Lay midwife - baby's death - page 2

If the couple had insisted on using a certified nurse midwife, this would not have happened: A midwife present during the delivery of a newborn who died in a Town of Vernon home last month is... Read More

  1. by   fergus51
    Quote from Marie_LPN
    And if there is a lawsuit, the jury will be sympathetic to the parents.
    I dunno. I can tell you that I wouldn't be. If they wanted the ambulance to come get the mother earlier, I am sure dad could have called. They made a bad decision and unfortunately they will have to live with that.
  2. by   Marie_LPN, RN
    I wouldn't be either, i feel that perhaps a jury would see "two parents, baby died" and based their decisions on emotion.
  3. by   SmilingBluEyes
    I would not be sympathetic to the parents necessarily. I would need a lot more information, however, before judging anything on this case. Even though the article is long and involved, we STILL do not know all the "ins and outs" of this case (such as the pertinent patient history)----- therefore, deciding and assigning "guilt" on any part--- (and from what I read, there is PLENTY to go around)---- is premature.

    However, I would caution anyone to think prudently in such cases, and not judge homebirth or these parents harshly or unwisely based on this alone. Nor would I jump to the parents' defense right off the bat.

    I also know nothing of this midwife's experience-----but reading the article leads me to believe there may be some malpractice indeed involved.

    VERY complicated case, to be sure. I reserve judgement, as I don't know enough to be sure where fault truly lies here.
    Last edit by SmilingBluEyes on Dec 11, '05
  4. by   MissJoRN
    What was going on? 6 episiotomities!? Over a span of "hours" Maybe there was a known CPD risk by the previous CNM? But even a (trained) lay midwife should have known she was in over her head... she should have been firmly convincing the parents that it was time to rush to the hospital, not the other way around!
    Sadly there seems to be more than enough tragedy and blame for 3 people to share.
  5. by   yvonnemuse
    I had my first child at home in an absolutely heavanly care of a CNM. I was screened vigorously for all manner of health issues, examined, required to be within 30 minutes of a hospital or to spend the last week of my pregnancy in the 'cabin" next to the midwife's home.
    My second child I had my prenatal care of a lay midwife but had a hospital birth due to elevated blood pressure/preeclampsia. She knew that I was no longer a candidate for a home delivery. I thought my L and D experience was horrid, being told how heavy I was (oh duh I gained 30# of WATER this week) Bu7t I agree it was the place to be at that time.
    I feel sorrow for the parents for the loss of their child.ALL parties involved bear culpability. The parents for not calling 911, the midwife for not using judgement and realizing the time had come to seek help. so sad.
  6. by   TheCommuter
    In my honest opinion, the most bone-chilling aspect of this story is the fact that an unlicensed, uncertified midwife performed an invasive incision (episiotomy) on the antepartal woman. Never in a million years would I allow anyone other than a licensed physician to make an incision anywhere on my body. My heart goes out to the infant who never got to live a full life due to the stupidity of his parents and a so-called 'midwife'.
  7. by   Spidey's mom
    Quote from birthmamaew
    I had a similar experience. My first baby was born in the hospital, and while it was a completely normal vaginal birth, my experience(drugs being pushed when I said I didn't want them and please don't offer them, being chastised for trying to be a "hero", having my baby taken from me and told I could not visit her in the nursery, but that she was fine and that I should just rest, the nursery giving her formula when it was expressly stated by me, my husband and our caregiver that she was to be nursed exclusively etc etc) was not a positive one. These are reasons why women choose NOT to have births again in an L and D ward. I did not enjoy all the "comforts" of the L and D ward, and sadly, this experience is not a unique one. I have in my earlier incarnation as a doula seen it happen over and over again all over the country. It is actually what inspired me to become a CNM.(Currently in training) It is a problem with philosophy and with hospital admisitration who are overworking nurses therefore they become maybe a little jaded from time to time. I would be too if I were being asked to work ridiculous hours for little pay. It's totally understandable

    After doing loads of evidence based research and discovering that home birth was a perfectly safe option for a young low risk woman like myself, and feeling comfortable with the proximity of the nearest hospital should there be a need for one, we had aour second child at home with out a problem. My well- trained, experienced CNM had an OB with whom she worked in case of a need to transfer, she carried all emergency equipment necessary, and ran any and all prenatal tests that one would see in an OB practice unless I refused them. (Such as amnio.) It was a fast, normal labor resulting in a healthy baby. I would do it again the same way if in the same situtation. (Young, healthy, proven pelvis etc)

    I think the situation in WI is truly tragic. WHY did this women feel the need to have a homebirth so strongly when clearly contraindicated as stated by a CNM who referred her elsewhere? What on earth happened to make her think the hospital was absolutely no place for her, when clearly it was where she needed to be? On the flip side, what in the world was this lay midwife doing refusing requests for transport? I think the responsibility lies with both parties, in this case, but honestly, I think this baby's death could be related to a deeper problem on a systemic level. I'dlove to know her full story.
    Sorry all for the philosophical rant. Thanks for indulging me.



    Interesting story - I'm so sorry about your experience in a hospital but to tell the truth, I've never experienced anything like that in the 7 years I've been in L&D. We don't take babe away from mom, we don't give formula unless mom asks for it and we encourage b/fing. Amazing that nurses would be that wrongheaded.

    The baby dying is the worst aspect of this story but the episotomies . . that is shocking to me. Poor woman must have been cut to smithereens . . . . .

    steph
  8. by   geekgolightly
    Quote from stevielynn
    Interesting story - I'm so sorry about your experience in a hospital but to tell the truth, I've never experienced anything like that in the 7 years I've been in L&D. We don't take babe away from mom, we don't give formula unless mom asks for it and we encourage b/fing. Amazing that nurses would be that wrongheaded.

    The baby dying is the worst aspect of this story but the episotomies . . that is shocking to me. Poor woman must have been cut to smithereens . . . . .

    steph

    the two times ive been in the hospital to give birth i was treated horrendously and given really bad advice (dont sleep with your baby he will get spoiled, dont cuddle for too long. dont breatfeed, formula is better (WTH???)) and then ten years later i gave birth to a preemie 4lb 6oz and was told that i shopuldnt kangaroo care, to go home because i was bothering the baby, discouraged nursing "because it took too many calories to nurse," and then after two weeks when he was five pounds they gave me HECK before they discharged him. i had to threaten to walk out a couple of times before they relented. he was fine. he was thriving. he desated once into the 80s while feeding DUH of course he will desat while feeding from a bottle. he wont desat from a breast

    anyways

    there are really good reasons why someone would want to avoid a hospital birth if at all possible

    and just as an aside, i really want to be a midwife, but i can't stand the attitude of most LD nurses i've encountered. i recently shadowed to see if i could tolerate that enviornment and i was greeted with "oh thank god she doesnt want to breastfeed. it's such a pain to do all of that teaching!"
  9. by   TheCommuter
    When I was a student, my clinical instructor told me that hospitals in 'upper middle-class' neighborhoods tend to encourage breastfeeding. Also, about 90 percent of the births at these hospitals will be spontaneous vaginal deliveries. These 'educated, professional' women obtain meticulous prenatal care, possess birth plans, and attended prepared childbirth classes.

    This instructor also spoke of a popular hospital in a lower-class section of town where 70 percent of the births were cesarean deliveries and all of the new mothers bottle-fed their neonates. The instructor cynically indicated that hospitals with a large census of 'Medicaid' patients perform mostly C-sections and keep a lot of formula on hand since none of the moms breastfeed.
  10. by   mstigerlily
    I work at a busy urban hospital in an affluent area and you are right about the breastfeeding - 95% of our patients are breastfeeding at discharge and nearly 50% at six months.

    But our c-section rates are high - about 35% or higher. Affluent upper middle class or wealthy hospitals like this generally are associated with fertility specialists and/orsometimes means older moms who waited, fertility problems, more health problems like PIH or GDM, fertility babies, multiples, surrogates, donor eggs. A hospital like this will also have an antepartum unit which means preterm labors, cerclages, other problems as well.

    I've only been a postpartum nurse about a year now but whenever I've seen a birth plan it never goes according to plan. Not a single one. The L&D nurses hate them and I think they're kind of stupid too. No way of telling how you will manage birth until you get there. All three of my births were all different and only one went according to my "plan" (which I had in my head, not on paper).

    Quote from TheCommuter
    When I was a student, my clinical instructor told me that hospitals in 'upper middle-class' neighborhoods tend to encourage breastfeeding. Also, about 90 percent of the births at these hospitals will be spontaneous vaginal deliveries. These 'educated, professional' women obtain meticulous prenatal care, possess birth plans, and attended prepared childbirth classes.

    This instructor also spoke of a popular hospital in a lower-class section of town where 70 percent of the births were cesarean deliveries and all of the new mothers bottle-fed their neonates. The instructor cynically indicated that hospitals with a large census of 'Medicaid' patients perform mostly C-sections and keep a lot of formula on hand since none of the moms breastfeed.
    Last edit by mstigerlily on Dec 11, '05
  11. by   mstigerlily
    I am pretty horrified at the idea of lay midwives. Certified Nurse Midwives, however, are great. If you are at home or at a birthing center within a few minutes of transferring to a hospital or actually AT the hospital - fine.

    I had a CNM at the birth of my second child. She was calm and patient, prior to becoming a CNM she was an OR nurse. Very competent, very skilled, very thorough. Anyone taking the responsibility for delivery a baby not their own should be a medical professional. When did unlicensed personnel start doing episiotomies?? And you should ALWAYS listen to the patient - that patient asked that 911 be called - the midwife should have called immediately.



    Quote from BSNDec06
    If the couple had insisted on using a certified nurse midwife, this would not have happened:

    A midwife present during the delivery of a newborn who died in a Town of Vernon home last month is suspected of practicing medicine without a license, according to documents filed in Waukesha County Circuit Court on Friday after authorities seized evidence from her Milwaukee home.

    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.

    Lay midwives, such as the one in this case, typically follow an apprenticeship program.

    Two other women were with the midwife at the couple's home, including one who referred to herself as a "care and comforter." At 2:30 p.m., the mother told the midwife to call 911 and "get me to a hospital." The 51-year-old midwife assured her, however, that all would be well.

    Six times in the hours that followed, the midwife performed an episiotomy using scissors, a procedure aimed at widening the birth canal. At 6:22 p.m., a 911 call was placed from the home with the caller reporting that a newborn was not breathing. When emergency personnel arrived, they attempted unsuccessfully to revive the child.

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

    Your thoughts?
  12. by   mstigerlily
    I have heard breastfeeding is harder work than bottlefeeding. The early and small babies just get worn out doing it and have a hard time staying awake. Don't know why they would discourage breastfeeding other than that.

    Sadly, our L&D nurses think breastfeeding is a huge pain in the butt. Our postpartum/L&D floors are seperate units and occasionally they are floated over and the #1 thing they complain about is breastfeeding.

    Quote from geekgolightly
    the two times ive been in the hospital to give birth i was treated horrendously and given really bad advice (dont sleep with your baby he will get spoiled, dont cuddle for too long. dont breatfeed, formula is better (WTH???)) and then ten years later i gave birth to a preemie 4lb 6oz and was told that i shopuldnt kangaroo care, to go home because i was bothering the baby, discouraged nursing "because it took too many calories to nurse," and then after two weeks when he was five pounds they gave me HECK before they discharged him. i had to threaten to walk out a couple of times before they relented. he was fine. he was thriving. he desated once into the 80s while feeding DUH of course he will desat while feeding from a bottle. he wont desat from a breast

    anyways

    there are really good reasons why someone would want to avoid a hospital birth if at all possible

    and just as an aside, i really want to be a midwife, but i can't stand the attitude of most LD nurses i've encountered. i recently shadowed to see if i could tolerate that enviornment and i was greeted with "oh thank god she doesnt want to breastfeed. it's such a pain to do all of that teaching!"
  13. by   geekgolightly
    Quote from mstigerlily
    I have heard breastfeeding is harder work than bottlefeeding. The early and small babies just get worn out doing it and have a hard time staying awake. Don't know why they would discourage breastfeeding other than that.

    Sadly, our L&D nurses think breastfeeding is a huge pain in the butt. Our postpartum/L&D floors are seperate units and occasionally they are floated over and the #1 thing they complain about is breastfeeding.
    If they think it's a big pain in the butt, they should seriously consider finding another line of work. That attitude astounded me.

    Babies may work harder to get breast milk but they are rewarded by better milk, as well as a sharp decrease in desat'ing while feeding.

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