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. 

 

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).

 

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?

remember, this meeting IS being recorded (part 2)

This part two of the review of the meeting by utah midwives that occurred in response to a preventable death caused by a serially negligent midwife (Valerie El Halta). Part one can be found here.  Keep in mind that these women are all keenly aware that these remarks are being recorded, so they believe that their reaction to a preventable death in their profession is normal and acceptable. Summaries of the meeting content are in bold, my commentary is in normal text.

A woman discusses the need for legal assistance for midwives. 

Another woman said that UMO needs a legislative agenda.

A  student midwife named Catherine  discusses possible legislation in California to make it easier for direct entry midwives to order labs, use medications, and attend births without any medical oversight. She shares how other midwives can help the effort to make life easier for direct entry midwives. Catherine wants to remove physician/nurse supervision of midwives and carrying of medications and oxygen. She notes that the problem is that physicians put their own malpractice insurance at risk by supervising these sorts of births and birth centers. 

Insurance companies are not caring corporations, they don’t take on policies or reject them on the basis of politics. They crunch numbers, do the math, and conclude if covering a practitioner it is an acceptable risk to insure. They have declined to insure these birth attendants, even with physician supervision. That should be a red flag for anyone paying attention. Midwives act as though there is a vast conspiracy instead of the simple fact that out of hospital birth increases the rate of perinatal death and injury, and this is especially true when non-nurse midwives are the attendant.

Around 37 minutes a midwife named Dyanna Gordon says “One of the big problems is that, we are on our way to mandatory licensure.You know, we haven’t played nice with each other for years.And if we don’t do something quickly, we are not going to have many options left available to us. 

We left things how they were, you know, and I believe that there are very few midwives in Utah who believe in mandatory licensure. I think most of us are very happy, with where things are, with licensure being optional. But that’s not where we are going to be in a year or two, if things don’t change. 

Those who are licensed are managed by DOPL. If there are problems in practiced, theres peer review required,all of that was established with saying ‘okay, the unlicensed midwives will govern themselves, they will work out their own issues,they will have their own peer review, and things will be taken care of accordingly.’ But the truth of it is that its not happening, and it is affecting everybody.”

DOPL stands for the Department of Professional Licensing. Diana Gordon understand the problem- there is no real oversight of unlicensed midwives, they can do whatever they want. It is obvious that a midwife could seriously injure or even kill someone by practicing dangerously. Diana is right that it is ‘affecting everybody’, but not in the way she means. She means it is affecting other midwives. I mean that it is affecting the parents who had to bury their child, other community members who were supporting them through that time, the investigator who had to go through the details of it, reporters, and everyone else who heard of the story and felt heart broken. How do I know Diana has no consideration for the community or the dead baby? Her solutions are all about keeping the situation the way it is instead of changing it to prevent the next tragedy.

There is discussion about how to organize, logistics, etc.

The details are boring and I am continually astounded at the lack of technical knowledge that the midwives display during the meeting, such as the constant echoing and the lack of editing for the first 6 minutes of murmurs. I was also surprised by their inability to actually make any progress in making a decision. They take two hours to decide if to have a meeting and when and what to call themselves. Yeesh.

Tara Tulley talks about legal fears because a member of the old organization’s computer was seized during a search warrant (Vickie Sorensen).

The professional organization’s computer was seized by police during a raid of some sort. Needless to say, this is not a problem that real medicial professionals are likely to have. The Utah Medical Association certainly doesn’t have this problem.

I cannot find any information on what happened to this computer, or why it was taken, except on the laughable “our sisters in chains” website, which claims it was all persecution (as you will note, basically ever midwife arrest is unfair in the owner of OSIC’s opinion). They want to raise money for criminally negligent midwives, which I have learned is the norm in this line of work. Comparing their story of what Jessica Weed of New Mexico did and the actual news accounts makes this website completely unreliable in my mind (scroll down to New Mexico or control+f for Jessica Weed). Who knows what Vickie Sorensen was accused of or why her computer was seized? If anyone finds any information about this raid please let me know in the comments.

Tara Tulley asks Suzanne Smith if there are legal concerns with continuing with the new organization. She says that she would rather move onto a new organization because there is no real hope of getting the seized computer back so they have to start again from scratch. She doesn’t feel that the activity of any member does not taint the organization so it would be okay to be the utah midwives association. 

Well, we were all aware that Suzanne Smith was okay with shady behavior from other midwives, due to her previous actions (ignoring complaints of forced vaginal exams and inappropriate sexual touching at her clinic, and subsequently recommending that same midwife to new patients), but now we have her saying it out loud. She doesn’t care if a midwife is under investigation for a death or anything else, it just matters that they are there to protect their collective income stream.

One of the midwives apologizes to Valerie [the midwife that killed a baby], saying “I’m sorry that you had to be the catalyst for this, but we have to move forward. What do we need to do today to move forward?”

Why are they sorry to valerie? Why aren’t they sorry to the parents who had to bury their child?  Direct entry midwives consistently display a depraved indifference to the well being of babies and mothers.

Another midwife says “I know there are hurt feelings over this or that, but the truth is we will be digging our own graves. I hate to be the negative nelly about that, but I think our main push needs to be legislative in nature, so we can keep the status quo.”

The status quo allowed a clearly dangerous woman with a pattern of negligence to legally practice midwifery in the state of Utah. The status quo allowed a baby to die for no real reason. How is no one at the meeting able to see how horrible this looks to normal people, who generally have a reaction of total devastation when they think they could have contributed to the death of another human being? These women directly contribute to whoever ends up dying or being damaged next, and they could not care less about it.

The same woman continues on about how important it is that ‘we can all practice midwifery in the way we believe.”

People can “believe” whatever they want to about birth, it does not merit an endorsement by the state by letting those practices continue legally.

It is also worth noting that this framing of midwifery practice from the meeting, where being a midwife is about practicing in whatever way you believe to be best… is very different than the way they presented midwifery to legislators when they originally passed the direct entry midwifery act. Previously, utah midwives made it seem that there was one responsible way to practice midwifery, the way where you only accept low risk women and transport at the first sign of trouble. They claimed it was an evidence based and safe practice. I doubt that law makers care at all about what midwives believe to be true about safety (especially when they believe clearly dangerous things, which I will demonstrate in a later post), they want facts. Midwives OWE the public evidence based practices because they have the potential to be a public health menace.

Suzanne smith says- what im sensing, from the way the conversation has gone, is that everyone is very concerned about how the Valerie situation, and possibly to some extent, the Vickie Sorensen situation, may affect us all legally. So it seems to me like the big motivating factor for everyone to suddenly be interested now, is the possibility of incoming legislation. I think that’s very reasonable (chuckles), I think that’s a very real possibility, that we will face hostile legislation as a result of this, and I just want to give a little reality check to the meeting.

She notes that they may have as little as 90 days to formulate a response because of legislative session deadlines.

Again, absolutely no concern about what to do to prevent the next death, just information on how to tell politicians that the legal situation of midwives is totally acceptable even though it quite literally cost a child their life.

Political strategy is discussed. 

Suzanne Smith- “there are a lot of people in government who do not understand why our licensure is voluntary. They just think that’s the weirdest thing ever, and don’t think its right. “

That’s because it isn’t right. The proof is in the tiny grave that none of these women bothered to think about when they realized they might make less money if the public got wise to what midwifery is really about.

Tara Tulley interjects to discuss how Oregon is currently fighting against legislation to make licensing voluntary, and that at the time of the recording Oregon and Utah were the only two voluntary licensing states. She notes that if midwives there lose voluntary licensure (which they ultimately did) then it puts Utah midwives in a position that is difficult to defend.

Of course Tara doesn’t mention WHY Oregon was changing its laws- it is because of a string of deaths caused by negligence, just like the one in Utah (and the future deaths that will no doubt occur if nothing changes). The bottom line is that this type of legislation has been tested in Oregon. It was tried, and it failed spectacularly. Do Utahans want to wait for more deaths before taking action? What possible reason is there that things would turn out differently here?

Tara tulley- “I don’t know if Holly Richardson can join the committee, but I know that she will be involved and will help us.

Tara notes that Holly has been consulting with her about this issue already.

Republican Holly Richardson, who was instrumental in getting the original direct entry midwifery act passed in Utah, is consulting with the midwives about what to do about their bad PR, now that the logical conclusion of the state’s policy has become apparent. She unfortunately couldn’t attend the meeting, so she was unable to demonstrate her cold indifference to the grieving family along with the other Utah midwives in attendance.

Around 1:30 into the meeting Tara Tulley says “… And Jennee Allan- and you’ve been working with Valerie, right? As well. Oh, I’m sorry, if you didn’t want that stated. *laughs*”

That is the opposite of funny. That is the opposite of acceptable response to a tragedy. It shows that these midwives either worked to help El Halta or they found it acceptable that someone in their ranks would help. Here is a brief reminder of what a monster El Halta is:

“Valerie … wasted, like, a whole hour,” Malloy said.”She played god. She had this ego: She was the guru of birth. Valerie knew there was a problem, and she withheld the information from us.” – A mother whose child died under the ‘care’ of el halta

Without warning, she “stripped the membranes” — a procedure to separate the amniotic sac from the wall of the uterus and stimulate labor, Rose said.

“It was rough and painful, and she brings her bloody glove back out. ‘I figured I’d just help you along,’ she said. That was her attitude: Auntie Val knows best.”

“It was the single most painful thing Val did during my birth,” Rose said. “She had both of her hands inside me. I was yelling at her to get them out, but she refused because she was helping. If someone has two hands in you, and you’re telling them no, and they don’t stop — that’s why I call it a rape.” -the mother of the child who died under valerie el haltas care

El Halta arrived at the mother’s home Aug. 17 and inserted a vaginal pill that she said she received from her son, a pharmacist. El Halta had “boasted … that she used real ‘medicine,’ not herbal medicine.” Investigators later concluded the pill was Cytotec, a drug used to induce labor despite warnings that it can cause uterine rupture and other complications. The mother received three more doses.

The next evening, El Halta “seemed to have become anxious that the mother’s labor was not progressing.” She allegedly performed a painful vaginal exam on the mother, saying, “Let’s get this show on the road.” El Halta explained she was “breaking scar tissue” and “just moving things along.”

A few hours later, El Halta checked the baby’s heartbeat, which slowed and sped up again. As the mother began to vomit and have diarrhea, El Halta became “agitated and snapped at the mother and her husband.” The mother pushed for about an hour, but the baby slipped back into the birth canal. No heartbeat could be heard.”- the case report for the recent Utah death

THIS is the woman that these midwives are defending. All the talk about patient autonomy, about low risk women, about safe practices, it all disappears when they get in a room together and decide that their sisterhood is more important than…anything else really. Its even more important than other people’s lives and safety.

Tara  Tulley remarked “This feels good to me. I feel like we’ve accomplished a lot today. I’d like to thank Angie Blackett, Cathy O’Bryant, Erin Elberdean (sp?),  for all the work she has done. I think sometimes it takes a bit of a scare to get people motivated *chuckles*” 

A baby dying isn’t “a bit of a scare” to the parents, or anyone who isn’t a total sociopath.

Around 1:53 someone asked “What should we call this meeting?”  Tara replied “Call it the “oh crap” meeting!” 

You can there hear many midwives laughing. 

Laughing. About this. The death happened on August 17th. This meeting took place a little more than 4 weeks later.

Its worth noting that another prominent member of the community, Kristi Ridd Young, was also in attendance, but felt the need to say nothing. I find it deplorable that no one mentioned the baby or the family at ALL during the meeting. No one discussed what they could do to help that family or help prevent the next tragedy. The entire meeting was about protecting their own cause instead of what their cause had cost a family.

remember, this meeting IS being recorded (part one…)

I found the recording of a meeting of utah midwives after the preventable death of a baby at the hands of a serially negligent midwife (Valerie El Halta). This post aims to summarize the meeting (click this link to listen). I have it saved on my computer if they decide to delete it. Descriptions of the meeting are in bold, my commentary is in normal text.

The first 6 minutes is murmuring and obviously not the meeting itself. You can skip it.

Tara Tulley leads the meeting with a statement, and stresses repeatedly that the meeting is being recorded and the media might get their hands on the tape because it will be posted online later. She starts the meeting by talking about how she doesn’t want to discuss the charges against the midwife, just how she wants to gear up the community to prevent any legislation from restricting a midwifes ‘freedom’ to practice without any licensing.

When a preventable death occurs in a hospital, there is usually a case review where people get together to try and figure out what they can do to prevent it next time. Here we see midwives behaving as the opposite of medical professionals, as these midwives are only seeking to defend their income source. This has nothing to do with the freedom to birth at home, because women are free to do that in many other states that require licenses for midwives (meaning every state except for Utah). It is about the freedom of midwives (sometimes self proclaimed, under qualified midwives) to conduct births however they please without having to face any consequences for the outcomes.

Around 13 minutes Tara says she wants a midwives organization to exist so that they can ‘develop standards of practice’. She wants to be able to say “look we are organized and have a standard of practice” when legislators come after midwives the next time a baby dies or is permanently injured.

The unstated assumption is that all these midwives know that another midwife is going to kill someone negligently, so they need to be prepared when it happens again. Tara stresses how important this is to unlicensed midwives, how important it is to ‘keep that option open’. I’m sure reckless people would very much enjoy keeping an option open that would let them do whatever they want to.

Around 17 minutes in she discusses ‘relative conformity’, meaning that they need a standard that most people can agree on but that midwives don’t actually have to adhere to 100%.

This is the opposite of an effective standard of practice.

An un-named midwife comes up and says “the frustration is that when one midwife chooses to do something, we all pay for it.” She discusses being upset at midwives who have bad outcomes. “How do we open our hearts and say: I do love you, even though you are hurting us.”

I cannot understand why anyone would need to profess their love for Teresa El Halta just because they work in the same profession. The woman is a reckless killer who has wronged countless people over the years. She has a pattern of using interventions that she is completely unqualified and untrained in, as well as doing forced vaginal exams and procedures all while taking on extremely high risk cases. Then she moves to a new state when she gets in trouble.

Tara agrees and  with the “open our hearts” comment, then talks about how important it is to manage public perspective on “events like these” (meaning the needless death of an innocent baby).

They are clearly more worried about appearing a certain way that actually preventing future deaths. El Halta would not have been able to become a licensed midwive in Utah because she had her NARM certification revoked. That can only happen if two separate people manage to file complaints against a single midwife. NARM gives grieving mothers the run around, so it is really a testament to how terrible she was at her job that NARM formally revoked her midwifery certificate.

These midwives, who are supposed to uphold the well being of infants and pregnant women, don’t want anyone to hold them legally accountable for what they choose to do. They want the appearance of accountability by having their own group, but they are not capable of meaningful legal action. Don’t be fooled by any by laws or standards of practice that are demonstrated by UMO- they don’t mean anything when there isn’t a real consequence for violating the rules. Getting kicked out of UMO would not make someone unable to practice in the state, so what good would it do for patients? None, really. It benefits midwives exclusively.

This entire meeting I just want to scream:

A BABY WAS KILLED.
A BABY WAS KILLED BY A MIDWIFE.
AND YOU ARE WORRIED ABOUT KEEPING THINGS THE SAME?

No normal person reacts to the death of a baby this way. I don’t know what is wrong with these women, but they should not be tasked with governing themselves. Stay tuned for part two later this week.