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.

Advertisements

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.

Utah Midwives are afraid of this website

I am currently being threatened with legal action unless I hand over my blogs to a midwife’s attorney, they are demanding that I agree to never speak of them negatively again. They have never actually told me what was wrong on my website (as I am eager to correct any errors), or why they would need access to ex home birthers. They are threatened by someone pointing out the truth about direct entry midwifery in the state of Utah.

I will not be bullied into silence. I have the first amendment right to talk about my political beliefs and to lobby for changes to the law in my state. I’m willing to fight this as long as necessary to let parents in Utah know that there are more legal requirements for driving a car than calling yourself a midwife and delivering babies. 

If anything goes down I will be contacting Ken White of Popehat, who has been extremely effective at finding pro-bono help for bloggers who have been sued to try and curtail freedom of speech. I’m prepared for whatever happens. 

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. 

 

Not even sorry

I’ve covered the VIckie Sorensen manslaughter charges extensively before, but I thought readers might be interested in the absolute lack of remorse on vickie’s part for her role in the death of a newborn.

vickie sorensen cheers to my haters

vickie sorensen witch cartoon

 

vickie sorensen haters

vickie sorensen status stringing up midwives

She also made a point of accusing valley view medical center of having a conspiracy against home birth mothers.

valley view medical center accusations

 

unlicensed midwives and their dangerous practices

Here is a look at how one unlicensed midwife chose to operate (likely due to the lack of accountability for her actions). This part is telling:

She practices near one of the largest Amish communities in the US in a state where lay midwives operate in a “gray area” legally. She likes it that way because the Amish women don’t question her, trust her implicitly, and will not pursue litigation or repercussions of any kind. They call her for any kind of medical questions they have, even outside of women’s health, and she freely dispenses medical advice over the phone without seeing the patient in question. Sometimes her advice even contradicts a doctor’s advice. . .guess whose opinion carries the most weight?

If you think that Utah midwives are operating any differently…you are in for a surprise.

practicing medicine I have already covered some midwives practicing medicine in my posts titled “seriously?” and “seriously? part 2“, but above is a post from the vickie sorensen support page talking about the same behavior from a midwife who was recently charged with manslaughter in connection with a baby’s death. They are using the words of people who openly discuss vickie sorensen acting outside her scope of practice, and they think that proves that she is a wonderful person instead of an irresponsible person. This seems to absolutely be the norm for midwives, although when they lobby for legislation to keep unlicensed midwifery legal, they claim that midwifery is different from medicine. They have to claim that. If they told the truth then it would logically follow that they need to obtain a license and insurance to practice.

midwives respond to the newest preventable death

There are many anonymous donors on  Vickie Sorensen’s gofundme page, but there are some midwives that aren’t afraid to lend their name to the ’cause’ of supporting a midwife who allegedly lied to EMTs about her patients condition as she almost died from blood loss, and they are:

Darby Partner

Jessica Weed*

Melissa Valet

Susan DiNatale

Katharine McCall*

Juanita Michelle Gober

Marcene Rebeck*

*The names with asterisks are midwives who have been prosecuted in different states for negligence of various sorts. I’ve linked to the cases on their names, you can click to see for yourself that none of them were exonerated.

Most of the other donors are former patients, other birth workers (like birth photographers, doulas, etc), and anonymous donors.  They have managed to post Vickie Sorensen’s bail, and so they raised the gofundme goal to 80,000 (likely for her legal fees).

So far I haven’t seen any midwives condemn the laws that allowed this to happen. I’ve only seen them try to put a good face on this and pretend that most midwives follow a reasonable standard of practice, when I’ve pointed out before that most do not.  The norm is midwives making up their own rules and their patients remain blissfully unaware of it unless a problem arises. Most Utah midwives, including midwifery school owners, are against vaccinations and are far outside their scope of practice by discouraging vaccination in their patients.

The salt lake tribune is the biggest news outlet reporting on the charges against Vickie Sorensen, and their comments section has a few midwives willing to put their name on the line to pretend that legislation would solve nothing in these situations. Tara Workman Tulley, political candidate for city council in Springville, Utah, was among the most vocal in support of keeping things exactly the same as they are now.

tara tulley most midwives would not

First she starts with a statement that “most” midwives would transfer this case, and that this is not considered “normal practice” for midwifery care. In reality there is no standard for midwifery care, so this statement is entirely based on her personal opinion of what other midwives would do, rather than any actual data.  I get the feeling that Tara will say anything so long as it helps the “cause” of keeping midwives unlegislated.

What is particularly alarming is that she only thinks “most” midwives would transfer, rather than “virtually everyone” or “all competent midwives”. This should be alarming to the general public- Tara Tulley runs a midwifery school and trains other midwives.  Tara is vice president of the Utah Midwives Association. She started a political committee to respond to the last death caused by negligence, and she clearly felt that it was persecution. Her acceptance of this conduct is deplorable in light of that fact.

tara tulley against licensing

In subsequent posts, Tara Tulley pretends that Vickie Sorensen is worse off as an unlicensed midwife, and therefore not licensing midwives is the rational thing to do. It would be a good argument except for the fact that Vickie Sorensen and other Utah midwives only feel comfortable taking high risk pregnancies like twins, premature, vbac, etc because they have legally done so before, or because they know there is no legal consequence for taking these cases in and of themselves. The legal consequences only emerge when there is clear negligence, like in this case (refusing to call an ambulance, interfering when they did show up, etc). Taking on births that should never reasonably be attended at home is not a legal problem in the state of utah unless the midwife does something else to merit an arrest. It doesn’t matter if the baby lives or dies. Licensing of midwives would prevent this, it would punish them for taking on cases they should not *regardless* of outcome, and insuring of midwives would make sure that even negligent midwives who break the rules would be able to pay for the damages that they have caused. Tara Tulley is against any legislation of midwives.

tara tulley voluntary standards

At this point Tara Tulley acknowledged that the standards that are available in direct entry midwifery are entirely voluntary. People can follow them, or not. Throughout the comments on the salt lake tribune she pretends that this is the norm in other medical professions. She conflates other medical professionals breaking the rules as a case for foregoing standards, when in fact it evidences the opposite case. Punishment for deviation from protocols should be swift and harsh as to discourage such behavior. She has stated before that she prefers a mentorship style program to actual legislation aimed at protecting people from clearly negligent midwives.

tara supports dangerous midwives cropped

This is her (ridiculous) solution to the problem- mentorship. She calls it ‘responsible inclusion’, but what I call it is using pregnant women as guinea pigs, and then being unable to pay when you damage them. If you don’t know what you are doing, you shouldn’t practice midwifery. Period. No matter how skilled you are you need insurance in case you hurt someone on accident. Its become clear to me that virtually none of the midwives in Utah know what they are doing, and that is probably because there is no central body governing evidence based practices. There desperately needs to be a change in the situation of direct entry midwifery in utah.

I’ve contacted the utah midwive’s association for an official statement on the Vickie Sorensen situation. I will update this post if and when they respond (or fail to).