A preventable home birth death- Possibly in Utah


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

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.


6 thoughts on “A preventable home birth death- Possibly in Utah

  1. I’ve tried to answer your question 2 times on the SOB blog, but it keeps disappearing.

    Utah has voluntary licensing for midwives
    Oregon has voluntary licensing for midwives
    Minnesota as voluntary licensing for midwives.

    There are other states where midwifery is legal – but CPMs aren’t licensed – there’s considerable gray area in these states.


    Then there are states that have work-arounds which allow licensed midwives to attend all kinds of wack-a-doo births.

    • thanks for the information. I will update my post as soon as possible to reflect the info (once I verify it of course). I’m not ungrateful for replies I just have so many things going on right now that its hard to read em all.

  2. Pingback: how midwives manage a retained placenta | Ex Natural Childbirth Advocates

  3. Mothers and babies die in hospitals all the time due to preventable causes. Let’s not forget that. The U.S. ranks #60 in maternal mortality and has the highest day-one infant mortality rate of all industrialized countries.

    • day one infant mortality is called perinatal mortality, and the USA is doing just fine on that measure. If you look at the actual causes of maternal mortality it is strongly correlated with the rise in obesity and maternal age.

      As for the rest- of course mothers and babies die in hospitals, but they die at a much, much lower rate than people cared for by home birth midwives. “all the time” is quite an exaggeration when you look into intrapartum fatalities- they almost never happen in hospitals. You can check the MANAstats numbers (a non-random survey of home birth midwives) against the numbers Judith Rooks, certified nurse midwife, found in her report to the oregon legislature. There is a 5-6 fold increase in deaths when non nurse midwives attend births. That is just a simple fact at this point.

      But lets pretend for the sake of argument that the death rate was exactly the same. A home birth midwife does not carry insurance, so the family is left to deal with the cost of someone elses mistake. Its not fair. A midwife who screws up can just move to a state with fewer laws, while physicians and nurse midwives can be barred from practicing again. If you care about home birth moms and babies you should care that there is so little accountability.

      I would also like to point out that you are trying to bury the memory of this baby. Could you imagine if a mother came forward about her child dying from a faulty car seat, and people said “well babies die in car accidents all the time”? That would be a ridiculous reaction, something you could only expect from someone who was trying to obscure the role of the faulty product in the death. “Babies die in hospitals” is only a useful argument if you are trying to excuse or obscure the prevalence of negligence by home birth midwives.

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