utah midwives are doing external cephalic versions (ECV) at home

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:

Fetal monitoring
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. (…)

Version procedure

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.

evc pic

This is dangerous and stupid. If someone wants an ECV they need to go to a doctor in a hospital.

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freedom of choice for birthing mothers

I support the choice of mothers to give birth where and how ever they want.

However, that doesn’t mean I think every birth choice should be endorsed by the state, either. There is a victim in poorly made birth choices, and that victim is almost always a baby. Babies deserve legislative protection to make the birth providers that facilitate dangerous practices accountable for their actions. Reckless home birth midwives are the ones who profit from spreading the fiction that home birth, water birth, etc is as safe (or safer) than hospital birth. They are the ones with everything to gain and nothing to lose, and that is why legislation should be aimed at controlling their actions rather than the parents who were duped into hiring an incompetent provider. Indeed parents should be able to choose what happens to their bodies and when, but that does not mean it is moral to legally allow a profession to flourish to facilitate poorly made decisions.

Right now any charlatan can call themselves a midwife and boast any safety record they want- there is no way for you to know if they are lying. Even if your midwife is licensed, you would have to trust that any negligence on their part was actually reported to DOPL. There are protocols in place that demand reporting adverse events in hospital births, and there are no such safeguards in home birth or out of hospital births. Home birth midwives who lose babies that could have otherwise been saved are very good at convincing clients (and seemingly, themselves) that the death was not preventable. They don’t have the clinical training to actually know if that is true or not most of the time. It is worth noting that I have never, not once, seen a home birth midwife admit that a baby that died in their care could have lived had they been born in a hospital. This is true even when the baby dies because the time between home and hospital was too long for the baby to endure. They won’t admit wrong and I’ve certainly never seen a home birth midwife that stopped practicing after a preventable death, unless the court ordered them to stop (like with Valerie El Halta and Gloria LeMay).

If your midwife loses her license because she hurt people through negligence, guess what? She can just keep on practicing as an unlicensed midwife. She can change her name if needed, and keep doing what she wants to, with full support from the midwifery community. You would never know.