Sunday, October 19, 2014

Tandem Care ~ Home Birth in Sheep's Clothing

There's a new term in town aimed at marketing home birth as a safe option...
"It’s called 'Tandem Care', and it was developed by Lansing-area obstetrician Dr. Nancy Herta. It’s a little-known alternative for local mothers who want to attempt a home birth with a midwife but still want to have access to the latest medical developments," explains a recent article published in Lansing's City Pulse: "Born This Way".  

I've read City Pulse's article many times over, and I'm still confounded as to what about "Tandem Care" makes birth outside the hospital one bit safer than traditional home birth...access to the latest medical developments?  Well, if we consider what Dr. Herta herself explains in the article regarding her self-made term "Tandem Care", I'm not sure what medical advice she really offers these dual clients.  
" system is still not the best. I can’t go into homes. I can’t even give direct advice to midwives — I have to phrase it as hypothetical situations.”

City Pulse reporter Allan Ross explains further the relationship between doctor and midwife when he says, "Herta maintains recommendation-free communication with the midwife."

Recommendation free?  Dr. Herta can't even give direct advice to the midwives in which she has so willingly "partnered" to offer this safe alternative to home birth.  What's the point?  

I wonder why exactly it is Dr. Herta isn't able to advise or make professional recommendations.  Perhaps because she carries malpractice insurance, notably unlike the midwives she's supporting, and the aforementioned insurance company likely understands how dangerous it is to take responsibility for practices taking place that are unregulated, and without true medical back up.  

Perhaps if we look more closely at what Tandem Care entails we'll see how it improves safety... 

Naturally I ask myself, where did the term "Tandem Care" come from?   
Dr. Herta shares in the Pulse's article, “I invented the term tandem care, but it’s not a new idea,” Herta said. “It takes the place of the European model, (which is) no-intervention midwife-driven birth centers attached to hospitals...”

Whoa.  Wait just a minute..."takes the place of the European model...birth centers attached to hospitals..."  What?!?  This is where I take tremendous pause to carefully consider what Dr. Herta is claiming.  

First, the European model of midwifery requires midwives to be highly much so that most US home birth midwives (namely CPMs like Audra Post) are not qualified to even practice in any other first world country.  CPMs do NOT meet the International Confederation of Midwives standards for education and training.  Second, Herta herself even mentions the idea of birth centers attached to hospitals.  She is describing what would be ideal, truly integrated, collaborative care where midwives work together with doctors in a setting where emergency care is readily available.  

The problem you ask??  The problem is that Dr. Herta is marketing herself as working with highly educated midwives, like those in Europe, which is completely inaccurate.  She is also misleading families by telling them her self-titled "Tandem Care" model is as safe as a birth center attached to a hospital in Europe, when in fact she (the doctor) is not present during labor, not present at delivery, does not show up to care for patients if or when they do transfer to the hospital, and assumes zero responsibility for any type of counsel or outcome.  Instead, Dr. Herta offers a few prenatal visits in which she cannot actually counsel, and hands patients off to the unlicensed, unregulated, uninsured midwives doing home birth to monitor labor and deliver the baby The hospital is still several minutes away.  There is still no immediate medical care present.  So how, please someone tell me, is this one bit different than home birth??  

What exactly does "Tandem Care" really offer?  
To be frank, Tandem Care benefits the midwives, who through OB partnership have access to labs, ultrasounds, and screenings that they otherwise don't have.    There is no arguing that MI midwives need access to these things independently.  The problem is that most MI home birth midwives are not licensed, nor do they obtain educational training that even comes close to international standards set forth by the International Confederation of Midwives.  They are not AMCB certified so earning licenses and further access to labs has been challenging for them, and rightfully so.  In addition, MI midwives cannot obtain their own prescriptions.  Under Dr. Herta's Tandem Care model, unlicensed, uneducated midwives can fill prescriptions under her name and administer them without oversight.  Dr. Herta is attempting to utilize loopholes as well as her prescriptive privilege, to allow midwives access to labs and prescriptions without taking any real responsibility for the outcome of negligent care with which she is heavily associated.  

Well as the saying goes, if you pat my back, I'll pat yours....Home birth midwives who encounter cautious, unsuspecting parents-to-be, easily suggest Dr. Herta's "Tandem Care" as a solution to their safety concerns. 
"When Gaƫlle and I said we were concerned about doing a home birth completely outside the hospital system ... Audra Post told us about tandem care and put us in contact with Herta. ~ Allan Ross from City Pulse

 Ironically, Dr. Herta and area home birth midwives are working in tandem...selling "Tandem Care" as some sort of bridge between hospital and home birth when in fact all of the important components of a truly integrated model of care are absent.  It's flat out fraudulent, misleading, and dangerous for families. 

Sure Herta's involvement provides more access to labs, but what good does that really do if neither care provider believes that risk factors matter, that everything is a variation of normal, or "...that high risk pregnancy doesn't necessarily mean a high risk delivery," as Dr. Herta put it.  There might be paper work that gets "pre-registered" at the hospital, but anyone can do that as it is standard protocol and readily available on Sparrow's website.

What tandem care DOES NOT offer families...A safer alternative to traditional home birth!

The Truth Every Mother Deserves to Know...

Midwives are telling clients that Dr. Herta is their "back-up physician."  The reality is that Dr. Herta shares in prenatal care that doesn't legally offer any real recommendation or advice.  She is not present at the labor or delivery.  In fact, if your home birth goes wrong and you transfer, you won't see her at the hospital either unless she happens to be on call that night.  Chances are you'll see another doctor, one you've never met, right smack dab in the middle of an emergency in which hopefully they can save you and your baby.   

What Dr Herta and and local midwives are selling is a false sense of security, home birth in sheep's clothing.  "Tandem Care" is light years away from the safety of European models of Collaborative Care. 

Full Article: City Pulse ~ Born This Way