Heres my brand-new facebook group for Safer Midwifery Utah.
thanks for the support!
I took a doula training course from Kristi Ridd-Young, the president of the Midwives College of Utah. Part of the course was about bereavement and unexpected perinatal death. She told a story that I assumed was totally true at the time, but since reading this piece about electronic fetal monitoring I am starting to think it wasn’t as she said it was. The story went something like this (I am paraphrasing, though I should note I have an impeccable memory when it comes to remembering what people said, and I do have notes from the class to jog my memory):
I was with a mother when she lost her baby at a home birth. I was acting as a doula, not a midwife. I might stop being a midwife someday, but I will never stop being a doula. It is too important to mothers.
The mother was a nurse at a labor and delivery floor at a hospital. Her husband was a big, stoic, navajo man. I was helping her through contractions and she decided to get into the tub. Everything was fine, until the next time the midwife checked the baby’s heart rate. She couldn’t find a heart beat. We all, very calmly, drove to the hospital to confirm what had happened. The doctors gave her the bad news that there was no chance of a live birth at this point. I remember her husband standing in the corner, expressionless, but tears were coming from his eyes. I hugged him, and then held the mother while she cried, too. There was nothing to say. It is important not to try to fix what happened. I remember us all admiring the baby after the birth and the way the nurses dressed her. Just because the baby died didn’t mean it wasn’t still their baby, it is important to always treat them with the care you would give a live infant.
They never tried to have another baby. But the mother losing her baby at home made problems for her at work. The other nurses blamed her for the death because she tried to birth naturally at home. They went as far as having a meeting with a pathologist to tell the other nurses that these kinds of deaths can’t be prevented, they can’t even pin down the cause a lot of the time, and that it most likely would have happened if she birthed in the hospital.
I remember a red-headed woman leaving because she was way too upset to hear the entire story. I remember everyone buying this story, and I did too. It was my worst fear about natural birth- a sudden loss of heart beat. My heart ached for women who went through this, and I read more than one story about it. Every midwife made it seem like a sudden, unforeseen tragedy. Now I know that there is ample warning for fetal heart problems during labor, and that it probably could have been spotted if midwives were actually trained in recognizing trouble. If there really was an abnormal sudden drop, the baby could have been born quickly, via c-section (and possibly revived) in a hospital setting. I am doubtful that the meeting with a pathologist took place at all in light of this fact- how could L&D nurses be unaware of these facts?
Midwives only seem to be able to spot trouble if the heart rate has dipped lower than is normal, but cannot discern other information that could save lives via electronic fetal monitoring. They can never know how many minutes it has been since the drop unless they just happen to be listening when the problem starts. If the president of the midwives college, a midwife who has decades of experience, does not know this, how can patients be expected to see through the lies? How many women have gone through losing their baby only to believe their midwife, support her, thank her for doing a good job? We can never really know. The ‘it was an unavoidable tragedy’ line is very important for midwives to learn, so that when babies die they can avoid being accountable to the mother or the community (and keep her fee of course).
The fact that a woman who is the most powerful person in Utah midwifery believes this nonsense should be cause for grave concern for citizens and legislators- what other harmful myths does she teach midwives? How many lives will be lost as a result? I should have seen the red flags in my doula training- like when I noticed that Kristi Ridd-Young being more concerned about pimping her supplements and essential oils than reviewing HIV transmission prevention for doulas. There were a few pages on it in our binders, but it was never brought up during class.
Utah midwives should not be allowed to get away with lying to patients. We deserve informed consent.
I was poking around better birth’s website the other day, and I was perplexed to find this pdf on their website (titled “The Advantages of Out of Hospital Birth”, by Suzanne Smith LDEM). the very first claim is a whopper:
Out-Of-Hospital Birth is Safer than
Yes, that’s right, safer. Scientific studies
from around the world show birth outside
a hospital with a competent midwife to be
the safest way for normal, healthy
She bases this conclusion off of the fact that the vital statistics for Utah lists out of hospital birth as having a perinatal death rate that was lower than that in the hospital. She bases it off of only two years of data. Here is the table:
If you didn’t think about it for more than a few minutes it would seem a plausible claim, until you realize that hospitals take all…
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Midwives in Utah are unaccountable for their actions. There is a deceptively long list of requirements for licensed direct entry midwives in the state of utah, but the law has no real teeth in it. Midwives who choose not to be licensed are not subject to any of the requirements. You can just declare yourself to be a midwife and practice, if you so please. You can declare yourself a licensed midwife in utah and face no consequences for misrepresenting your credentials (I know because this happened to me, I went to a midwife who claimed to be licensed and was not, and every avenue I tried to address the problem with told me they could not reprimand her).
Is it any wonder that women like Valerie El Halta come to utah to practice after being banned from several other states? . When Valerie ran into legal trouble in multiple states, she finally landed in Utah. She abused a woman and negligently caused the death of a baby by using drugs and a vacuum extractor. She was not qualified to use the drugs or the vacuum extractor. Here is a horrifying quote from the mother about valeries conduct:
“It was the single most painful thing Val did during my birth,” Rose said. “She had both of her hands inside me. I was yelling at her to get them out, but she refused because she was helping. If someone has two hands in you, and you’re telling them no, and they don’t stop — that’s why I call it a rape.”
This is a disgusting way to treat people. What is worse is how the midwifery community in utah decided that it was persecution for an investigation to occur. Simply investigating after a perinatal death is considered inappropriate, according to utah midwives. They seem to believe that any level of accountability for patient outcomes is too much. Utah midwives formed a watchdog committee in response to the investigations. There is no sympathy on the part of midwives for the parents of the child who died needlessly. The people hurt by the midwife are a non-issue in the minds of most Utah midwives, apparently.
You would think that a charge of negligent homicide would result in some real penalties for El Halta, who had caused other deaths by negligence in the past, but she was not sentenced to any prison time. Her sentence was probation and a court order to not attend any births. People who carefully read the salt lake tribune article about El Halta’s history will note that being charged with crimes in the past has never deterred valerie from attending risky homebirths, and it is unlikely that she will stop in the future.
Valerie El Halta has also been sued for a previous infant death in a different state, but the fact that she did not carry malpractice insurance means the debt is basically un-collectable. Utah midwives are not required to carry malpractice insurance, so it is hard to get an attorney to assist when utah midwives hurt a pregnant mother or their baby. There is no safe guard in place to prevent a tragedy of this sort from happening again. I find this totally unacceptable. Birth attendants (of any type) are bound to make mistakes a certain percentage of the time, and should be accountable for the outcome. They should pay for any damage caused by their mistakes.
Midwives in utah are also not bound by HIPAA. They have no legal obligation to keep your private health information confidential. Better Birth of Utah has resorted to talking about the (alleged) mental health status of past patients when negative reviews were posted to the internet, breaking the contract that states they will not discuss health information with anyone not involved with patient care (unless legally obligated to do so).
There are midwife-run review boards like utah midwives organization or NARM, but they also do not have any real power to punish midwives. Valerie El Halta had her credentials revoked by NARM several years before the negligence in Utah, it did not prevent her from legally practicing in Utah.
The other thing I found out too late was that the health department does not regulate one room birthing centers. You can run a birthing center however you want to as long as you restrict it to one room. This is a major loophole in the law that could cause many problems for utahans who assume that their birth center is up to code- when there isn’t one. I know that when I used Better Birth LLC as my birthing center I was perplexed at the fact that they had a washer/dryer combination in the SLC birth suites (“bellanatal birth suites). I knew from my time working in hospitals that medical linens usually have to cook at a high temperature in industrial laundry services in order to kill transferable diseases. Better Birth was under no such obligations to sanitize the sheets, blankets, towels, etc used at the birthing center. I am sure there are other examples of why it is a bad idea to let lay midwives self-regulate their birth centers.
If a midwife harms you or your baby your only real recourse is court, and if you can’t find an attorney willing to represent you then you have to try your luck at small claims. There is a maximum of 10,000$ that can be rewarded in small claims (about double what most states offer), but it doesn’t even begin to compensate someone who lost their life, child, or functioning at the hands of a midwife.
I doubt that most Utahans find this state of affairs acceptable. Utahans generally place a high value on children and family, and these regulations undermine the safety of infants and pregnant mothers. Mistakes in the world of prenatal care and childbirth carry a high price for the parents and children affected. I believe that people who manage labor and prenatal care should be held accountable for their actions.
I was inspired by safer midwifery for michigan. I will be starting a similar website (hopefully a movement) in Utah to better regulate midwives.