Back in March, testifying before the Oregon legislature, Judith Rooks, CNM presented data that demonstrated that planned homebirth with a licensed midwife in 2012 had a death rate 800% higher than comparable risk hospital birth.
Oregon midwives have remained publicly silent on the issue, but now the Oregon Midwifery Council (OMC) has advised its members that things must change.
[gview file=”http://www.skepticalob.com/wp-content/uploads/2013/10/OMC_letter_Sept._2013.pdf”]
In a letter sent to members, President Silke Akerson wrote:
I am writing on behalf of the Oregon Midwifery Council to suggest specific rule changes to address the apparent increase in perinatal mortality with Licensed Direct-Entry Midwives in Oregon in recent years. While we know that Oregon Midwives generally provide excellent care, we also have been receiving reports of more deaths than usual in 2012 and 2013 and were deeply troubled by the vital records data for 2012 which showed a perinatal mortality rate significantly higher than what we would expect.
Higher than what she would expect? How would she know what to expect when she never bothered to check the perinatal mortality of Oregon DEMs at all, and when Melissa Cheyney, the Head of the Board of Direct Entry Midwifery, categorically refused to released the death rates Oregon homebirth collected by the Midwives Alliance of North America?
In response, the OMC recommends common sense measures that they have hitherto opposed, including:
1. Require LDMs to participate in peer review per Oregon Midwifery Council guidelines …
2. Require continuing education in risk assessment…
3. In recognition of their greater risk and the need for deeper informed choice, we recommend that you separate breech and twin births from the non-absolute risk criteria and put them in their own category with their own rules for consult and informed choice…. We recommend that the LDM be required to recommend that the client consult with a hospital based physician or CNM in order to hear risk and benefit information from a hospital based provider as well as from her midwife as part of the informed choice process. We also recommend that the LDM be required to give the client detailed and specific information about her hospital birthing options related to breech or twin births, including any options for vaginal breech or twin delivery in hospital.
Oops, it turns out breech and twins aren’t variations of normal, something that everyone else has known all along. Indeed, the legislature insisted on separate consent as of June 2011, but Melissa Cheyney and the Board repeatedly applied for extensions, at least up to July of 2012. It is not clear to me whether they ever produced a consent form in compliance with the requirements.
It appears that these common sense provisions, that should have been instituted years ago, are merely “recommendations,” not requirements. It remains to be seen whether Oregon DEMs will comply and whether the Oregon legislature will turn these recommendations into mandates.
I’m glad for the recommendations (woefully late and woefully inadequate as they are), but I find it particularly ominous that Akerson reveals that the hideous death rate of 2012 has apparently continued in 2013.
In all other circumstances, when we find that a product is particularly dangerous, we recall it and ban its use temporarily until the problems can be fixed. It is truly amazing to me that knowing what she does about the ongoing high death rate, Akerson does not recommend physician consultation for all homebirth patients until proper regulations are in place.
I never doubted for a moment that the hideous death rate of homebirth would catch up with CPMs and DEMs, and slowly but surely it is beginning to do so. What I cannot fathom is the extreme coldbloodedness that allows midwives like Akerson and Cheyney to ignore the babies that are inevitably going to die in between now and the time that rigorous standards are instituted.
I learned yesterday of yet another Oregon homebirth death, although I don’t yet have all the details. We cannot bring back the babies who have already died at the hands of Oregon homebirth midwives, but shouldn’t everyone be doing everything in their power to make sure that no additional babies die preventable deaths at homebirth?
I’d be happy to give Silke Akerson a chance to respond in a guest post if she so desires, as long as she is willing to address the fundamental question: why are homebirth midwives still practicing if they are so very dangerous?
MANA knows the death rate for Oregon and for every other state in previous years. Please sign the petition to force them to release their own death rates, which they have been hiding for years.
