This made me physically ILL. I have considered serving as a back up physician for CPMs, but I just cannot bring myself or my medical license to do it… it’s unsafe CPMs like this that make me advise against home birth. How do you know what or who you’re getting? I know there are safe, well-trained CPMs our there, but who tracks the quality of their work and complications???
The truth is, most times a healthy woman with a healthy baby will deliver without issue wherever and with whomever is present. The OB or midwife is there to reassure the mama and help her optimize her delivery. But clearly this birth was complicated, and was clearly an MD-level delivery with meconium, elevated BP, and tachycardia?? At home?! The mom left to “fend for herself for hours on end??
I have tremendous respect for the practice of midwifery, but like any medical professional, you must KNOW YOUR LIMITS and seek help when necessary.
If we keep it real, the fact is most women don’t need a hospital and/or an OB for routine vaginal deliveries, but ANY woman can have serious complications during or after delivery that need IMMEDIATE attention. An Obstetrician trains AT LEAST 8 years, then spends another 3 years taking a written exam, collecting a year’s worth of patient cases they managed and then a grueling set of oral board exams to become board-Certified. You don’t absolutely have to have an OB for delivery. MANY babies have been delivered by family members, nurses, midwives, and family docs without any problems. But we are trained for the off the wall, totally unexpected, absolutely emergent complications that can happen. That is why although I support a woman’s autonomy over her own body and her own birth, I simply cannot fully support home births. People don’t hear the horror stories, but I LIVE them with the families and they are always tragic. The hospital and the OB you choose MATTER. You can enjoy your labor and birth comfortably in a hospital. At most hospitals, there is a lot of autonomy if you find the right hospital and doc or CNM. I ASK my patients to make a birth plan. My patients are not starved or chained to beds. They eat and move and bounce and walk. They get an epidural if and when they want. We give them plenty of time to labor, and don’t intervene unless we really need to. All babies are placed skin to skin and left there unless they are having trouble transitioning to being outside the mama. Cords are left pulsing for at least 1-2 minutes, and the the designated person cuts it–usually the father. Baths are delayed, parents must consent to vaccines, pacifiers, and formula feeding.
I think the popularity of home birth is increasing because doctors and hospitals have been painted as “money-grubbing,” “abusive”, “5pm cesarean monsters,” when in fact, many of us are not. Many of the ideals that a woman may be looking for in a home birth are available in a hospital as well, as are OBs, Pediatricians, L&D/ Nursery nurses, CRNAs, and staff who can respond to an unexpected emergency very quickly.
As evidenced by this case, it’s all about who you choose for your care, not necessarily where you deliver. This couple was CLEARY kept in the dark for 60 hours during which Ashlyn and Asa were experiencing some serious complications. To add insult to injury they paid this CPM a cost HIGHER than what an OB in GA would get paid to do a delivery, Prenatal and postpartum care… this whole situation is just messed up an so many levels, and my heart grieves for this poor couple.
deliveringjoymd 