Homebirth and loss…

Homebirth has been in the news A LOT lately.

The NY Times ran an article in May in glowing admiration of Ina May Gaskin as the pioneer of the home-birth movement and a founder of MANA, the organization that certifies professional midwives. The article also tells a bit of biographical information of Gaskin, including her involvement in a 4-way marriage and use of psychedelic drugs. This article of course received lots of hail and praise from the homebirth and natural childbirth community and any reference made to the risk and safety of these decisions continued to be mocked and minimized as women were berated for not trusting their bodies, not educating themselves enough and being unwilling to let women have choices.

Where was the voice for those of us on the other side of this story?

Myself and a number of other moms who have encountered adverse outcomes after homebirth were interviewed by Michelle Goldberg of Newsweek. She asked many questions to gain insight into what leads to the desire for a homebirth, what the culture of the community is, and what happens when you experience loss after a homebirth.

Her article went live on The Daily Beast on Monday, Home Birth: Increasingly Popular, But Dangerous.

I’ll admit I was disappointed when I first read it. She did a great job presenting the dangers that are often hidden from public view, the side that only those who have had to deal with the loss have endured. My fear is that those reading this article could see the horrific details of Mindy’s loss of Henry or Tweeny’s loss of Wren and come away thinking that the occurrence of loss is isolated and rare and only associated with what would be deemed as high-risk conditions by most.

It isn’t rare and it isn’t isolated.

There are moms that go through their pregnancy with no known risk factors, who choose to birth their baby at home and face the death of their child. 

Yes, I do understand that babies die in hospitals too. Please do not comment on this post claiming that argument, it is not at all helpful. Full term babies do not just die in hospitals. On the occasion that they do there are investigations launched and failing providers are held accountable.

The homebirth community does not seek accountability of midwives. All responsibility for an adverse outcome is placed in the lap of the parents. After all, it was their responsibility to be well-informed, to educate themselves, and they were to accept the risks associated with their decisions.

But what about when all the information is not given? What about when a midwife does not disclose her losses, or her legal status? What about when a midwife encourages a mom to pursue a homebirth even when she has a number of risks that warrant the attention of a doctor or the services of a hospital? What about when your midwife, a CNM with 26 years of experience and  the education to back it hires ‘birth assistants’ with very little or no formal medical education and allows them to see her patients without disclosing their qualifications (or lack there-of)? What about when she disregards her own education and refuses to practice in accordance with acceptable standards of care?

Those were some of the questions I was dealing with on Monday as I read the comments of Goldberg’s article.

Things were further compounded as I watched the news on Tuesday night. I sat there with my mouth open as I realized that this family must be the same as Complaint #2 in the summary suspension of Evelyn Muhlhan, my former midwife. The following morning it was the front page article in The Baltimore Sun. With more details of the family’s story which solidified the connection for me (and infuriated me because of the double standard it presented; parents bear the responsibility for the homebirth outcome… unless there is a hospital involved to bear it?)

But how, with all the incriminating information regarding the way Muhlhan mishandled the labor, could the jury find the hospital responsible for Enzo’s injury?

Here is the case information Case Number:24C11001081. If you look at docket 74 you can see that any evidence or testimony that would explain Muhlhan’s actions during labor that most certainly could have caused hypoxia were precluded from the trial. The jury would not receive this information.

I am stunned.

The assertion that Johns Hopkins Hospital was punishing them for attempting a homebirth and made them wait with no justification is ridiculous to me. JHH is the final hospital that received Miranda and placed her on ECMO. Never once were we lead to believe that providers there were looking down on us or punishing us for our choice of birthing at home. They never interrogated us for our choices. They did everything they could to try to help her.

They did their job and tried to save my child.

There was no ‘transfer of care’, Muhlhan never communicated with any of the medical teams that cared for Miranda. She never showed up at any of the facilities Miranda was transferred to. Vince and I were responsible for communicating to the doctors and nurses my prenatal history and the events of labor and birth while we sat with nothing but questions in our minds about how those preceding events happened and where it all went wrong.

I can only hope that the amount of attention that homebirth is now receiving will grab the attention of Maryland lawmakers, especially as they are set to begin the work group whose goal is to bring CPM licensing to Maryland. Maybe now they will see that while planned homebirth can occur without incident, when it does go wrong it is horrendous and expensive and it won’t be the midwives bearing the responsibility, it will be the parents, the hospitals and the state.