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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.