More birth tragedies
It is deeply depressing that the militant independent madwives continue to ply their trade whilst the Royal College of Midwives stands with its disciplinary telescope resolutely clamped to its blind eye. Regular readers may recall the Kent Independent Midwives, led by Virginia Howes:
I printed, verbatim, the Kent Independent Midwives account of the management of a multiparous woman with a large baby and polyhydramnios. It was a catalogue of ignorance, arrogance, incompetence and negligence. It can still be read here. I sent a copy of it to the Nursing and Midwifery Council. Shortly after I printed the story thus giving it wider publicity, the story mysteriously disappeared from the website. No comment was made. No explanation was offered. Now, only the headline and picture remain. (see here). What action has the Nursing and Midwifery Council taken? I have just received an email from Amy-Lee Crampton, the case officer who dealt with it. I print it verbatim deliberately. I find the typos, spelling and punctuation mistakes depressing; not what one likes to see in correspondence from a respected professional organisation.
Dear Dr Crippen,
After careful consideration I have to inform you that your referral will not be taken forward. Your referral was about Sharons Case and referalls receivesd from Doctors and mothers in Kent ; the Nursing and Midwifery council has not received a response to correspondence sent on 14th May 2008, 11th July 2008 or 16th September 2008.I am returning all documents you have sent to us. You can appeal this decision if you so wish. To do so you should submit your reasons to the Triage Case Manager.Yours faithfully,
Amy-Lee Crampton
Case Officer
Fitness to Practise
Nursing and Midwifery Council
Email: Amy-Lee.Crampton@NMC-UK.ORG
Phone: 0207 462 5847
Fax: 0207 636 6282
I replied to it as follows:
Hi Amy-Lee
I am sad you are not investigating it further. That of course is a matter for you. I have drawn your attention to the case. I was not personally involved and I am not in a position to do anything other than draw your attention to it. I will report the fact that you are not taking it further
Dr John Crippen
Let us turn now to Deborah Purdue of Dorset & Wiltshire Independent Midwives. She is based in Iwerne Minster in Dorset.
Why choose Dorset & Wiltshire Independent Midwives?
Frances and Debs share a similar philosophy that women are in the best position to choose the safest and best way for them to give birth. We both have experience with women choosing all kinds of care packages and are keen to support couples to achieve the birth experience they would like.
We both believe that 'less is more'. The less we do - the more we give. We believe that most women can give birth normally with minimal intervention if well prepared and supported, and able to do so in peace. Of course, some women and some babies need assistance, but even if the birth does not go according to plan, the aim is always to keep women involved in decisions regarding their care so that they feel that their choices have been respected.
Dorset and Wiltshire Independent Midwives
Deborah is also a stalwart of the Independent Midwifes Association and has strong views of professional indemnity insurance:
New legislation threatens independent midwivesWe must again recall the statement from Anne Francis, a spokeswoman for the Independent Midwives’ Association. A statement that still shocks me even though I have read it many times:
Independent Midwife Deborah Purdue, who lives at Iwerne Minster, voices her concerns about legislation affecting insurance provision for midwifery practitioners.
“As an independent midwife working in the Blackmore Vale area, and covering an area about 60 minutes drive in each direction, my livelihood and way of working is being threatened. There are about 200 of us in the whole country and we had tried to obtain professional indemnity insurance but have been unable to globally. Independent practitioners in New Zealand, Germany and Eire have secured it through the health services. If this is instigated it will make working a criminal activity; choice for women will be undermined: 200 experienced midwives will be unable to work legally and some women will choose to birth with no attendant (very dangerous for mothers and babies). It will affect all midwives by removing how they choose to practice, including NHS midwives. The public assumes that insurance is payable if something goes wrong but insurance is only payable if negligence is proved, and that is very difficult to prove. Insurance DOES NOT EQUAL safety, which is what the government is saying. The Nursing Midwifery Council (NMC) ensures safety of the public through regulation and supervision of midwives, all midwives. We are bound by our regulatory body as any other midwife is.”
Independent Midwives Association
Independent midwives tell mothers-to-be verbally and in writing at the first meeting that they are not covered for claims.The newspapers are now reporting a maternity case involving Deborah Purdue practising her “less is more” obstetric care, presumably without professional indemnity insurance:
“Most clients understand you can’t insure against things going wrong during childbirth, only against negligence, and negligence is not really an issue for us,” she said.
Deborah Purdue, 47, ignored repeated warning signs indicating that the baby boy was in distress during the outdoor water birth, it is alleged. She delayed carrying out an examination of the first-time mother at the woman's home in Dorset and allowed her to sit in a birthing pool in her garden even after a machine recorded that the unborn child had had an increased heart rate for more than two hours, it is claimed. An ambulance was finally called only when the child discharged his bowels into the water, a Nursing and Midwifery Council (NMC) panel heard.
But the midwife then left the distressed woman unattended while awaiting the ambulance, it is alleged. When the woman, known only as Patient A, was rushed to Poole Hospital doctors found that birth was already advanced, with parts of the boy's body displaying bruising. He was delivered shortly after arriving at hospital and immediately placed on a ventilator.
He died 15 hours later.
Daily Telegraph
There are more graphic details (as one would expect) in the Daily Mail:
The case is still sub-judice and it must be said that:
Mrs Purdue denies failing to monitor the woman adequately, failing to safeguard the baby's wellbeing, failing to adequately assess the progress of labour, failing to communicate effectively and failing to take appropriate action when her labour fell outside normal parameters. She admits not attempting to carry out a full examination until 5.30 am, allowing Patient A to remain in her birthing pool for around ten minutes and not taking steps to transfer Patient A to an obstetrics unit until 6.15am.
We shall await the final verdict. The most worrying aspect is that most likely Deborah Purdue is not insured. If as and when she is sued by the parents of the dead baby payment of any damages will have to come from her own assets.
Why do we allow this to go on? To some extent it is seen as a women’s lib issue. Remember our dear friends, the coffee shop feminists, who try to portray routine medical examinations on pregnant women as rape? Have another look at Not a happy birthday in the F-word and the subsequent attack on NHS BLOG DOCTOR. Hard to argue with the wimmin at the F-Word when they say:
This blog is a safe and friendly space for feminists and feminist allies. Debate and critique are welcome where it is constructive and deepens analysis or understanding. Anti-feminist comments will not be approved. We get to decide what's anti-feminist.The ploy to portray hospital obstetric care as provided by doctors and NHS based midwives as anti-feminist is a clever one. It appeals to the emotion rather than the intellect. We need a change in the law. Reckless and negligent mismanagement of labour resulting in the death of a baby cannot at present give rise to a charge of manslaughter. It is time the law was changed. Currently a foetus has no legal rights until it has been born. I would like to see the foetus given legal personality and legal rights in the last two or three weeks of a pregnancy; say from 37 weeks gestation. No, I have not been dining with Nadine. This is not an anti-abortion argument. I strongly favour giving women an absolute right to chose to have an abortion. But sanctioning abortion is not an argument for allowing a load of “right-on”, ten-green-bottle singing, placenta eating, tree-hugging doulas the right to practise their ludicrous theories on fully developed, viable, defenseless babies.
The F-Word
+++++++++
A sensible midwife covers the Purdue story here (and see the comments)
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There have been two outstanding posts in the blogosphere over the last few days, both of which relate directly to the NHS.
Mike Denham of Burning our Money, in what is (from a strong field) one of his best posts, looks beyond the lynch mobs that are heading for Haringey. In “Passing the rotten buck” he describes the institutional decay that is endemic in our top-down managed Welfare State.
Why do I mention this under a post on “home births”? Because a sensible NHS midwife (yes, her again, they do exist!) takes a look at the impact of a “home birth” on her own failing hospital midwifery department. This truly is a tale from the “Circumlocution Office” and puts ground floor flesh and bones on everything Mike Denham says:
My colleague then went on to relate how she was disciplined for advising a couple to write a letter of complaint. The reason. Well apparently if a complaint is put in writing they have to respond and be seen to take action. Well blow me down, I thought that was the whole objective of putting in a complaint, whether in writing or verbally, someone taking notice of it!How do you think the Haringey social workers are feeling?
I have a multitude of issues with all this. If we complain nothing at all gets done, unless we go to occupational health and tell them we are stressed, and you really don’t want to do that as it goes on your record. Most of the time the discord we feel is due to the impact that restraints on the service have on our women and the care we can provide. The women will, obviously, grumble to us about shortcomings, but it is pointless us presenting the issues to managers, as they do nothing, so if that’s the case it is sensible to advise the women to let the managers know how they feel.
No whistling allowed
Labels: feminists, home births, independant midwives, Kent midwifery practice, professional insurance
46 Comments:
At one point I was a NHS midwife.
When I worked in the community as a (NHS) midwife, I and my colleagues were very anxious about women in remote areas who insisted on home births.
In these cases, we were obliged to provide care, but we certainly did not choose to do so, especially as it seemed always to be a mother in a remote area in the hills with a due date in the middle of winter, who insisted on a home delivery.
I find it hard to understand these "madwives".
Hmm. These independent midwives seem to be getting into trouble at the moment.
Sarah Ruth Samuel Montagu
Monday 10th to Thursday 13th November 9.00 Start
Conduct & Competence Committee
Sarah Ruth Samuel Montagu, a 50 year old Registered Nurse (Adult) and Registered Midwife from Oxford, England. Whilst employed as an Independent Midwife, under the supervision of West Midlands NHS Local Supervising Authority, Montagu is charged with failing to act in the best interests of clients, failing to inform hospital and/or ambulance staff of a Red Alert Transfer and failing to record that blood tests were not carried out at booking
She says
http://www.sarahmontagumidwife.co.uk/aboutme.htm
She obviously doesn't believe in medicine, she thinks women give birth safely automatically:
The miraculous nature of birth and the power of women's bodies to give birth safely never fails to move me
WTF?
Sarah has attended hundreds of births and she had total faith in my ability to bive birth to my baby naturally. The birth was calm and relaxed and very different to my previous hospital births"
Kerrie, mother of Liv, home VBAC
Ah, this is why they don't want insurance, because they don't care about risk. Home vaginal birth after caeserean. What a fab idea (Mrs. madwife obviously thinks though, because she's chosen to mention it on her website).
And another:
"It was brilliant having Sarah as my midwife - being able to trust her implicitly made all the difference - any of my colleagues would have been very uneasy about me pushing for 3 and a half hours - but Sarah helped me give birth naturally in my own time"
Jo Hindley, NHS midwife, after homebirth of Theo
But of course yer independent madwife doesn't bat an eyelid, no medical intervention required!
(Jo by the way is also a hardcore madwife, possibly not an independent one, but mad nonetheless)
Here we have it
http://www.midwifery.org.uk/Daeth%20to%20Life.htm
from the 'Association of Radical Midwives'
"I MISCARRIED my first baby"
"It took 23 hours and 17 minutes. I pushed for 3 hours and 27 minutes"
"I was in the pool throughout the night. Every time I had a particularly painful contraction I was sick. I also had heartburn. Large pots of yoghurt were the answer and I tried to down a spoonful whenever I could. I examined myself at about midnight and felt the baby's head was low but my cervix was far back and not open much. I needed to find a way to relax. I asked John to get into the pool with me. The room was dark lit only by nightlights. I didn't want to be watched so asked if the others could go into the other room. I requested a tape of Celtic harp music. I was figuring out what I needed. "Let's make love" I suggested. John found points on my back that he could press to relieve the pain in my front. For a while I was pain free."
The full thing is far longer, but essentially amounts to 'let's pretend we are ancient druids and have the same access to medical care that they did'.
There's plenty of documented evidence of Sarah Montagu ignoring medical advice:
http://www.homebirth.org.uk/jo_anne.htm
I wasn’t too bothered about having an anomaly scan; I hadn’t done with Chelsea as the local hospital weren't offering them then. However, my husband was keen so Sarah arranged one. I hadn't planned on having any antenatal care, other than that provided by Sarah, but the scan showed a problem with my baby's left kidney. The sonographer said it was hydronephrotic and there was a dilated renal pelvis so I agreed to see the consultant. I was offered, and accepted, another scan, this time with a fetal medicine consultant, who said the kidney wasn't hydronephrotic or enlarged but was polycystic and I should have consultancy led care and hospital birth so the baby can be checked immediately.
I spoke to Sarah that night but she wasn't too worried and said she couldn't see any reason why I shouldn't have a home birth
Obviously the independent madwife knows better than the consultant.....
I saw the obstetrician who said I was high risk even without the kidney problem because I'd had a previous precipitate birth at 43+ weeks. He said I didn't need to worry about not getting to hospital in time, as I would be in hospital anyway for post-dates induction! The baby was placed on the perinatal alert register and I would have to have paediatricians in the delivery room and baby would be taken off me straight away to have a direct scan of the kidneys.
About midday a couple of days before my due date, she did a stretch and sweep. Although the two I'd had done with Chelsea hadn't bothered me at all, I found this incredibly painful. Half an hour later I started having pains but thought I was imagining them. I am a qualified complementary therapist, and I worked the reflex areas on my ankles that correspond to the reproductive organs to see if this helped get me into labour. Then I went shopping and the pains intensified, getting both stronger and closer together. I wanted to believe this was labour but was still expecting to go really overdue again. Also I was expecting labour pain to be one long pain as it had been with Chelsea, even though that isn't typical of labour pain. At 8 pm I was unable to talk through the pain so I sent Sarah a text.
I went down and let her in and it seemed like she was there for ages just sitting on the floor doing nothing.
After what seemed like hours and hours, Sarah asked to examine me.
I am still an NHS midwife, working in the community and attending homebirths.
I wrote about the Deborah Perdue case on Nov 45th - http://midwifemuse.wordpress.com/2008/11/04/an-indie-in-the-news/
and expressed my feeling that we were not being given the whole story. There was a 2nd midwife present, why no mention of her? Was the baby breech, and if so were all the paticipants aware of this prior to labour?
What I didn't comment upon at the time, partly out of a wish not to be interpreted as deflecting 'blame', was that the parents were not present at the hearing and that there was no mention of them taking any legal action. I wonder if they were aware that the birth was deviating from the norm but were still desiring a homebirth, in other words refusing transfer to hospital.
As a community midwife I have had experience of women who refuse to transfer, even when strongly advised to do so by midwives, supervisors and obstetricians. There is little we can do to force the issue, we just have to remain with them.
Very often a woman will employ an 'Indie' because the local NHS maternity service is unhappy with her decision to homebirth. As a result Indie's appear to have a high proportion of clients who do not fulfill the low-risk criteria which Trusts set for homebirth.
I may sound as if I am defending the Indie in this case, what I am doing is waiting for more information before I blame her for this baby's death.
"This is not an anti-abortion argument."
If you say so. Used by a different writer, it could be.
Now Matthew, I know you are a cynical old bugger like me, but do you think you, and the independent madwives, have been spoofed by this alleged account of a home birth?
"Making love in the birthing pool?"
"Celtic music?"
And you forgot:
…It was bright and sunny and the grass was very green. I had not come across the Buddhist practice of 'touching the earth' before. I prostrated myself flat on my front…
…. I handed in the final copy of my dissertation for my master's degree on the Thursday. On Friday I felt a period-like heaviness in my groin. Saturday morning I went to the toilet to discover I was having a show. On Sunday my Mum and Dad came to visit for the day. They had been keeping out of the way for me to finish my dissertation. I hadn't seen them since Christmas. They helped bolt together the birthing pool; Dad played Chopin mazurkas on the piano…
++++++
It must be piss take. Surely. Isn't it? Please God, it must be.
I mean, if this is for real, how does one write a piss take without going OTT?
John
little black sambo said...
"This is not an anti-abortion argument."
If you say so. Used by a different writer, it could be.
Saturday, November 15, 2008 7:19:00 PM
++++++++
Yep. That's a serious point and needs answering, though I don't want the main point of the post to be sidelined.
This was a statement of my personal opinion.
I repeat I am a 100% supporter of a woman's right to chose to have an abortion. I would prefer the top age for abortion to be 24 weeks - I have resuscitated babies not much older than that - but I don't want to get side tracked into that.
What I do definitely believe is that I would not contemplate abortions - by which I mean operations designed to destroy a baby as opposed to deliver it - at over, say, 36 weeks.
That is not an argument against the right to chose. I know Nadine and her cronies would say, well, if a baby is a human being at 37 weeks, so it is at 24 weeks or 24 weeks and so one. Well, sorry Nadine, the lines have been drawn.
But at 37 weeks the baby is viable, and it is quite wrong that loony madwives should get away with killing these babies because they do not approve of sensible medical precautions. If a baby is brain damaged by a loony tunes madwive, I would give that baby the right to sue her; and to sue the mother as well.
We prosecute people, incuding mothers, who harm new born babies or toddlers. I want to take those rights back three weeks.
John
John
"It must be piss take. Surely. Isn't it? Please God, it must be."
She does seem to be genuine, there are a few references to her on nursing sites.
The worrying thing is that despite working for the NHS, she makes no reference to the use of any medicine, but she does follow a vast list of primitive rituals:
* weekend meditiation retreat
* Buddhist practice of 'touching the earth'
* a big wave [in the sea] invaded sand under my swimsuit and into every crevice and orifice of my body [to cleanse the miscarriage]
* cleaning the kitchen floor, black polishing the fireplace and laying a fire when she got her first contraction at 3:15am [fire is presumably very significant for the NHS druid midwive team]
* wedding banners in the birthing room
* yogurt (for vomiting)
* accupressure
* Celtic harp music
* giving birth in a darkened room
* giving birth in a paddling pool
* sex as pain relief
* chanting "Present moment, wonderful moment" "Here and now", "All is well", "I relax the long length of my back" to relieve pain
* "Kate Bush's The Hounds of Love got me moving"
* Telepathically communicating with her unborn baby 'Focusing on the goodness of John I connected with our baby. "I want you." I told the baby'
* Belief that her sister had phantom pregnancy symptoms in sympathy with her
* Claim that her birth could only proceed when she had finished " performing an exorcism; moving from death to life."
* Burning lavender oil so she could 'touch the earth again'
* Burying placenta "beside the apple tree in our garden near to where we had laid Frehel" [the miscarried baby]
* "A herbalist friend provided marigold flowers (calendula) and lavender oil"
* "I dosed on arnica 1M. " [This is a homeopathic 'remedy', the top Google result for which says: Arnica the Miracle Remedy - Brief case histories . Ah, yes miracle remedy. Not entirely sure what she was supposed to be treating.
* Hanging out 'prayer flags' 'out the upstairs window and down the garden' in the colour of her blood, her baby's shit, and her milk.
* 'Aconite' (bonkers homeopathic remedy) brought by the m-i-l
According to the homeopathy page above:
What is Aconite made from?
A poisonous plant
return to top
What brings on an Aconite state?
Exposure to cold, dry winds
Shock or fright
return to top
What are its Key uses?
Acute infections with sudden onset, such as fevers, colds, coughs, eye inflammation, throat or nose symptoms.
The remedy is also given for fear or panic attacks and restlessness,
Numbness or tingling
She also has a massive hangup that non-druidic birth means are 'failure'. Perhaps this is why these madwives get into trouble:
"Sarah asked if there was anything psychological holding me back. Sarah's question gave me space to clear the way forward. I cried with frustration and exhaustion as I named my psychological blocks. I was thinking of friends who had planned homebirths, got to 6-7cm dilatation and stuck there. As midwife I had felt out of resources to help them. I felt guilty for their ending up with C sections."
Hilarious. Those that would satirise it simply wouldn't have the imagination to make it up.
When will these morons realise that there were no such people as druids, they were a 19th century invention. No such people as Celts, either. The word was first used in 1707 to describe a collection of north european peoples of different origins who may have had a common route tongue.
I digress. Or do I? Their basis for practice is fictional, their practice dangerous, and their literature absurd. I would much rather they spent their time wandering around Stonehenge in sheets than being actively dangerous.
Idiots.
arnica apparently cures:
WOUNDS 30c
GENERAL TONIC IN DAILY USE 30c
SUBSTITUTE FOR MORPHINE POST MAJOR SURGERY 200c and 30c
EASES URINE FLOW CAUSED BY BPH 30c Wet Dose
HELPS TO CONTROL INCONTINENCE AFTER TURP 30c
JET LAG 30c
LACK OF MOTOR FUNCTION OF EXTREMITIES IN 82 YEAR OLD 1M Wet Dose
ALZHEIMERS 1M
CHRONIC ACHES AND PAINS 30c
INSOMNIA 30c
ECZEMA 6c
I have used it in over 30 cases some of which were chronic for over 10 years and within a week, the patient is usually cured. The success rate is better that 80%.
CELLULITIS 30c
PROMOTES GROWTH OF HAIR 30c
ANGINA 200c
CHRONIC HEADACHE 30c
INTERNAL HAEMORRHAGE IN A HAEMOPHILIAC 30c
PIMPLES, ACNE, BLEPHARITIS, ROSACEA, STYES 30c
BED SORES 30c
Prevents their formation.
NOSE BLEED 200c
ERECTILE DYSFUNCTION 6c
RHEUMATISM AND GOUT 30c
TONSILLITIS 30c
DIABETES 30c
I then prescribed 1/4 teaspoonful Cinnamon powder to be used twice daily and have 2 patients who are able to control their ailment without recourse to the standard drugs used for the control of Diabetes.
The comments are hilarious
"Joe,
Should I use Arnica 30 for hair loss? or should I buy arnica hair oil?
Thanks,
Neeraj"
"Arnica 6c or 30c are very effective for Hair Loss. You are advised to take it in the water dose twice daily. Start with the 6c and if it reacts OK stay with it. Otherwise 30c.
Important: No coffee or cola drinks or sausages"
No sausages! Ha ha ha ha ha.
"i have a 2 cm. cyst in my breast. Becuase of history Dr. wants aspiration/biopsy. What can I do?"
Note:
http://news.bbc.co.uk/1/hi/health/2710107.stm
"The popular homeopathic remedy arnica proved to be no more effective than a dummy treatment in clinical trials."
Haringey social workers are feeling they've got away with it.
Shouldn't you worry more about how Baby P is feeling?
I think you're revealing too much about your attitude to professional negligence: the same arrogance you share with Haringey social workers.
"* Burying placenta "beside the apple tree in our garden near to where we had laid Frehel" [the miscarried baby]"
Aren't you supposed to eat it? The placenta not the Frehel. Frehel? Is that a Dutch breakfast cereal?
"When will these morons realise that there were no such people as druids, they were a 19th century invention. No such people as Celts, either. The word was first used in 1707 to describe a collection of north european peoples of different origins who may have had a common route tongue."
Not exactly, the earliest use of druid comes from a Greek text by Sotion of Alexandria and some Roman texts make mention of the druids, Caesar in Gaul etc.
You are of course correct in stating that little is known about the druids and that the usual assumptions that New Agers make about the religious activites of pre-Roman Britons and the like are pretty baseless.
"The popular homeopathic remedy arnica proved to be no more effective than a dummy treatment in clinical trials."
Isn't arnica supposed to do 'something' (mostly negative) to you if you don't dilute it out of existence?
"Shouldn't you worry more about how Baby P is feeling?"
Bit peaky maybe? I think it's a little late for him to be feeling anything, the people who killed him and the people who failed to prevent them are still here.
You seem to have omitted some other useful information -
http://www.dailymail.co.uk/news/article-1048408/Obstetrician-stars-faces-multi-million-pound-negligence-claim.html
Obstetrician Yehudi Gordon has admitted he was negligent in the birth of a child who suffered severe brain damage and needs round-the- clock care, according to a High Court writ.
Dr Gordon also advocates home births and is credited with introducing the birthing pool to the UK as well as using yoga techniques to combat labour pains - not midwives.
And apparently it's not just midwives alleged incompetence that kills babies:
http://www.boyesturnerclaims.com/case-study.html?id=147
Aged 33, this was the mother’s first pregnancy. It had been uneventful. However when it came to the birth, her labour became protracted. The medical team missed signs of increasing foetal distress. The signs were eventually recognised and her son was delivered by emergency caesarean section. However this happened too late to save his life. The cause of death was severe hypoxia (lack of oxygen).
and more... and both of these were conducted IN a hospital...
http://www.lees.co.uk/news-article.php?iNewsId=23
Despite being induced that same day, she had not had any contractions by the Wednesday morning, two days after she had been admitted to hospital. During the labour, she had been left unsupervised for long periods of time and started to feel increasingly unwell. It was only when her baby's heart rate became very unstable that the obstetric team at the hospital took any action.
The delivery was traumatic and she had to be referred for an emergency caesarean
The baby died 4 years later as direct consequence of CP.
So let's get off the 'only independent midwives negligence kills babies' bandwagon.
Yes there is a real increase in risk to births at home - but lots of these home births are being advocated by GPs and obstetricians.
Overall, one baby in 1,400 died during birth or in the first week, whereas one baby in 800 born at home or intended to be born in the home died.
The risk was greatest for intended home births where complications arose and mothers had to be transferred to hospital. One in 150 of those babies died.
April 2008
http://www.telegraph.co.uk/news/uknews/1583598/Home-birth-babies-at-greater-risk-of-dying.html
There is so much can be read or misread from statements like these tho - of the 1 in 150 hospital transfers - how many would have survived a hospital birth anyhow?
There is no direct figure that asserts the number of deaths attributable to at home deliveries or of those how many are attributable to the (in)actions of a midwife alone.
But I'm not at all sure about the buddhist practice of touching the earth.
Anon: 2:33
Aren't you supposed to eat it? The placenta not the Frehel. Frehel? Is that a Dutch breakfast cereal?
You're a fucking idiot and an insensitive prick.
Are you the same Anon who doesn't like his social ignorance interrupted by stories of social workers letting babies die a la Haringey thread?
Dr. Crippen, practitioners like this are immune from criticism in the USA as well.
I've had the local naturopath respond to the "I'm tired" complaint from a middle-aged woman, and the naturopath gave enough "natural" thyroid to drive the TSH to zero and put her in atrial fibrillation and angina pectoris. I had to clean up the mess.
The naturopathic board could care less. When you complain, you're the evil male troglodyte physician trying to squelch competition from the nice progressive female naturopath.
...........arf
Mr Ian,
You crapulous idiot.
If there's negligence in the NHS or with a private doctor, instruct lawyers and reparations will be made if you have a case. See your own example about Gordon.
If one of these midwife crackpots is negligent (and they are all the time - their belief in the way childbirth should be managed is negligent) and your baby dies or is brain injured, you have no comeback, as their assets are in another's name, and they declare bankruptcy.
Unethical. Immoral. Sick.
One of these midwives has delivered 100 babies over 15 years. That's about one every 2 months or so, a pathetically small number but still a nice £20-30K for on average a couple of hours work/week.
THAT IS WHY THEY DO IT - MONEY.
ok I'm sorry I didn't understand. I really am mistaken.
Can you clarify for me though:
- why is it medically necessary to admit every pregnant woman to hospital?
- at what point the midwife orders the parents to have a home birth?
- at what point the GP is excluded from the decision making process?
- at what point the local obstetrician is not allowed to advise on the risks of home birth?
- why we don't have enough NHS midwives who are vicariously covered support home births
- why parents aren't allowed to choose the birthplace of their child, simply because there is no service provision.
Yes I'm sure that are a few that see the money option. Just as there are medics or lawyers who choose their career for prestige and money. What's your point?
Most midwives are in it for the job satisfaction tho.
Midwifery has long argued the case that medicine does not need to ordain on all childbirth.
It seems the govt has now heeded this fact and encourages home births as an option - possibly as it also saves money - to pay for improving services at Haringey council no doubt to avoid upsetting you over your eggs n bacon.
Or should we not do that?
The medical profession refuse to give patients an option that is outside of their (the doctors [who don't have Doctorates]) control and so they do not support home births. I can't say I totally blame them - it's a bit daft to ask them to endorse something that they have no control over.
Hence midwives - who are acting in the interests of parents - can only make that choice available by setting up independently.
So - and just like we hacked on Haringey - (as opposed to harangued on Hackney) - it goes back to what service provisions are being made to provide optimum service for mum.
It may be that Purdue is crap. That remains to be determined in NMC hearing.
But where malpractive is not the issue (as in many unfortunate home birth deaths - as well as hospital ones) it's just like isolating out social workers for the failings of a system or individual.
One bad episode and everyone gets to throwing the baby out with the birthing pool water.
"One bad episode and everyone gets to throwing the baby out with the birthing pool water."
Clever. Did you see what he did there?
Re insurance:
While I understand the preference to having medical insurance (tho really why would you need it - the state will provide everything for them won't they? I mean - it's their job to deal with all the problems)
Up until 1994, all midwives were covered by the Royal College of Midwives (RCM) indemnity scheme, regardless of their area of work. Midwives within the NHS were also covered by their employer’s vicarious liability. However, in 1994 the RCM withdrew insurance cover from independent midwives amidst much controversy, and although there were one or two insurers willing to offer cover at first, the premiums rose to £15,000 per midwife per year and the number of providers fell over the next few years until 5 years ago, the last provider withdrew from this market and since then there has been no insurance available to independent midwives in the UK. Four years ago, the NMC proposed to make insurance a ‘requirement’ for registration; a campaign then resulted in it becoming a ‘recommendation’ and every midwife practising without insurance therefore has an obligation to make the implications of the situation clear to every client she or he books. Independent midwives are not happy to be forced to practise without insurance but have had to accept it as the only way to be able to continue to practise. The Independent Midwives Association (IMA) has continued to campaign publicly and negotiate privately with innumerable insurance providers over the years, all to no avail.
It seems as if the independent midwives are more than aware of this issue and are attempting to redress it - whilst also being sure to advise all parents there is no indemnity insurance.
As an aside - there's some interesting reading on Hansard regarding the passing of the Midwives Bill 1902 - for the nostalgic amongst us.
hansard.millbanksystems.com
It's funny how even their own kind, the RCM, won't insure them.
Does that not make you think what kind of practitioners these "independents" are?
Most midwives are in it for the job satisfaction? Tripe.
They're in it to maximise their fee and minimise their work. A fair price for, say, 30 hours total work per woman would be maybe £1500 and enable much wider access. Most charge £3-4K. Why should these midwives get £100+/hr for a piss poor incompetent, uninsured "service".
Mr Ian
Generally love your trenchant views but, for once, you are not seeing the wood for the trees.
Of course there are lots of doctors who make cock-ups and some who are negligent. But there are two big differences:
1. Doctors carry insurance and so, if a baby or mother, is harmed by their negligent mismanagement at least compensation is available
2. A Doctor's prime motivation is to protect life. The madwife's prime motivation is to have a right-on touchy feely experience and she does not care, nor does she understand, the risks she takes to acheive that.
John
John
1. Agreed and in this day it is not really acceptable. Tho the whole 'negligence' thing scares me in lieu of our American cousins and their approach taking over the UK.
2. Disagreed. Midwives also have principles to preserve life (and how very dare you insinuate otherwise!) but they consider the parent's right to choice also. Doctors deny this as fas as they can and opt for omnipotence.
I have posted the story before, I'm sure. of my ex-wife who was cajoled by the GP into attending the local DGH (meat market) for our second child much against her wishes.
But it wasn't against any home birth or midwifery he protested - We wanted to attend the local less busy and more relaxed cottage hospital where the first was born buy caesarian. But the GP scared her into it with horror stories of the baby dying and it being all her fault for not having the best equipment around... yada yada.
Our local obstetrician was extremely pissed at this when we told him after she was transferred there post-c-section at the meat market.
So I'm not so pro midwives and home births (tho not against it) - as much as I am anti-medical controlling by scare mongering the parents.
But it's confusing to create a third argument when we've already got two going (tho you did slip me an opportunity by referencing the 'medical rape' topic - I'll bite next time).
So I choose a side (of course, I choose my nursing cousins) and bang on.
As a mutual interest - it seems the Medical Provident League (no idea who are they were/are - anyone?) of 1902 had the same sort of objections to the original Midwives Bill as you yourself.
4. IT WOULD BE DECEPTIVE AND DANGEROUS TO THOSE WHO EMPLOY MIDWIVES.
It places a Government stamp of efficiency upon women who, at the present time, are avowedly ignorant and inefficient. It provides that for the future such a stamp of efficiency shall be placed upon women whose knowledge of Midwifery must be but small, and who can know nothing at all of Medicine and Surgery. Yet parturition involves dangers and results which require a complete knowledge of medicine and surgery to combat successfully. Midwives' now work on their own responsibility and are correspondingly cautious. With the fear of the Coroner always before their eyes they generally send for skilled assistance immediately danger threatens. As independent practitioners recognised by the Law, this ever-present need of caution would be lessened and Ignorance is the most fruitful cause of carelessness, which in Midwifery spells danger to both mother and child.
http://rcnarchive.rcn.org.uk/data/VOLUME028-1902/page414-volume28-24thmay-1902.pdf
"The Nursing Record and Hospital World"
Love the last line -
Ignorance is the most fruitful cause of carelessness, which in Midwifery spells danger to both mother and child
They choose their words with even less care than you!
It's beautiful to read - the same argument over 100 years ago! :o)
'but they consider the parent's right to choice also. Doctors deny this as fas as they can and opt for omnipotence'
Mr Ian/no-one you're at it again.
How much you know of quotes and refernces, and how little of medicine.
My sympathy.
I would not ascribe sinister motivations but risk aversion and defensive medicine are clinical realities, Crippo [not to mention rampant consumerism] - look at the c-section rate which is now 23% [rather than 15%, as recommended by the WHO].
Only 15 years ago the c-section rate in the UK was less than 10% - why the massive increase ?
The National Patient Safety Agency reported 60,000 maternity errors [between 2003-2006] - by far the biggest contributor to medical negligence payouts.
Injured mothers have made £2billion worth of claims for Obs & Gynae mistakes since 1995.
Medical management during labour is something of lottery [in certain cases] but even if it wasn't, the plain fact is a percentage of women do not want to birth in hospital.
I have heard very few sensible comments about how these women can be supported at home, so I can understand why the indies might seem attractive to them.
Crippo:
I've never professed to know "medicine". I know of medics and other professionals I work with. I know of medication to the extent of my role requirement.
What do you know of nursing or midwifery? Or Nurses or Midwives? Let me know your standard of knowledge of other professions and I will endeavour to be as multi-enlightened as you.
Having said that - I opt to re-word my comment on doctors -
'Doctors deny this as far as they need too in order to maintain omnipotence'
And I'm not sure on your reference to "no-one" who hasn't posted in this thread. Are you inferring we are one and the same? Or are you simply, in the absence of an argument, just blanket protesting against people who antagonise you?
Either way; you're an idiot.
Don't post merely to exercise an ad hominem assault with no substance. It demonstrates little more than an arrogance that is defined by a lack of intelligence.
Ah, but it gets you going a treat. You quite clearly loathe doctors and almost everything we stand for. And yet, in the final analysis, who would YOU want to treat you? Try the crystals.
Oh, and I have a great deal to be arrogant about. I'm bloody good. Idiot savant, really.
So much for mr ian/no one.
AECN you make a very valid point. I have written on this before, but to reapeat IMHO mothers and children are safer in a well run hospital unit. That does not mean that poeple cannot have their dignity and wishes respected; that is crucial. My first child was born in a unit where this was automatic, and 20 years ago at that. Peace and quiet, no one came in to the room unless they knocked first, the midwives were excellent, and the memsaab was well looked after. Her birth plan was followed by all. Complications developed, the medical staff were there promptly and all was fine.
The second one was horrible. Good old fashioned 'the midwife knows best' sort of thing. My wife took her own discharge rather than stay in the place. Left 8 hours after child delivered, in the days when the norm was a 4 day stay.
This proves nothing. But I don't blame women who would rather have a child at home than go through that again.
It is up to us as professionals to make birth in hospital something that women can go through and still feel in control, while at the same time making sure that all medical facilities are there. Many units are simply not fit for purpose, and I know from experience that the midwife only ones can be the worst of the lot. Even though birth is a 'natural' process there are a lot of midwives who feel the need to treat women as if they have a mental age of 3.
As far as the LSCS rate is concerned, I have a theory that this may also be due to the way docotrs are now being trained in this country, as well as the legal climate. If I am an experienced obstetrician who has a woman under my care who might need a section, I would rather do it during the day than have an emergency at 3am which may be dealt with by an inexperienced trainee. Too many 'communication' lectures, and not enough actual work.
Perhaps it should be 'memsahib'. Makes her a car, otherwise.
"You're a fucking idiot and an insensitive prick."
Thanks for the free IQ test. As for me being insensitive. Yes I am and I also laugh at the adverts were little umbago has to drink stagnant water out of the toilet while his mum dies of AIDs...
Okay seriously I am insensitive in the sense of not letting myself get bent up like a pretzel over stuff that happens to people distant frome me. Unlike many people I don't feel the need to board the grief train when somebody who I never knew carks it ala Princess Di fever.
"Are you the same Anon who doesn't like his social ignorance interrupted by stories of social workers letting babies die a la Haringey thread?"
Nope, but he sounds like a cunt.
Crippo:
Ah, but it gets you going a treat.
Yes I'm in awe at your powers of control over me and my actions.
You quite clearly loathe doctors and almost everything we stand for.
I loathe certain qualities in people and their behaviour. If that includes some doctors, lawyers, judges, Catholic priests, nurses, police, buddhists or God him/herself, then so be it.
And yet, in the final analysis, who would YOU want to treat you?
Well if I was going for a natural home birth - I'd want Oprah there for the publicity, of course.
But as it happens my last sprained ankle took 5 weeks to heal - all by itself and without an Xray or a hobble to the A&E.
Imagine my surprise when I realised that my body can heal itself without Prozac or probiotics.
[I took Ibuprofen 400mg on about 4 occasions]
As for other treatments at home?
Well my grandad's last few days with cancer were managed quite well at home with 2 experienced learning disability nurses, a consultant psychiatrist and a consultant geriatrician psychologist and a student nurse in mental health - and even tho none of us had done Oncolgy or been a MacMillan nurse we still managed to stave off the Oncologist who wanted to do biopsy to find the primary in his last 3 days of life.
So in that instance - the medical specialist was a dickhead.
So it depends - treat me for what, how, and what are the alternatives?
This is merely what midwives are offering parents - an alternative that is not tied to NHS bureaucracy and protocol.
I rarely attend a GP or A&E unless it's something that quite seriously needs experienced skills - like surgery and of course a surgeon would be most apt. Tho I think I've been "closed" by a theatre nurse before on one of my 4 ops.
And all my sutures have been removed by a nurse or student nurse.
I could of course redirect the argument to mental health and watch you seriously flail to provide some evidence as to the medical prowess that presides therein - but I don't want to detract from the theme.
Be careful how highly you rate yourself. Doctors - and even nurses or hospitals - are not required for every state that is a whiff off - or even terminally off - homeostasis.
Interesting observation -
GPs (and A&E staff) tend to complain (mostly rightfully) about wasteful attendees and how their time is often sucked up unnecessarily.
Yet, in the majority of childbirths there are no complications yet the the medical profession insist on them all coming to hospital and having an obstetrician?
So I don't understand why home birth is so disliked amongst the medics when they berate other patients for practising a form of defensive/cautionary medicine - in seeking medical confirmation - yet doctors ought be permitted to do so in childbirth by covering all eventualities even down to having the machine that goes "ping"?
Anon 4-04: Thanks for the reply.
Unlike many people I don't feel the need to board the grief train when somebody who I never knew carks it ala Princess Di fever.
Well I guess, since I don't know you - by your own principles - you should review your own insignificance to life and fuck off and die.
And I'll try not to get bent up like a pretzel over your invalid opinion.
You seem a pretty forthright chap for one so dedicated to wibble, Mr. Ian.
Anon's point is that he's sufficiently distant from some nutty nurse going on about the sand in her vagina to laugh at the absurdity of her tale, rather than sobbing faux tears at some unknown woman's misfortune.
Why you choose to translate that as he (to oneself one is of course the MOST important person) himself should 'fuck off and die' is either because of your base stupidity, or otherwise the intolerance for the opinions of others you demonstrate while simultaneously claiming to want to preserve 'choice'.
matthew: I think (and hope) you missed the distasteful irreverance of Anon's comments that sparked my anger:
Anonymous said...
"* Burying placenta "beside the apple tree in our garden near to where we had laid Frehel" [the miscarried baby]"
Aren't you supposed to eat it? The placenta not the Frehel. Frehel? Is that a Dutch breakfast cereal?
Sunday, November 16, 2008 2:33:00 AM
Excuse me if I am mistaken, but Frehel was the name given to a miscarried baby? And Anon felt fit to insensitively ridicule this 'personalised' fetus - or deceased baby - depending on your view - as it simply does not matter to him/her that a child died.
Regardless of how unusual such practices as burying a fetus under a tree along with the placenta - this is the spiritual choice of the person - just as it is to name their child how they so choose.
I find this insensitivity offensive and tell him/her so.
His/Her response to honestly declare he doesn't really give a shit about those he hasn't met (a la Princess Di fever) is rejoindered by asking, if these are his principles, what is s/he doing in a thread that discusses the risks to unborn children and their parents that s/he will never likely meet and why not remove himself from the situation that he has obviously no interest in; couched in the terms 'fuck off and die'. His/Her value base is obviously so far off the scale as to render it redundant.
As for dedication to wibble, I have no idea how you conclude this. As I don't even have a degree, what would I know about wibble?
'I could of course redirect the argument to mental health and watch you seriously flail to provide some evidence as to the medical prowess that presides therein'
Well, as Regan said, there you go again.
Interesting assumption. Do you know what I do? However you are right. I can't comment on any 'evidence'. I'm not familiar with the journals in that field. However as my family have been consumers of said service for quite a few years, for reasons I won't go in to, I doubt if I would flounder as much as you think.
As for arrogance I confess that I am in error. Mind you, you can't teach me much about humility either.
Crippo: I have no idea what you do. I am merely edging my bets - that even if you were consultant psychiatrist - I'd trounce your likely myopic medicalised opinion.
I also do arrogance rather well, I think, with a huge dollop of uppity. I have very little need for humility as I'm only a nurse and ergo do not - as indeed I am not permitted to do, by medical decree - reach such dizzy heights of self-importance; so it's philosophically impossible, apparently.
Mr. Ian, what ??????? Ooooh you do go on.
" I would like to see the foetus given legal personality and legal rights in the last two or three weeks of a pregnancy; say from 37 weeks gestation. No, I have not been dining with Nadine. This is not an anti-abortion argument."
But that is how it could (potentially) be used. Start at 37 weeks then keep pushing it back, 36, 35, 34 32, 30 weeks.
Thank you for publishing the note from the Nursing and Midwifery Council saying that they found no reason to pursue a case against Kent Midwifery Practice. Could you tell us when you received this email?
The midwife in question has now published a detailed discussion of the case at
http://kentmidwiferypractice.blogspot.com/2008/11/sharons-story-normal-birth-of-12lb-baby.html
It appears that the case was quite different from that portrayed here. The original account was grossly simplified. She states that the local supervisory authorities reviewed the case and commended her practice. So we have a situation where experienced NHS midwives (which is what Supervisors are) have reviewed the actual case notes and the hospital notes, and have found no cause for concern. They (and the midwife you have been criticising) work in maternity care day in, day out, year after year.
I don't really think their spelling and punctuation are the big issues here. I like your blog generally, but you should check your facts carefully before criticising well-regulated UK health professionals in print.
Mr Ian,
Your posts are far too long and hence lose their impact. You may have a point, but it's too hard to find out whether or not this is the case.
Rgds
Lionel R.
Lionel,
It's an indisputable fact; I suffer with eternal verbosity.
I put this down to my arrogant and pedantic nature, but also to the fact I tend to counter argue everyone for everything.
I also type faster that most these idiots but I've decided I really should type slower as some of them obviously can't read very fast.
Comment noted.
TY
:o)
Dammit - I typoed an insult.
Now I'm gonna get flamed.
Thanks Marie.
You said:
Thank you for publishing the note from the Nursing and Midwifery Council saying that they found no reason to pursue a case against Kent Midwifery Practice. Could you tell us when you received this email?
It says nothing of the sort. Can you not read? It merely says the case will not be taken any further because I have not sent them any further details. The only details I have is the report which was presented on the Kent Midwives' site. Blind eye to telescope I think.
The midwife in question has now published a detailed discussion of the case at
http://kentmidwiferypractice.blogspot.com/2008/11/sharons-story-normal-birth-of-12lb-baby.html
So I see, and I shall be taking a detailed look at it later in the week.
It appears that the case was quite different from that portrayed here.
If by "here" you mean on NHS BLOG DOCTOR then you should be aware that I have kept copies of the case as written by the midwives and as presented on their site. I was careful to present it verbatim, omitting nothing. Your suggestion that I have altered there account is inaccurate and offensive
The original account was grossly simplified.
That is the midwife's fault. She was presenting the account as an advertorial to try to sell her wares. Having put it up in public, she must expect to get comments.
She states that the local supervisory authorities reviewed the case and commended her practice.
So I gather. I note in particular that her practice was COMMENDED. May I ask who commended it? Do you have a name?
So we have a situation where experienced NHS midwives (which is what Supervisors are) have reviewed the actual case notes and the hospital notes, and have found no cause for concern. They (and the midwife you have been criticising) work in maternity care day in, day out, year after year.
I am delighted to here that the longer unpublished case account gives no cause for concern. I will take a look at it.
I don't really think their spelling and punctuation are the big issues here.
I did not say they were big issues. But they are relevant. These women are representing midwives in public. They should therefore check their spelling and grammar.
I like your blog generally,
why thank you
but you should check your facts carefully before criticising well-regulated UK health professionals in print.
Oh but I do! Believe me. Please advise of any "factual" errors - but given that I printed the midwive's account of the case word for word with no alterations of any sort, you know damn well that there were no factual records.
Oh! and by the way, do not try to alter the original account put up by the Kent Midwifes. That will make them look dishonest as well as silly - and will be a complete waste of time as naturally I kept an exact copy of their original account as displayed on the internet. Before they took it down, that is.
John
Mr Ian,
Perfect: I read all of that (bear in mind that I'm in Australia and at work!)
Cheers
Lionel R
Likewise, I'm in Oz.
Good 'ere innit?
:o)
Mr Ian is boring even when he just writes a few sentences.
I don't mind the fact he's wrong 80-90% of the time, but...
Please become more interesting you vacuous cretin... at least spur me on to knock back your crappy ideas and arguments...
Just had a quick look through this:
http://kentmidwiferypractice.blogspot.com/2008/11/sharons-story-normal-birth-of-12lb-baby.html
The original text is mostly intact, apart from numerous spelling/grammar changes.
There is one notable 'stealth edit' made:
She had not breast fed any of the others and really wants to succeed this time. About an hour after her birth Sharon had another large blood loss and felt slightly clammy so I lay her down on the sofa gave her some syntometrine and looked for my blood pressure cuff. It was no-where to be found! I had it during labour but now it was lost.
To date on day 3 it is still not located. I was concerned that I might have a woman who was compromised and so I called a paramedic.
becomes
She had not breastfed any of the others and really wants to succeed this time. About an hour after her birth Sharon had another large blood loss and felt slightly clammy so I lay her down on the sofa, gave her some syntometrine and looked for my blood pressure cuff. It was nowhere to be found! I had it during labour but now it was lost. ...
I was concerned that I might have a woman who was compromised and so I called a paramedic.
In shorter words version 1:
'she lost lots of blood immediately after the birth so I needed to check her blood pressure, because she was potentially very ill but I'd lost it, so I did nothing. Two days later I STILL had't found it, so I finally called the ambulance she needed urgently two days earlier.'
Version 2:
'She lost lots of blood and I couldn't find my blood pressure machine, so I immediately called an ambulance.'
This sees rather damning, that the paramedics needed to stay for three hours, yet she stealth edits out the fact that this didn't happen in timely fahion due to her failure to act.
Mr Ian,
It's not bad at all! Just hope K07 doesn't emulate the UK's modernising tendencies wrt the health service. There's already a bulge of medical students coming in 2012 with limited training places... deja vu for me.
Chz
Lionel R
Anon: I like how you assert me to be "wrong" 80-90% of the time on matters that have no right or wrong - merely opinions. If you are suggesting my opinions do not match with yours this much - then I acknowledge your right to be equally wrong.
But thanks for agreeing with em 10-20%. I'd reciprocate but, as "anon", I have no idea if you've contributed anything of value or interest.
Lionel: I'm not really read up on cmnwlth health care policy tbh. I'm of the opinion - whatever happens there will be an outcome - and we'll just go from there.
matthew : yeah I noticed similar - the cuff was an interesting comment - and essentially it seems the clinical reason for calling a 999 ambulance was to get a BP (as had she found the cuff she wouldn't have likely transferred - but since they'd driven all that way in 2 minutes....)
Midwives as a whole - can't comment and I stand by my opinion - whatever that was.
But have read the 'story' - words of 'methinks they doth protest too much' and embellishment wouldn't be amiss IMO.
Abandon ship.
What is the significance of the video clip of the children's nursery rhyme? You've lost me there.
What is the significance of the video clip of the children's nursery rhyme? You've lost me there.
__________
Madwives believe that women who have analgesia during labour have failed and are second rate mothers. Instead, they traditionally suggest singing "Ten green bottles" to take the mind of the pain
John
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