Homebirth advocacy is based in large part on mistruths, half truths and sometimes outright lies. One of the bigger lies that you often hear in the wake of a homebirth death is “it would have happened in the hospital, too.”
No, it wouldn’t have for a very simple reason: when you “trust” birth, you assume that everything will be fine and therefore avoid real medical care until it is too late.
[pullquote align=”right” cite=”” link=”” color=”#004C01″ class=”” size=””]Homebirth killed Caroline Lovell.[/pullquote]
Caroline Lovell’s story was horrifying even before we knew the details. Death from a routine childbirth complication like bleeding is almost unheard of in an age of blood transfusions and surgical repair … but not in an age of homebirth.
Lovell was an Australian homebirth activist who wrote the following in response to midwifery legislation under consideration:
On a personal note, I am quite shocked and ashamed that homebirth will no longer be a woman’s free choice in low-risk pregnancies… I feel the decision to outlaw homebirth’s is contrary to women’s rights … Please find a solution for women and babies who homebirth after this date as their lives will be in threat without proper midwifery assisstance. And as a homebirthing mother I will have no choice but to have an unassisted birth at home as this is the place I want to birth my children.
Yours sincerely,
Caroline Flammea, Nick Lovell and daughter Lulu Lovell
Lovell did not act on her dare, but perhaps she would be alive if she did. Instead she hired midwife Gaye Demanuele.
The testimony at the Coroner’s inquest was chilling:
“A mother told her midwives she was dying and needed to go to hospital in the moments after she gave birth to her second daughter in her Melbourne home, the Victorian Coroners Court was told on Tuesday…
But just over an hour after the “overjoyed” couple greeted their daughter in their Watsonia home, the court heard Ms Lovell told her midwives she needed to go to hospital. Ms Lovell, 36, died later that night in the Austin Hospital.
And so Caroline Lovell bled to death … slowly, preventably … because the midwife she depended on was too ideologically brainwashed to perform even the most basic midwifery tasks. Instead, as reported by the assistant midwife Melody Bourne:
Just over an hour after Zahra was born in a birth pool, Ms Bourne said Ms Lovell was light-headed and hyperventilating, telling her midwives she was dying and needed to go to hospital.,,
“Gaye and I also made efforts to calm and reassure Caroline.”
Five minutes later, Ms Lovell became pale, cold and unresponsive and an ambulance was called. Examination by hospital clinicians revealed Ms Lovell had suffered two tears and a blood clot.
Any real healthcare provider will tell you that the most chilling words you can hear from a patient are: “I think I’m dying.” That’s because they probably are dying and it is up to you as the provider to undertake whatever examinations and tests are necessary to prove that they are not.
It would have been laughably simple for the Demanuele to have assessed Lovell BEFORE she reassured her. Her life threatening blood loss would have been easily diagnosed by taking her blood pressure or checking her pulse. Nothing sophisticated was required, merely the most basic of clinical skills.
The Coroner offered his assessment this morning:
After Ms Lovell gave birth at home in 2012, Coroner White said the baby had blood on her head – a sign that Ms Lovell may be bleeding. Despite this, Ms Demanuele allowed Ms Lovell to remain in the pool for an hour unchecked. Her baby was with her most of the time so they could bond.
Had Ms Demanuele turned on the lights, Coroner White said she may have noticed the pool had turned a reddish brown due to her blood loss. The blood loss was likely caused by injuries to her vaginal wall, perineum, and probably her uterus.
When Ms Lovell tried to get out of the pool, she fainted. After regaining consciousness, Ms Lovell said she feared she was dying and asked for an ambulance to be called. Ms Demanuele did not call an ambulance. Later, Ms Lovell collapsed again. Ms Demanuele started CPR and an ambulance was called.
Furthermore:
Coroner White said while Ms Lovell was being treated at the Austin, Ms Demanuele returned to her Watsonia home and removed the pool and its contents, “despite what I am satisfied was her comprehension of the potential relevance of this evidence to questions likely to be later asked of her”…
He said Ms Demanuele had:
failed to conduct a proper risk analysis before deciding to approve a home birth for Ms Lovell
failed to consult Ms Lovell’s GP throughout her antenatal care
failed to provide a safe environment for her to give birth, which made it difficult to observe the complications unfolding
failed to call for an ambulance when Ms Lovell needed one; and
failed to provide paramedics and Austin hospital staff with adequate information.
Despite these damning findings, I’ve already seen homebirth advocates declaring on line that it wasn’t homebirth that killed Ms. Lovell, it was Gaye Demanuele’s malpractice.
Let’s be clear:
Homebirth killed Caroline Lovell.
Yes, hemorrhagic shock was the proximate cause of her death … in the same way that hemorrhagic shock may be the proximate cause of death of a pedestrian hit by a drunk driver.
It is disingenuous to blame Demanuele’s irresponsible commitment to demedicalized childbirth for Lovell’s death. As in the case of many homebirths, she was hired precisely because she was willing to sacrifice safety on the altar of natural birth.
Homebirth is ALWAYS a gamble, or perhaps more accurately a dare. The mother gambles that she or the baby will not experience a life threatening complication at home. In the world of homebirth, greater risk factors mean a greater dare and therefore a greater “triumph” if mother and baby come through unscathed.
The dreadful irony is that had Lovell given birth unassisted, she might be alive today. When she told her husband she was dying, he may have called an ambulance to summon real medical professionals.
Instead, Ms. Lovell trusted homebirth Gaye Demanuele who was willing to defy basic safety precautions to attend her homebirth. In an effort to prevent “medicalization” Demanuele reassured Caroline Lovell she was fine even as her life ebbed away.
Ms. Lovell believed homebirth was safe and that belief killed her.
Her death, like nearly all homebirth deaths of babies or mothers, was entirely preventable.
