Questionable Care...What Should I do?

This post is intended to be a guide and resource for any mother in Michigan who has questions about the care she received or the outcome of her birth experience in an out-of-hospital setting.  (Some of it may apply for adverse hospital care as well.)  These are resources we had to find along the way.  There was no one place or person we could go to who could guide us through this process and I'm hoping to alleviate some of that searching for our readers.  If you, or someone you know received questionable care or has suffered an adverse outcome in an out-of-hospital birth, here are some suggestions:  

1) Write down your entire recollection of your labor and delivery.  Ask your husband to do the same, but to write his separately because your recollections will vary slightly. 

2) Contact a civil attorney who handles medical malpractice and personal injury for a consultation.  This doesn't mean you're committing to any particular action, it just means you can share your story and hear whether or not you have grounds to be concerned about the care you received.    

We only know our own experience and based on that would recommend Brian McKeen of McKeen and Associates in Detroit, MI.  He has handled numerous cases that have to do with out-of-hospital as well as in hospital births.  We found him to be honest, realistic, and truly working for the improvement of maternity care in our state.    

3) Ask for a copy of all of your records (midwife or birth center, ambulance, hospital, etc.)

4) Find other midwives, obstetricians, and other families to share your experience and ask questions.

If you're wondering where to find families who have experienced adverse outcomes in out-of-hospital birth, please contact us.  We can connect you with those resources.

5) If your birth experience had a particular complication, research it and ask other professionals how that particular complication should be managed. 

Funding Renegade Midwives

Renegade:

1. a rebellious individual who rejects conventions or laws of a group  

2. an individual who rejects lawful or conventional behavior

I have met in recent years, several midwives who work hard to serve their clients with a great deal of ethical responsibility.  They are educated, licensed, insured, transparent, cautious, and appreciate that sometime birth falls outside their scope of practice.  They know when and how to seek transfer of care and appreciate that at any moment "normal" birth can deviate.   These midwives build healthy relationships with and within hospitals and work to hold safety of mom and baby in the highest regard. 

Let's consider the question, What is a "renegade midwife"?  A renegade midwife is someone who prides herself on making a statement through her work, one who "trusts birth" at all costs and believes that when things go wrong it's just the way it's meant to be.  Renegade midwives are those to often put their clients in danger by taking on known high risk situations to better advance their own movement or to prove a point.  A renegade midwife will tell you that any risk factor is, "just a variation of normal", that moms know how to give birth and babies know how to be born, and fill their clients with fear about the hospital instead of building a healthy relationship with them (and yes, that effort goes both ways).  A renegade midwife doesn't report her outcomes, nor is she accountable to anyone.  She is uninsured, unlicensed, and unafraid to practice even when it's against the law.  These midwives "fly under the radar" and pretend their work is serving women, empowering them.  These are the midwives that put philosophy above safety and pose great danger to any mother seeking their care. 

With families speaking out more and more about their less than perfect experiences in the hands of renegade midwives during home birth and at freestanding birth centers, the question of support comes into play.  The trend appears to be that the Natural Childbirth advocates instantaneously jump on the bandwagon of support to protect their “choice”, their pleasant outcomes, their “movement”, and ultimately themselves without any real analysis of what may have gone wrong and why.  What ever happened to the responsibility to review adverse outcomes and improve practice?  Why are these “communities” so quick to dismiss the experiences of families who do find the strength to come forward and talk about what happened to them? Perhaps the very "advisory boards" that support them should offer advice that includes careful analysis of adverse events aimed at improving practice instead of asking for donations to support legal fees. 

For those who criticize the action of a lawsuit I ask them this…What other choice do these families have but to turn to lawsuits when there are no regulations or laws by which to hold midwives accountable?  Would they suggest discussing it over dinner and cookies and accepting that, “some babies just aren’t meant to live?”  When we experience something we knows to be reckless, unethical, and dangerous, is it socially responsible to say and do nothing? Is it acceptable for those people responsible to walk away without so much as a reprimand? Certainly not.

Even further, many of these “supporters” are throwing their money behind renegade midwives to support them financially due to the burden of legal fees, never mind the fact that if they had been responsible in having liability insurance in the first place, the “burdens” wouldn’t hit their pocketbooks so hard.  

A friend of mine brilliantly drew this analogy:

“Imagine you are sitting on an airplane, about to take off, when the flight attendant comes on the speaker and says this: "Hello ladies and gentlemen, before we take off we will be passing a collection plate around the cabin. You see, your captain and co-captain had a crash last year and a few people died. The settlements to the survivors and families are really steep and so they are hoping that you will consider making a donation to help them out. They love flying and can't wait to get you up in the air today! Thank you!

Seriously . . . would anyone on the flight put money in the plate? I doubt it. Moreover, would anyone stay on the airplane? I for one would grab my stuff and get the hell off. “

I’m growing weary of the folks that can’t see outside their own good outcome and recognize that something is very wrong for many of us - and it’s no coincidence.  How can people blindly support individual midwives knowing that their actions are at the very least questionable, to the point of costing babies and mothers their lives?  How about working toward improving out-of-hospital birth instead of ignoring and vilifying the outcries of families across the country while the midwives act like martyrs?  Recognizing the problem is the first step. The next is doing the hard work necessary to improve outcomes for all of us. 
 
For the moment, I hope that families in the Natural Childbirth community will choose to spend their money wisely and, in the meantime, have the sense to get off any plane that is piloted by irresponsible captains.

Who do midwives protect?? (“From Calling to Courtroom”)

Ever been told how honorable, how noble a midwife’s role is during childbirth…to “be beside” a woman as she intuitively hears her instincts and births her child?  I always assumed that a midwife’s first and foremost concern was the safety of the mothers and babies they serve.  As more and more families come forward to share their alarming experiences with out of hospital birth, we are learning this isn’t always true…in fact it is often not true. 

Low and behold, midwives have even written a book about how to protect each other and themselves.  The title, “From Calling to Courtroom: A Survival Guide for Midwives”. 

“Knowledge is power and protection. This book strives to make a positive contribution to every midwifery practice and is dedicated with the intention that no midwife should ever again be unjustly prosecuted or persecuted.”

Knowledge is power and protection which is why EVERYONE should read this book to fully understand the warped efforts to “protect” themselves above all else.  No one should ever be unjustly prosecuted, midwives included…BUT those who are guilty of gross negligence, negligence, and wrong doing should absolutely be held accountable as is the rest of society.  Midwives should not be excluded on some pedestal of birth worship. 

“Too many midwives have been forced to expend too much of their energy, finances and sanity trying to defend the practice of midwifery. Too many midwives are serving jail time for providing appropriate midwifery care.” 

Nothing like playing the martyr and the victim with such dramatic conviction.  Really…defending the practice of midwifery OR more accurately defending their negligent, reckless, irresponsible, and unethical actions?  I’d further say that not enough midwives are serving jail time for inappropriate care.  Are midwives really so self-righteous that they can’t see that some members of their “profession” don’t act ethically?  Isn’t that true of every profession?  How sanctimonious to protect your own so loyally without really aiming to improve the practice, this is why the “profession” is in danger. 

Chapter 6 also mentions a progression of interest in protecting first mothers and babies, then “themselves, and their profession”.  The focus of the book is about the latter.    

The reality of the care that’s being distributed across this country speaks more accurately to serving themselves & their profession first and foremost...and forget about the moms and babies, "some of them just aren’t meant to live”.  If you question this reality, please visit the "Hurt by Homebirth" blog. 

Of particular interest on this blog would be Chapter 6 which specifically addresses the history and current state of lay midwifery in MI.  It details motivation and strategy for midwives to obtain licensing and seek “regulation” so they can both seek insurance reimbursement and make it so they are less likely to be prosecuted or sued.  It has nothing to do with improving practice, practicing in a safer way, or being more accountable.  In fact, in MI they want to follow their own rules set by their own board with a panel for review of only themselves.  Check out NARM's (North American Registry for Midwives) new statement about licensing.  Nothing like advocating for licensing and regulation but writing it so that no one can make any rules or have any oversight except for themselves.  Purposefully confusing politics, read it carefully.  Is this any different that what’s already happening???  Unaccountable and protecting themselves instead of the families they are supposed to be serving…No wonder ACNM (American College of Nurse Midwives) doesn’t support them. 

Let me remind everyone that CPMs, those fighting so hard to keep their unbelievably lax “rights” to practice in MI are the same thing as lay midwives who renamed themselves DEMs (Direct entry midwives), then changed that label to CMs (Certified midwives), then again to sound more official to CPMs (Certified Professional Midwives).  The history is all in Ch 6.  The book expresses how “fortunate” Michigan midwives are b/c they can function under the blanket of “alegal status” in our state, not regulated, but not illegal.  How lucky.  We are on an “island in the Midwest”, one that is costing babies and mothers their lives. 

These are NOT CNMs (Certified Nurse Midwives).  I contend that if CPMs would like a license and the right to deliver babies, perhaps they should consider a college education and practice as a professional like the rest of us.  Why should they be granted a license to protect themselves without earning one, and without being accountable?  The only legal “midwife” should be a Nurse Midwife and yes, they should be required to carry insurance as a measure of responsibility for practicing within parameters of safety guidelines, professional development, and as a responsible professional.