preventable home birth death- not in Utah after all

I made an entry about a preventable home birth death earlier, and before details were confirmed it was possible that it took place in Utah. Looks like it was in Nevada, a neighboring state with midwifery laws as ineffective as Utah’s. An unlicensed midwife, Christy Collins, who had previously denied being the midwife, has been outed by a source that Dr Amy of the skeptical OB has verified. She posts a letter from the midwife to the family that is damning. It demonstrates the inadequate training and judgment of Direct Entry Midwives. These women refuse to regulate themselves. No one with adequate training or insurance would have allowed this situation to end in mortality.

Let the Nevada state legislature know about what happened and that residents of Nevada deserve better. Here are the email addresses for Nevada State Senators who would likely be interested in fixing the states lax midwifery laws. The full list of contact info can be found here.

Joyce.Woodhouse@sen.state.nv.us

Pat.Spearman@sen.state.nv.us

Debbie.Smith@sen.state.nv.us

James.Settelmeyer@sen.state.nv.us

tsegerblom@sen.state.nv.us

Michael.Roberson@sen.state.nv.us

David.Parks@sen.state.nv.us

Mark.Manendo@sen.state.nv.us

Ruben.Kihuen@sen.state.nv.us

Ben.Kieckhefer@sen.state.nv.us

Justin.Jones@sen.state.nv.us

Mark.Hutchison@sen.state.nv.us

Joe.Hardy@sen.state.nv.us

Scott.Hammond@sen.state.nv.us

Don.Gustavson@sen.state.nv.us

Pete.Goicoechea@sen.state.nv.us

Aaron.Ford@sen.state.nv.us

Moises.Denis@sen.state.nv.us

Barbara.Cegavske@sen.state.nv.us

Greg.Brower@sen.state.nv.us

Kelvin.Atkinson@sen.state.nv.us

Please email them, urging them to do something to prevent another tragedy from happening in Nevada.

UPDATE: Here is the letter I wrote to the legislators. Copy or modify it however you would like to.

Recently a Las Vegas midwife negligently let a woman go past 42 weeks of pregnancy with zero amniotic fluid present. For anyone unfamiliar with pregnancy, this is an extremely dangerous combination of risks that merits immediate medical attention. The midwife did not get immediate medical attention for the pregnant patient. The baby died because of the lack of care. Myself and many other people watched it happen in real time on facebook, because the midwife (Christy Collins) asked her friends what to do about the danger instead of using common sense.

There is nothing in the law to prevent this from happening again. Current Nevada laws allow for midwives like her to keep on practicing, and she intends to do so.
It is worth noting that Christy Collins was charged with practicing medicine without a license in California and seems to have moved to Nevada in order to keep practicing as a midwife under the lax laws.
The details of this horrifying case can be found at the following website:
There are many possibilities to try and prevent the next tragedy from happening, such as:
1. requiring midwives to be licensed by the state to practice, with harsh punishments for those who practice anyway
2. Strict transfer protocols for midwives regardless of licensing status
3. Making it illegal for a midwife who is disciplined in another state to practice in Nevada before the legal situation in the previous state is resolved
You are all smart people I am sure, and can come up with some solution to this problem. Please try to help. This story is getting a lot of attention online and I am fairly sure that it will pop up in local news soon. Being proactive will impress voters who will no doubt be outraged that this happened and could very well happen again.
Thank you so much,
(name)

Holly Richardson responds

Holly Richardson left some comments on my last piece about her. Lets get the easy stuff out of the way, by disproving this bit that Holly said:

And ps: I have not hosted a “midwifery meeting” in almost 10 years. Your “facts” are, in fact, wrong.

holly gave presentationwhoops July 2013 was last year, not ten years ago.  I have my own copy of the audio from the meeting from before UMO made their page private, I will upload it soon. Now that thats out of the way, we can move onto the comments with some meat to them:

While I’m flattered you want to highlight my campaign, your anti-midwife agenda will get you nowhere in this state.

I am not anti-midwife, I am anti-unaccountable medical practitioners. I am sure that the majority of people in utah are.

And really, you have no idea what you are talking about when it comes to Utah law, the process we went through, or the mood on the Hill.

Holly does not cite the portion of the law that would prove me wrong or tell me exactly where I made an error, I am very interested in knowing where I made a mistake. I will correct it if it is demonstrated to me.

Sadly, you’re not even brave enough to use your real name to attack political candidates.

I don’t use my real name because I blog about my abuse history, and it is humiliating to me to have anyone googling my name find out that it happened to me. Newspapers use this same standard in their reporting, and it is reasonable.

 I am proud of my work on behalf of midwives in this state. We have a long history of safe midwifery care.

I linked to several stories of extremely dangerous breech, vbac, and twin births being presided over by utah midwives. Holly is already aware of how unsafe Valerie El Halta’s practices were, because they killed someone who did not have to die.

Dr Amy Tueter has a saying about home birth babies that die- they are buried twice. Once in the ground, and again by midwives and their advocates who don’t want the public to know about them. This is a prime example of being buried twice, pretending that there is a long history of ‘safe midwifery care’ when there was at least one high profile case of extreme negligence in the past two years. I am joining the skeptical OB in using the #notburiedtwice hashtag on twitter to make sure that these babies did not die in vain.

For those who practice outside their scope, there already are safeguards in place.

Oh really? Where were those safegaurds when I was pregnant, and my midwife lied to me about her qualifications and practices? Because I’ve tried, unsuccessfully, for over a year to get something done about the midwife I had that acted outside of her scope and abused me during my labor. If there is some resource I am missing I am very interested in hearing about it, but so far I’ve tried the owner of the birth center where the midwife worked (who blamed me for what happened), DOPL (can’t do anything about unlicensed people), the police (do not know what to charge someone with who pretends to be licensed but isn’t, do not have enough evidence to go to the DA with my other claims), Utah Midwives Organization (who I had to pester to get a response and ultimately rallied behind the midwife that abused me),  and the Midwives College of Utah (who are putting a note in that birth center’s file for later- no idea what that actually accomplishes). Nothing was done. Valerie El Halta made the ultimate mistake, one that killed someone, and she got probation and a ban from attending other births in the state. She will probably just move again to another state where midwives can get away with being unlicensed.

We are a right-to-work state and we are predominately Republican, which means we believe in limited government and in people’s right to make decisions for themselves and their families – and those include healthcare decisions.

I am pretty sure that republicans also believe that little babies should not be killed because of their parents choices, right? Or are republicans pro-choice now? Because what I see is a lot of babies being sacrificed to letting parents decide to birth out of hospital, and in fact the states with the most restrictions on home birth are predominantly republican.

Although you refuse to use your real name, I am quite certain that you were never a part of the discussions to legalize midwifery in Utah, nor have you ever been involved in lobbying. It’s evident that it is difficult for you to read and understand the Utah code but I assure you, there are consequences for those midwives who practice outside their scope.

Once again, the consequences are not named and law isn’t cited, and I have first hand experience in trying to get something done about this and there isn’t any real consequence for midwives. There just isn’t. I am eager to learn of any new avenue for getting my situation resolved.

Believe it or not, midwifery is not my primary interest in running for office. It’s education and the economy.

It should be your primary interest because the state of midwifery in Utah is appalling and you had a hand in it. Take some responsibility and pledge to fix the law. I’m not going to stop my exposure of the deplorable practices of utah midwives in response to negligence.

You all are just one more tragedy away from this whole thing blowing up again. I can wait, but I wish I didn’t have to, I wish that someone with the power to change things before they get out of hand would do so.

Holly Richardson and the “rogue” midwife

I was able to get in contact with Holly Richardson (of Holly on the Hill), who is running for house district 57 in Utah right now regarding the problems with the midwifery bill in Utah. She was instrumental in passing the bill, so I was interested in what she would want to do about the gaps that allow dangerous women like Valerie El Halta to come to Utah and practice legally. Here is the first exchange, which she deleted from her facebook page:

holly richardsonI said “What do you plan to do about negligent midwives? Your bill is what enabled killer midwife Valerie El Halta to deliver babies in utah without a license. What do you want to change about the bill to prevent another tragedy in the future?

Holly “You obviously have NO IDEA what you are talking about but thanks for your input.”

I tried to reply but she had deleted the thread already. I am not sure what she meant here, I did know what I was talking about. El Halta had her NARM certification revoked before coming to Utah, she came here because she could practice midwifery without having to obtain a license. If there had been mandatory licensing in our state she would not have come here, and would not have worked as a midwife, and would not have been given permission by the state to kill another newborn. A life might have been saved by that legislation and we now have an opportunity to maybe save someone else in the future, but Holly isn’t interested. She isn’t interested in being responsible for the legislation she pushed through in Utah and its deadly results.

I would be more willing to be charitable towards Holly Richardson if she took some responsibility for what happened, but she doesn’t. I went back to her facebook page to talk to her more because I think the public deserves answers.

holly richardson 3I ask again about what she plans to do about the bill that enabled the death of this child. She replies “Which is why I spoke to the press about the rogue midwife practicing far ouside her scope of practice”.

I point out that unlicensed midwives aren’t subject to the scope of practice standards in the direct entry midwifery act. Holly claims there are standards, “including criminal”, but I could only find two actual standards for unlicensed midwives. They can’t claim to be licensed, and they can’t carry certain drugs. The law says that doing those things is “a misdomenor”, but when I reported the midwife I used (who claimed to be licensed but was not) nothing happened. Valerie El Halta was not charged for using prescription drugs w/her patient either, so the law is not being enforced nor is it clear what misdomenor police are supposed to charge unlicensed midwives with when they violate these (weak) standards.

Unlicensed midwives can attend any kind of birth they want to, and that is the important issue that is cause for concern in utah. They can attend a footling breech birth after 4 c-sections with triplets if they want to. Nothing in law prohibits dangerous practices from midwives who aren’t licensed. Holly knows that, because her personal reaction to the newborn death was to host a meeting instructing midwives on how to lobby to keep the laws exactly the same. A baby died and her reaction was to help everyone keep things the same so that this can happen again.

I want to take a moment to address Holly Richardson’s claim that Valerie is a “rogue” midwife, because I know that isn’t true either. Holly is an administrator of the Utah Midwives Organization. When they were getting together for an annual conference a few years back they had a poll asking who should be the keynote speaker.  Check out the names suggested here: UMA keynote speaker valerie el haltaLooks like you can choose Ina May Gaskin, Valerie El Halta, or “other”. Valerie came to utah after a long history of dangerous practices and dead children, so it wasn’t some sort of secret that she behaved this way. If she was a rogue then she was one that the community completely supported and accepted (meaning, she wasn’t a rogue at all). Only when the press came asking questions did anyone pretend like this death was surprising. Holly also pretended that it was unusual for midwives to practice far outside of the scope outlined in the direct entry midwifery act, but its not. I know for a fact it is not.

Do you have a baby that is in breech position after 36 weeks gestation (which licensed midwives aren’t supposed to attend)? Don’t worry, there are unlicensed midwives willing to help you out, and your licensed midwife will pick up the phone and call her if things get dangerous and give you tips on how to avoid going to the hospital. Here is a ‘breech expert’ even (whatever that means), who delivered an almost dead baby in 2011 because midwives helped the mom avoid transfer.  It was a VBAC too. That is a combination of risk factors that no midwife should find acceptable, but more than one of them did.  There are other breech stories floating around, and that the Midwife Alliance of North America (MANA) has demonstrated that breech births have horrendously bad outcomes when attended by CPMS in out of hospital settings. There is no excuse for why this continues in our state, knowing what we do now.

UPDATE 2/24- the story I linked to above has been removed. Luckily its been screen capped and can be found here. 

Oh no, but what if you have twins or gestational diabetes? What if you have those problems and a prior c-section? Don’t worry about that either, here is a woman who will take you on as a patient even though she isn’t qualified to manage those conditions.

Here is a story about an overdue set of twins being attended to in utah by a midwife (who was likely unlicensed).

Here is another unlicensed  Utah midwife advertising her willingness to attend vbacs, twins, and breech births.

The question I have for Holly Richardson, and anyone else who thinks the midwifery act in utah is so great, is this:

Do you think that the public will stand for deaths to happen again and again? How long do you really think this will last? Wouldn’t it be better to prevent a death instead of trying to cover up the practices that led to it?

A preventable home birth death- Possibly in Utah

 

UPDATE : Jan Tritten had this to say after deleting the thread on facebook:

“The
questions on this page are messaged privately to me and put up
anonymously. They are not my cases. This is to help mothers, midwives,
doulas and physicians in their work. it is to get opinions from many
different practitioners and parents.”

I found a link today to the facebook page for an editor of Midwifery Today (Jan Tritten), a trade magazine for direct entry midwives. She makes a habit of posting questions on behalf of other midwives. I assume she does this because midwives may not want their names known when asking about dangerous practices OR because Jan has more friends and will therefore get more responses to questions. It seems that she was posting about her own client this time.

I found a ton of these types of posts on her timeline. In this specific instance, a woman who was over 42 weeks pregnant and had no amniotic fluid visible in her ultrasound, and the patient’s midwife decided to crowdsource advice via facebook instead of immediately transferring care. Here are the screencaps

midwifery today editor crowdsource midwifery today editor crowdsource 2

Note the part on the first post that says “We’re in a state with full autonomy for midwives and no transfer of care regulations past 42 weeks”.  What does ‘full autonomy’ mean? Its midwife speak for “no rules to protect patients from negligence”. Utah is a state that lacks these protections for mothers and babies. This could be a death here or in Oregon- it is not possible to know, however Oregon does have more restrictions on unlicensed midwives than Utah does. 

In Utah, a midwife can do whatever she wants to unless she voluntarily decides to get licensed. The law is very misleading to the public- if you look up the law about midwifery in utah it looks as though there are strict practice guidelines, but they only apply to women who volunteer to abide by them. If those women lose that license they can still practice afterwards, with fewer restrictions.  They cannot call themselves licensed midwives, and they are not supposed to carry drugs, but when I tried to report an unlicensed midwife claiming to be licensed there were not any consequences. Utah midwives (licensed or not) don’t carry insurance so if they injure or kill someone the grieving families are unlikely to be able to sue, and if they can sue they are unlikely to collect any money.  What reason is there for the midwife to act differently? There is no negative consequence for depraved indifference and a lot of praise for delivering high risk clients to ‘prove’ that birth is inherently safe.  You can see from the comments that virtually every other midwife seems to act like this was an unforeseen tragedy that could not have been helped. There were multiple, glaring indications for transfer and the midwife did nothing. Other midwives in the comments talk about the importance of midwives setting their own standards of practice, when in fact that is exactly what caused the death. Jan Tritten is the editor of the trade magazine for midwives, and she engages in behavior which enables dangerous practices like this to happen. Why is she not ashamed?

Something similar happened in Utah awhile back. It was another case of depraved indifference to the wellbeing of a mom and baby, and it ended in a death. What consequences were there for that midwife?

The harshest consequence I’ve seen for a midwife in Utah was to be charged with negligent homicide, and then be sentenced to probation and banned from attending births. That’s it. Probation. She wasn’t even shunned by the community in the aftermath, they embraced her and probably still do (while the public isn’t watching).

One of the main reasons Utah’s state laws are set up this way is because of legislator Holly RIchardson (republican, of Holly on the Hill fame). She was instrumental in getting the original direct midwifery act passed as legislation, and has yet to take any responsibility for the outcome of such an outrageously negligent policy.  Even if this death was not in Utah, there is absolutely nothing that would have prevented this level of negligence from happening here. There is absolutely nothing in place to punish or discourage this level of negligence by unlicensed midwives, and that’s the way Holly Richardson and her friends at the Utah Midwives Organization prefer things to be. Without new legislation we are literally waiting around for this to happen again. How many dead newborns will it take for people to demand change?

Holly is running for House District 57 in Utah this election. Let Holly know how disgusted you are at her for enabling dangerous quacks to operate without any accountability. Her contact form is here.

Edited to add- there are actually multiple states with lax licensing on midwives. Read the comments for additional information. In the end it turned out that this tragedy happened in Nevada.

I am officially a midwife!

I hope everyone is happy for me, I am officially a midwife. I will be applying to join UMO very soon.  Here’s my nifty bio:

I believe birth is a wonderful, natural experience and that women’s bodies know how to birth. I’ve attended 800 hundred births over the past 15 years, and have received advanced birth attendant training. I was a doula before I became a midwife.  I am the founder of the North American Midwives Educational Association’s College of Midwifery (NAMEACM), which has certified me as a Level 12 Midwife. I have had quite a journey that led me to my ‘calling’, the most major impact was birthing my 17 children at home.  I am humbled to be able to attend your birth and help you through your own personal journey of feminine empowerment. I will encourage you and will believe in your own power to birth naturally in a setting of your choosing (at home, at a birth center, while water skiing, at fashion place mall, etc). I am an expert in breech presentation, twins, VBAC, and other variations of normal. I also encapsulate placentas and make memorials out of umbilical cords, in addition to any other arts and crafts you request be made out the awesome raw materials that birth grants me. I can show you all my great testimonials (once I have written them, of course).  My prices are 3,500$ for basic a basic birth package, but believe me- it’s worth it.

Oh sorry, none of that makes a midwife, because none of it is actually true (except for having attended birth attendant training_. What makes me a midwife, legally a midwife in the state of Utah, is that I’ve simply declared that I am one. I can attend the births of babies without any training and while passing off false information to my ‘clients’. I can do dangerous births for large fees (non-refundable, of course) and then wash my hands of the consequences if I kill someone. After all, I can trust other Utah midwives to rally behind me, right? There is nothing to stop me from claiming I have experience that I don’t because there isn’t a way to check up on unlicensed midwives. There is nothing to stop me from simply inventing my own midwifery school website and testimonials to fool people into letting me deliver their babies.  I can pretend that I have experience in births that I have never attended. There is nothing to prevent me from pretending that I had 17 home births when I’ve only had one baby via c-section. After all, why would clients need to meet my kids? All there is to it is to pretend that you know what you are doing and that everything will work out okay, oh and to call yourself a ‘midwife’ and say all the right buzzwords. If I were a dishonest person with good networking skills I could be attending births in no time, I would just need to find someone vulnerable enough to fall for my scam.

If you think that you need real qualifications to attract clients, think again. Check out this midwife’s ‘about me’ page, it has absolutely no qualifications listed except her own kids births and having been at it a long time. Oh, and testimonials.

This should frighten Utahans, parents or not, because its ridiculous and obviously very dangerous. If I wanted to cut someone’s hair for money I would need much more training than I would to deliver breech VBAC babies.

direct entry midwives: a public health menace

There is a curious overlap between anti-vaccination activists and midwives. It seems that it is hard to find a pro-vaccination midwife, despite the overwhelming scientific consensus that vaccines are a fantastic way to prevent illness. Midwives will outright tell patients anti-vax propaganda during their pregnancy- I should know, it happened to me. The midwife telling me reasons not to get a flu shot did not know that the flu is a virus instead of a bacteria, and she also believed that getting the flu shot causes the flu. I looked into the Midwives College of Utah and The Community School of Midwifery to see if midwives are actually being trained to reject vaccines or not. I could not find any vaccine specific information. But did I find an inadequate level of training for them to make any recommendations about vaccinations. The health courses that midwives take are very basic, and almost all related to birth, well woman visits, and newborns. Again, it is worth noting that when legislators ask midwives if they are practicing medicine, they vehemently claim that they are not in the business of practicing medicine. When their clients ask them questions that should be answered by a doctor, direct entry midwives claim to know what they are talking about and readily accept money for answering their questions.

Luckily I was informed enough to know that the flu shot is a good idea for a pregnant woman. What is more troubling to me is the fact that there is not any requirement for midwives, who work with a vulnerable population (newborns and pregnant women), are not required to be vaccinated against possibly fatal diseases. This is yet another gap in the Direct Entry Midwifery Act that should be bridged by new legislation.

Anti-vaccination midwives are totally at odds with the Utah Health Department’s vaccination initiative. Rates of vaccination are low in some parts of utah, and outbreaks of disease like measles and pertussis are increasing. This initiative is important and will save lives, but Utah midwives are purposely undermining this cause because of their own mistaken beliefs about vaccines. I do not think most parents who hire midwives know that they are not qualified to make a judgment for or against vaccination when they consult them. I certainly didn’t! I would not have asked if I did not think my midwife was knowledgeable about the process. This mom almost didn’t vaccinate because of the word of her midwife, so I was not the first or last person to make the mistake of asking the midwife about vaccines.

I found that the president of the Midwives College of Utah, Kristi Ridd-Young, discouraged the cancer-preventing Gardisil vaccine on her facebook page:

kristi ridd young is against vaccines

“Ughhhh! ank goodness I had a bad feeling about recommending this vaccine.” Someone (correctly) points out how there is a lot of information online about how the information Kristi linked to is not correct. Her response?

kristi ridd young is against vaccines 2

“Thanks Emily and Katy. As always, we should all be aware of all research. Sadly I now know two people personally who have experienced serious repercussions from the vaccine with no information prior to the vaccination that there was such a possibility.”

So her knowing some people with problems that she believes are caused by vaccines is enough reason for her to feel uncomfortable recommending it to people. That type of thinking privileges anecdotes over data, an obvious mistake when discussing matters of public health. Also, the nonsense about ‘no information that such a thing were possible” could be false as well. I have gotten vaccinated more than most people- I had my childhood vaccines twice because I could not obtain records and needed them to work in the medical field. The shot was cheaper than a blood test so I got everything again. I get a flu shot every year. When swine flu vaccine became available, I was the first one in line at the health department to get vaccinated. I have had gardisil and hepatitis b vaccines (three shots each). Every time I was either automatically given the CDC information sheet on vaccines or I was offered it. It is a requirement for informed consent. I am not saying that people behave perfectly or that the sheet is never forgotten, but it just seems much more likely to me that regular people likely skip reading detailed information about vaccines when they could be doing something else. It isn’t interesting to most people, and that is fine. This is also a story that cannot be verified because none of us have access to either of these people, the details can never be known.

She isn’t just against gardisil, she is against varicella (chicken pox) vaccines:

kristi ridd young is against vaccines 3

This is also a bit of nonsense that has been thoroughly debunked. There has not been a meaningful connection made between vaccination for chicken pox and shingles. There seems to be some other factor causing an increase in shingles infections that has not yet been identified.

If the president of the midwives college doesn’t know this, how can Utahans reasonably expect students to know? I would imagine that someone willing to publicly discourage vaccination would likely pass this message on to students, who in turn pass it on to their patients. The ripple effect of these damaging beliefs should not be underestimated.

I also found that the Utah Midwives Organization administrator is rabidly anti-vaccine. No one expressed disapproval of her ridiculous beliefs:

UMA admin against vaccines UMA admin against vaccines 3 UMA admin against vaccines 4 UMA admin against vaccines 5

She also seems to subscribe to the deadly belief that garlic is better than antibiotics. This belief has unfortunately cost at least one baby their life. Again, the idea that medicines and medical professionals are totally unnecessary passes without comment by the other midwives in the community

UMA admin garlic is better than antibiotics

People can believe whatever crazy thing they want to- I don’t take issue with that. What I do take issue with is midwives acting outside their expertise and scope of practice in order to spread beliefs. They have a position of authority over the clients that they serve (even if every effort is made to negate that authority, it still exists). People trust midwives to tell them reliable information about their health, and instead they are told rumors and falsehoods. Midwives are unlikely to regulate themselves, so I believe that the Utah senate should step in and do something. I will have a new page up soon about how to contact your representatives and possibly a form letter for concerned citizens.