Are homebirth midwives morons?
I can’t think how else to explain how licensed Texas midwife Ms. Duffy handled this woman’s labor. The baby nearly died and it was only the father’s determination to transfer to the hospital that prevented the baby’s death. It’s not clear, however, how much of the baby’s brain function was sacrificed in the process.
Here is the mother’s story with the midwife stupidity helpfully highlighted. The patient was already more than 42 weeks pregnant.
Moronic homebirth practice #1: Failure to transfer the patient for postdates and pitocin induction.
[After 2 doses of castor oil] I woke up around 2am to heavy and obvious contractions…
Around 6am Matt called Ms. Duffy…
… At 10:15 am I was 5cm, 75% effaced, and the baby was at +1 station. My vitals were good…
Right after the check… my contractions began to space out … They began to give me black and blue cohosh drops to help get labor into a good pattern again. I would continue to get these drops every twenty minutes… The midwife was checking the baby’s heart rate every 30 minutes. It was great. Usually it was between 120-130…
Moronic homebirth practice #2: Inducing a postdates pregnancy with castor oil and failing to monitor the induction.
Moronic homebirth practice #3: Failing to recognize that the patient was in latent phase labor and attempting to speed up normal labor.
Moronic homebirth practice #4: Dosing a woman repeatedly with black and blue cohosh, which is toxic.
Moronic homebirth practice #5: Failing to monitor the baby’s heart rate at a minimum of 15 minute intervals as per the established protocol for intermittent ausculatation, after both inducing and augmenting the patient’s labor.
I was still continuing black and blue cohosh and nipple stimulation at 1:15 when I was checked next. At 1:15pm I was 6cm, 80% effaced. She said baby was lower, but still not quite a +2 station, so she kept it at +1…
… Ms. Duffy told us that she had only ever done this three times in twenty years, but she thought it might help speed things along if we broke my water… My water was broken just a few minutes later [at 4:45 pm]. It was clear.
Ms. Duffy checked me right after she broke my water, and I found out I had actually gone backwards. I was now 5cm dilated… I had suddenly gone from very manageable pain to pain so intense that I was screaming and crying through each contraction… I must have been pretty bad off because I remember looking over and seeing [my husband] crying many times.
… At one point I … began to feel “pushy”. Ms. Duffy told me … I could push any time I wanted if it felt good. I began to push during contractions. I noticed pretty quickly that something didn’t seem right… Ms. Duffy ended up checking me before I started pushing too hard. I was 9.5 cm and almost completely effaced. It was at this point that we learned I had a cervical lip left.
Moronic homebirth practice #6: Encouraging the patient to push without checking to see if there was a cervical lip, thereby causing swelling of the cervical lip.
Ms. Duffy … began to try to stretch and hold back the cervical lip while I pushed so that I could try and get rid of it… Ashley held back and stretched my cervical lip for about two hours… Finally Ashley [the midwife’s assistant] said that she thought the cervical lip was gone. I continued to push on my own under the assumption that the cervical lip was out of the way.
Moronic homebirth practice #7: Sticking your hand up a woman’s vagina and holding it there for TWO HOURS!! If that isn’t “birth rape,” I don’t know what is.
Around 7pm Ms. Duffy checked the baby’s heart rate… Ms. Duffy told me I needed to get out of the pool immediately and get in knee chest position. I later found out this was because the baby’s heart rate was suddenly going down into the 80s.
Moronic homebirth practice #8: Ignoring deep decelerations and pretending that they could be handled at home.
I got out of the pool and got on the floor in the knee chest position… Ms. Duffy told me I could not move from that position because it was what my baby needed. She had me on 8L of oxygen at this point…
Ashley began to continuously read out the baby’s heart beat. Ms. Duffy had her hand inside of me and was still stretching and pushing back my cervical lip while I pushed…
… After being on the floor for about an hour, I begged to move to the couch. Baby’s heart rate was still having bad decels as low as the 70’s. I was still on oxygen… [M]y midwife refused to remove her hand from me. I kept begging her to get her hand out of me and let me rest, but she told me she had to do it to get the baby out…
Moronic homebirth practice #9: Ignoring deep decelerations after it is clear that delivery is not imminent.
At 10:45 … Ashley was still telling baby’s heart rate (literally non-stop as if she was reading a book. 130, 120, 80. 75, 83, 90, etc). Ms. Duffy had her hand in me stretching my cervical lip and messing with the baby’s head… My husband … looked at the midwives and told them, and told me he gave them a look that said he was done… At this point, baby’s heart rate was not coming back up above 100…
Ms. Duffy called the hospital and they asked if she wanted them to send an ambulance. She said we didn’t have time to wait on them. She told the hospital we had oxygen and would be driving ourselves. When I got to the back door, I noticed the oxygen was no longer working. Ms. Duffy looked it over and realized the tank was empty. We left the house with no oxygen. I was scared out of my mind…
Moronic homebirth practice #10: Failure to call for an ambulance when transferring for fetal distress.
Moronic homebirth practice #11: Failing to appropriately monitor resuscitation equipment and failing to notice that the oxygen tank is empty.
It was 11:15 when we got to the hospital… I heard someone say we had thick meconium… They checked me and I was basically 10 with a cervical lip. They grabbed my legs and told me to push…
The OB showed up. He told my husband they were going to do a c-section… They told me to rest and breathe between contractions… I couldn’t help but push. My midwife kept snapping at me saying “if you don’t stop pushing you’re just going to cause that cervical lip to swell and then they won’t let you try to have a natural birth. If you don’t stop pushing your baby can’t get any oxygen”…
At 12:45am … [t] wheeled me back to the operating room… At some point during the c-section I heard the doctor say “head is out. Nuchal cord x1”… Finally, someone said “you have a baby boy”. The neonatologist came over and told me that Jonah was born with a heartbeat of 60 and he was not breathing. He told us it took two minutes to get him breathing, another two minutes to get him crying, and then at six minutes old he still didn’t have any muscle tone and was very floppy. They let me kiss his cheek and then took him to the NICU…
About half an hour later my husband came back and told me that they had run a set of blood gases on his cord blood and that it was very acidic. The neonatologist informed us that meant he was deprived of oxygen … [and] he was showing signs that it may have affect his organs and his brain. So the decision was made to transfer him to the downtown Children’s hospital where they had a protocol to treat the problem. Jonah was life flighted to their hospital
Fortunately, there was no evidence of serious brain damage. No test, however, can diagnose subtle brain damage in a newborn.
We got a call later that morning that he had showed no signs of seizure activity (this is what they were watching for). They decided to hold him for observation, and ran a bunch of neurological tests, all which came back normal.
So the baby is alive and appears to be healthy but, not surprisingly:
… I have severe post traumatic stress from this birth. My husband and I are already looking into counseling and some resources to help me. I never imagined I would go into labor with a healthy baby and then almost have him die on me…
Well of course she never imagined it. Her homebirth midwife never told her that childbirth is inherently dangerous or that post dates increases the danger or, especially, that Ms. Duffy had absolutely no idea what she was doing.
I’d like to think that someone is going to report the midwife for gross malpractice and violation of just about every standard of regulation of homebirth midwives. Even if no one reports her, I hope she reads this because she needs to know that she is a danger to mothers and babies. Her stupidity exceeds even that typically found among homebirth midwives and probably extends to the fact that she has no clue that she nearly killed this baby and may have left him with permanent brain damage.
