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

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

 

Link

this is the future, if we choose not to learn from the past

Safer Midwifery for Michigan is the group that inspired me to start Safer Midwifery Utah. The founder of SMM lost their child during a breech birth by a home birth midwife. They won a settlement but the midwife filed for bankruptcy so she would not have to pay. The same midwife is still practicing (Audra Post), and she is still willing to attend a breech birth. Safer Midwifery for Michigan says that she has attended at least 2 deaths, and on Audra’s web page she claims to have attended “over 300” births. Lets round it up to 400, to be charitable, and then she has a notably high death rate of 1 per 200 births. That is shameful, absolutely shameful. Direct entry midwives are like walking cases of dunning-krueger effect, their incompetence is what feeds their sense of confidence in their practices. 

This is the future for our state if something is not done soon. I have no doubt that our state has one or several Audra Posts in our midst, but its impossible to hold anyone accountable in a system like ours or find out who they are until its too late. The victims of home birth midwives can be made silent in many ways. It takes remarkable strength and dedication to go through a lawsuit when the plantiff knows the judgment will likely go unpaid, and their child will never be brought back by a judgment. To rehash every detail in front of a judge, to your lawyer… the pain of it makes many loss parents turn away from fighting. It is completely understandable. Some might believe the convenient lies that their midwives cook up to cover up what happened. Without very strict record keeping requirements there is no way to determine exactly how many babies died preventable home birth deaths in Utah, though if Oregon’s numbers are any indication its far too many (these numbers were collected when Oregon had the same legal requirements for midwives that Utah currently does). 

Please click on the action guide on the left side of the page to contact your legislators about preventing the next home birth tragedy. 

Utah Midwive’s Association statement on the Vickie Sorensen trial

Here is the Utah Midwives Associations official statement:


We, the Utah Midwives Organization, are aware of the reported charges against Vickie Sorensen, a midwife in Cedar City, UT. The charges are very serious. We are always concerned when there has been loss of life or potential misconduct of a midwife. 

Midwifery care is meant for normal pregnancies proceeding in a normal manner, and there are definitely times when pregnancy is outside the scope of midwifery practice. We cannot comment on this case specifically as it must work its way through the legal process. 

We offer our condolences to the family who has suffered the loss of their child.

 
This statement reminds me a lot of when MANA’s death rate came out. They said that midwifery care is for low risk pregnancies (as to excuse the astronomical rates of death for twins, vbac, and breech births), but did not make any practice recommendations. The Utah Midwives Association has done the same thing- they have said midwifery care is only appropriate for certain pregnancies, but does not have plans to actually change anything legislatively to ensure that midwifery care is only dispensed to women with low risk pregnancies. 
 
It also reminds me of the Valerie El Halta fiasco. When that happened Utah midwives also acted as though this was some kind of isolated incident or a deviation from the normal, but I happen to know that two of the midwifery schools in Utah teach breech, vbac, and twin births to students. I know that the trade magazine for home birth midwifery calls all these conditions “a variation of normal”. I’ve read Ina May Gaskin books that say the exact same thing. 
 
The standard you walk past is the standard you accept, and unless UMA lobbies for common sense policies to ensure the safety of moms and babies I will be forced to assume that they find the legislative situation of utah midwives acceptable. 

The mention of the family is appreciated. I wonder if their condolences extend to plans to make sure no other family ever has to endure such a tragedy again?

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. 

Utah midwives make a mockery of peer review

Peer review is a process that exists in many disciplines, usually ones with high stakes decision making like medicine or science. The purpose of peer review is to verify the truth, and sometimes to recommend a disciplinary action (if the peer review arose out of an incident that ended poorly).  Peer review can be very scary for those who are going through it, since the idea is to be critical of a person’s actions or ideas. No matter how scary peer review is for the person being reviewed, it is absolutely essential to everyone else that it be done. Drugs cannot be put on the market because the researcher’s feelings might be hurt if someone points out a flaw in their study of its safety. Doctors cannot be allowed to keep practicing in a negligent manner because the peer review board thinks doctors should stick together. Everyone recognizes that patients and the public in general are the reason for peer review.

 

…everyone except direct entry midwives of course.

 

I found the utah midwive’s association’s peer review protocols, and they are an absolute joke. You aren’t allowed to question why a midwife performed a certain action. You will be asked to leave if you ask why someone chose the course of action that they did- this means even if someone died or was disabled because of the action, other midwives aren’t allowed to be critical of it.  You are only allowed to ask if they considered a different course of action. You aren’t allowed to hurt another midwife’s feelings, that seems to be the main concern throughout the document. They do peer review for “educational” reasons, although I don’t know how much education can be gleaned from a discussion where critical thought (which generally involves asking hard questions) is not allowed.

Interestingly enough, you also aren’t allowed to be honest about your case if it involved anything illegal. Here is what the practice guidelines say:

  • Please do not present cases in which there has been or may have been illegal conduct, such as an unlicensed midwife administering medications or a licensed midwife acting outside her scope (delivering twins, for example). We want the review to be a safe place where we can learn from each other. Announcing that you have engaged in illegal or questionably legal activities as a midwife puts you and each participant in an emotionally, ethically and legally perilous situation. Just don’t do it!

 

How are the midwives who are doing illegal things supposed to learn about the dangers of it if they aren’t allowed to discuss it in peer review? The utah midwive’s organizaton has lobbied to make it so that unlicensed midwives can take on any client they feel comfortable with, regardless of the risk level involved, and now they refuse to even let these women learn the error of their ways through a peer review instead of by personally maiming or killing someone. Its deplorable. It is worth noting that the majority of midwives in utah do not decide to become licensed, likely so they can practice outside the state’s guidelines. The Midwive’s College of Utah and Community School of Midwifery both teach skills for homebirths that fall outside the license midwife’s standard of practice (such as twins and breech births at home). These practices are encouraged in the name of “trusting birth”, and bragging rights of course. I’m sure its wonderful to be the breech expert in town like Melody Pendleton claims to be.

 

You can contrast their joke of a peer review process with an actual hospital peer review protocol. 

When the findings of the assessment process are relevant to an individual’s performance, the medical
staff is responsible for determining their use in peer review and/or the periodic evaluations of a
licensed independent practitioner’s competence, or in connection with any corrective action, in
accordance with the procedures and standards set forth in the Medical Staff Bylaws, Credentialing
Procedures Manual and Corrective Action and Fair Hearing Plan.

….

Peer review is the review of the clinical activities of members of the Medical Staff by other qualified
practitioners with comparable training and experience who can render an unbiased opinion on the quality of
care

 

Peer review is supposed to be about improving the care provided. Advising participants to lie about their activities or to avoid hurting anyone’s feelings is just another piece of evidence that direct entry midwives aren’t professionals, they just pretend to be to deceive more Utah families into hiring them.

If your baby dies or is injured in a home birth, if your midwife fails to show up or lies to you about the safety of your pregnancy, if your midwife does ANYTHING she isn’t supposed to, these are the people you are supposed to be able to turn to. But they will do nothing to help you, they turn their backs on anyone who does not aid them in the goal of hiding the deaths and injuries caused by home birth midwives in our state.