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.

No Remorse

Vickie Sorensen, a midwife charged with negligently killing a baby, is going to trial.

I have seen people die when I worked in health care. I saw the deep sadness that surrounded those cases, as well as the institutional review systems in place that were meant to analyze what could be done differently next time. Home birth midwifery seems to lack both of those things. Providers who are under review after a death rarely feel persecuted because they know the gravity of the situation and would rather be held responsible. This is what we see from midwives, time after time:

vickie sorensen is going to a jury trialPeople familiar with the reported facts of the case would find it to be totally preposterous to dismiss these charges. Vickie instead feels entitled to a dismissal on the grounds of “common sense”.

None of this has stopped Vickie from delivering babies, by the way. That is because there is nothing in place to stop anyone from delivering babies in the state, even the serially negligent or incompetent. All they have to do is brand themselves a midwife, and legally they are one. It seems like if a midwife is being charged with reckless endangerment and manslaughter in relation to her practice, she should be monitored or sanctioned somehow until the justice system has determined innocence or guilt. This reminds me very much of the Josh Powell case, there was nothing in place to prevent him from visiting his children despite being the prime suspect in the murder of their mother. That lack of legislation cost lives, just like the lack of legislation of midwives in Utah has cost lives. No one involved with the Direct Entry Midwifery Practice Act is willing to be accountable for the lives lost. Not only do they not feel responsible, they don’t even feel sorry.

Vickie Sorensen and Camille Wilcox learned nothing from the death they presided over

The title of this post is a bold statement to make,  I know. How could someone preside over a preventable death and not change their practices? I can’t pretend to know the mental gymnastics needed to justify the practices at Pathway to Wellness birth suites. I have very good evidence that Vickie Sorensen and Camille Wilcox learned nothing from taking on a twin birth with additional risk factors, because they took on another twin birth with additional risk factors after that poor baby lost its life at the path to wellness birth suite (its called a birth suite because legally its not a birth center).

This birth story is told enthusiastically by the mother as a ‘success’, when to just about anyone else its clear that the midwives agreeing to take this case on nearly cost a baby their life. Its pretty horrifying. Here is the way the mom found Pathway To Wellness:

 I contact the midwives at the Pathway to Wellness Center. I sent them an email and asked if they would be willing to deliver twins. I also asked them if I could be supported with gestational diabetes and at the age of 41. I was so happy the day that I heard back from Camille, one of the midwives at the center, when she said “YES”- they could deliver twins, and that they don’t consider my age or the diabetes a risk because older women usually take better care of their health and I didn’t need medication to regulate the diabetes.

Wrong, wrong wrong.

Risks of pre-existing diabetes in pregnancy are numerous and requires a lot of monitoring– monitoring direct entry midwives are not able to provide.

Risks of advanced maternal age (meaning over 35) are quite similar to the risks for pre-existing diabetes, so it would not be unreasonable to think that each risk factors could exasperate the other.

If a mother is actually informed of the risks of such a pregnancy and decides to do it out of hospital anyway, then I support her right to choose out of hospital birth. But this case illustrates the problem with home birth and informed consent quite vividly- the midwives don’t believe that there is any significant risk, so they by definition cannot inform the patient of the risk. The only condition I have seen midwives reject uniformly is complete placenta previa, where the placenta grows over the cervix. Literally everything else has been fair game for them.

I don’t mean to imply the view that this was a good idea for an out of hospital birth is rare among Utah midwives, its actually quite common for direct entry midwives nationally. Trade magazines such as Midwifery Today declare that twins are just a variation of normal, along with a lot of stories of midwives delivering twins at home intended to support the view that this is entirely safe.

Anyway, one of the twins in the may 2014 delivery was very close to dying:

Mr. Alexander took us all by surprise by being born first. No wonder the midwives had had a hard time finding his heart beat during labor. He was moving down, down, down to be the first born! He was so sweet and innocent that I just laugh every time I think about holding him that first time, thinking it was Megan- but so obvious that he was not Megan.

Losing heart tones on a twin is an emergency, not a funny story. They did not know which twin was coming out first either, another total failure on their part when it comes to monitoring. Things get even worse when:

Again, another surprise! Giselle said, “I have a foot!” Megan’s feet were down and coming through the birth canal. The little girl must have turned around right after Alex was born! Giselle continued to help Megan with a now breech delivery… one foot, two feet…I reached behind me and felt little baby feet kicking in the water… legs, chest, one arm, then two arms were out. John could see that Megan stopped kicking and that her body was floating in the water with no movement.

There are a few breech presentations, feet first  is called a footling breech. It is the most dangerous breech presentation. I have an emergency childbirth guide for military OBGYNs that explains how and why footling breech births are the absolute worst presentation with a ‘significant’ increase in risk for complications and death.

Unbelievably, it gets even worse:

 When Megan was completely out of the water, she wasn’t able to breathe. The midwives held her white, limp body and started calling her name. She was given a breath through mouth-to-mouth resuscitation and they tried to stimulate her with pats and calling her name. Megan took one gasp and then stopped breathing again. They checked her heart and it was still beating. The cord was cut and the team rushed Megan into the other room and onto the crib so they could continue the resuscitation work.

John and the midwives continued to stimulate her, give her mouth-to-mouth breaths and also used some cayenne solution on her chest to get her respiratory system jump started. After about 4 minutes, Megan was breathing successfully on her own.

We found out later that the two placentas were fused together. When Alex was born, the placentas detached. By the time Megan was born, just 14 minutes after Alex, Megan’s placenta had completely shut down.

No one called 911 at any point during this, but they did pour pepper on a baby to try and get it to breathe. They are lucky that their child did not die, but there may have been some damage done by the lack of oxygen. The mother continues:

 We think Megan missed out on about a minute of oxygen from being delivered to her via the placenta. (fyi- newborns that miss around 20 minutes of oxygen may start to experience brain damage.)

Not sure why they think she only missed one minute of oxygen. They do not use electronic fetal monitoring so everyone has to guess about how long the baby went without oxygen.I don’t know who told her a baby can hold its breath for 20 minutes without brain damage (probably her clueless midwives), but they were lying to her. Every source I could find said 5 minutes before hypoxia sets in, even Ina May Gaskin  says so and she is the big name in home birth midwives. All the other indicators of hypoxic brain injury require hospital equipment to detect, and a lot of the time these brain injuries do not become apparent until years after the birth. There is no way of knowing if that tiny baby came out of this unscathed without following up in several years.

The mom is happy because she thinks she received great care. Her babies weren’t dead, although they came much closer to death than they ever needed to, and were attended by incompetent practitioners who think that sprinkling pepper on a baby is a better idea than calling 911 when they aren’t breathing.

I realize the birth story I linked to may soon disappear once it reflects poorly on the midwifery community (a story about a near dead breech birth was removed after I reported on it before), so I have saved this one in its entirety on my computer just in case. I hope the prosecution for the VIckie Sorensen case is paying attention- this additional birth shows a craven disregard for the life of newborns and mothers on Vickie Sorensen’s part. Delivering one dead twin wasn’t enough to discourage her from taking on twins again. Most people try to learn from their mistakes, especially when they are costly to others, but this mother-daughter midwife team seems to think that its normal or acceptable to ignore what they have been responsible for (when the outcome is bad, anyway). Regular people would be tormented by even possibly having played a role in a newborn death, these midwives are so unconcerned about it that they decided to risk it again.