Looking for The Lactivist? She's retired. But you CAN still find Jen blogging. These days, she's runs A Flexible Life. Join her for life, recipes, projects and the occasional rant.
Monday, April 03, 2006It's been a busy few weeks for the home birthing segment of the population when it comes to following news stories. While it's always true that sad/negative stories are always more entertaining to read about than happy stories, it's still disappointing to see the way that home birth continues to be portrayed in the media.
A few examples...
The Jennifer Williams Indiana Incident
Synopsis: Home births attended by anyone but a Dr. or a Certified Nurse Midwife (CNM) are illegal in Indiana. Nonetheless, many Certified Professional Midwives (CPM) practice underground and do home births. (CPMs can legally attend births in 41 states) Williams delivered a stillborn baby last June and has since been charged with practicing medicine without a license. Williams was not at fault in the baby's death. In fact, this was the first death at the more than 1,500 births Williams had participated in. Williams performed an episiotimy during the birth, which is what led to the charges. (An episiotimy is considered a surgical procedure, thus, it's practicing medicine.)
Coverage in the NYT
Letter to the Editor of Ft. Wayne News-Sentinel
Article in the IndyStar
The Helen Dentice Wisconsin Incident
Another instance of a state where only CNMs are able to attend births in the home. Once again, prosecution came about because of the death of an infant. The news here is a bit more murky however. According to published accounts of this story, at least one midwife had already turned the mother down due to her high risk status (3 previous c-sections). When the birth did begin the midwife repeatedly discouraged the mother from transferring to the hospital, despite the mother's feeling that something was wrong. The midwife also told the couple that if something did go wrong, she would be leaving and taking the video tape of the birth with her. (which is what happened after an ambulance finally was summoned.)
Coverage on WFRV TV
Coverage in the Milwaukee Journal
Now, there are two key differences between these stories, despite the fact that they are being portrayed the same way.
In the first instance, it has been made clear that no one, not even the medical professionals that examined the case felt that the midwife was in any way at fault for the infant's death. In fact, the death likely would have occurred even in the hospital. Instead, the state is using the death as an excuse to make an example of a highly skilled and respected midwife that has a better track record than many OBs do. In this case, tragedy occurred despite everyone doing "the right thing."
In the second instance, we have example after example of poor choices behind made on all sides. Few reputable midwives would attend a home birth for a mother that has had three prior c-sections because the risk of uterine rupture is too high. The fact that they were turned down as high risk by midwives, but continued to interview until they found one shows that this couple was likely more focused on the home aspect than the safety aspect. We also have a prime example of a mother's intuition telling her that someone was wrong. The news stories report that she first insisted on calling 911 for a transfer at 2:30pm, more than four hours before the eventual birth and death of her baby. Yet, the midwife insisted that things would be fine and the mother and father "gave in." Again, a tragedy, but likely an avoidable one.
So what's the take away from all this?
Home birth is still safe. These horror stories are tragic, they're sad, but they are also part of life. In the last few weeks I've also read about the death of a woman who was paralyzed by her epidural in the hospital. I've also read about a woman whose OB applied too much traction to the cord in order to detach the placenta and ended up quite literally pulling her entire uterus out. Does this mean that hospital births are not safe? No, it means that tragic things can happen in the hospital by chance and by acts of stupidity, the same way that they can at home.
What bothers me about all of this?
That most of the stories that I've read include plenty of quotes from doctors that go on and on about the dangers of home birth, yet fail to counter those statements by citing even the most recent studies that show home birth for low risk women to be EVERY BIT AS SAFE as hospital birth. Instead, the articles focus on moms wanting home births because of some lovey-dovey emotional reason, making it seem that these mothers have no idea what they're getting into. That annoys me and it should be inciting all of us to whip out our pens and start sending letters to the editor with the link to that BMJ study every single time we see that type of drivel being printed.