Any of you drive-by viewers from Facebook want to leave a comment? How did you land here? Do you agree or disagree with a post? Have I made a mistake that requires correction? Enlighten me.
Here at Utah Midwives we do not carry malpractice insurance. It isn’t required by law, and it eats into our profits. We aren’t worried about being sued because without malpractice insurance, very few lawyers will take on a lawsuit against us since there isn’t enough money in our bank accounts to make the lawsuit worth it. And if a lawsuit is successfully won against us, we’ll just declare bankruptcy, close our birth center, and open a birth center with a new name and continue practicing, like the that one birth center in Michigan.
ECV is a procedure that is meant to flip a breech baby in utero so they can be born head first. Here is a run down of it by web md. I am going to note the bits that make it a very bad idea for home birth midwives to attempt an ECV:
To avoid harm to the fetus, a version procedure is closely monitored.
Fetal ultrasound is first used to confirm the fetus’s position, where the placenta is, and the amount of amniotic fluid. Fetal ultrasound is often used to watch the fetal position during the version attempt.
Electronic fetal heart monitoring is used before, possibly during, and after a version attempt. An active fetus whose heart rate increases normally with movement is usually considered to be healthy. If the fetus’s heart rate becomes abnormal, the version procedure may be stopped. (…)
Before the version attempt, you may be given an injection of tocolytic medicine to relax the uterus and prevent uterine contractions. The most commonly used tocolytic medicine is terbutaline.
While the uterus is relaxed, your doctor will attempt to turn the fetus.
Potential risks of version, for which the fetus and mother are closely monitored, include:
Twisting or squeezing of the umbilical cord, reducing blood flow and oxygen to the fetus.
The beginning of labor, which can be caused by rupture of the amniotic sac around the fetus (premature rupture of the membranes, or PROM).
Placenta abruptio, rupture of the uterus, or damage to the umbilical cord. The potential exists for such complications, but they are very rare.
There is also an extensive list of reasons not to perform a version, and many of them are things home birth midwives cannot actually monitor or recognize.
Here is a screen shot of utah home birth midwife of 35 years Raeann Peck talking about how she performs ECV, as do her colleagues.
This is dangerous and stupid. If someone wants an ECV they need to go to a doctor in a hospital.
Here are some choice quotes that families may want to see before choosing these lay people to attend their birth:
I am certainly guilty of allowing my memory to lead me down a primrose path. My memory lingers over moments when I was heroic, times when I saved the day, and events that make me seem, in my own mind, like a smart and responsible caregiver. I have to force myself to see things differently, and it is uncomfortable. That time when I expertly resuscitated that breathless baby? I didn’t know he was in distress until he was born; I had missed any warning signs of that. The time I successfully helped a mom avoid the hospital when her blood pressure was a bit high? Her blood pressure was actually dangerously high, and that stunt could have ended in a double tragedy. The time I had to hoist that mom out of the pool and get her on the bed to free her baby’s shoulders? (What a hero I was!) Except, she shouldn’t have been in that pool at all; she trusted me that it was a good idea to get in there in the first place. And it was only luck that her baby’s shoulders freed in time. My memory wants to remember me a certain way, and it is up to me to strive for a more honest perspective.
The author of The Honest Midwife found the exact same insulting facsimile of “peer review” in her career that I have in Utah:
The peer review process after a midwife presides over a complicated birth is a disturbing procedure. Midwives rarely ask hard questions, such as whether this mother truly was a low-risk candidate, whether or not the midwife was monitoring the baby carefully, and why she decided not to call for help sooner. Most peer review processes are characterized instead by soothing platitudes, an atmosphere of comfort and understanding toward the midwife, and reassuring all participants that they are indeed wonderful, special people.(…)
It was a couple weeks before I had an opportunity to discuss the case at my very first official peer review. A new midwife at the time, I was very eager to hear my fellow midwives’ opinions on what I could do differently next time to avoid ever seeing a hemorrhage like that again. I got an answer I was not really looking for: “We know you didn’t do anything wrong. We know you. We know you’re a good midwife. Sometimes things just happen.” At the time, it felt flattering, but insincere: they didn’t actually know me. They had never attended a birth with me and had spent precious little time with me. They claimed to know me, but what they really knew was what they would want to hear if they were in the hot seat. Peer review was more like an enabling therapeutic back-patting than any form of accountability. I learned how to play this game, even though it never felt right. You failed to risk someone out? Well, the birth went well anyway, so your intuition must have been right-on! You didn’t call the second midwife in time for the birth, ten times in a row? Your mamas sure go fast! Your client ended up in the hospital needing a blood transfusion? These things happen in hospitals all the time! Sometimes I would forget my place and offer a piece of harsh criticism; I was never the most diplomatic person, after all. But this was met with resounding censure: we are here to be supportive. I would apologize and get back in line. I felt I had too much to lose to stop playing their game.
Frandsen also found a culture of illegal activity and silence in her time at a midwive’s college:
When, as a student midwife, I first participated in nonhospital births, I witnessed some things that made me uncomfortable. At my school, the head midwife would sometimes do illegal vacuum-assisted deliveries. The first time I saw one done I didn’t realize it was illegal, but when I started talking about it freely, I was quickly quieted by the more senior students. “We call it ‘the fruit,’” they said, a reference to the vacuum’s brand name, Kiwi. I rationalized that these other students and midwives would not be using “the fruit” if it was really harmful, so the law must be an unnecessary one. Soon, I was recruited to help usher family members out of the room “so the mother can rest,” as a cover for the vacuum use; I would then lock the door and stand guard. If I was instructed to cover the mother’s face with a cold washcloth “to help her relax,” I made sure her eyes were covered so not even she could see the vacuum being applied. I rationalized that surely she would have given us permission to do this to help her get her baby out without transporting, but that it wasn’t smart to ask permission to perform an illegal procedure. Toward the end of my apprenticeship, I was the one holding the vacuum, applying it to the baby’s head, exerting the carefully angled pressure to help pull the baby down. I rationalized that now I would know how to get a baby out, if I were ever in a situation where there were no available hospitals. I did not originally plan to attend a school where I would learn to perform dangerous, illegal procedures; I became complicit through a chain reaction of participation and justification. “The fruit” was only one of many “exceptions” I learned to make; many of these exceptions I carried with me to my later practice. Illicit use of medications, cavalier usage of toxic herbs, induction techniques, pretending not to see a cesarean scar, fudging dates, doctoring charts, “accidental” breech deliveries, cheating blood pressure readings, lying to doctors, ignoring borderline test results, pretending to know answers while furtively Googling, waiting just a little bit longer for baby’s heart tones to improve, purposely underestimating the staining of amniotic fluid, misrepresenting our personal statistics and the statistical realities of our “profession”… all of these practices are endemic to direct-entry midwifery in the United States. I know because I did most of them. I was present (and silent) as others did them. I heard the stories in “peer review.” Not every midwife does all of them; very, very few, if any, do none. It all starts with one small step, and we justify along the way, until we are lost in the woods with no moral compass left to guide us.
Originally posted on fox13now.com:
About 32,000 pairs of high-end children’s pajamas are being recalled due to the risk of fire. The pajamas are made by Roberta Roller Rabbit and were sold between 2012 and February of this year. (Photo Credit: CPSC)
About 32,000 pairs of high-end children’s pajamas are being recalled due to the risk of fire.
The pajamas are made by Roberta Roller Rabbit and were sold between 2012 and February of this year.
The Consumer Product Safety Commission say the recalled pajamas, which range from toddler size 1 to youth 12, were sold with either long sleeve with pants or short sleeves with shorts.
The agency said the pajamas fail to meet federal flammability standards. No incidents or injuries have been reported.
Made in Peru, the pajamas retail for between $55 and $65.
The recalled products come in 18 prints in various colors; Babar, Bump, Christopher, Colada, Dino, Elephant, Goby, Hathi, Heart…
View original 36 more words
someone found my blog by googling “can a midwife legally let a patient gi past 42 weeks”
To answer your question (in Utah), an unlicensed midwife can do whatever she wants to. A licensed midwife is supposed to demand a consult, but might compromise by fudging your due date or otherwise falsifying records (I’ve seen it more than once online as a measure to “save” women from having to get an OB consult).
Of course its a really, really bad idea to go past 42 weeks (or arguably 40 weeks) for reasons illustrated above. The placenta ages and is less able to provide adequate blood and oxygen during contractions, which may contribute to fetal distress, hypoxia, or death during labor. The stillbirth chart is not an all inclusive profile of the risk of going overdue, but it certainly is a scary one. Unless your baby’s heart stops beating while you are already in the hospital there is no real chance of survival. Choose wisely.