Arkansas Midwife Loses License - Mother Speaks Out Merged

[SweetFellowshipper]

19 hours ago, SilverBeach said:

Women today have more options than ever. I haven't seen FJ members bashing non-doctor births, but some are reluctant to take any risk at all since things can go south very quickly, even when the pregnancy has been non-eventful. So, a doctor and medical facility is considered by many to be the gold standard.

When you see posts implying that doctors are safer, as you put it, you can certainly challenge that without saying the opposite, which in my opinion is no better. 

BTW I used the term imply because you did not link to any studies supporting your assertion. Also, saying that it depends on a huge number of factors, and there is no conclusive right answer for everyone, contradicts a blanket statement that doctor assisted births are less safe.

I never said what you posted was offensive. I said it was not useful. I stand by that, because an us vs. them approach is not beneficial to anybody. A robust discussion of advantages and disadvantages to all birthing approaches is good, realizing that a woman's personal choice is hers and hers alone. Unless she is blatantly careless and unnecessarily risking her and the baby's health, it's all good.

For low risk births, they have been found to be safer. For high risk, they have been found to be less safe. Since the vast majority of pregnancies are low risk (and thus low risk is "average"), I don't think my statement was contradictory. I said throughout all my statements that I valued choice and that people have different environments, experiences and desires that make them choose whatever they choose. 

 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2742137/ Here's one good study from Canada. It includes only low risk pregnancies. I can post more if you like but I didn't want this to devolve into a back and forth study comparison. Regardless, that's a recent one with a fairly large sample population so you know it's not just my random opinion. And yes, I do believe *based on my research* that in general, midwife attended births are safer for low risk pregnancies as long as the midwife is well trained, due to the tendency towards unnecessary obstetric interventions in other situations. That doesn't mean I look down on other choices or that my statement isn't helpful (to whom?), it means that is my choice based on my research. If others' research leads them to a different conclusion, that does not offend me and I'm happy their choice is what it is. Here are a couple others: 

http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2648.2012.05998.x/full

http://www.sciencedirect.com/science/article/pii/S000293781000671X

http://onlinelibrary.wiley.com/doi/10.1111/j.1523-536X.1997.00004.pp.x/full

Re: bashing on FJ, that's always a dicey thing because there will always be people who feel there has been and people who feel there hasn't, especially if their opinion is popular. I will say that I did get a PM from another user who thanked me for bringing up the midwife issue/paternalism in hospitals because they felt the same way about FJ and its bashing of anything but doctor-attended births but were afraid to say anything because it seemed to be unpopular here. So I'm not the only one with that opinion. Of course everyone's mileage varies. 

I believe that's my last post on the topic as I've said my piece. Moving on!

[SweetFellowshipper]

1 hour ago, Denim Jumper said:

The problem is that the 10-15% recommendation isn't based on empirical evidence, but on observing the change in maternal and perinatal mortality rates. The WHO observed that mortality rates decrease when c-section rates rise to 10%, but don't decease further when the c-section rate goes higher than 15%. However, WHO also acknowledges that mortality rates should not be the only consideration, and the 10-15% recommendation is not applicable across the board. 

ETA: not to mention, that 10-15% figure is from 1985. A lot has changed since then, such as increased obesity, women having babies later in life, more high-order multiples. All risk factors for a c-section birth. 

Yes, but I think there's significant evidence that c sections are indeed overused. http://m.acog.org/Resources_And_Publications/Obstetric_Care_Consensus_Series/Safe_Prevention_of_the_Primary_Cesarean_Delivery?IsMobileSet=true

[Denim Jumper]

10 minutes ago, SweetFellowshipper said:

Yes, but I think there's significant evidence that c sections are indeed overused. http://m.acog.org/Resources_And_Publications/Obstetric_Care_Consensus_Series/Safe_Prevention_of_the_Primary_Cesarean_Delivery?IsMobileSet=true

I don't disagree, but I think "overused" isn't really an accurate discription; how does one determine whether it is overused, aside from Monday Morning Quartbacking?

The problem is there is no "ideal" c-section rate, and trying to adhere to one puts mothers and babies at risk, in light of the poor outcomes that c-sections prevent. 

Planned c-sections are lower risk than emergency and crash c-sections, so in a situation where a safe vaginal delivery isn't very likely, it makes little sense to delay a c-section until it becomes an emergency situation. 

[Denim Jumper]

@SweetFellowshipper

Just as an illustration about c-section "overuse", I'll use two of my birth experiences.

The first was a planned c-section. By NCB standards, that would automatically qualify as "unnecessary"... however, given the circumstances (macrosomic, floating vertex, 42.5 weaker) the odds of a vaginal delivery was sketchy enough that it made sense to just go ahead with a planned c-section, rather than wait until it became nessecary.

Contrast that with my third birth. It was indeed a vaginal birth, which I guess is considered a success in some peoples' view... but had a c-section been done earlier, my baby wouldn't have contracted group b strep and I wouldn't have ended up with a 4th degree tear and surgery immediately after birth. I'm not angry because I know my midwife couldn't have predicted the outcome, but it taught me that sometimes we don't know until after the fact whether or not a c-section could have prevented complications.

[SilverBeach]

1 hour ago, SweetFellowshipper said:

For low risk births, they have been found to be safer. For high risk, they have been found to be less safe. Since the vast majority of pregnancies are low risk (and thus low risk is "average"), I don't think my statement was contradictory. I said throughout all my statements that I valued choice and that people have different environments, experiences and desires that make them choose whatever they choose. 

 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2742137/ Here's one good study from Canada. It includes only low risk pregnancies. I can post more if you like but I didn't want this to devolve into a back and forth study comparison. Regardless, that's a recent one with a fairly large sample population so you know it's not just my random opinion. And yes, I do believe *based on my research* that in general, midwife attended births are safer for low risk pregnancies as long as the midwife is well trained, due to the tendency towards unnecessary obstetric interventions in other situations. That doesn't mean I look down on other choices or that my statement isn't helpful (to whom?), it means that is my choice based on my research. If others' research leads them to a different conclusion, that does not offend me and I'm happy their choice is what it is. Here are a couple others: 

http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2648.2012.05998.x/full

http://www.sciencedirect.com/science/article/pii/S000293781000671X

http://onlinelibrary.wiley.com/doi/10.1111/j.1523-536X.1997.00004.pp.x/full

Re: bashing on FJ, that's always a dicey thing because there will always be people who feel there has been and people who feel there hasn't, especially if their opinion is popular. I will say that I did get a PM from another user who thanked me for bringing up the midwife issue/paternalism in hospitals because they felt the same way about FJ and its bashing of anything but doctor-attended births but were afraid to say anything because it seemed to be unpopular here. So I'm not the only one with that opinion. Of course everyone's mileage varies. 

I believe that's my last post on the topic as I've said my piece. Moving on!

Your first paragraph would have avoided a lot of confusion if you had said that in the first place.

I appreciate that others feel like you do, but it would be more helpful for them to post in the thread rather than render opinions by PM. Nobody here bites. We even have a thread for unpopular opinions, so have at it! 

This too is my last post about this, I am so far past having a dog in this fight. I do want all women, including my DD, to have the best birth experience possible, with positive outcomes for mother and child. There are various ways to accomplish this, I think we agree on that. 

 

[SweetFellowshipper]

1 hour ago, Denim Jumper said:

I don't disagree, but I think "overused" isn't really an accurate discription; how does one determine whether it is overused, aside from Monday Morning Quartbacking?

The problem is there is no "ideal" c-section rate, and trying to adhere to one puts mothers and babies at risk, in light of the poor outcomes that c-sections prevent. 

Planned c-sections are lower risk than emergency and crash c-sections, so in a situation where a safe vaginal delivery isn't very likely, it makes little sense to delay a c-section until it becomes an emergency situation. 

I'm just going with what the medical professionals said. 

[Denim Jumper]

38 minutes ago, SweetFellowshipper said:

I'm just going with what the medical professionals said. 

Yes. ACOG unequivocally states the risks must be weighed against the benefits, in terms of whether to perform a c-section or not. The consequences performing a potentially unecessary c-section must be viewed in light of the consequences of failing to perform a timely c-section. 

[Iamtheway]

I chose the hospital that had the shortest way between the delivery and the operating room. I fought hard to have that baby and I was not going to risk anything. 

In Sweden most babies are delivered by midwifes (educated ones) in hospital. You only see the doctor if something is wrong. I've never heard of anyone doing a planned home birth so I don't know how that would work. 

I feel like everyone here tries to stear you to a vaginal birth and it can actually be quite hard to get a planned c-section. I had such a long delivery I had two different midwifes. The first one wasn't great but I liked the second. (This might have someting to do with the fact that the first one was there for all the worst parts and the second one actually delivered the baby.) 

The epidural man though. I loved him. And was only half joking when I suggested we should name our son after him.

[ClaraOswin]

From a "medical" standpoint, my c-section would be considered "unnecessary." But due to some reasons I don't care to go into on a public forum...it was 100% the best choice for me. I don't really care what the studies say about it though.

[aurora_boo]

So much one-up-man-ship and pissing in corners about drugs/sections/vaginal births.

Just get the baby out and enjoy it once it's here.

The rest of it just sounds really ridiculous.

*YOU* sound ridiculous.

[DaniLouisiana]

I've had two sections-one for breech and huge and the second for a wedged in head. I've also had a VBAC. If I had to do #3 over again-I would have had a another section. I had more complications from the VBAC than from either section. Baby was also sleepier and hard to get started nurser from the VBAC. DD, who had a section with GrandBoy, will be having a scheduled section for #2, as she remembers vividly how miserable I was every time I went to the restroom for the first three months after Kiddo.

[WhatWouldJohnCrichtonDo?]

11 hours ago, Bethella said:

It depends entirely on the state. In Oklahoma, no. In Arkansas, yes. She would need to have supervised practical experience, pass the NARM exam, and pass the Arkansas Midwife Regulations Exam to be licensed. Details can be found at http://www.healthy.arkansas.gov/aboutADH/RulesRegs/LayMidwifery.pdf. Here's a state-by-state listing of midwifery laws http://mana.org/about-midwives/state-by-state.

snipped

Thanks for the links! The last time I tried Google to research the midwifery regulations in my state, the third site I read was a Sovereign Citizen blog that was promoting home births so that "our precious babies wouldn't get registered by the federal government and be given ID microchips". 

And for the record, I had 2 hospital births, both with an OB/GYN and I felt as respected and in control of my choices as was possible. I also know a mom who had a hospital birth with a CNM and a mom who gave birth at a birthing center with a midwife (not sure which type). I definitely agree that there are benefits to having a choice of provider and location. My first 3 nieces/nephew were born at 1 hospital and the last 2 were born at another. There was quite a difference in the culture of the 2 hospitals, which helped me choose where I gave birth. It must be difficult in more rural areas, where choice can be very limited. (My state is more rural than urban, but I've only ever lived here, in the biggest city.)

[feministxtian]

My last birth was almost 27 years ago...I've said it before and I'll say it again...MOST women (especially the ones here) are smart enough to educate themselves regarding birthing choices and make the ones they feel are best for THEM. Personally, i don't give a damn how your baby got here (or mine)...they're here, they're healthy, they're loved. That's ALL that counts. 

[Gillyweed]

My brothers and I are all C-section babies. My oldest brother needed it because he got stuck in the birth canal. I din't think my 2nd needed one, but the doctor didn't advise a VBAC (my mom is very small). I needed one because I was a very high risk pregnancy (my mom was in a car crash while pregnant with me). We're all 90s babies  

Personally, if/when I have kids I think I'll be more comfortable having a C section just because I'm so small. 

[WhoompThereItIs]

29 minutes ago, Gillyweed said:

My brothers and I are all C-section babies. My oldest brother needed it because he got stuck in the birth canal. I din't think my 2nd needed one, but the doctor didn't advise a VBAC (my mom is very small). I needed one because I was a very high risk pregnancy (my mom was in a car crash while pregnant with me). We're all 90s babies  

Personally, if/when I have kids I think I'll be more comfortable having a C section just because I'm so small. 

Same. While pregnant with my older brother, my mom's response was "cut me open Doc!" after hearing a woman screaming bloody murder during natural childbirth down the hall. This was the early 1980s - In those days they didn't advise VBACs, so I was born via C-section as well.

[Jana814]

35 minutes ago, WhoompThereItIs said:

Same. While pregnant with my older brother, my mom's response was "cut me open Doc!" after hearing a woman screaming bloody murder during natural childbirth down the hall. This was the early 1980s 

I'm sorry but it really funny that your mother said that. I probably would do the same thing. 

[ClaraOswin]

2 hours ago, Gillyweed said:

My brothers and I are all C-section babies. My oldest brother needed it because he got stuck in the birth canal. I din't think my 2nd needed one, but the doctor didn't advise a VBAC (my mom is very small). I needed one because I was a very high risk pregnancy (my mom was in a car crash while pregnant with me). We're all 90s babies  

Personally, if/when I have kids I think I'll be more comfortable having a C section just because I'm so small. 

If it helps, many petite women still have a wide enough pelvis or whatever to give birth without complications. And a larger woman can actually have a narrow pelvis. I'm not sure you can really tell just by looking at someone.

If there are no complications, a vaginal delivery has a much easier recovery than a c-section. A c-section is no walk in the park, that's for sure.

[The butcher's wife]

I got to witness some births during my nursing training this summer, and talked to the midwife about women being too narrow/small to have a big baby (I used to be afraid of this issue because my ex was 6'3" and I'm rather small and despite having a big butt actually have tiny, narrow hips). She said she has seen tiny women give birth to 10 pound babies with ease and has seen women who are 6' struggle giving birth to 6 pound babies. Apparently the outside appearance of the hips doesn't have too much to do with the actual capacity and the width of the birth canal. Also of course it depends on the size and head circumference of the baby, and oftentimes at least the predictions of how big the baby will be are more than a little off.

Mums after a c-section are often in a lot of pain and barely able to get up for the first four days or so (though I've also seen mums who were right back on their feet and getting by on surprisingly little pain meds. But it's rare.). The mums who delivered vaginally were usually able to take care of their baby right after birth and could take them on a little walk the next day. But I still get considering a c-section. Giving birth is hella scary.

[SweetFellowshipper]

6 hours ago, ClaraOswin said:

If it helps, many petite women still have a wide enough pelvis or whatever to give birth without complications. And a larger woman can actually have a narrow pelvis. I'm not sure you can really tell just by looking at someone.

If there are no complications, a vaginal delivery has a much easier recovery than a c-section. A c-section is no walk in the park, that's for sure.

It's major surgery so should be taken seriously. 

 

22 hours ago, Denim Jumper said:

Yes. ACOG unequivocally states the risks must be weighed against the benefits, in terms of whether to perform a c-section or not. The consequences performing a potentially unecessary c-section must be viewed in light of the consequences of failing to perform a timely c-section. 

Yes, never said any different (and I don't think anybody else did either, though admittedly I'd need to go back). They also said that the huge increase means that many of them are likely to be unnecessary. It's always wise to be careful about major surgery. Many c sections are needed. It doesn't mean all of them are or that doctors always truly have their patients' best interests in mind rather than their own when they choose them. 

I don't think some being necessary negates the fact that many are not, which was ACOG's point. 

[Denim Jumper]

1 hour ago, SweetFellowshipper said:

It's major surgery so should be taken seriously. 

 

Yes, never said any different (and I don't think anybody else did either, though admittedly I'd need to go back). They also said that the huge increase means that many of them are likely to be unnecessary. It's always wise to be careful about major surgery. Many c sections are needed. It doesn't mean all of them are or that doctors always truly have their patients' best interests in mind rather than their own when they choose them. 

I don't think some being necessary negates the fact that many are not, which was ACOG's point. 

Again, I agree with all of that; the problem is that whether a c-section was performed unnecessarily or not can only be determined in retrospect. When an OB or midwife has the patient in front of them, the best they can do is make a judgement call based on each individual case; they do not have the advantage of knowing ahead of time what the outcome would have been if a different decision was made. And at the heart of the matter is the fact that they are FAR more likely up be sued for failing to perform a timely c-section, than for performing one that turned out not to be necessary.

[SweetFellowshipper]

28 minutes ago, Denim Jumper said:

Again, I agree with all of that; the problem is that whether a c-section was performed unnecessarily or not can only be determined in retrospect. When an OB or midwife has the patient in front of them, the best they can do is make a judgement call based on each individual case; they do not have the advantage of knowing ahead of time what the outcome would have been if a different decision was made. And at the heart of the matter is the fact that they are FAR more likely up be sued for failing to perform a timely c-section, than for performing one that turned out not to be necessary.

Yes, but either way it's the patient who suffers. The litigiousness of the mainstream medical system is why some people are opting out for their prenatal care. Decisions should be made based on what is truly better for the patient and whether the benefits outweigh the real risks, not a possible lawsuit. It's a shame. 

[Denim Jumper]

4 hours ago, SweetFellowshipper said:

Yes, but either way it's the patient who suffers. The litigiousness of the mainstream medical system is why some people are opting out for their prenatal care. Decisions should be made based on what is truly better for the patient and whether the benefits outweigh the real risks, not a possible lawsuit. It's a shame. 

That's the thing: doctors don't get sued unless something goes very wrong. The best possible outcome (safe birth with a live, healthy mom and baby at the end) is what prevents lawsuits. In other words, birth interventions aren't just about preventing lawsuits, but about preventing the injuries and deaths that lead to lawsuits. 

[socalrules]

It's interesting we are having a discussion about using a doctor versus a nurse midwife. Both sides involve a professional truly educated in the child birth. Fundies seem to deliberately seek out "midwives" who have little to no real education and who are more likely to look the other way when bad decision is made, I.e let's wait a little longer and maybe that baby will slide out, even though a true professional would know it wasn't going to happen. 

I wonder for fundy home births, how many go bad because they only have a Jill level midwife with no real medical training? What worries me is that they don't notice the signs of something going wrong that a doctor or nurse midwife would spot in a second. My friend had to have an emergency c-section when her son's heart rate dropped dramatically and she was already at the hospital. I don't know all the details other than it was a life or death issue and her son had to stay in the hospital for five days. Had she been at home with - fundy midwife neither she nor her son would have survived. What do these fake midwives do in that situation? Do they even notice there is a problem? What has to happen before they suggest calling 911? I wonder if fundy midwives that suggest seeing a doctor or going to the hospital get a negative reputation in their part of the universe. 

[Jana814]

I don't have kids but if I did I would want to give birth in the hospital. Just in case something goes wrong. 

[Joyleaf]

Considering studies about homebirth:
Studies from other countries aren't really helpful when looking at the situation of the country you actually plan to give birth in.
Midwife education, equipment available for midwifes, experience with homebirths, cooperation between hospitals and homebirth midwifes, hospital transfer times, homebirth regulations, and so on - standards in general can vary widely and influence the outcome.
There is a huge difference between a homebirth in Uganda and in Great Britain, but also still a big difference between a homebirth in the Netherlands and in the US.

I found this pdf an interesting read as it touches the subject of midwife education in the US as well which studies are generally used when talking about the "safety" of homebirth in the US. It's a long read but maybe you'll find it interesting as well.

http://www.honestmidwife.com/download-pdf-2/