Thursday, November 19, 2015

Statement from Arkansas Midwife

As we announced in September, Jill Dillard is now a certified professional midwife (CPM). Many of you know that she studied under Venessa Giron, a senior CPM who has participated in more than 500 births since 2000. Via the Facebook page of her established midwifery service, A Mommy's Butterfly, Venessa released a statement this week:

I didn't want to respond in this forum but due to the overwhelming support and calls and emails. We were not Jessa Seewald's midwives. I am sad that Jessa suffered a postpartum hemorrhage. I am happy that Jessa and "Quincy" are home, safe and sound. Both Jessa and Jill made decisions that do not fairly reflect home birth nor the care of the midwives in this state. But what matters most is Healthy Baby, Healthy Mama!



Photo shows Jill assisting at a birth in 2014; used with permission from A Mommy's Butterfly Midwifery

82 comments:

  1. This sounds as if they are saying that Jessa and Jill nade decisions different from what the midwives would normally do. The health of mommy and baby are the ultimate concern and I think Jill and Jessa both made decisions that were best for them and their babies. Not everyone can have a home birth

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    1. I agree Lorraine (11/19@ 1:01).

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  2. Wow, I did not even put 2 and 2 together. I never even thought about looking at these girl's birthing techniques or practices as a source of "blame" for their complications.
    I am the oldest of 8 children, and my mother describes each of our births as individual, different, and we did have a brother who was C-sectioned. There are complications all the time, there is no such thing as a routine or standard birth. Each woman is different, a is their baby and birth story.

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  3. How does going to the hospital when hemmorhaging unfairly reflect on a home birth? What a strange statement.

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    1. They are saying that the decisions led to the hemorage. They didn't say that going to the hospital was wrong.

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    2. I am so pleased that they had their say, I would not encourage my daughter in laws to have home births especially with a first time mum.As there is a family connection with that midwifery group people would expect them to use them so at least this does distance them from any unsafe decisions which were made.

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  4. I'm confused as to what this is supposed to mean... Although it sounds to me that she did not want to take responsibility for the poor decisions both Jill and jessa made during their labours.

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  5. I think home birth is the right way to go :)

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  6. I totally agree with the last sentence of the statement. As long as the baby and mommy are healthy, they received a priceless blessing!

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  7. What does she mean "made decisions that do not fairly reflect home birth nor the care of the midwives in this state."?
    Jessa didn't do anything "wrong". Jill waited way longer than I have heard recommended. Is she suggesting that going to the hospital was not what she would have had them do?

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    1. I'm sure most midwives doctors ,etc would have insisted they go to the hospital much sooner. Especially in Jill's case. Too many hours of labor causes stress and possible permanent damage to the infant; including but not limited to, cerebral palsy.

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  8. Wierd, it never crossed my mind to ask anything about who delivered these two babies. Well I guess whatever floats your boat.

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  9. Whoa! Well, the viewers have been saying it, and now the expert chimes in. Who will trust Jill to help deliver her baby, after reading that?!!

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  10. Jessa: Why would you use an unlicensed midwife? To keep the costs down? :)

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    1. Where did you get the idea she used an unlicensed midwife? She just didn't use this particular midwife practice

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  11. Jill made a disastrous decision to have a home birth: her baby was transverse and she was expecting a nearly 10 pound baby. Both reasons to go to hospital, not attempt a home birth. Jesse made a bad decision for also having a nearly 10 pound baby at home. In a hospital, she would have be given a drug to prevent the postpartum hemorrhage and subsequent blood transfusion.

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    1. Jill's baby didn't turn breach until she was at the hospital. They got there the doctor said she was fine and they would go along with a natural birth she wasn't ever in a emergency situation at home only after she arrived at the hospital. And Jessa probably had complications because it was her first birth and such a big baby. It may have been no ones fault.

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    2. I delivered a 9 lb 12 oz baby at home, did have some hemorrhaging, but my midwife had a shot of pitocin to give me to stop it. A good midwife is prepared.

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  12. Which decisions are they referring to? Transferring to a hospital or Choosing a home birth with such large babies.

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  13. I see nothing wrong with home births or an all natural birth in a hospital setting. Women have been giving birth naturally since the beginning of time! However, i do believe God made mankind smart and able to evolve and grow to make advances in technology and medicine. God have mankind the abilities to be able provide safer health care practices over the centuries. Home births are perfectly safe as long as the pregnancy is uncomplicated and the proper qualified individuals are there to help assist. Having said that, this statement speaks volumes as to the Duggar daughters poor choices regarding thier home birth plans ( or jills attempt). Hopefully future plans for more children will open the doors for conversation about a safer method or at least real professionals close by.

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  14. What does it mean that both Jill and Nessa made decisions that does not fairly reflect the care and midwifery in the state they both had threatening conditions

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  15. What is meant by the comment both Jill and Jessa made decisions that do not fairly reflect home birth and midwife care i n the state they both had threatening conditions

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  16. What decisions did they make that do not fairly reflect home birth nor the care of the midwives in this state??

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  17. Why aren't the families involved, Dillard and Seewald saying just who delivered their children? Jill, obviously delivered C-section at the hospital, but WHO was in charge of her horribly lengthy labor during those 60+ hours while at home? Why delivered Jessa's son? I would imagine it was't her mother, mother in law, nor either of her sisters present, so who was it?

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  18. It's sounds scary not to have the right midwives.

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  19. CPM is a Certified Professional Midwife or Lay Midwife or Direct Entry Midwife. They are great for straight forward births with no complications. These midwives have no hospital experience, and do not have a bachelor in nursing degree. The other type of midwife is a CNM, which stands for Certified Nurse Midwife. This kind of midwife has a 4 year nursing degree and hospital experience. In some states they have a masters degree in order to become a CNM. Jill is a CPM, Vanessa Giron is a CPM, Joy Coonfield (Jiil's midwife) is a CPM. Who attended Jessa's birth?

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  20. Always great to have updates and I did wonder if the midwife Jill trained with was involved with Jessa birthing experience.
    I don't however understand the quote "made decision". Initially it sounds off.. Neither turned out the typical home birth and both made the choice to seek additional care due to complications that hospital staff could resolve. Neither made a bad choice and made every effort to get through the process. Having that plan B in place is smart in any state.

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  21. Congratulations Jill. Good for you to achieve your goal! I hope your other brothers and sisters follow your example!

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  22. Wait...it wasn't my fault! Sounds like someone is covering their tracks!

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  23. What are we to glean from this statement? Is Venessa Giron distancing herself from the Duggar sisters? It sounds very much like an insinuation that Jessa and Jill made bad decisions regarding their deliveries? Can someone shed some light on why this statement was released?

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  24. There is a fake account posting on that statement on Facebook trying to get a lot of people in trouble. I think you should bring that to someone's attention because it really seems like this person has a major agenda against the Duggars and people in their circle.

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    1. I agree. That thread is not good.

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  25. What's the issue? What happened during their births that "do not fairly reflect home birth nor the care of the midwives" in Arkansas?

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  26. Why can't they have a midwife deliver their babies in the hospital?? It just seems like that might be a safer option to me.

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  27. This poor family can't even give birth without being criticized - enough! Just love and support this family and stop all the negativity.

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  28. Every birth is different and not always in control of anyone but God. Every mother knows this, after having two or more births. You are your own best advocate and you should be making the decision on the type of birth you want to experience. The process doesn't always happen they way you want, but the end result is what really matters. I would trade my hospital experiences with having a midwife if I could have. Not a lot of mid-wives around in the 1980's.

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  29. If I weren't in such a rural area where vbac births are basically forbidden, I would love to have a home birth......too many hospitals use a cover your butt approach to everything they do......now should there be complications or risks too great, sure but I don't think their choice of home birthing reflects badly on midwifery at all.....there are just things that are out of our control and on God to handle..... 😊

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  30. i don't get the naming one thing on the birth certificate and going by a different name. Besides, the person they named him after's first name was Charles. Why not name the kid Charles.

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  31. This is a very cryptic statement for someone to make...I am wondering what is meant to be read in between the lines.

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  32. What I think she is trying to say is both girls made their own decisions. As in Jill's case she waited a long time to go the hospital even though she had midwife experience and knew what was going on and could be harmful to the baby. Doctors won't do anything without the parents consent, as midwives I'm sure. Now idk if her midwives suggested sooner for her to go to the hospital and she choose not to listen. There is not a lot of straight answers on Jessa's delivery other than she was bleeding more after baby was born, maybe her midwives did suggest for a hospital birth cause they could tell the baby was going to be so good we just don't know. What she is trying to say is they gave them advice and they choose not to go with it. Both babies and mamas are healthy that's all that matters

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  33. CPMs usually don't have hospital privileges because they aren't RNs or NPs. Jill and Jessa may not have known they were having large babies though. My son was 9lbs 5oz and I had no clue he was going to be so huge. I had a similar labor and delivery to Jill except that I was in the hospital the entire time and my labor was only 27 hours. I had an emergency c-section because my son's heart rate dropped. Both of them did the right thing by going to the hospital, but Jill should have gone much sooner than she did.

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  34. The midwife has now back tracked and changes her story. Her statement now reads:
    "I didn't want to respond in this forum but due to the overwhelming support and calls and emails. We were not Jessa Seewald's midwives. I am sad that Jessa suffered a post partum hemorrhage. I am happy that Jessa and "Quincy" are home,safe and sound. There were decisions made that do not fairly reflect home birth nor the care of the midwives in this state. But what matters most is Healthy Baby, Healthy Mama!"
    Interesting that she removed all mention of Jill and her apparently poor decisions regarding home birth. Definitely adds some intrigue to the story.

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  35. Is this part of buy used and save the difference. Why not have a licensed midwife at the hospital. What is wrong with hospitals - they help save lives.

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  36. I don't understand... Can someone fill me in???

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  37. Gosh as people have said that's a vague and confusing statement that sounds like they are trying to distance themselves from something that currently no actually knows anything about. Weird! All they needed to say was that they were not the midwives and thanks for asking.

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  38. How can people say home births are alright in uncomplicated pregnancies. I thought anything could go wrong once labour started.

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  39. It sounds like she has been given grief over their decisions when she wasn't there. So I guess she is entitled to say 'Whoa! It wasn't me!'. It's a shame she felt the need, but we don't know what abuse she may have been receiving. Their mother has received such good treatment & support giving birth in hospitals it is a shame, when they knew they were having big babies, especially for the size of the mothers, that they didn't have them in the safety of a hospital.

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  40. Until there is a statement from the Dillards and Seewalds, we should not speculate anything. How they birthed their children is their choice. We have no right to judge the choices others make.

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  41. Still asking....."WHY did Jessa hemorrhage ? What caused it? The silence on this is quite telling.

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    1. Telling of what? Postpartum hemorrhage occurs in up to 6 percent of all births; there is nothing mysterious about it. Healthcare decisions and results are private information and they are not obligated to share them with the public

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    2. Hemorrhage was most likely caused from the placenta not coming out in tact and then someone going up into the uterus to peel it off thus causing a hemorrhagic event!

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  42. What is this supposed to mean?!? I find it very weird that they say this. Both Jessa and Jill absolutely needed hospital care due to the complications of their babies' deliveries! If Venessa somehow blaims them for going to hospital and that way "not promoting home birth right" she is wrong.
    I'm a doctor-to-be myself and would personally never do a home birth knowing all the things that could go wrong very quickly.

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  43. I am a midwife who had a hospital birth and a postpartum hemorrhage. Unlike being attended by a midwife at home, who has just 2 patients--the mom and baby--my nurse in the hospital left me alone on my first trip to the bathroom after birth, where I lost consciousness on the toilet. As an RN who worked in L&D before becoming a midwife, that is a big no-no. Thankfully, my husband was there with me. Diligence, observation, and presence are key. Even if I'd had the baby at home, I could have easily been transported to the hospital and done just as well.

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  44. Wow, this seems to have become a huge issue. I feel bad for the Duggars. No matter what they do their name is shattered. I don't see what they did wrong here. Seems like people are just out to get them again. But really, it seems the midwives that made this statement are the ones who are going to lose....so sad!

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  45. @AnonymousBoth womens labors turned potentially dangerous to mom and baby and intervention should have occured way before the labors went 2-3 days.

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  46. I don't understand. This article sounds like it blames the girls for having birthing complications.

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  47. Wow, I clicked on the link to A Mommy's Butterfly Facebook page. It's blowing up over this. Lots of interesting info.

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  48. It's good this is being said. I don't know what Jessa did that could be considered unwise, but Jill took castor oil (not recommended/highly controversial) and then waited way too long to go to the hospital after her water broke, both of which were publicized, and as such a public figure training to be a midwife a the time setting a terrible example for others.

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  49. I don't understand this. It sounds like she is trying to defend midwifery and home births since neither Jessa or Jill's went very well. They both had such large babies for young first time mom's!

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  50. As a midwife, everything I do reflects on the birth community and midwives as a whole. If someone formerly associated with me made bad decisions that kept coming back as if to include my involvement, I would issue a similar statement. In other words, they somehow (and I don't know the story) did not follow Standard of Care, which is especially dangerous if you're a new midwife. You HAVE to go by the book and know you're stuff. I would imagine it was really hard on this midwife to issue this statement, as our goal as midwives is one of unity and collaboration.

    Btw, I'm a CPM and a licensed midwife. Being a CPM does not make you substandard, nor does being a CNM make you a better midwife. It's a different scope of practice. You better believe, that while I'm very good at normal and the scenario of everything going right, I'm also highly trained to handle emergencies. It's newer midwives that have to work hard to know what they don't know, and make sure they have an experienced hand with them to bounce things off of. Just setting a previously quoted misconception straight.

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  51. from what I've read, I think many people assumed Venessa was Jessas midwife and possibly Jill's midwife, (although it was obvious Jill chose other midwives). I guess Venessa received a lot of backlash from some of the unwise decisions for both girls home-births from people assuming she was their midwife. The unwise decisions being both girls measurements at the end of their pregnancies showed they were having big babies, considering both girls are quite petite & not tall then it needed to be taken in consideration as a first pregnancy the possibility of baby getting stuck in the birth canal at any point causing the baby distress & forceps or c-section immediately needed thus, home-birth was a much higher risk. Jill's delivery of her waters broken for over 48 hrs risking infection, the baby was transverse, labouring for so very long causing unnecessary distress on baby & exhausting her (some women's bodies go into shock afterwards) were all risks that could have been reduced. Jessas post-partum haemorrhage can't be foreseen though.
    Thankfully by the grace of God both babies & mums were healthy and most importantly all now thriving.

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  52. what she means is that the COMPLICATIONS during both Jill & Jessa's individual home birth experience and as a result having to make CHOICES because of those same complications are not the normal typical home birth experience for most mothers and their midwives as most home birth are A typically free of most complications, as most pregnancies that have pre birth complications are handled by a hospital not at home with midwives. This does not mean that complications cannot arise during a normal home birth with midwives such as was with both Jill & Jessa.. But this does mean that both Jill & Jessa's home birthing experiences were not the normal run of the mill home birthing experience for the majority of women in Arkansas. So please don't think that this is what should or does happen in 99% of home birthing cases. This was what she was trying to say I hope that this makes sense.
    I will add of my own accord that in Jill's case, as I have seen it happen more than once, that even in a hospital setting with a first birth, the mother is often left to labor for many many hrs, as was with Jill with out medical intervention ( but with monitoring ) both at home AND at the hospital. The reasoning behind this is that a first time mother is usually a lot slower to dialate and may take many many hrs to get to the stage were she is actually considered to be in proper full labor with consistent contractions that are actually doing the job. The doctor or nurse / midwife will only intervene as and when needed guiding the patient toward the end goal, which is where all their training and experience come into play. often they will say lets try this or you can try this before we try that or we can just go straight to that, depending on how the mother and baby are coping with the birthing process. Where as a second or third time mother is considered one to take more seriously e.g. when she says I think the baby is coming, as it may well be actually coming - a lot faster as these mothers usually diatate a lot quicker than first time mothers.
    Regardless of whether a baby is to be born in a hospital, birthing center or in a home setting there is always the chance of an uncomplicated birth becoming a complicated birth. This is why all mothers to be have a plan A , B & C. as nothing is EVER set in stone until the baby is born.
    I know of one mother who's doctor, in a hospital wanted her to keep pushing, ( she had been pushing for some hrs ) The baby; head was stuck but he doctor wasn't listening to the mother, who was exhausted by then. Finally another doctor was called in and the baby was pulled out by forceps. Needless to say she had a midwife, but in a hospital setting for the next birth and this was an uncomplicated birth.

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  53. I have given birth to 8 children all in the hospital. I had to have intervention for bleeding with 4 of the deliveries. Hospital or home safety for mom and baby is important.

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  54. I've had some time to reflect on the statement made by the midwife. It seems to me that every baby is different, every pregnancy is different. If either Jill or Jessa was thought to be high risk, then they would have been referred to an ob/gyn. They weren't. However, both had big babies, but then so were mine. In fact, the ultrasound tech at my hospital underestimated my daughter's weight by over a pound. I have three and my third was the smallest at just over 8 pounds. One was almost 10 pounds. You just never know.

    However, this really isn't about me---just an illustration that everybody is unique. I wonder if the midwife has been criticized? I understand that babies that have become breech can be turned and midwives will do that at home sometimes. Jill didn't override her midwife. In fact, I remember the special on TLC where she emphasized the need for the safety of the baby! She made a big point of it. People like to criticize and use sensationalized and/or fake stories as real news when they are not.

    As for Jessa. We don't really know that much at this point. I'm not a medical specialist, but if the hemorrhage had happened at the hospital, the only difference is that she wouldn't have had to wait for transport in an ambulance for treatment. Either way that it happened is not anyone's fault. It just happened, that's all. Who knows why the midwife is making such a statement? It sounds very defensive.

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  55. If anything the aren't saying that going to the hospital was wrong, but likely there were decisions that made either home birth unwise or the way they went about home birth wasn't wise. Or, at a minimum, not consistent with what she would teach.

    And I don't blame her for qualifying her lack of involvement. Her reputation is key to her business/ministry.

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  56. This Duggar family has always led us to believe they know quite a bit about the childbirth process. If so, then why did these two births come so close to absolute disaster?

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  57. I will NEVER have a homebirth. I at first considered it, but I was 9lbs exact, and I want an epidural!!!!! My aunt has homebirths, so she challenged me to consider, but after these stories with Jill and Jessa, I care about the safety about my baby more than my comfort. Period.

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  58. @Janice Ingle Israel was not transverse at the start of labor, he was head-down. He moved into that position mid-labor.

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    1. Just wanted to clarify that after waters break, a baby cannot turn inside the uterus, especially one of israels size. He was likely transverse to begin with and no one caught it.

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  59. Hemorraging happens. There are times when the uterus does not clamp down.

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  60. @Anonymous TOTALLY AGREE. The baby's health is the most important thing. Too many things can go very wrong very fast to risk a home birth.

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  61. I had two home births and my last two were hospital births, if i would have had my beautiful boys at home I would have lost them and probably my life as well, so thank the LORD I went to the hospital, something just told me is was right, i had a bad feeling something was wrong even though my first two were eventless.Babies are not worth the risk.Yes, i know women have been doing it since the beginning of time, but there were no other options then, we have evolved.

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    1. It is true that women have been having home births since the beginning of time but I think we tend to forget that for centuries it was commonplace for women to die during or after childbirth. We have the technology to prevent such needless deaths now. I am so happy that you listened to your intuition saved yourself and your babies.

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  62. Kelly Bates had almost all of her children at home.

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  63. @Anonymous
    Everyone is different, and you should do what's right for you, but home births don't have to be bad. I had three of my four children at home (where I live in England), and one weighed 10lb 6oz, and everything was fine! Am glad you found a route you are happy with, just wanted people to know that size doesn't always matter!

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  64. @Nicole Holding

    I'm a labor and delivery nurse and I assure you it can.

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  65. @Anonymous

    Neither were good candidates for home birth, let alone with a lay midwife. The size and position of Jill's baby, you can't deliver a transverse lie vaginally no matter how long you labor for and a baby the size hers was isn't going to be able to change positions.

    As far as Jessa I really wonder if she had any prenatal care at all. I also don't think even a lay midwife was present. I think she decided to "freebirth". Yes she had family around but no one with any training.

    No matter conditions up to labor, once labor starts ANYTHING can happen and both had issues that were potentially life threatening, either to themselves or their babies. Yes they finally called an ambulance when it was way past obvious but I bet even a lay midwife attending either of those births would have suggested transferring to hospital a LOT sooner than when either went in. But no one can force a mother to transfer. I believe that is where the "bad decisions" come into play. They would have been told by any half reasonable CPM to transfer earlier. The problems they had are easy enough to pick up on.

    I think with Jill she was probably told she should transfer after day 1 of labor but she refused to move until 72 hours in.

    Anyone who births a very large baby is at a higher risk of post-partum hemorrhage. This alone made Jessa "high-risk". I don't think she was under the care of anyone but if she was I think they probably would have suggested transferring sooner also.

    No one can force a laboring woman to do anything but when things go south they have no one to blame but themselves.

    I think another big factor in Jessa's birth decision is that most hospitals will NOT allow a film crew in. Of course they knew they were filming the new series and wanted to focus on the births. The only way Jessa's birth could have been captured by a film crew is if she had the baby at home.

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  66. @Anonymous

    There is a big difference between a lay/CPM midwife in the US and a midwife in the UK. The qualifications for your nurses are the same as our certified nurse midwives. Very highly educated with a degree in nursing and then extended education in maternal/fetal well being/care and deliveries.

    CPM/lay midwives/homebirth midwives in the US have no formal training and no medical background. There is no peer review, no regulation board to examine poor outcomes and therefore no "quality control". Births attended by these kind of midwives have up to an 800% higher perinatal mortality rate than those born in a hospital. If a baby dies there is zero accountability.

    I would consider a home birth with a nurse midwife or a midwife that meets the requirements for UK, Holland, and any other western trained midwives, but never with a lay midwife.

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  67. There is some serious misinformation here about the CPM credential, and as a CPM student, is discouraging. CNMs are not "better trained" in the least. Our scope is normal healthy out of hospital birth scenarios but we are highly trained in handling emergencies.

    Also neither Jessa or Jill did anything wrong and I am not sure why they are being so heavily judged. Postpartum hemorrhage happens. Babies changing positions in labor happens. It's not a reflection of poor care.

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