I try not to write about birth stuff here too often. After all I’m not pregnant nor will I be. Four kids is enough I think. For me anyways. However, this is not to say I don’t still care about the world of birth just because I’m done having children. Hey, someday I’ll be a grandmother. So sure, I want to pave the way for safe birth options for my daughters and future daughter in law.
My birth experiences were just fine by the way. I have no major qualms about any of them. But that’s not to say there is not room for improvement. But you see, there are some things that scare me which has really only come to my full attention since I had my youngest daughter. This trend of homebirths which I have come to learn here in the United States is currently not as safe as it could and should be. Homebirths are being attended by people who don’t have the knowledge and experience to deal with things should something go wrong. And mothers and babies are dying or becoming severely injured from this.
Now I know, I know, babies die in hospitals too. Yes, they do and it’s sad. And sometimes it’s after all the knowledge that is available to us with modern medicine is used and sometimes it’s after someone in the hospital screwed up. But do you know what the difference between those deaths and injuries at home and in the hospital are? The neglectful ones that is. The difference between home and the hospital is at the hospital there’s accountability. If someone in the hospital does something wrong they are punished. If a doctor had numerous babies die due to his neglect then he would lose his license and couldn’t practice medicine. Insurance pays someone for these wrongful deaths and handicaps due to neglect. And this hurts doctors and hospitals because those insurance premiums go up.
Well, the doctors will just pass the buck to the patients, right? We’ll be the ones who end up paying that cost in the end it doesn’t matter to the doctor. Well, of course it does. If one doctor is charging $5000 to deliver a baby and another doctor is charging $2500 to deliver a baby, who will you go with? Not to mention it’s public record these outcomes. You can find out what a doctor’s stats are. How many lawsuits have been filed and paid out on.
Now lets look at a midwife. Oh they are so nice. They truly love mothers and babies. They aren’t in it for the money like those stingy doctors. But wait, does a midwife carry malpractice insurance? No? Why not? I get in my car everyday to drive somewhere. I have no intention of harming anyone, but by law I must carry insurance on my car. It protects me and it protects other drivers. I’m having an off day. The kids are screaming, I’m functioning on an hour sleep in a 72 hour period, and my dog just died. But I have to drive my daughter to her doctor’s appointment. So I get behind the wheel and in my condition I do something stupid and I side swipe a few cars on the road and end up in a ditch. Now I didn’t mean to do this. I wasn’t out to get those cars, but now I have caused a lot of damage that I can’t afford to remedy. Good thing I have insurance. Now I won’t go broke and those people that I hurt through my negligence will not have to eat the cost or go to their insurance to have it paid for.
So why exactly wouldn’t a midwife need to have insurance? Well, we need to keep those prices affordable for people, right? But then when tragedy strikes what happens? We get an I’m so sorry, but it was God’s will. Life goes on. The midwife isn’t the one who now becomes financially responsible for that brain damaged baby. She doesn’t have to pay funeral expenses. She doesn’t have to go on with her life forever playing the what ifs. Her hands are clean and she can go onto the next mother and child and just keep doing it over and over again leaving everyone else to pick up the pieces. Does that sound right to you? No? Me neither.
And who’s going to be any the wiser? Would you put the outraged mother of the baby you killed on your resume for future clients to call? Do you think lawyers are taking these cases? Of course now, a midwife will cry poor and no one will get any money. So there’s no prosecution and there’s no lawsuit and therefore no paper trail. Because who’s the midwife reporting to? Herself! Well, she’d probably say God, but really is God making those numbers super clear to people?
So that’s why it’s so important to me when I see groups like MANA (Midwife Alliance of North America) blowing smoke up people’s butts. Saying that a baby’s death is just an unfortunate birth outcome. And this past weekend MANA apparently had a conference where they were getting people all fired up with just such words. And for me, it made me angry. And it made some of my friends angry. So we tweeted our concern to the MANA12 hashtag. We asked why are babies and mothers dying in homebirth? Why is there no accountability for midwives? Where are the numbers which prove your premise that homebirth is as safe as hospital birth and how did you compile those figures? I think the answers might surprise you when it’s put into perspective.
MANA wants midwives to be held accountable. At least that’s what MANA Community on twitter was telling me. They should be held accountable through licensure in all 50 states. Okay, that’s all well and good, but why aren’t we there yet exactly? MANA was established in 1982. In 30 years of their existence they haven’t been able to get all 50 states to see that midwives need to be licensed? What exactly are they waiting for. If that’s what they want, then why are they not lobbying the lawmakers to make that happen?
And really in the meantime what’s a person to do? Oh well too bad you went with an unlicensed midwife, I guess you should have known better. Lets blame the parents. They don’t have enough on their plate right. One midwife kills 8 babies, but it’s in a state without license so we can’t hold her accountable. Well, MANA what exactly do you care about? Actions speak louder than words. And if you are saying the only way that midwives can be held accountable is by them having to have a license to practice like every other medical profession needs and in 30 years we aren’t there yet, then now what?
What do I say to my friends whose babies have died? Well, I’m sorry, but hey MANA believes there should be accountability. You hold onto that. That should keep you all warm and fuzzy at night. Oh, that doesn’t make you feel better? Well, I don’t know what to tell you then. Because if your state isn’t going to regulate them with a license, then MANA can do nothing for you. Thank you for that MANA.
Of course the fact that midwives have been practicing so long WITHOUT a license sure has me wondering what kind of accountability making it a licensed profession will have in the beginning. Will things just go back to status quo? If a midwifes license is revoked I guess she’ll just be doing births in back allies. What a great regulatory system that is. Thank you oh so much MANA for saying we need accountability. You’re such a help.
The proof is in the numbers, right? So MANA what are the numbers? MANA’s response to that was you want the numbers, we’ll give you the numbers. The numbers are comparable to what we found 12 years ago when it was mandatory to report even though now reporting is voluntary.
Wait, did you get that? So in 2000 it was mandatory for midwives to report their numbers and what we’re seeing today is that even voluntarily the numbers are just about the same. Isn’t that wonderful? No? You mean you want actual numbers? Oh, those won’t be released until the article is published in 2013. So you’re sitting on numbers that show that birth is as safe at home as it is in the hospital, but you can’t share the numbers?
And did anyone else notice that they are saying numbers which were voluntarily reported. They didn’t have to tell us the bad stuff, but they did anyways. And look it’s just as good as it was 12 years ago when they HAD to tell us the numbers. Are you feeling all warm and fuzzy yet? Well, I’m sure not. Handpicked numbers does not equate to factual statistics of the safety of homebirth. Oh, but what I fail to realize is these stats were entered prospectively, meaning before the moms gave birth. So therefore, we are to come to the conclusion that homebirth is safe because they were cherry picked before birth and not after.
I’m still not feeling good about this. And here’s why. You see the premise behind homebirth is that it is only done with the most low risk of patients. A young healthy mother, without Gestational Diabetes, high blood pressure, multiples, breech presentation, GBS positive, or previous c-section. There are more, but just off the top of my head these are situations which should rule a mother out of homebirth. Four out of six of those things are exactly why I said no to homebirth with my last even though I thought about it. Now while a midwife might say oh these are all just a variation of normal to her patient I’m sure she knows that with these conditions the chances of complications rise exponentially. So to make sure the homebirth movement looks good and she’s not out of a job (because she doesn’t want anything clouding that agenda that homebirth must appear as safe as hospital birth with fewer interventions) she only inputs the patients she sees who are truly low risk. Come on MANA, you might get some people with your bait and switch, but you ain’t foolin’ me. Voluntary means they can disclose what they want to. Therefore when comparing voluntary to mandatory it’s like comparing apples to oranges.
What about the transfers? Yes, I know when something goes wrong we want the midwife to transfer to the hospital. But we want her to do it in a timely fashion. We don’t want her to wait until it’s too late. So the baby dies after being transferred to the hospital, but is that on the midwife or hospital statistics? It goes on the hospital. That’s not included in the numbers. And we may never know how many times a quicker decision by a midwife to transfer would have saved a life, but I would imagine it happens more often than MANA would like to admit.
And did anyone take notice that even if voluntary numbers were acceptable as proof that there has been no improvement in a decade? The numbers are as good as the numbers from 2000 is what we’re being told. Well gee I would hope to see improvements in that time. I mean don’t we want to see doctors do better and save more lives? Why wouldn’t we want to see that from midwives too?
So how’s everyone feeling about those statistics now? The non existent ones which MANA is hanging onto until sometime in 2013. I’m not having much confidence in MANA here. I wouldn’t put it past them even to have some sort of hold up on that 2013 publication either. So no one hold your breath on seeing any actual statistics from MANA. It all appears to just be a bunch of smoke.
MANA Needs To Grow Up
After much discussion with MANA about the accountability and the validity of the statistics which we have STILL not seen MANA has decided that my questions are not in need of answering. Nope, they would rather hold me to their community guidelines on a site that they don’t even own. After I used the term “baby killer” I was directed to their rules for civil debate. Well you know what MANA I don’t like your use of the word voluntary so I have a few rules you need to follow when you’re debating with me. You can only use full facts, not half truths. You cannot tell me that you want accountability, but then don’t hold anyone including yourselves accountable. Because you see that just makes me not want to have a conversation with you because I feel hosed.
Talking in circles might generally work on the people you deal with, but it takes a lot to get me dizzy and mesmerized. So you’ll have to come up with hard proof of what you say. And you will have to deal with phrases like baby killer. Because when someone neglectfully takes the lives of 8 innocent babies, I don’t care if she’s a midwife or a doctor, I will call it like I see it. I’m sure if it were doctors we were talking about the term baby killer would not have been so offensive to you either. I don’t really understand why anyone would take that term so personally unless she herself had killed some babies in her time.
MANA you need to put up or shut up!
What do you think about MANA and their views on accountability and their so called statistics?