Who is REALLY at Fault?

This photo is what dangerous arrogance looks like.  Angela Hock, an unlicensed midwife was charged with “negligent child abuse resulting in death after a baby died following an unsuccessful home delivery in Omaha.”

Last month paramedics were called to the home, where they “found Hock, who operates Nebraska Birth Keeper, attempting to help 25-year-old Emily Noe deliver a breech baby in the home. Noe was on her hands and knees as another woman held the partially delivered baby, the affidavit said.”

The female infant was delivered en route to the hospital, limp and apneic, where the on-call OB determined she was likely suffering anoxic cerebral edema.  She was taken to the NICU, where she died 3 days later. 

“According to the website, Hock began her ‘journey as a birth professional’ in 2004 and started attending births as a doula in 2013 ‘before discovering my calling to help women find their power and ancient wisdom through traditional midwifery.’” 

“I believe … that women possess the God-given wisdom and intuition to birth their babies free from regulation,” said the former doula, as worthless a distinction as I could imagine.

“Mr. Dornan said Ms. Hock had performed about 50 deliveries in the past without any episodes, as well as aiding in an additional 25 to 50 deliveries before that as a doula, a person who has no medical training but provides guidance during pregnancy and birth…’She is not a medical provider,’ Mr. Dornan said of Ms. Hock. ‘She makes that clear with respect to her clientele. My client is an old school midwife, in that she’s not certified. Midwife is in the Old Testament, if you will.'”

“When the emergency responders arrived at the home, Mr. Dornan said, they gave Ms. Hock a pair of scissors to try to help make a wider opening for the baby, which is considered to be a surgical procedure and is mentioned in the criminal complaint against his client.”  Yes, I have sewn those up in the L&D suite once the OB was through, and I would consider that to be a surgical procedure.  And I’m glad I never had to perform one.

“’You’re looking at a choice of evils, if you will,’ he said.”  And sad I am to say that I think the lawyer has a point.  But we are looking not at a choice of evils, but collaborative ones.

Dear merciful heavens, this is not the Nebraska of sod houses and laudanum.  This mother had a C-section with her first child at their local hospital, so SHE chose to have a VBAC with an untrained doula-quack (sorry, redundant) under completely unnecessary circumstances, incurring almost completely avoidable risks.  

I’m fine if they throw the maximum 20-year prison penalty book at this charlatan for her arrogant disregard of the child’s life.  We here try to describe the proper line between not blaming the patient, and holding them accountable for their choices.  Some of you won’t like this.  But the couple that paid $4,000 cash for an in-home birth experience had every opportunity to seek professional, trained care, and did not.  As far as I’m concerned, in this day, in this nation, the parents deserve equal blame for the death of this child.  I’m a “buyer beware” kinda guy, but at some point, especially with 9 months of lead-time, it falls to the patient – or parents – to demand proper care.  

Education and training matter.