Utah health department: Home birth kills babies that would otherwise have lived

The Utah Health Department released a study on home birth, and it mirrors the findings of the data released in Oregon several years ago by Judith Rooks (CNM).

According to page 10 of the document, neonatal deaths in home birth happened at a rate 2.3 x the rate of hospital births. The statistics go on to note that the home birth deaths were reviewed by a committee which states that at least half of the home birth deaths were “strongly” considered to be preventable (meaning those babies would have survived had they been born in hospital). The remainder still had evidence of being preventable, just not as strong of evidence as the other half. None of the cases were considered to be completely unpreventable. The home birth fatalities were attended by midwives, midwives who likely told their clients that home birth is as safe as hospital birth.

What is shocking is that these findings actually skew the data in favor of home birth midwives- the real numbers are likely much worse. For instance, women that transfer to the hospital too late will have their babies death counted as a hospital death instead of a home birth death. You can read more in the “limitations” section of the document.

Here is all the proof anyone should ever need, in black and white- home birth in Utah kills infants that would otherwise have lived. Please refer to my Action Guide at the top of the page if you want to change things for the better.

UPDATE: this large peer reviewed study found nearly the same results. The authors have admitted to soft balling the risk in order to spare themselves the ire of the home birth community.

Alabama: please learn from Utah’s mistakes

I read a great article written by Dr. Michael Flanagan, addressing Alabama’s proposed legalizing of direct entry midwifery. He makes several concise arguments about why lay midwives are not adequate birth attendants in emergency situations.

Complications of labor can include, but are not limited to, a baby getting stuck in the birth canal, tangling of the umbilical cord around the baby’s neck, bleeding, infection, or even unexpected immaturity of the newborn’s lungs. These dangers are possible even in the most state-of-the-art facility, but at least the infant and mother have the best possible chance of survival. I have personally participated in urgent and emergent care that required quick decisions by the physicians and nurses to save the life of the unborn child and mother. The same cannot be said for a birth that is planned for the home and attended by a lay midwife. Instead, you will have a well-meaning, but woefully undertrained and underprepared individual and a false sense of security for the parents. When a planned home birth takes a turn for the worse, the time spent in an ambulance ride to the ER can mean the difference between life and death.

 

Dr Flanagan is talking about births that just unexpectedly go wrong, and the problems associated with that. He cannot even begin to understand the negligence associated with unlicensed home birth practitioners, they take high risk pregnancies if there is no oversight preventing it. Home birth midwives in Utah, for instance, regularly attend breech births, vbacs, and twin births (or shockingly, a combination of the above risk factors). There have been fatal results.  Dr Flanagan continues:

 

There will always be babies born spontaneously in elevators, taxi cabs and parking lots. Most of these deliveries will likely be fine, given the law of averages.

This is true, and this is exactly why midwives can claim their practices are safe. Midwives also deliver far fewer babies per year than a obstetrician or a nurse midwife working in a maternity unit, and so they can claim to have worked for many years without a death, or they can choose to see the deaths they have attended as unavoidable because of their ignorance of obstetric interventions. They scoff at the idea that they have attended so many non-lethal births out of sheer luck, but its the absolute truth. Midwives take credit for good outcomes and deny responsibility for bad outcomes- its an abhorrent model of patient care. Dr Flanagan continues:

 

However, if the State of Alabama passes a law legalizing lay midwifery, it sends a message to the public that this practice is safe. This idea could not be farther from the truth.

I cannot speak for other states that have unfortunately legalized this dangerous practice. Perhaps no one spoke up against it.

 

Plenty of people speak up against it. Several physicians have spoken to me about the danger of home birth midwifery, the disasters they encounter at their work because of incompetence. A legislator in Utah told me in confidence that they believe most of the legislators in our state would rather not have home birth midwifery allowed legally, but the midwives are very organized and have friends in high places. They are willing to pour as much money as needed into their cause to make it happen- after all, if the practice is outlawed, they are out of a job (or risk prison). They have much more to lose than the average citizen (who will not choose home birth), so they understandably put more effort towards keeping their job legal. Midwives have a weird habit of teaching classes on activism as part of required courses in their midwifery school. They know they desperately need unity to keep the sham going because home birth midwifery cannot stand on its own merits. 

 

If anyone from Alabama is reading this- please, please contact your representative and tell them that you don’t want the state to endorse this practice. If citizens of Alabama fail to stop this action you will be in the same position as Utah’s citizens- watching helplessly as tragedy after tragedy unfolds before our eyes, fighting against a status quo of legal unlicensed midwives practicing without any oversight or required training. Every community values its children, and this is a very serious threat to their well being. 

 

Vickie Sorensen’s victims should not be buried twice

Dr Amy Tutuer of the Skeptical OB has a very apt saying about home birth deaths- the babies get buried twice. First in the ground by their parents, and then by the home birth midwives who wish to bury the memory of what happened. It does not have to be that way- take action, call your legislators and let them know that you don’t find it acceptable that its harder to legally drive a car than it is to legally deliver a baby in our state.

It may seem like common sense that the law changes after this, that legislators will wake up to the problems with voluntary licensing and voluntary insurance for midwives, but that did not happen last time a horrific home birth death happened in Utah (at the hands of serially negligent midwife Valerie El Halta). The reason nothing changed is that Utah midwives stand up for each other regardless of how heinous their actions might have been. Right now, instead of asking themselves how this could have been allowed to happen or how to prevent it the next time, they are raising funds for Vickie Sorensen’s defense. They are denying reality by trying to say that this is persecution or that there is no merit to any of the charges (we will have to wait and see, but I have yet to see a midwife charged in a case like this that is let free- there are simply too many witnesses in home birth deaths).

They also have a leg up because legislators like Holly Richardson support home birth, even after the bill she passed cost a life (now we know its cost many more than that). I brought this to her attention and she ignored me and my concerns. She is running for house district 57 in pleasant grove, and will no doubt push the home birth agenda if she is elected. She is a major reason this state of affairs exists in the first place, but she has washed her hands of all responsibility. You will see that she more or less blames parents for not being diligent enough in checking references, but in both Utah home birth deaths the midwives in question have glowing reviews from a large number of people and professional achievement (El Halta wrote for Midwifery Today, Vickie Sorensen was integral to the original Utah Midwives Association). The Utah Midwives Association (now the Utah Midwives Organization) had a meeting about how to best cover this up and prevent any laws from being passed. The El Halta death happened very shortly before the legislative session opened so no one else was organized enough to change the law.  It seems that the lack of action from that death has unfortunately allowed other deadly midwives to operate legally.

These babies need you and me to contact everyone we can to try and prevent the next death. Midwives refuse to police themselves and prefer to have a total lack of supervision or guidelines for their practices. There is actually an official guide for home birth midwives to avoid accountability for deaths they attend, it is called From Calling to Courtroom. You can read it here. You will notice that a lot of what Vickie Sorensen is accused of doing- lying on medical records, interfering with EMTs, etc is encouraged in this book. This is standard operating procedure for home birth midwives.  You and I are the only thing standing between negligent midwives and the next preventable death- please help, it will only take a few minutes of your time.

You can sign a petition demanding licenses and insurance for midwives here. 

Jessica Weed- the next Valerie El Halta?

Those who follow this blog or home birth stories in general are aware of the tendency of midwives to move around when the cops come knocking. Jessica Weed is no exception. Here is what she did in New Mexico:

Jessica Weed, a midwife in Albuquerque, New Mexico, helped in the breech delivery, when a baby is positioned to be born feet first, on August 28 but the newborn suffered bleeding on the brain and in the retinas after the complicated birth.  

Additionally, the mother’s placenta was not delivered and the woman, Kristin Himm, developed an infection when it became toxic.

two days after the birth, Himm took the newborn to the hospital on August 30 and Weed allegedly told the mother not to disclose that the midwife had delivered the baby because Weed said she was having problems with her Midwifery license, according to the Albuquerque Journal.

Imagine my surprise when I saw that Jessica Weed is still in business as a ‘birth guru’ despite demonstrably poor judgment and training. One of the cities she has hosted trainings in the past is Provo, Utah.

jessica weed in provo

What would prevent Jessica Weed from delivering babies here? Absolutely nothing. She has a CPM credential, which is more than enough to secure clients. Other midwives support her just like they do every other dangerous midwife, because sisterhood matters more than safety to non-nurse midwives.  The credential is more than Valerie El Halta had when she secured clients in Utah after a history of trouble in other states. 

You might be thinking that guilt is an adequate deterrent. Perhaps Jessica feels bad about what she did and does not intend to deliver babies anymore, right? 

jessica weed still attending births Wrong!

“I had a beautiful birth last night with me just sitting in the corner, as the parents asked. It is so nice to see a birth just happening as it should without any interference at all! She even birthed her own placenta like a champ!”

Remember that this is a woman who got in serious legal trouble for failing to intervene when a reasonable person would.  She still waxes poetic about the beauty of not doing ANYTHING during a birth.

Maybe you are thinking- she probably just learned from past mistakes and incorporated the experience into her practice. Wrong again!

jessica weed unassisted birth not a good option lolShe does nothing but whine about how it was unfair and how she did nothing wrong. These are not the words of someone who has learned from their mistake- she would have to admit a mistake was made to learn from it. 

The highlighted portion is worth noting:

“If you don’t have the choice of a midwife and a homebirth, your only choice will be to birth in a hospital or to go it alone at home without support. Those are not good choices for most women who would choose homebirth!”

There are two issues with Jessica Weed deciding that unassisted childbirth is a poor choice.

The first problem is that her case is proof that not having a midwife is often superior to having a non-nurse midwife. If you look at her case you will see that the client had concerns and Jessica told them it was fine. Over and over she said it was fine, and when it became clear that it wasn’t fine, she advised the parents to lie to the hospital about her role in the birth (which by definition prevents her from participating in the exchange of important patient information with the hospital). Both of these things put the patient in more danger than if they had birthed at home alone. A concerned parent without expertise will go to the hospital when concerns arise or call 911. The mother likely could have been spared a serious infection and the child could have been monitored and treated for their internal bleeding. A care provider who insists on lying to cover her own legal bases instead of giving priority to protecting patients runs the risk of giving inaccurate information to physicians (or failing to give important information at all). Jessica Weed pretends that midwives never make things worse, when she should know first hand that they can.

The second problem is that Jessica Weed promotes Unassisted Childbirth (which she calls ‘freebirth’). This means she is either lying about the safety of freebirth or she is lying about the utility of a lay midwife during home births. The common theme here is that she says whatever will earn her more money at the time. 

Jessica Weed has Unassisted Childbirth (‘freebirth’) coaching for 1000$ a pop. 

freebirth coaching jessica weed She is willing to charge 1000$ for emails and phone availability, despite her history of saying “everything is fine!” when medical attention was needed. 

I am alarmed by the lack of restrictions on midwives and their practices. A physician or a nurse that has their license suspended for negligence cannot simply pack up and start practicing somewhere else without some major hurdles in the way. There are literally no hurdles for midwives who kill or maim- they get to keep going, all with the support of other midwives who are too invested in keeping unlicensed midwifery legal to care about what it costs babies and families.  Utah midwives, including political candidates like Tara Tulley and Holly Richardson, have no problem with the system as it stands. They would likely welcome Jessica Weed or Christy Collins to Utah with open arms and kind words, if their welcome of Valerie El Halta is any indication. 

 

 

 

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.