Sunday, November 25, 2007

Baby seizing, probably brain damage; plan: just keep "trusting" birth

Homebirth midwives are dangerous. They are dangerous because they are grossly undereducated and undertrained. They are dangerous because most of what they think they "know" is factually false, and merely ideology. And they are especially dangerous because they don't learn from their own mistakes, even the ones they bury.

Don't believe me? Check out my favorite forum (which illustrates the dangers of homebirth better than I ever could) in the "birth professionals" section. A homebirth midwife reports on a recent homebirth disaster. It sounds like a severe shoulder dystocia. The baby ended up with a broken collarbone and seizures. It is unclear how much brain damage was sustained. The midwife wants to know how she can "move on". Move on? She was involved (and perhaps responsible) for the injury, potential brain damage, potential life long impairment of an otherwise healthy baby and she's already talking about moving on?

Here's some unsolicited advice from me: Before you do anything else, find out precisely what has happened to the baby; that's part of professional responsibility, the legal and ethical responsibility that real professionals undertake. Second, learn what you did wrong. Should you have counselled this patient against homebirth? Should you have obtained an ultrasound to estimate fetal weight? Could you have managed the delivery more successfully? Did you call for transport soon enough or did you wait precious minutes while the baby's brain function was damaged? The hospital holds weekly morbidity and mortality rounds to discuss bad outcomes and how they might have been avoided. Everyone learns from M&Ms, not just the individuals who were involved in the incident.

Another homebirth midwife offer sympathy and a story of her patient whose baby died of massive brain damage after a homebirth earlier this year! No one seems to notice that these horrible disasters are happening with some frequency.

Then, inevitably, someone offers the inane prescription to continue trusting birth. No, no, no. If the midwife learns anything from this incident (and it would be a tragic dereliction of professional responsibility to refuse to learn from this incident), it is that BIRTH IS NOT TRUSTWORTHY. What does it take for homebirth midwives to understand reality? How many cases of brain damage are required? how many babies have to die hideous deaths before they understand that they are completely and utterly WRONG in their assumptions about birth?

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