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Natural Birth
MissusTexas
member
Negligent midwife?
MissusTexas
member
I'm curious as to if this is really negligence and if anything can be done to make sure this doesn't happen again.
My coworker's grandson was buried last weekend after dying in the womb 4 days before his due date.
Apparently, the mother decided to go with a midwife because they didn't have insurance and that was the most affordable option. The family believes that the first mistake the midwife made was in taking the mother as a patient because she has a history of losses: 2 in the first trimester and then the baby lost last year at 5 months into the pregnancy. The mother is 37, obese and developed gestational diabetes in pregnancy before.
The mother developed gestational diabetes in this pregnancy, too, managing it solely with diet. The midwife was not diligent about checking the mother toward the end, and when she measured she said mother was measuring large but the midwife said it was mostly water weight.
Last Monday, no heartbeat was found and on Wednesday the baby was delivered dead via c-section, weighing 15 lbs 12.6oz. Shouldn't he have been taken weeks ago?!
Even as the mother was being wheeled into surgery the midwife was trying to convince the mother that a natural birth was still possible, hugging her and saying "You can do this!".
Should the midwife be held responsible for this tragedy? Or is the family grasping at straws? I don't know anything about what requirements there are to be certified here in Texas, but the family wants to take any licensing she has away.
This discussion has been closed.
Re: Negligent midwife?
The midwife is based out of a birth center in Killeen.
Oh, and the midwife thought the baby was only about 13lbs (?!) at that point... so she knew he was already very big.
Sounds like a terrible situation. Midwives are licensed by the state. It looks like there is a compliant form on the webpage for TX. I don't know what sort of civil lawsuit would be needed for this sort of thing, they should probably consult a lawyer and another midwife for an opinion on this.
https://www.dshs.state.tx.us/midwife/default.shtm
My 2nd cousin had something similar - GD and stillborn at full-term, but she was under a doctor's care and has since had 2 healthy babies. It's heartbreaking.
...baby #3 is here...
I had GD with my first.
The only measurements ever taken was my blood sugar (and I took that myself) and fundal height by my GP.
I am sure the family is looking anywhere they can to assess blame for this tragedy. Should the midwife have turned this patient away? Would the mother have been better off with NO prenatal care?
You are getting all of this third hand. You don't actually know the conversations, the advice that was dispensed. You only know the outcome, and it is a tragic one.
Sounds like a bad situation to begin with. I agree that midwife should not take the case, but family should know that they needed a high-risk specialist too. Pointing fingers will really not make anything better, but someone definately needs to check the midwife and why she took a high risk case and what other things she does not comply with.
See, this was my first thought when I heard she chose a midwife because of cost. I thought people decided to go with them based on their principals regarding natural birth. I don't know if that was a factor here at all.
I'll have to update if anything ever happens one way or the other with this.
This. I think that the people to file a complaint, if they feel one is warranted, are the baby's parents and those at the hospital who were witness to any medical evidence. Friends, family, neighbors, etc. have zero business of getting involved in anything but offering support to the family in their time of grief, as they are all third-party (or more) sources who cannot possibly know the full story from both sides unless they were at every appointment.
It is tragic that a baby died, my heart aches for this family, but the whole, "I---outside person (even if that is a grandparent)--want to find someone responsible and punish them and make sure that this never happens to any woman ever again" mentality is most likely misplaced grief unless the parents have specifically asked for this kind of advocacy.
More Green For Less Green
I have a hard time believing that an OB would have let her carry that large of a baby to four days before the mother's due date under his/her care.
You may have a hard time believing that but the fact is neither we nor OP knows. And the baby's loss could be unrelated to the third (fourth) hand knowledge we have here.
It sounds strange to me as well. I'm assuming this was a homebirth midwife? While they can order ultrasounds, they don't perform them. I would wonder what advice she gave this couple. I don't know many who would be laissez faire about a mom with GD and a baby measuring 13 pounds. Most err on the side of being very conservative. Did this couple insist on her care or refuse doctor care due to price, from what you say, that seems to be the case. If she was negligent, I'm sorry to say so were they given their history. What a horrible tragedy. Where I live, there are a lot of people who chose unassisted birth because they don't have insurance and can't afford other alternatives, even midwifery sometimes. It makes me incredibly sad when parents have to make that choice.
I hope they find a place of healing. I can only imagine how hard that will be.
NorCalMOMS bio* NorCalBOTB* babywearingBIO
Harmony Doula
I'm a nurse licensed in Texas. I'm also familiar with midwives (I had one for my care with my son). I also lived in Killeen for 5.5 years and just moved from there a year ago.
My honest suggestion is that 1. the family needs to not try and determine if the midwife was negligent. They have no background in nursing or midwifery, and they are grieving. If they believe that the midwife was negligent and they would like her licensing and credentialing looked at, they can contact the Texas Board of Nurse Examiners. They are the credentialing body for nurses in the state of Texas. The BNE will send the case to what is called peer review. A board of nurses and midwives will review the details in the case, conduct an investigation if needed, interview, review medical charts, etc. They will then make a ruling if remedial training is needed or revoke the license of the midwife. This entire peer review situation is 100% separate from a civil lawsuit and a lawsuit does not have any bearing on the results of the peer review board. The family can contact the BNE with questions to see what steps they need to take. There is a BNE website with email and phone contact information.
I sat on the peer review board at a hospital in Killeen. We went through cases like this, and it was often very difficult for us when we had to make recommendations that the Texas BNE look at revoking someone's license. We don't want to throw each other under the bus so to speak. But if the midwife was in error, the BNE should be alerted so they can make that determination and take the appropriate actions. Please pass this information along to the family.
While I agree that it is impossible to know what would have happened under the care of an OB, I also agree that it is more likely that this death would not have happened under the care of an OB. If the baby was over 15 lbs it is obvious that her diabetes was NOT controlled - it was very much out of control.
Also, the fact that the mother did not want to seek the care of a doctor doesn't mean that the midwife was competent to take on the care of such a high risk patient. If a care provider is not qualified to care for a patient, it is their responsibility to refer to a qualified provider, and refuse care from that point further. If a friend of mine doesn't want to seek medical care and wants to consider me her medical care, does the fact that "my basic understanding of pregnancy, labor and delivery is better than her complete lack of it." mean that I should allow her to think that I am capable of caring for her? Absolutely not! The correct response is, "I don't have the ability to answer your questions/help you with that. You need to see a doctor." The same is true for a midwife that is in over her head.
This. I agree that something is missing here. This is a terrible tragedy, and it certainly sounds like the MW should have referred this to a physician sooner, but I'd like to know more facts.
I think they have to do what they feel is right. If that means filing a complaint, they should. After that, they should stay out of it until the investigators do their job. When loss occurs, we need someone to blame. We don't know all the circumstances. The loss of a child, at any age, is tragic.
My only experience is that I was a bad candidate for a BC due to my age, risk of GD and risk of PreE. I also live in Texas.
If she's a CPM (certified professional midwife), she's regulated by the Texas Midwifery Board, not by the Board of Nurse Examiners: https://www.dshs.state.tx.us/midwife/default.shtm
(CNMs are regulated by the BNE, but most BC/HB midwives are CPMs.)
My (homebirth) midwife would have permitted me to stay in her care if I had GD, but I would've had to keep my blood sugars under control with diet alone, no insulin necessary. I'm guessing a woman who had a nearly 16 lb baby was not keeping her blood sugars under control.
As for the previous losses, it totally depends on the reasons for those losses. I've had a first trimester loss and that has zero impact on my eligibility for out-of-hospital birth.
Mommy to DD1 (June 2007), DS (January 2010), DD2 (July 2012), and The Next One (EDD 3/31/2015)
Are you kidding me? yeah that woman needs out of the practice
Weird. My midwife absolutely would not have taken this woman as a patient. I can't imagine a midwife putting two lives on the line like that (not to mention, her own @ss) for such a high risk. I agree with others--I don't think we've got the whole story. If it really did go down like this, then yes, I absolutely believe that midwife should have her license revoked. However, I'm also giving the parents the side-eye for going to the midwife instead of an ob; that was the first mistake, given the mother's history. I understand money is a huge factor, but is it more important than a life? I don't think either side is blameless.
What a tragedy...my heart is breaking for that couple, and I can't even begin to imagine what that poor mama is going through right now.