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let’s clear some confusion…

March 17, 2012

Some may assume that my purpose for speaking up is to make others understand or be sympathetic to my pain.

If that is what you think than you know nothing about me.

If that was my mission, this would not be my outlet. There are more effective ways of accomplishing that task.

Why I choose to speak is because unfortunately sometimes the only way your eyes will be open is when they are forced open by the reality of tragedy.

My goal is not vengeance for the death of Miranda.

I serve a God who has already said:

“Never take your own revenge, beloved, but leave room for the wrath of God, for it is written, “ VENGEANCE IS MINE, I WILL REPAY,” says the Lord.” Romans 12:19

I walk through the doors He leads me to. When He closes those doors I will abide in the peace of knowing I spoke the truth in love. I have never spoken to or about this CNM out of hate. I had her in my house days after finding out the other complaints against her, I did not raise my voice, I did not shout obscenities, I did not ask her to leave my home, I did not cry foul. I asked questions, I maintained dialogue. What I am doing is not revenge. I only seek to give the information that was withheld from me. The very information that prevented a true educated CHOICE.

The bill I spoke in opposition of on Thursday (HB1056) is seeking to license Certified Professional Midwives(CPM). I did not receive my care from a CPM. When I began to consider home-birth seven years ago I sought a state-licensed Certified Nurse Midwife(CNM) because I was not choosing home-birth because I felt it was my “right” or because I was in danger of “cascading interventions” if I gave birth in a hospital, I just wanted something different. My pregnancies were uncomplicated, my labors were relatively fast, I didn’t think I would make it for the hour and a half drive to the hospital  and I had NO DESIRE to give birth on the shoulder of the highway. I was most interested in a free-standing birth center but the closest one had closed the year before. I received recommendation of a CNM who was doing home births since the birth center had closed. She had an excellent education, her years of experience in a nursing setting almost eclipsed the number of years of my life. She had privileges at local hospital if the need for transfer existed. She would also come to my house with equipment and medication if an emergency happened at birth. She had a competent assistant who was years into apprenticeship who assisted in my care. The midwife I hired was my primary provider though, I saw her for every visit, even if it was initiated by the assistant. I had three beautiful, healthy children (two of which were born without my midwife actually being there on time, so yes, I get that you don’t need an expert when everything goes right) and continued to see her for the care of what would be my fourth home birth. Over the course of the seven years I sought care at her practice there was a shift. Home-birth was becoming more popular, and why not word of mouth advertising is *the* best advertising and if a woman has a good experience she will of course spread the word, her client-load got larger. Somewhere along the way her privileges at the hospital ended. I guess since I had never needed hospital care they didn’t feel it was important to explain why that option no longer was available. Not sure, this question still hasn’t been answered. After the tragic loss of the assistant who was there when I first started getting care there was a high number of different assistants coming and going through the practice. I remember no less than six. Their credentials were never disclosed and when they were no longer with the practice, their leave was not explained. So much for the personal continuum of care. It wouldn’t be until later  that I would find out that some of them had nothing more than certification as a doula, while that certification has its merits it was not my CHOICE to be seen for prenatal care by a doula. These women were often performing as primary care givers, they oversaw prenatal and postpartum appointments. There were times that even with monthly appointments I went for two months without seeing the CNM I had hired. For my final four appointments only one was conducted by my CNM. I also trusted that not only did they carry resuscitation equipment to birth but that they were well-trained in how to perform neonatal resuscitation protocol to make those tools into a life-saving apparatus.

Ill-use of good equipment does not give you a good outcome, it gives false security.

Those that spoke in favor of HB1056 claim that birth is inherently safe and a process to be trusted. They minimize the very risks that our country’s obstetrical system has worked so hard to mitigate. They forget that for the thousands of years that lay-midwifery care was the primary line of perinatal care there was a higher rate of maternal and perinatal mortality.

Don’t forsake the advances our medical society has made to save women and children in order to promote your agenda.

Stop minimizing home-birth losses as “something that sometimes happens”. It is a great disrespect to these families especially when what caused the death could have been well-managed in a different setting.

Call a spade a spade.

Admit that you do fail in low-risk settings and that it isn’t all that rare. Admit that you aren’t ready for some of the last-minute emergencies and that when they occur you may not recognize it because your expertise is in *normal*. It’s the inverse of the argument you use against obstetrical care of the childbearing year. You claim that doctors do not have enough experience in normal to effectively provide it. Be willing to admit that because you don’t often see a lot of the emergency situations that you don’t always recognize them until it is too late. Even in the hearing a delegate asked a question of the CPM on the first panel to speak, he retold of his experience with the birth of his daughter 16 years ago. He explained how as she was being born she kept ascending back into the canal. The OB called for immediate back up to help get his daughter out, he added how even today when they try to wake her in the morning she hides under the covers. He asked the CPM what she would have done in the situation, she gave a long explanation about how she couldn’t really assess the situation without being there and that what he was saying didn’t sound like anything that wasn’t just a variation of normal. She failed to recognize what he described as something every other birth professional listening would immediately recognize as the turtle sign, a crucial indicator of shoulder dystocia. She laughed it off with a joke about forceps to help coax his now 16-year-old out of bed in the morning. I guess the laughter her joke invited was supposed to dissuade us from seeing the ignorance that answer revealed.

Something that will never leave me is a conversation that was held has the birth assistant drove me to the ER to be reunited with my husband and daughter. She said they (the practice) had hospital transfers for moms before but they had never had a bad baby out come. I would learn just a few months later that one of the complaints included the death of a baby intrapartum (during labor) just three months before. How am I supposed to interpret this? Is there a belief that since they didn’t “catch” that dead baby that they were not even partly responsible for that baby’s outcome? Do they have the false belief that since Miranda died 28 days after her birth that her death was not at least partially caused by what they did and did not do?

Do you wonder why so few people on this side of home-birth speak out?

Perhaps they’re still grasping with the loss of their child thinking that the liability waiver they signed also released their midwife of moral responsibility.

Yes, when you choose to birth at home you do assume a voluntary risk. I am NOT arguing that. Do you have ALL the information needed to make your choice? Have you asked your midwife about her last bad outcome? Do you know the certifications each of your attendants holds? Or are you like me, trusting that your licensed provider is only hiring competent qualified experts.

Do not allow perceived trust to keep you from asking tough questions. If you want to know some of the questions you might be missing be bold enough to have dialogue with moms who have not only experienced the joy of home-birth, but speak to those who have also experienced loss. Keep in mind that they are not just moms that have experienced great loss and need your love and support, believe it or not we have some amazing networks for that.

Why not value our words of experience.

Trust me when I say that you do not want to have to experience this loss to understand this. It is a lesson better learned through the experience of those before you.

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5 Comments leave one →
  1. Beth Tiedemann permalink
    March 17, 2012 2:41 PM

    I am proud of you for speaking out. You are courageous!

  2. Mom permalink
    March 17, 2012 4:52 PM

    Lisa I couldn’t be prouder of you .I wish I could take your pain away but we all know that’s not possible .All we can do is stand by you &your family & remember your sweet little Miranda until you unite with her again .

  3. Heidi Riddle permalink
    March 17, 2012 5:08 PM

    Excellent post…. I hope you know how much respect Dan and I have for you and Vince and your decision to speak out about this! Many many hugs!!!!

  4. Lisa A. permalink
    March 17, 2012 7:22 PM

    You have been on my mind & in my prayers, sweet friend! ❤ I wish I could have "popped" over on Thursday.

  5. Emmaline H permalink
    March 17, 2012 8:14 PM

    You are so brave. Although those of us who have lost children never completely heal. The sad thing is that some people don’t understand that everytime you retell your story, your heart breaks again and again. We are still praying for you. Love, Emy

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