sMommy · Pass a Note!
Posted 07/13/2010

i think a lot of moms start ignoring their gut instincts when they're so gung ho to do things a certain way. I think part of hombirthing, and of course especially free birthing, is tuning into your baby and your body. The story that's all over the place on MDC... hang on let me go get it to link her blog.

ok here's the original birth story she wrote after her baby was born still:
http://ecmama.blogspot.com/2009/12/aquilas-birth-story.html

and the one she wrote recently after taking the midwife to court and chewing on it for a while:
http://ecmama.blogspot.com/2010/06/whole-story-tragic-homebirth-of-aquila_21.html

She is in her 3rd trimester of her first baby since her baby's still birth and is going with an OB and a hospital birth! She was such a HB advocate and her SN brings up tons of threads on MDC about how HB is the only way to go. That was of course after her daughter's birth. When I read her original birth story but gut was in knots- something didn't sound right about the way she was contracting and the pain she was experiencing with her 3rd (I think maybe 4th?) child's home birth. You can get a shitty midwife who can change your life forever- negatively. But that's no reason to post warnings in all the due date clubs on MDC about how homebirth risks your baby's life. Cry

Courtney (blog)

IBCLC in training & newly single mama to Ariana 8.31.08 (EBF, ERF & almost an EC grad)

and she said

ruralmama25 · Pass a Note!
Posted 07/13/2010

Courtney, your story reminds me of momofmanyfeet, she is on BBC and she had one successful homebirth and then one where she was 35 weeks and her baby died (my mw would absolutely not deliver a baby that early, I don't know what hers's problem was). So she goes around saying CPMs should be burned at the stake (she literally said that) and that homebirth is awful and she's very nasty about it.

Here's the thing that I think people should be honest with themselves about--birth is risking your baby's life. Not every pregnancy ends in a live baby. I'm sorry if that's harsh, but if you can't deal with that you shouldn't be getting pregnant. I know SO many people with full term or late term losses, mostly hospital but a few homebirths also. Some were iatrogenic, some were unavoidable, some were unexplained. I knew that it was possible DS or I could die simply because I chose to be pregnant (I was and am totally healthy by the way). I personally feel that HB with a trained attendant lowers that risk significantly for both of us, but it's unrealistic to think that every pregnancy and birth are goign to be rainbows and unicorns. But blaming a homebirth for something like a cord accident or a premature baby is just stupid. Those things happen no matter where you are, and some thigns like cord accidents are unavoidable, if a baby gets a knot in their cord, there is no way to prevent that--nothing you can do, it's just a horrible tragedy like being hit by a car.

Mother, wife, and educator--the rest is just details....

Support for Choosing not to Circumcise

and she said

ThrivingforBaby · Pass a Note!
Posted 07/14/2010

*clap clap clap* AMEN ruralmama! Seriously couldn't agree with you more. So many people just don't get that birth - regardless of where you do it - isn't 100%. And they always have to blame someone/something else if it goes wrong.

I'm fat because there's a McDonalds and a Jack in the Box around the corner from my house - it's all their fault. Boo hoo!

Oh suck it! Your fat because YOU EAT THERE - go eat a carrot, drink water and exercise. (So I'm being so general and offensive, but you get the point.)

I really think there are very few actual "accidents" and things that you can't control. Everything else is not someone else's fault. Could you imagine if everyone took responsibility how much fewer lawsuits there would be??

M. ♥ 's S.

Thriving for Baby
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so i said


ecmamaliz · you!
Posted 1 second ago

i would hope you people are kidding about what you are posting about me- but you are not- "you" do not "get" birth , until YOU have YOUR baby die in your hands. it is REALLY easy to talk about infant death as an abstract concept- that yeah some babies are going to die.until you have YOUR baby die- when they would have lived had you not choosen homebirth. MY baby would not have died in the hospital, as much as you would like to comfort yourself by thinking this.

i have never said to anyone ALL homebirths are bad. i have mearly pointed out truths. that you are not as close to the hospital as you think- and that when it is TRUELY an emergency transporting is very difficult- like with a baby's head stuck, or a prolapsed cord, or as your hemmoraging- especially since it takes 8 minutes to bleed to death. not all midwives are created equal. the difference between a CNM and a CPM is the differnce between a MASTERs degree and a GED plus some very easy classes. these are the things i have said- people who i have met ITRW or online who where looking into my midwife i have steered to CNMs here who have very good , long records- i have NEVER tried to convince any of them (and there have been about ten so far) to have a hospital birth, only a safer midwife.


and whoever on here is in my due date club on MDC, i noticed you never said anything to about this problem you have with me- instead you are posting about me else where- heres a tip for you- if you post a link to someones blog- they are going to see where the hit came from- so you are talking about me behind my back- and i can "hear" you.

so thanks for all your kind wishes. i hope all your babys are born healthy and safe, so you can scoff at me and think you in your great supiriority did a much better crunchier job than i.

liz paparella

Liz mama to DS 10, DSS 9, DD6, DS 3, DD (adoption!) 2, and Aquila born still 12/19/09..due with another girl 11/15/10 www.ecmama.blogspot.com
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this is the crap i am talking about. what's making me get more and more turned off from everything i used to think is the holier than thou, natural is always better crud that floods these circles. dosn't matter that i nurse my kids till three...dosn;t matter that all my births have been o natural, dosnt matter that we eat organic, that i cloth diaper and baby wear and cosleep- because i have BROKEN THE TABOO_ i spoke out against the reteric that homebirth is the safest option for mom and baby. it just isn't usually true. sorry, i have never been a person that belives to be considered in the "in group" -this one being "crunchy", one must follow all established rules in said group. and i will tell you a secret- i don't fully buy the left side or the right side of politics either! (gasp, shock!!) i think for myself. if that means people arn't going to like me- tough. it was never about what other people think about me- it is about what God thinks about me.

home birth and experience

Your brother came so softly
born in the water
no crying
quiet contemplation
pink and rosy

how different your coming was
born in blood
no crying (no breathing)
sudden expulsion
limp and pale

everything got so dark

can't tell up from down anymore
all the sweet reminiscing of your brother's coming
marred by your passing

what power gained from birth
can not be stripped away
by death?