# BC "midwife" charged with baby death



## Mamid (Nov 7, 2002)

http://vancouver.cbc.ca/regional/ser...idwife20040706

Quote:

RCMP in Sooke say Amy Marie Labadie, 33, has been presenting herself as an experienced midwife for women wanting a natural childbirth.

In mid-June an infant identified as a breach baby died during a home delivery. Paramedics called the Sooke RCMP.
The article below is not on the web anywhere and I searched for it...

Quote:

Times Colonist (Victoria), Page B02, 06-Jul-2004
'Midwife' charged after probe following death of Sooke baby

The death of an infant during an attempted natural childbirth at a Sooke home last month has led to charges against a 30-year-old woman.

Amy Marie Labadie has been charged with criminal negligence causing death following an investigation that involved the Sooke RCMP, and the RCMP's major-crime units from both Victoria and the West Shore detachment.

The infant, a second child for the mother involved, died around the time of birth on June 14, Sooke RCMP said. Labadie was arrested June 30, and later released under several conditions, including that she stay away from pregnant women.

"The investigation revealed that Labadie allegedly presented herself as an experienced midwife for a woman who wanted to have a natural childbirth," Sooke RCMP Staff Sgt. Jennie Latham said in a news release. "Labadie is not registered in B.C. and is not recognized by the College of Midwives."

The pregnancy had been identified as a breech birth, where a baby's buttocks rather than its head emerge, and natural childbirth was not advisable. Labadie is alleged to have acted negligently before and during the birth, police said.

An ambulance was called to the home but the infant could not be saved.

Labadie's next court appearance is scheduled for July 13 in the Western Communities courthouse.


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## mammastar (Nov 5, 2002)

How sad, the poor family.

Is there any reason why an otherwise legitimate, trained midwife would object to registering with the College of Midwives in BC?

I had my daughter at home in BC with a fantastic, registered midwife. I know that, although home births are covered under medicare, there is a lot of tension between midwives and conventional practitioners about them. I hate to think that something like this could be used to discredit the wonderful work done by many midwives and families.


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## Mamid (Nov 7, 2002)

Talked to my midwife about it - she hadn't heard anything at all about the case. Apparently midwives aren't allowed to attend breech births in BC. At all.

If you want to find out why some won't register, look up the name "Gloria Lemay." Or the restrictions put on them. Or the hoops they have to jump through to get licensed.


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## JessicaS (Nov 18, 2001)

What are the laws regarding Midwives and registration in B.C.?? Are they even supposed to practice without being registered?


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## Mamid (Nov 7, 2002)

This is Mamid's DP who is using her account cause he hates using Nutscape. From the BC College of Midwives website (http://www.cmbc.bc.ca/)

Quote:

In order to be registered to practice in British Columbia, applicants must either be graduates of an approved education program or take part in the CMBC's Prior Learning and Experience Assessment (PLEA) process. To date, the Midwifery Education Programme in Ontario, Canada is the only approved educational program, although it is expected that the midwifery program at the University of British Columbia will be approved prior to its first graduating class in 2005.

The PLEA process includes a portfolio review, written and clinical exams, and an Orientation program. In order to be eligible to proceed to the examination stage, applicants must provide evidence that they have graduated from a formal midwifery education program, that they have sufficient clinical experience, and that they are fluent in the English language. More information on the PLEA process may be obtained on this website.

This document is intended to describe CMBC requirements of formal midwifery education programs. It is hoped that this information will assist potential candidates to assess whether their educational programs meet CMBC requirements. We also hope that this document will enable aspiring midwives to choose educational programs that will give them the greatest chance of successfully completing the PLEA process and registering to practice in BC.

CMBC Requirements for Midwifery Education

The standard for midwifery education in BC is a four-year Bachelor of Midwifery at a Canadian University. The combination of an applicant's midwifery and other education will be assessed against this standard. There are three parts to the CMBC assessment of a PLEA applicant's education as outlined below:

Part A: Formal Midwifery Education
According to Registration policies, applicants must have graduated from a formal midwifery program that meets these requirements:

1. Location in a jurisdiction where midwifery is recognised by law and midwifery practice is regulated;
2. Minimum length of two years of full-time study for a direct-entry program or one year of full-time study for a post-nursing program leading to a formal credential in midwifery;
3. Inclusion of both academic and clinical curricula;
4. Clear links between the academic and clinical curricula;
5. Curricula must be based on clearly defined competencies;
6. Curricula must cover all aspects of care, including antepartum, intrapartum, postpartum, and newborn care;
7. Curricula must assume a primary care perspective preparing the graduate to independently manage maternal and newborn care.
8. The program has a solid evaluative process at all stages which allows students to learn progressively;
9. The program provides tutorial supervision of students in clinical placements and supervised preceptorships;
10. Upon graduation, the applicant clearly demonstrates the knowledge and ability to practice according to current standards of midwifery care in BC.
There is more but this covers the important points. Like the fact that the first graduates from the _approved_ course in BC won't graduate until next year. Right now there are a grand total of 96 practicing midwives for the entire province. Also to note there are several clinical requirements as well as the academic ones.


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## mammastar (Nov 5, 2002)

But there are other 'non-approved' midwifery programs, whose graduates can then get certified via prior learning assessment, right? For example, my midwife had trained in Scotland and worked in Ghana, I believe.

Regulatory hoops can be a pain, especially with a newer program (and yes, I know midwifery isn't 'new', but the system's openness to it is!) - but there are certain advantages to taking it slow and ensuring that programs and candidates meet certain agreed-upon standards. Heck, I want to know my midwife had to 'jump through hoops' to get licensed, so long as the hoops have some rational connection to assessing her level of knowledge and skill.

Midwives can attend both home and hospital births in BC, so long as the hospital extends hospital privileges (and I understand that some are really uncooperative in this regard, though not in the community I was in). No breech births or other "high risk" births - I can't remember all of what qualifies, but stuff like twins, older mothers, etc. I hope that some of this changes over time as midwifery becomes more accepted. You're not allowed a home birth if the baby is over 2 weeks 'late', and I remember how anxious we were, having planned a home birth, as the clock ticked up to the 2 week mark (she was born 2 weeks late on the nose at home).

Basically, I think some of these rules are silly but that they're born not only out of prejudice (to some degree) but also out of an abundance of caution in trying something that for conventional medicine is quite new. I would rather midwives shifted conventional perception by wowing everyone with their competence and high levels of training, than practice while unregistered and engage in questionable behaviour.


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## pamamidwife (May 7, 2003)

That is so sad. It makes it sound like because she wasn't a RM that she wasn't a "real" midwife. The family must be devastated - this certainly adds to grief.


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## Mamid (Nov 7, 2002)

BC College of Midwives "ownes" the word _midwife_ in BC. So anyone calling themselves a midwife better be a registered midwife or if they find out about it, the book is thrown at the infringer of their trademark.







:

That means lay midwives here have to call themselves "birth attendants" instead of midwives.

My questions, which still haven't been answered - how exactly was she trained? Was it just through Hygeia or was it through another course? Nevermind the college resgistry, was she certified in another jurisdiction?


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## Mamid (Nov 7, 2002)

Mamid's DP again:

Quote:


Originally Posted by *mammastar*
But there are other 'non-approved' midwifery programs, whose graduates can then get certified via prior learning assessment, right? For example, my midwife had trained in Scotland and worked in Ghana, I believe.


Regarding equivilency of other programs...

Quote:

1. What is the Prior Learning and Experience Assessment (PLEA)?
PLEA is designed to assess the skills, knowledge, and abilities of foreign-educated midwives who wish to register to practice midwifery in British Columbia, Canada. PLEA includes a portfolio assessment, written and clinical examinations, a brief orientation program, and sometimes supervised practice. Experienced and/or university educated midwives may be eligible to apply for exemption from some parts of the exams.

Anyone who has not completed their midwifery education at a CMBC approved educational program i and who is not registered as a midwife in another Canadian jurisdiction, must take part in the PLEA process in order to be registered with the College of Midwives of British Columbia (CMBC).
So your Scottish trained midwife would have to go through the above process to register in BC. Plus their education would have to meet the 10 criteria in my first post. In time I think that the standards will be good.


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## mammastar (Nov 5, 2002)

Yes, that's right. Transferring between jurisdictions and getting one's qualifications recognized can no doubt be a bit of a pain, but the same is true if you're a doctor, a lawyer (believe me, I know!), a nurse, a teacher, or any other type of self-regulating profession that needs to ensure it has a baseline for who gets to use the name/represent themselves to the public as qualified. It's a privilege to be self-regulating, and ideally self-regulating professions will be vigilant in ensuring members are qualified and competent.

I was interested in Mamid's allusion to Gloria Lemay and to Hygieia, which I hadn't heard of, so I checked out their websites. I understand the impetus to integrate entire families into the birth process and recognize the profound impact that having a child has on one's psyche, which seems to be part of what they espouse. The astrology stuff, I can't really relate to, but that's fine.

However, I think that it is open to an aspiring midwife to integrate her philosophical and psychological approach into her work with families, while still completing the formal training that will allow families to feel confidence in her ability to handle whatever curveballs come her way. Also, if a midwife is not competent in some way, being a member of a self-regulating body ensures some accountability. Why boycott it? Why not take what is useful to you from it and then seek to broaden and diversify its focus from within? When a midwife's political agenda overtakes her focus on the care and security of the women under her care, that is a problem for me. I have no idea exactly what went on in this particular situation, but it seems unfortunate that, when midwifery has such a great opportunity to become an accepted and funded option for B.C. women, such a rift would develop. Change from within should be the focus, in my view.


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## crazy_eights (Nov 22, 2001)

One of the most amazing midwives I know is in BC and refuses to register with the college of mw's b/c she does not want to be subjected to their protocols. She now presents herself as a 'birth attendent' since she can be prosecuted for calling herself a mw. The part that I find really nasty is how the Royal College of Midwives have colluded to try to trap her in order to prosecute and put her out of business.


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## Mamid (Nov 7, 2002)

Mamid's DP strikes again:

This pregnancy we have a midwife and are planning on a home birth. With DS we were planning on a home birth using Lemay but then the whole her vs. the college erupted and we had no wish to become part of that. Unfortuneatly it resulted in us having a hospital birth.

We thought Lemay had good ideas but her....well...fanatacism to her cause blinded her to certain realities. I also think there is a lot of a pride factor in her refusal to take the college exams. Although I kind of wonder now in a perverse fashion if she would even be allowed to take those exams. Also what would happen were she to pass them. Although I don't think she could.

Especially when it comes to breech presentations. My 2 poe on that though.


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## cottonwood (Nov 20, 2001)

I'm not in BC, but I specifically chose to have an unlicensed midwife attend me in birth because at the time all the licensed midwives I knew of were concerned (understandably) enough about covering their asses that they felt they had to do things during the birth that I didn't want done.

mammastar wrote: "Basically, I think some of these rules are silly but that they're born not only out of prejudice (to some degree) but also out of an abundance of caution in trying something that for conventional medicine is quite new. I would rather midwives shifted conventional perception by wowing everyone with their competence and high levels of training, than practice while unregistered and engage in questionable behaviour."

And I would rather have the choice *now* not to have to abide by those rules and have my choices dictated by someone else's ignorance or prejudice. If there were no midwives willing to break those rules, I would have been forced into choices that I believe were not in my or my baby's best interest.

This is really an issue of who has control over women's bodies and choices. The women themselves, or some governing authority? Right now, the BC College of Midwives is firmly on the side of the governing authority. That to me, is not acceptable, and if I were a midwife I would feel strongly about making a political statement by *not* registering.

Furthermore, for the government to regulate birth attendants so that they _must_ submit to a certain medical protocol, the government is therefore defining birth as a medical event. In effect, the law is making it so. And I don't believe that is something the government has any business doing, as I don't regard it as an authority on birth.


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## Mamid (Nov 7, 2002)

*shakes head* must change password.









My sweetie forgot to mention a lot of stuff about Lemay. In my chart my OB made up with DS, he put in "no prenatal care" even though Lemay had been giving me my care for almost 6 months at that point when her court case blew up in her face. He called her "incompetent" and other worse things which made me want to cry. And in fact, he did make me cry.

He threatened me with a section if DS stayed breech. He refused to listen to me when I said I was having PreE symptoms and I won't even go into the alternative treatments for GBS arguement where he was right.

Because of that experience, we don't want to get into the entire rigamarol with Lemay if anything happens with her again. She has her sights set on a lofty goal, problem is women are suffering if they follow her. Lack of continuity of care if there is a problem during the pregnancy, lack of support from the medical professionals if it is found out you were a client of hers and that's just the tip of the iceberg of the problems associating with her causes.

And she refuses to regulate because of the restrictions the regulations causes. I don't even think she'd be allowed to take the exam if she had the desire to with all the crap that's gone on in the last few years. The way they were going on in court about how she was willing to study in Manitoba for a year and then come back here to take the tests they weren't going to let her pass. In fact, that compromise was "unnacceptable" to the college or at least the head of the college.

Honestly, with the amount of women looking for and being unable to find midwives in the province, you'd think the college would be more willing to help those interested in getting certified jump through the hoops to certification.


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## mammastar (Nov 5, 2002)

Blueviolet, what types of things did licensed midwives feel they had to do to cover themselves during the birth? Just curious. I already mentioned that the 2 weeks late, you need to give birth in the hospital thing gave me some grief when I was pregnant. But other than that, I felt like my midwife was able to give me the care that I wanted, and I didn't sense any compromising on her part.

Wow, Mamid (and Mamid's DP) it sounds like you went through a lot! Too bad that you ended up having to use an OB, he sounds really unpleasant. We had a brief run-in with an OB early on before deciding to get a midwife, and it was quite dehumanizing. At least, with a licensed midwife, if you end up having to do the hospital thing, they're still there with you.


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## mammastar (Nov 5, 2002)

One more thought -- I'm in law, and lawyers as you may or may not know make a fair amount of fun of the law society that regulates us. The fees, the regulations, the paperwork, the exams, etc etc. It is, truth to be told, pretty goofy and yes, some of it may be a bit of a cash grab on their part.

But...I still wouldn't set up shop and call myself a lawyer without getting my paperwork through them done. First and most obviously because I'd be in deep trouble. But also because, for clients, my being approved by the Law Society means that I have gone to an accredited school, demonstrated my knowledge of some core subjects and professional ethics, and made a commitment to continuing education. And, if I stiff them, I can be held accountable through their disciplinary mechanisms, while they can be compensated through the insurance program.

Not every regulation or restriction makes sense, but I think the trade-off is worth it, even more so if over time if people who feel the same way get involved in working to change the system.


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## Mamid (Nov 7, 2002)

Mamid's DP makes like Zorro and leaves his mark:

Yah, the OB we dealt with was.....was.....a moron is the most polite and accurate thing I can say. We are relatively sure he received an informal reprimand from the hospital regarding us. If it hadn't have been for DS coming out like a freight train with a JATO assist things would have been much more unpleasant I am sure. As it was we caught a nurse just about to stick penicillin into Mamid's IV line. Mamid is allergic to penicillin and had the big honkin' red allergy alert bracelet and notes in her chart.


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## candiland (Jan 27, 2002)

I purposefully went with a lay midwife.

She doesn't believe in doing things to women that are in the best interest of insurance companies and back-up ob's and not necessarily in the best interest of her patients.

For example: breech and twin cesareans. Induction and/or hospital birth after 42 weeks. Unnecessary prenatal tests. Etc. etc.

She puts herself on the line because she wants what is best for mom and baby, period. That means not following protocols meant to ward off lawsuits at the risk of mom and baby. She is one of the most experienced midwives around. She is far more of a midwife than the majority of "medwives" around here. She has better birth outcomes than any other ob or midwife in the state.


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## mammastar (Nov 5, 2002)

Now if only regulation could weed the morons out of all the professions, right?!

... and yes, I know I'm a big proponent of regulation!

My sympathies and I'm glad it worked out.


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## mammastar (Nov 5, 2002)

Candiland, are you in Canada?

I fully agree about the 42 weeks thing, don't know enough about the breech thing (I'm sure I read about it while pregnant but that was a while ago now - would be interested to know more). So far as prenatal tests go, I had virtually none and was always provided with full information and free rein to research and decide the way I wanted. But then, private insurers and HMOs also aren't an issue here.


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## Mamid (Nov 7, 2002)

The "Breech Thing" is about the Hannah Study. Too many doctors and midwives are using it to risk out low risk women simply because their babies are breech. They forget that babies can turn up until full dilation. Or that external versions exhist. Or that having a breech isn't an automatic section.

Nope. Now its all sections all the way. Even with Multiparas!


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## cottonwood (Nov 20, 2001)

Mammastar wrote: "Blueviolet, what types of things did licensed midwives feel they had to do to cover themselves during the birth?"

The 42-week rule was a big one. There is just no way I would feel comfortable with a care provider who would drop me because I refused to be induced for a non-medically-valid reason. Other requirements I found unacceptable: that I would only be allowed to labor for so long after my waters broke, before having to be induced (or again, I would be dropped, and have to go to the hospital and have the stress of them pressuring me to affect my labor adversely); that a certain frequency of cervical checks would have to be done during the labor; that they would have to chart the progress (timing) of my contractions, with the possible assessment being FTP and transport to hospital; that they could only wait so long for the placenta to be birthed before actively managing 3rd stage; etc.

But the details aren't important -- obviously, to some women, these requirements would be appropriate or just not a big enough deal to make a fuss about. The point is not that these things are inherently wrong -- that the protocol is inherently wrong -- that's not what I'm saying. What I *am* saying is that it's not inherently right for every person and situation, and that no one has the right to decide for _me_ whether it is or not, and to limit my choices based on that.


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## crysmomofthree (Mar 18, 2004)

We had midwives deliver both of our last two babies and I think the level of care was phenomenol. It is my understanding that 42weeks is the cutoff for home birth, the midwife will still delivery baby at the hospital. As for cervical dilation exams charting the progress of contractions and breech babies, the licensed midwives have a lot of flexibility there. I think registered midwives in bc offer a wonderful opportunity for women to direct their own care. my ds was born at 35 weeks in the hosp. (we were planning a home birth) I was only checked for dilation once (at my demand) My son was born into my arms and never taken from me, I think this birth could have been much more medicinalized if I didn't have a registered midwife with me.
The licensing bodies are in place so that the public can trust that the professional they are hiring is qualified for the job, Midwives who choose not to pursue licensing cannot allow the families in their care to believe they are a Registered Midwife, same as a nurse must meet the licensing requirements as well as dr's, teacher's etc. I am extremely happy our province has funded midwifery care and I agree there are not enough midwives but to push through the licensing of midwives who are not qualified, would be counter productive.


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## Ms. Frizzle (Jan 9, 2004)

FYI, a woman who knows the family (this was not printed in the news BTW) said the mother went to *many* different midwives who are registered, and they all turned her down because of her risk...


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## Mamid (Nov 7, 2002)

was it a risk other than the breech? because, as I said before, the breech one is bogus. But my own midwife says that a breech birth is something they are not allowed to do.


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## pamamidwife (May 7, 2003)

For me, it's hard to standardize midwifery. It's hard to have a set of rules and regulations and expect every midwife to follow them. In my eyes, midwifery is about serving the family. There are some people I'm willing to go out on a limb for (and I"m not referring to my state license protocols, but about risks in general) and other people that I would not even step out a bit for.

Serving families is so different. Each family's needs are different. I've had clients go 43, 44 and 45 weeks. I also felt like I had the ability to change the due dates a bit based on different calculation methods. I gave full informed choice agreements and the parents were aware of their choices.

I cannot imagine dropping a family just because of a regulation that a governing body makes to restrict my practice and my clients choices.

I feel so lucky to live in a state where it's legal to go to 43 weeks. That 42 week rule, common in a few states, is harsh. It's totally unfounded scientifically and puts so much anxiety and pressure on women during a time when they should be relaxing and having someone nurture them. We can also do breeches, twins and VBACs at home.

[all this and I'm still considering a move to BC sometime in the next five years!]


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## Greaseball (Feb 1, 2002)

How was the cause of death determined? Was it really the breech presentation? Any time a baby dies after a home birth it's always blamed on the mother or midwife, when babies die far more often in hospitals. Are OBs going to be charged for every death that is on their hands? We won't have any left, then!

I also went with an unlicensed midwife (though she had a partner who was licensed) and in Oregon midwives are allowed to catch breeches. Although she had no experience in breech delivery, I would still have gone with her instead of the hospital.


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## Mamid (Nov 7, 2002)

I don't know. Honestly. If I get word of what the problem/diagnosis was etc I'll post it here.

I just wish I wasn't 3hrs by car minimun from the courthouse or I'd be there to get a first hand account instead of the garbage that media gives us.


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## Mamid (Nov 7, 2002)

Another story about her - this time the local paper to where it occured.

BC Midwife charged

Quote:

It is alleged Labadie presented herself as an experienced midwife for a woman who wanted to have a natural childbirth. The birth was the second for the woman. It was identified as a breech and natural childbirth was not advised by a doctor, Latham said. It is alleged Labadie acted negligently prior to and during the birth, which resulted in the death. An ambulance was called, but the female child could not be saved. The RCMP were advised through the ambulance service.

Quote:

The charges against Labadie disturb Charlotte Millington, the director of the Global Birth Institute, a Victoria-based school that teaches skills in the field of birth, labour and delivery. If the allegations against Labadie are proven to be true, Millington said the misrepresentations can only be condemned.
Damage to the reputation of midwives might have already been done.
"An infant died needlessly and the legal proceedings to follow - regardless of outcome - deal a serious blow to people working legitimately in the field of birth and labour," Vern Faulkner, the GBI's director of media and corporate relations, said.
Midwives can oversee a variety of births, but breech births are a difficult challenge, Millington said.
"Breech births present an increased risk for both the baby and the mother," the 12-year birth professional said. "Few practitioners in the province have the skills required to oversee a vaginal breech birth.
"If anything can be gained from this, it is the need for women to learn more about the childbirth choices they can make."


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## pamamidwife (May 7, 2003)

Quote:

"If anything can be gained from this, it is the need for women to learn more about the childbirth choices they can make."
This was right on, though probably not meant the way I took it! lol!


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## saharasky (Dec 20, 2002)

I heard about this shortly after it happened from someone who was in the same prenatal group as the mom. So incredibly sad. Vaginal Breech births are seriously frowned upon here ...so the family refused a section ... midwife couldn't attend a 'home breech' so they found someone who would at the last second.


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## Mamid (Nov 7, 2002)

was reading through a site somewhere.. or its in my another breech birth drama thread....

Quote:

Unfortuantely breech vaginal deliveries have been so rare in BC in recent years that no one actually knows how to do them anymore ... so they're scared of getting sued.
And signing a waiver wouldn't work. You can not legally sign away your rights in Canada.

Nothing real new about the case, but apparently only her lawyer showed up to both court dates and has asked for "more time to prepare." I'm keeping watch to see if something new is reported.


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## darsmama (Jul 23, 2004)

How sad for the family, very sad for the midwife.


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## Yummymummy74 (Jun 7, 2004)

Quote:


Originally Posted by *mammastar*
How sad, the poor family.

Is there any reason why an otherwise legitimate, trained midwife would object to registering with the College of Midwives in BC?


Yup!

Adhering to the stringent protocols and guidelines that are issued by the college that limit the consumers right to choose about whats right for them..hence the breech birth.

That is why there is still a good strong movement of TBA's


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## Yummymummy74 (Jun 7, 2004)

Quote:


Originally Posted by *mammastar*
Basically, I think some of these rules are silly but that they're born not only out of prejudice (to some degree) but also out of an abundance of caution in trying something that for conventional medicine is quite new. I would rather midwives shifted conventional perception by wowing everyone with their competence and high levels of training, than practice while unregistered and engage in questionable behaviour.

I guess its all personal huh? I would prefer any midwife who was going to attend me or family to have a MINIMUM of *medico* styled training, as there seems to be a penchant to treat birth as a pathology.

But again for some of us the issue is moot anyway..









Still I wish Canada could get a grip instead of forcing what midwives we do have into becoming *medwives* ....


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## Mamid (Nov 7, 2002)

new news...
Sooke woman's day in court paused


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