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	<title>Comments on: Midwives in the UK: &quot;Like driving a car without insurance&quot;</title>
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		<title>By: Dr John Crippen</title>
		<link>http://www.kevinmd.com/blog/2007/04/midwives-in-uk-like-driving-car-without.html/comment-page-1#comment-73705</link>
		<dc:creator>Dr John Crippen</dc:creator>
		<pubDate>Sat, 07 Apr 2007 07:43:00 +0000</pubDate>
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		<description>Kevin, it is NOT a rant. I am not talking about midwives working within the system, with doctors and with insurance. I am talking about the Independent Midwives who work in the community doing home deliveries without medical supervision or back up. They are uninsured and uninsurable, and STILL they cary on. The are truly MADwives:&lt;br/&gt;&lt;br/&gt;Beatrice Carla, 56, is fighting to save her career after facing 27 charges, amounting to five counts of professional misconduct.&lt;br/&gt;&lt;br/&gt;An expert panel heard claims that the independent midwife:&lt;br/&gt;&lt;br/&gt;    * HAMPERED paramedics&#039; attempts to resuscitate the baby, so she could apply olive oil to its feet.&lt;br/&gt;&lt;br/&gt;    * STUCK her finger into the baby&#039;s mouth to apply a herbal remedy when a paramedic was giving resuscitation.&lt;br/&gt;&lt;br/&gt;    * BOTCHED attempts to use a lifesaving &quot;bag and mask&quot; device to resuscitate the baby.&lt;br/&gt;&lt;br/&gt;    * FAILED to perform basic resuscitation techniques when the baby stopped breathing.&lt;br/&gt;&lt;br/&gt;Carla had been asked to assist a pool birth at the mother&#039;s home. But the labour started to go wrong when the umbilical cord became wrapped around the baby&#039;s neck.&lt;br/&gt;&lt;br/&gt;Medics managed to save the baby&#039;s life but it suffered severe brain damage.&lt;br/&gt;&lt;br/&gt;Carla - who was advised at the hearing by Chris Warren, treasurer of the Independent Midwives Association - told the hearing in Edinburgh she attempted to use a &quot;bag and mask&quot; device designed to resuscitate babies.&lt;br/&gt;&lt;br/&gt;Carla faces further charges over&lt;br/&gt;&lt;br/&gt;    * the temperature of the water&lt;br/&gt;&lt;br/&gt;    * failure to react to a longer than average labour&lt;br/&gt;&lt;br/&gt;    * failure to document numerous clinical details which could have helped in the ongoing care of the baby.&lt;br/&gt;&lt;br/&gt;Carla denied the allegations over the birth on the grounds that they could not be proven. She said: &quot;Insufficient evidence has been given to prove that my practice fell below the base standard. There is no correlation between extensive record keeping and adequate care.”&lt;br/&gt;&lt;br/&gt;Chris Warren said:&lt;br/&gt;&lt;br/&gt;&quot;We have grave concerns that some women may choose to birth alone if independent midwives are stopped from practising. We focus on the women and their views are respected. The NHS has a lot of rules and some women can&#039;t get the care they require. Even if the wishes of a mother impair the safety of a birth, we will accept that.”&lt;br/&gt;&lt;br/&gt;The article concludes:&lt;br/&gt;&lt;br/&gt;Many independent midwives and their clients follow an &quot;alternative&quot; lifestyle and the use of homeopathy and herbal medicine is common. A full care package, including ante-natal, birth and post-natal care can cost up to £2500&lt;br/&gt;&lt;br/&gt;The full article can be found in the Sunday Mail&lt;br/&gt;&lt;br/&gt;John</description>
		<content:encoded><![CDATA[<p>Kevin, it is NOT a rant. I am not talking about midwives working within the system, with doctors and with insurance. I am talking about the Independent Midwives who work in the community doing home deliveries without medical supervision or back up. They are uninsured and uninsurable, and STILL they cary on. The are truly MADwives:</p>
<p>Beatrice Carla, 56, is fighting to save her career after facing 27 charges, amounting to five counts of professional misconduct.</p>
<p>An expert panel heard claims that the independent midwife:</p>
<p>    * HAMPERED paramedics&#8217; attempts to resuscitate the baby, so she could apply olive oil to its feet.</p>
<p>    * STUCK her finger into the baby&#8217;s mouth to apply a herbal remedy when a paramedic was giving resuscitation.</p>
<p>    * BOTCHED attempts to use a lifesaving &#8220;bag and mask&#8221; device to resuscitate the baby.</p>
<p>    * FAILED to perform basic resuscitation techniques when the baby stopped breathing.</p>
<p>Carla had been asked to assist a pool birth at the mother&#8217;s home. But the labour started to go wrong when the umbilical cord became wrapped around the baby&#8217;s neck.</p>
<p>Medics managed to save the baby&#8217;s life but it suffered severe brain damage.</p>
<p>Carla &#8211; who was advised at the hearing by Chris Warren, treasurer of the Independent Midwives Association &#8211; told the hearing in Edinburgh she attempted to use a &#8220;bag and mask&#8221; device designed to resuscitate babies.</p>
<p>Carla faces further charges over</p>
<p>    * the temperature of the water</p>
<p>    * failure to react to a longer than average labour</p>
<p>    * failure to document numerous clinical details which could have helped in the ongoing care of the baby.</p>
<p>Carla denied the allegations over the birth on the grounds that they could not be proven. She said: &#8220;Insufficient evidence has been given to prove that my practice fell below the base standard. There is no correlation between extensive record keeping and adequate care.”</p>
<p>Chris Warren said:</p>
<p>&#8220;We have grave concerns that some women may choose to birth alone if independent midwives are stopped from practising. We focus on the women and their views are respected. The NHS has a lot of rules and some women can&#8217;t get the care they require. Even if the wishes of a mother impair the safety of a birth, we will accept that.”</p>
<p>The article concludes:</p>
<p>Many independent midwives and their clients follow an &#8220;alternative&#8221; lifestyle and the use of homeopathy and herbal medicine is common. A full care package, including ante-natal, birth and post-natal care can cost up to £2500</p>
<p>The full article can be found in the Sunday Mail</p>
<p>John</p>
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		<title>By: Anonymous</title>
		<link>http://www.kevinmd.com/blog/2007/04/midwives-in-uk-like-driving-car-without.html/comment-page-1#comment-73690</link>
		<dc:creator>Anonymous</dc:creator>
		<pubDate>Fri, 06 Apr 2007 21:24:00 +0000</pubDate>
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		<description>Labor Nurse,&lt;br/&gt;&lt;br/&gt;As you should well know, the problem is that the low risk patient can become a high risk patient very very quickly....</description>
		<content:encoded><![CDATA[<p>Labor Nurse,</p>
<p>As you should well know, the problem is that the low risk patient can become a high risk patient very very quickly&#8230;.</p>
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		<title>By: Anonymous</title>
		<link>http://www.kevinmd.com/blog/2007/04/midwives-in-uk-like-driving-car-without.html/comment-page-1#comment-73668</link>
		<dc:creator>Anonymous</dc:creator>
		<pubDate>Fri, 06 Apr 2007 00:42:00 +0000</pubDate>
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		<description>My desire to deliver a healthy baby, certainly out weighs any idea I might have of being &quot;a real woman&quot; and doing home delivery. My ego is not that big. Not at the risk of my child.</description>
		<content:encoded><![CDATA[<p>My desire to deliver a healthy baby, certainly out weighs any idea I might have of being &#8220;a real woman&#8221; and doing home delivery. My ego is not that big. Not at the risk of my child.</p>
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		<title>By: Labor Nurse</title>
		<link>http://www.kevinmd.com/blog/2007/04/midwives-in-uk-like-driving-car-without.html/comment-page-1#comment-73666</link>
		<dc:creator>Labor Nurse</dc:creator>
		<pubDate>Fri, 06 Apr 2007 00:24:00 +0000</pubDate>
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		<description>Of course things can go wrong in childbirth, but with the advances in obstetrics we can categorize who is low risk or high risk.  Why not give the option of low risk women birthing outside the hospital?&lt;br/&gt;&lt;br/&gt;I agree with the first anonymous poster who states that women are not idiots or victims of persuasion.  Women who chose to delivery outside of a hospital have done their homework.  I have yet to meet a woman chose to take the road that harms her baby.  &lt;br/&gt;&lt;br/&gt;Perhaps some are worried the pendulum is slowly swinging the other way...</description>
		<content:encoded><![CDATA[<p>Of course things can go wrong in childbirth, but with the advances in obstetrics we can categorize who is low risk or high risk.  Why not give the option of low risk women birthing outside the hospital?</p>
<p>I agree with the first anonymous poster who states that women are not idiots or victims of persuasion.  Women who chose to delivery outside of a hospital have done their homework.  I have yet to meet a woman chose to take the road that harms her baby.  </p>
<p>Perhaps some are worried the pendulum is slowly swinging the other way&#8230;</p>
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		<title>By: Anonymous</title>
		<link>http://www.kevinmd.com/blog/2007/04/midwives-in-uk-like-driving-car-without.html/comment-page-1#comment-73661</link>
		<dc:creator>Anonymous</dc:creator>
		<pubDate>Thu, 05 Apr 2007 21:33:00 +0000</pubDate>
		<guid isPermaLink="false">http://clients.emmense.com/kevinmd/2007/04/midwives-in-the-uk-like-driving-a-car-without-insurance.html#comment-73661</guid>
		<description>&lt;i&gt;Amazing that human beings have managed to procreate for thousands of years.&lt;/i&gt;&lt;br/&gt;&lt;br/&gt;I&#039;ve never understood this argument.  Woman died by the score in the &quot;good old days&quot; doesn&#039;t sound like much fun to me.&lt;br/&gt;&lt;br/&gt;If I cut myself I&#039;m not going to have my husband close the wound with moss and mud he finds outback because thats how we&#039;ve been fixing these things for thousands of years.  If it&#039;s deep enough we&#039;re going to the hospital where it will be stitched, cleaned and I might even get some fun drugs.  &lt;br/&gt;&lt;br/&gt;Things are better now than they were a century ago and as a woman I welcome them.  &lt;br/&gt;&lt;br/&gt;But hey this is NHS they did it to themselves so frack them.</description>
		<content:encoded><![CDATA[<p><i>Amazing that human beings have managed to procreate for thousands of years.</i></p>
<p>I&#8217;ve never understood this argument.  Woman died by the score in the &#8220;good old days&#8221; doesn&#8217;t sound like much fun to me.</p>
<p>If I cut myself I&#8217;m not going to have my husband close the wound with moss and mud he finds outback because thats how we&#8217;ve been fixing these things for thousands of years.  If it&#8217;s deep enough we&#8217;re going to the hospital where it will be stitched, cleaned and I might even get some fun drugs.  </p>
<p>Things are better now than they were a century ago and as a woman I welcome them.  </p>
<p>But hey this is NHS they did it to themselves so frack them.</p>
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		<title>By: Gasman</title>
		<link>http://www.kevinmd.com/blog/2007/04/midwives-in-uk-like-driving-car-without.html/comment-page-1#comment-73656</link>
		<dc:creator>Gasman</dc:creator>
		<pubDate>Thu, 05 Apr 2007 17:11:00 +0000</pubDate>
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		<description>There are just some bodilly functions best accomodated in areas designed for them.  &lt;br/&gt;For bowel movements I retire to a specially designed room variously known as a lavatory, toilette, head, etc.  I don&#039;t have &#039;natural&#039; bowel movements just anywhere the mood strikes me.&lt;br/&gt;Similarly, when one needs to evacuate a baby from one&#039;s uterus, there are places where one can go that are quite nicely designed to deal with the needs of the body, provide a range of analgesic options, and have high tech resources immediatly available should things not go quite right.  &lt;br/&gt;Once can have a &#039;natural&#039; enough experience without having to resort to life in the 18th century.</description>
		<content:encoded><![CDATA[<p>There are just some bodilly functions best accomodated in areas designed for them.  <br />For bowel movements I retire to a specially designed room variously known as a lavatory, toilette, head, etc.  I don&#8217;t have &#8216;natural&#8217; bowel movements just anywhere the mood strikes me.<br />Similarly, when one needs to evacuate a baby from one&#8217;s uterus, there are places where one can go that are quite nicely designed to deal with the needs of the body, provide a range of analgesic options, and have high tech resources immediatly available should things not go quite right.  <br />Once can have a &#8216;natural&#8217; enough experience without having to resort to life in the 18th century.</p>
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		<title>By: Anonymous</title>
		<link>http://www.kevinmd.com/blog/2007/04/midwives-in-uk-like-driving-car-without.html/comment-page-1#comment-73655</link>
		<dc:creator>Anonymous</dc:creator>
		<pubDate>Thu, 05 Apr 2007 16:58:00 +0000</pubDate>
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		<description>Yes it amazing that people have procreating for thousands of years without medical care. They also died by the scores from hemorrhage, infection and eclampsia. &lt;br/&gt;&lt;br/&gt;Before the 20th century the average age for death was lower for women than for men. It is now the other way around. The reason for this is the amazing decrease in deaths from childbirth. It is the most dangerous natural thing that a woman can do to herself.&lt;br/&gt;&lt;br/&gt;With childbirth most will go fine, but when disaster strikes, it strikes very very quickly. The average blood flow to the uterus at term is 600 cc/min. So in 10 to 12 minutes a woman&#039;s entire blood flow  passes through her uterus. She can bleed to death in 20 minutes, well before she gets to a hospital.</description>
		<content:encoded><![CDATA[<p>Yes it amazing that people have procreating for thousands of years without medical care. They also died by the scores from hemorrhage, infection and eclampsia. </p>
<p>Before the 20th century the average age for death was lower for women than for men. It is now the other way around. The reason for this is the amazing decrease in deaths from childbirth. It is the most dangerous natural thing that a woman can do to herself.</p>
<p>With childbirth most will go fine, but when disaster strikes, it strikes very very quickly. The average blood flow to the uterus at term is 600 cc/min. So in 10 to 12 minutes a woman&#8217;s entire blood flow  passes through her uterus. She can bleed to death in 20 minutes, well before she gets to a hospital.</p>
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		<title>By: RJS</title>
		<link>http://www.kevinmd.com/blog/2007/04/midwives-in-uk-like-driving-car-without.html/comment-page-1#comment-73654</link>
		<dc:creator>RJS</dc:creator>
		<pubDate>Thu, 05 Apr 2007 15:16:00 +0000</pubDate>
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		<description>Amazing that human beings have managed to procreate for thousands of years.&lt;br/&gt;&lt;br/&gt;Before the advent of modern medicine, even! Astounding!&lt;br/&gt;&lt;br/&gt;&lt;a HREF=&quot;http://www.pixelrn.com/2007/02/switching-teams.html&quot; REL=&quot;nofollow&quot;&gt;PixelRN&lt;/a&gt;&#039;s take. Dr Dino agrees her move is a good one.&lt;br/&gt;&lt;br/&gt;&lt;i&gt;&quot;A &quot;right&quot; to a home delivery is as safe and as sensible as giving parents the “right” to insist that their children have their tonsils out at home on the kitchen table. That is the natural way to do it. That is what doctors used to do a hundred years ago, so why not now?&quot;&lt;/i&gt;&lt;br/&gt;&lt;br/&gt;Give me a break, Crippen. Fear-monger much?</description>
		<content:encoded><![CDATA[<p>Amazing that human beings have managed to procreate for thousands of years.</p>
<p>Before the advent of modern medicine, even! Astounding!</p>
<p><a HREF="http://www.pixelrn.com/2007/02/switching-teams.html" REL="nofollow">PixelRN</a>&#8217;s take. Dr Dino agrees her move is a good one.</p>
<p><i>&#8220;A &#8220;right&#8221; to a home delivery is as safe and as sensible as giving parents the “right” to insist that their children have their tonsils out at home on the kitchen table. That is the natural way to do it. That is what doctors used to do a hundred years ago, so why not now?&#8221;</i></p>
<p>Give me a break, Crippen. Fear-monger much?</p>
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		<title>By: Anonymous</title>
		<link>http://www.kevinmd.com/blog/2007/04/midwives-in-uk-like-driving-car-without.html/comment-page-1#comment-73653</link>
		<dc:creator>Anonymous</dc:creator>
		<pubDate>Thu, 05 Apr 2007 14:50:00 +0000</pubDate>
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		<description>Oh please - most births have little to no complications.  Pregnanat women are capable of making their own decisions about how they&#039;re going to deliver their baby - they&#039;re not idiots or victims of persuasion.</description>
		<content:encoded><![CDATA[<p>Oh please &#8211; most births have little to no complications.  Pregnanat women are capable of making their own decisions about how they&#8217;re going to deliver their baby &#8211; they&#8217;re not idiots or victims of persuasion.</p>
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