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Court Case – What Really Happened

I want to explain what is happening to me at the moment.  No newspaper has covered it properly or bothered to ask any questions surrounding the case or it’s implications.  The journalists have simply reported the government line.  What happened to investigation, research, opinion?  It is obviously not in the vocab of the South Australian journalists.

I birthed with a client 3.5 years ago where the baby had a severe shoulder dystocia and was not completely born for 20 minutes (not 40 or whatever the papers are saying.  Tate’s head was out for 20 minutes before her body was born).  This is a complication that for 0.6% of the population can be severe or fatal and is not related to the place of birth.

Cut Ruby Gem Stone

The baby passed away prior to the birth but we commenced cardiac massage and mouth to mouth and called the ambulance,  they found small amounts of electrical activity in the baby but no signs of life.  The baby was pronounced dead.

The Coroner in this state wanted to investigate the case because it is a homebirth. This is backed up by attorney general John Rau’s recent comment in the paper saying “the  inquest would significantly impact regulation of the homebirth industry.”  Even though shoulder dystocia happens at the hospital and a quick google of the Internet can show how serious and fatal it is regardless of venue.

The Coroner is bound by the born alive rule which states the baby must be alive after being completely born to fall into his jurisdiction.  As the baby had no signs of being alive then according to common law the coroner does not have any  authority over the incident. This is something that the woman and her family agreed with and they did not want an inquest at any time.  The coroner held a pre-inquest hearing to decide if the baby was alive.  Medical opinion at the court was that the pulseless electrical activity(PEA) was not a sign of life in this case.  This was contrary to the opinion of the coroner so he ruled in favour of himself and ordered an inquest.

I questioned the right of the coroner to decide that the baby was alive just because he wanted to pursue me/homebirth.  That he stepped outside his powers to get what he wants.

You can read the findings for yourselves. The claim that Dr Wheaton’s evidence was in support of the baby being born alive is incorrect. In this case he didn’t think there was an indication of the baby being born alive.  He said this in the Coroners court when questioned.

If  this case stands then the South Australian court have changed the definition of life.  Up to now, breathing, a pulse, response to stimuli and tone have been the signs of life.  Electrical activity is not a sign of life.  After we die we continue with this activity, sometimes for hours.  From now on if a PEA is a sign of life they will potentially have to stop transplants, termination for an abnormality, termination in general.  All forms of resus are affected.  When do we stop, how do we draw the line if there is a chance that someone will say “What about the PEA?”

A PEA has to be available to transplant an organ after a person has died.  There is a PEA in an aborted fetus.

PEA is electrical activity with no pulse, no breathing, no reaction, no life.   A PEA can be created with good cardiac massage from nothing, but there is still no life. This is something not even considered in the findings although it was something mentioned by their own obstetric expert Dr Pepperall.

This affects all of us, not just homebirth but any practitioner and every woman.

It will have professional, legal and maybe even criminal implications for us all.

It is also the approach which conforms best with contemporary conditions.  It is now virtually certain that a new born baby which shows any sign of life would have lived but for the conduct said to constitute manslaughter or dangerous driving, inflicted on the baby late in the mother’s pregnancy.  The viability of a foetus can now be both established and ensured in a manner which was beyond the realms of contemplation when the born alive rule was adopted.  That rule should now be applied consistently with contemporary conditions by affirming that any sign of life after delivery is sufficient.

Please support us to continue to try and prevent this massive legal precedent from slipping through.

‘For those who support homebirth (even though this isn’t what the case should be about) John Rau’s comment

“One of the questions no doubt the Corner will have to consider is had this delivery been managed in a medical setting, whether the child would have been in any way compromised let alone died,”

explains what the real agenda is here. It’s not about investigation it’s about blame and control, personhood of the fetus and the right to bodily autonomy.

Thanks to my wonderful clients for their on going love and support.  They are amazing people in the face of the media attention.

60 responses to “Court Case – What Really Happened”

  1. Amy Tuteur, MD

    “Electrical activity is not a sign of life.  After we die we continue with this activity, sometimes for hours.  From now on if a PEA is a sign of life they will potentially have to stop transplants, termination for an abnormality, termination in general.”

    Lisa,

    That is flat out false. You simply made it up.

    Look up PEA in any medical text and you will find that pulseless electrical activity was previous known as EMD (electromechanical dissociation). That is a good description of what is happening; the muscle function of the heart becomes dissociated from the electrical activity of the heart. The cause is almost always profound hypoxia and the TREATMENT is CPR, intubation, etc.

    There would not be treatment recommendations for people already dead. Clearly, PEA is a symptom found in a living person and can sometimes be reversed with appropriate care.

  2. Lisa Richards

    Thankyou Lisa x Much Love and Strength x

  3. loz

    Sending love and light as you walk this journey

  4. Cassie

    Yes I saw this I have been waiting for you to write something on this :-) I knew as soon as I read the “if it had been managed in a medical setting” and “cast shadows over the industry” it was purely an attack on homebirth/yourself. (scare mongering much) I tried to argue this with some colleagues at work only to get called stupid and an idealist. *rolls eyes*

  5. Daina

    This is about legal ground. If this gets through, to the detriment of all practitioners, midwives or whoever, the legal community will have a whole new source of revenue on which to prosecute, or sue and therefore make money, that is why they are so doggedly pursuing it. It is wrong, and sad and the implications are barbaric. Finance is the only reason that this case has made it so far. I am so sad for Tate’s Mum and dad. Love you Lisa, keep the fire.

  6. Jo Watson

    Wonderfully concise description… I hope this is spread far and wide for a proper understanding of what this means.

    Still sending love and hope and strength to you, Lisa. xx

  7. AP

    I think the real issue is not debate over PEA and signs of life, it is, would this child have been alive if they were birthed in a hospital setting? Of course we will never know, and it is true to say that babies with shoulder dystocia die in hospital too.
    However, this scenario reinforces my view that the safest place to birth your baby (with current practice in Australia) is in hospital, not at home.
    At least in hospital the mother and child would have had access to more staff, resuscitation equipment and life saving drugs.
    This is not to question your skills Lisa as a midwife, I am sure that neither you or the mother you were assisting with her birth wanted the outcome that happened, but I do not think trying to birth your baby at home is the safest idea.
    Some recent data in WA also supports that there is ~4x incidence of worse perinatal outcomes for women homebirthing compared to hospital birthing.
    http://au.news.yahoo.com/thewest/a/-/breaking/8312042/homebirths-far-riskier-review/

    1. basil

      I am not sure I understand your comment AP.
      On the one hand it reads as though you are supportive and recognise that the coroner is manipulating jurisdiction but then on the other you buy into the birth setting scrutiny.
      Actually the case was about PEA and if it is a valid sign of life or not. I am interested in your thoughts on this. In your opinion is PEA a sign of life when there are otherwise no other signs at all?
      I agree that inquiry into the death of baby Tate is just a political vehicle for a public hammering of homebirth by a group of people who clearly have no understanding of what shoulder dystocia is. Why does society lose all sense of reason as soon as the word homebirth is uttered?
      I look forward to the day that inquests are held for deceased hospital born babies and the question asked is: would this child have been alive if they were birthed at home?

    2. Kate

      Forgive me for being cynical Mr Pesce, but I am suspicious when statistics from a report are used that have not been released to the public yet. How can we be sure that this report you speak of is accurate. The same thing happened with the recent study about homebirth from SA. It got torn to shreds http://blogs.crikey.com.au/croakey/2010/01/20/more-critique-of-the-homebirth-study-and-its-reporting-by-the-media/ . However, the huge study in the Netherlands that looked at hundreds of thousands of births found that homebirth is as safe or safer than birthing in hospital. 

      The majority of families who choose homebirth, do so after extensive research and find that the literature supports the safety of homebirth. Please do not patronise us, with your fearmongering. 

    3. Ironica

      Had the birth occurred in a hospital, the dystocia might not have been an issue. Depending on the circumstances of the birth, the hospital personnel would have implemented various routines which may have included pitocin, anesthesia, amniotomy, and ultimately c-section. This may have circumvented the dystocia.

      But of course, the maternal morbidity and mortality is far higher for surgical births than for vaginal births, so perhaps then the baby would have lived and the mother died.

    4. Gaylee

      Andrew – I birthed my last child at home. It was a HBAC and I got a far better result than I would in a hospital. For starters, I don’t have to worry about the high infection rates

      http://www.northernstar.com.au/story/2010/12/21/staff-work-to-decrease-hospital-infection-rate/

      Or worry about breaking my hip due to faulty hospital

      http://www.northernstar.com.au/story/2010/12/21/injured-by-hospital-lift-hip-break-joy-scott-/

      Or accidentally be injected into my spine with antiseptic fluid:

      http://www.theage.com.au/national/toxic-epidural-ravages-mother-20100820-1390i.html

      Or bleed to death after a c section:

      http://www.news.com.au/national/father-jim-murrays-compensation-claim-drags-on-pain/story-e6frfkvr-1225873239560

      In NSW alone, your home state, MEDICAL negligence that has left babies with brain damage and mothers permanently scarred has cost the State Government $115 million in compensation over the past five years.

      http://www.news.com.au/national/paying-for-negligence-birth-bungles-cost-115m-in-nsw-alone/story-e6frfkvr-1225873236746#ixzz18hM6KPnn

      Or be involved in a drug trial without obtaining consent and then have a disabled child because of it

      http://www.smh.com.au/news/national/parents-win-drugtrial-case/2007/11/21/1195321867010.html

      Or be forced to miscarry in the hospital toilet:

      http://www.smh.com.au/articles/2007/09/26/1190486395840.html

      Or have the abusive Ob break my child’s leg during a c section:

      http://www.northernstar.com.au/story/2008/11/20/hasil-broke-newborns-leg/

      Or the same abusive Ob arrive to work drunk and perform an internal with no gloves on:

      http://www.finda.com.au/features/2008/10/09/dr-roman-hasil-allegedly-under-influence/

      Or the same abusive Ob roughly deliver my child which is now diagnosed with Cerebral Palsy:

      http://www.finda.com.au/features/2008/10/08/dr-roman-hasil-abuse-list-continues-grow/

      Do you want me to keep going to show just how utterly unsafe a hospital is to birth a baby in? You are insane if you think that hospitals are safer! Control does not equal safe Dr Pesce.

    5. SM

      AP, actually, I think its quite revealing that you admit that your concern is “would this child have lived had it been born in a hospital setting.”, rather than the question the coroner is asking.

      Given that information on the deaths of newborns and mothers in Australian hospitals is not generally not reported in the media, I would welcome coronial inquests into each and every one of them.

      In particular, I would like to see open information on the deaths of babies due to the use of instrumental delivery (ie forceps) and deaths of mothers due to caesarians, given that our rate is currently about 4 times that recommended by the WHO.

    6. Honey

      I wanted to say I doula’d for a woman who had a baby in hospital in the states. Her babe died…many babes die at the hospital but all in all…homebirth for healthy women and babes is a wonderful and safer option than hospitals. When it’s time for a life to return to the maker we can only do our best and hope they stay. Being in a hospital doesn’t mean a babe will live.

      Prayers and energy to you and yours Lisa.

      Honey

  8. Nat

    “…had this delivery been managed in a medical setting, whether the child would have been in any way compromised let alone died…”

    Yes, because “deliveries” “managed” in medical settings are never in ANY WAY compromised let alone die, of course. The real agenda is plain to see.

  9. Cassie

    haha Oh yes AP “access to more staff” how people love getting told one thing by one person then getting told another thing by another. Funny, I just heard a women complaining the other day about the complete lack of consistant information from Hospital staff. “Life saving drugs” you mean the shot women up til they can’t make a coherant informed decision. Oh and “current practises in Australia” you mean the “oops your cutting into my coffee break c-section time. ” I repeat everything Kate said and regarding your article well the word “expert” in “my view” is thrown around far to loosely. I think I will be determining where is the safest place to have my baby.

  10. Daina

    Coroners don’t generally get to look into hospital deaths. You’re a sitting duck for the lawyers Lisa. I can’t help feeling that you, as an IM, and homebirth are easy targets, and a politically convenient casualty of legal greed. Keep the faith. They are wrong and we are right. Until somebody successfully sues nature for a natural disaster. Then we’re screwed.

  11. Lee

    Hey Sister, I been in the business long time too.
    Royal Womens in Sydney 27 years ago. The System ‘stole my spirit’. I found it again about 4 years ago in a cosy bedroom in a suburban street. I always imagined that birth could be ‘magic’… now I know it.
    Here’s the catch … my close friend touched death seconds after the elation of her birth… in her sanctuary … at home. She bled and bled and bled… nothing could stop it.
    Something in me died too that day.
    She’s good now. I praise the lord and mother earth, stars and moon.
    Now I sew funky clothes, cook yummy desserts and do ocean swims every other day. I closed the book.
    Sister I am with you.
    I live in a gorgeous part of the world if you need to retreat at any time xx

  12. Danielle Martin

    Love to you Lisa x

  13. loz

    Already been said by many before me BUT

    AP I too find it a rather telling sign that 1 your comment doesn’t make much sense and is rather wishy washy like you have to have a comment here just to put forth that you dont agree with homebirth (let me tell you as a birthing woman in this country WE KNOW and a sarcastic THANKS!) and 2 that the question you are keen to put forth is not what the coroner is trying to determine in regards to PEA being a sign of life but whether or not homebirth should be ‘allowed’ and if baby Tate would have survived had she been born in hospital. Doctors, medical teams, equipment and a change of scenery aren’t ‘god’ and nor should they pretend to play ‘god’ so that is a question which can not be answered and one that you have no point in making other than to put in an emotional argument into the picture.

    As someone who is currently practising medicine I find it difficult to see why you too wouldn’t be putting your own opinion aside and seeing to it that the coroners findings determining that PEA is a sign of life are not within his jurisdiction and also the detrimental affects that would have on ALL avenues of the medical establishment not least of all organ donation and abortion. I truly fail to see how educated professionals such as yourself and those like you AP can not see the detrimental effects of putting your opinions before your knowledge yes you may succeed in squashy one midwives homebirth community in the process but something you can never do is stop women from homebirthing as we will birth at home as long as we deem safe. We are educated, informed knowledgeable families who will band together regardless of the restrictions that are placed on the midwives who support us.

  14. Oliando

    I’d really appreciate a continuing discussion on the points raised here in the comments between Lisa and Andrew Pesce.

    I think there is a lot of mutual ground on this issue, so please don’t just have a drive-by input Andrew! Lisa is really on top of this one, I think it’s well worth letting her bring the discussion between you two up to speed. As she says, this will have ramifications for everyone.

  15. Meg

    this makes me so sad : (
    My heart goes out to the parents and to you too, Lisa.
    I think it’s inhuman that this inquest even be happening when the parents agreed with informed opinion that the case shouldn’t be in the coroners court.
    I hope a wise resolution – and some peace – comes to you soon
    xxx

  16. Kerrin and Mike

    Sending you all our support Lisa, love and light to you xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx

  17. Murasaki

    Its not just about homebirth, not at all. We already know the AMA is anti-homebirth, just like McDonalds is anti Hungry Jacks, but the outcome of this inquest will have impact upon hospital workers too. Dr Pesce do you look forward to flogging dead babies for hours, or having to hook them up to machines (meaning there wont be enough machines for the babies with a chance – this is a reality in other countries where brain dead is not dead if theres a heartbeat)?

    You’ve already succeeded in driving homebirth under ground, isnt that enough. The tiny percentage of women that will birth at home regardless are not going to add up to much moolaa really.

  18. Beverley Walker

    I observed an obstetricians who ignored the then available use ultrasound to locate the placenta This procedure (amongst other clinical methods) ought to have enabled him to assess whether a pregnant woman truly had poly hydramnios (Excess Fluid) . The placenta was low down and across the Os which gave the appearance of polyhydramnios.It was decided in a rather cavalier fashion that the excess fluid required draining. Even if this condition had existed this management ought to have been discussed with others, What actually happened is that the Drew Smythe catheter (metal) went through the placenta praevia Placenta first – the maternal haemorrhage which resulted was so gross the baby was badly damaged and not expected to live a normal life.

    We know this because he invited a few students/midwives to watch him perform. This doctor continued to work in the hospital and when discharged (re-cycled) to the bush continued to wreak havoc – currently he is in trouble again but will settle out of court probably and continue to practise unnamed in press, unharmed reputation by AP or any other of his colleagues. I have named and shamed and reported – but not published and this is sub judice currently..

  19. Jenna

    Good luck!

  20. Daina

    I don’t think Dr P is any keener than HB peeps for this case to get through, Murasaki (as annoyed by your attitude as I am Dr P). HB is just convenient and vulnerable to a legal juggernaut. Hospitals and doctors have massive indemnity schemes (having said that at least one I know of has been shut down for insolvency over a bad outcome birth case), midwives have their resources and their community. The HB community is under attack, and if the HB community loses, the doctors lose too.

  21. Sunflower

    AP, you are avoiding the issue at hand. This is an issue regarding the definition of life. Given you seem quite comfortable with the Coroner’s findings could you please outline how you forsee hospital policy will change in the future to incorporate this new definition of life. Do you honestly feel that SD will become a thing of the past?

    However, if we turn to your comments regarding homebirth, just for a moment, I have two questions. Firstly, are you willing to guarantee the currently pregnant woman that births vaginally in hospital that she will not face SD? Is that an outcome you are prepared to guarantee?

    Secondly, as the head of the AMA, and a part of a collaborative partnership with a number of Sydney IMs, I would love to know how you envision to maintain a collaborative – a union of professionals, if you are to maintain such a stance? Can you really argue that homebirths are terribly unsafe but truly support your relationships with these MW. What sort of women are going to be allowed to HB with you? Ones that pop like a pop tart out of a toaster at 40 weeks?

    Finally, I would love a few answers. Firstly, what equipment would have ensured this baby was BORN alive? How many people would have been of true assistance in a similar situation in the hospital? How many people does it take to intubate, to resuscitate…. What, two, three, five… ten?

    Aren’t you in the least bit frightened that you are going to be increasing the CS rate in Australia by not supporting Lisa in this particular aspect of the fight? Your members are surely going to be terrified that they are going to be up on manslaughter charges, after all, the precedent may be thoroughly forged in stone within the next few months.

    Are your members so obtuse, or is the members of the public that they cannot differieniate between different aspects of an argument. You can support someone in one respect and disagree on another. Do your members really, honestly, want to see this change? Or are they more interested in the fact that they will get a coroner to say HB is dangerous. For goodness sakes, if that is the case, surely, doctors being the gods they are, do not need a wig wearing, book worm to reinforce their understanding of medicine?

  22. Kate

    It would be great if AP would come back and answer a the questions that have been posed here….?

  23. Violet

    “No newspaper has covered it properly or bothered to ask any questions surrounding the case or it’s implications. The journalists have simply reported the government line. What happened to investigation, research, opinion? It is obviously not in the vocab of the South Australian journalists.”

    Are they refusing to speak with you? Have you contacted them repeatedly? Sounds like you could do with wider support (including financial) and media attention – if you want it – may help with that, as well of course as telling the other side of the story to the general public. Most journos are very busy and don’t have time to run around researching; or investigating EVERYTHING….but if you put in the effort get them interested and make a good connection with one or two then I don’t see why your story shouldn’t be told. Keep in mind that media is a business and you need to sell the idea to them somewhat. It is a big effort – maybe you could find a volunteer to help out with media releases/follow up?

  24. Sunflower

    Lisa, could I make a suggestion. What about Radio National’s Law Report. Something like this would be right up their ally. After all, the mind does has to boggle as to the implications of the Coroner’s findings IF they are upheld by the High Court.

    I wonder too if ethicists, such as Peter Singer would be interested in this case both due to the AMAs desire to use this case of an unfortunate death surrounding birth to further their case against homebirth and from the human rights angle.

    As an aside AP, your determination to use a case which proves little more than birth is unpredictable to ‘prove’ homebirth is dangerous merely undermines your argument and the relationship and trust many women who wish to HB have in the system. After all, the manner in which this case is being used is just ridiculous. SD is a disaster in any setting, not a HB disaster. It does lead a woman to distrust you and your colleagues. You are doing more damage than you are doing good to prove your position or to gain the trust of your critics.

    AP, if HB is so dangerous find a better example. If we are to fear SD in the manner you suggest than the advice you should be giving is to have a Caesar. There is no way to predict SD or to ensure that SD will not led to death in a hospital setting.

  25. Tanya Malcolm

    Hi Lisa,
    I am sending big love your way. I know it is probably hard for you to re-live that birth, but as a student midwife I would love to see a post about the steps you took after tate’s head was born. Physical and emotional, communication with the mama and papa, etc.
    Wishing you nothing but clear thoughts and moments of happiness throughout your journey to the truth. Thank you for all you do. I admire so much about the midwife you are.

  26. SS

    So what does happen then if a baby with shoulder dystocia is born in a hospital?
    8 mths ago i was Tates mum, in a hospital. I am told i am lucky the head ob was on duty & delievered my baby or else the shoulder dystocia may have resulted in death. after not being allowed off my back or off the bed due to incessant monitoring, then being made to birth a large baby (9lb1oz) on my back, i am not at all suprised my babys shoulder got stuck. my requests to birth my baby squating we ignored or out right denied. i had given birth squatting previously with a larger baby (9lb8oz) without any drama…in the same hospital but with a young midwife & no doctors.
    The ob called for an emergency ceasar too late, babys vitals dropped out, the room was flooded with midwives, paeds & nurses, they conducted McRoberts Manouver & subpubis (?) pressure, he did an episiotomy & yanked my baby out with forceps. my lifeless baby was touch & go for a while & we spent 8 days in hospital SCU with me being allowed minimal physical contact. I was accidentally allowed to breastfeed my baby by a young nurse on night duty although i was told my baby would now not feed due to the birth. for the record he fed/ feeds perfectly.
    Is it common that the further you go up the medical ladder the less practical understanding you have of human beings…or ‘medicine’ for that matter?

    I was told (over & over again by hosp staff) that i was lucky. yet somehow i didnt feel so lucky. that ob was lucky. I was told i should be thankful that ob birthed my baby the way he did. Since when did cure become greater than prevention? since when did medicine become greater than nature?
    The most interesting part to all of this is that one of the first things the Ob told me before active labour began was that my baby might get stuck.
    Although i run the risk of having further (large) babies who may have shoulder dystocia at birth, i will not ever risk birthing in a hospital again.
    I could tell you a hundred similar hospital birth stories, most of them ending in medically required csection, now theres a way to avoid all this PEA stuff. did someone say agenda?

    this is just the experience of one birthing mum, i know it doesnt account for much these days.
    our medical system is failing birthing women.

  27. Andrea

    Hi Lisa,

    I know that everyone wishes it could be about the actual issue here which is PEA and signs of life, but it is clear they are making this about homebirth.
    I was closely involved in the case of a friend where the PEA on the baby was picked up when the baby arrived to the closest hospital after the baby had been born alive and deteriorated rapidly after birth. Because there were no signs of life apart from PEA when he arrived to the hospital, the time of death was an approximate time from when the baby deteriorated and was transported to hospital. You can’t have it both ways!!! no signs of life is no signs of life, the dying process takes several hours and electrical activity is a part of that.
    I hope this family and Lisa get their justice and can heal from this horrible attempt to drag homebirth under (that is the real agenda here).
    My love Lisa xx

  28. Jane A-C

    No Obs on the planet can guarantee a live baby. A homebirth guarantees you dedicated one to one care – a hospitla birth means you’ll be left with a machine and an ignored buzzer until the crowds are needed – and as their tools are hammers, every problem will be treated like a nail.

  29. Suelah

    Lisa, I just think it is awful that a homebirth is “judged” differently to a hospital birth. None of the babies that are resuscitated (and live or pass away, both term and preterm) in my hospital have PEA measured.

  30. Danielle

    I heard Sue Cookson say on Karin Ecker’s DVD “A Breech in the System” that she feels sad because the medical profession generally believe they are doing a good job because of the reduction in morbidity and mortality rates (to the baby) but they are not looking at the important issue of what that means for the mother, culturally, to have so much intervention in childbirth (this is not a direct quote, just a generalisation about what she said).

    My bug bear is that NO ONE has the right to tell someone WHERE they must birth their baby. I don’t care what is or isn’t more dangerous – you CANNOT take the choice away from the birthing mother. SHE has the right to decide. Banning homebirth is going to increase free birthing for women that really want to birth at home – and that is so much more dangerous for the women and babies!!!

    Anyone who truly believes women should be birthing on a bed, flat on their back needs to read Maggie Banks’ article “Active Breech Birth: The Point of Least Resistance” http://www.birthspirit.co.nz/Articles/Articles/Active%20breech%20birth%20-%20point%20of%20least%20resistance.pdf The concepts relate not only to breech birth, but any birth on a bed flat on your back!

    Love to you Lisa… and to the parents. It is so so sad that they cannot grieve for their daughter in peace.

  31. HGG

    “I birthed with a client 3.5 years ago where the baby had a severe shoulder dystocia and was not completely born for 20 minutes (not 40 or whatever the papers are saying. Tate’s head was out for 20 minutes before her body was born). This is a complication that for 0.6% of the population can be severe or fatal and is not related to the place of birth.

    The baby passed away prior to the birth but we commenced cardiac massage and mouth to mouth and called the ambulance, they found small amounts of electrical activity in the baby but no signs of life. The baby was pronounced dead.”

    Lisa,

    What is your process for complications such as severe shoulder dystocia during home birth? I would have thought a ambulance should have been called as soon as this complication, which you knew could potentially have been fatal for the baby, was arising.

    I support home births – planning one myself – however, my midwife and I have put measures in place to ensure the safety of myself and my baby even at the slightest complication. In your case, I would have thought 20 mins for a baby’s head to be out but not the body was far too long a time to wait before emergency services were called?

    You may see this case as a bit of a “witch hunt” for homebirths, however, I too have to question if the baby would have been born alive if there was medical intervention at an earlier stage.

    I seriously hope this case does not jeopardise home births in Australia.

  32. Danielle

    Maybe you were supposed to perform a Zavanelli manoevre, get Mum to hospital while holding the baby in and have a dead mother from a ruptured uterus??? Meanwhile, the ambulance could be on route to the hospital ready to perform an emergency caesarean section in no quicker time than the mother could’ve got it if she was in the hospital labour ward!

    People who don’t understand should not be passing judgements here. No midwife delights in unexpected complications with undesirable outcomes. Hospital’s are not like ER or Grey’s Anatomy. You cannot just take someone to theatre whenever you need it… it needs to be set up, nurses and surgeons need to scrub (and be available) and the patients need to be preped!

    God bless Lisa. I know how much it hurts to lose a little one during birth.., but most of us do not get dragged through the coroner’s court because of it! Anyone that thinks you just walk away and never think about it again clearly has no idea!

  33. Julie Lewis

    My mother had 4 of her 11 children at home, back in the 1940′s, when homebirths were common. She had no problems with any of them. Also, my daughter had 2 of her 3 children at home, and is a staunch advocate of homebirthing, so although I’m no expert, I have some knowledge of homebirths. If a woman wants to have homebirths, it should be her right to do so. Young woman these days research the whole thing, and midwives are very well trained in birthing. (I know 2 MW’s who are really superb at their job)
    Lisa, I hope that everything turns out well for you. This Coroner should be disciplined, and the AMA wake up to itself. Two things we know won’t happen, because the ‘boys’ stick together in these things.
    My love to you and Tate’s parents.
    Julie

  34. CB

    My first child was “delivered” by Dr AP using vacc extraction after an episiotomy and 22 hours of induced labour. I shouldn’t have been induced in the first place, I wasn’t overdue and my cerivix was closed, there was no medical reason to induce me, I was in no risk and neither was my baby. The labour was a nightmare, contractions ran one into another with no relief, after 10 hours I ended up having every drug I could get. :( I had been fully dilated and ready to push for almost an hour but was not allowed to because the Ob had not arrived, the midwives were told to wait for him despite the fact that my baby was ready to be born. When he did arrive I was told “You have 20mins to get this baby out, I have another appointment” ! In hindsight it is no surprise to me that after only 2 or 3 pushes I was told my baby was in distress and had to get out quickly. I was cut and she was pulled from my body. She lay in my arms and whimpered pitifully after the birth, the memory still brings tears to my eyes. She had 12 months of Physio at the Childrens hospital to treat her Sternomastoid Tumor as a result of the vacc extraction. The birth of my first child was the most traumatic experience of my life. It left me feeling depressed for months. I felt like a failure, I felt robbed and violated. It still makes me sad to think about it, and angry as hell. I hope the Ob made that other appointment, he sure made my decision to homebirth my last baby a hell of a lot easier!!
    My last child was a water homebirth under the care of a homebirth midwife. I can’t even begin to tell you how different that experience was. The level of care of fantastic, I still keep in touch with my midwife today such is the relationship that she fostered. My child was born into my arms, perfect and unharmed as nature intended. Born into our home with no complications and no intervention. It was the most empowering, magical experience of my life. Such a stark contrast to the medically managed hospital birth of my first child.
    We need to be able to homebirth should we chose to. Thank you Lisa for standing up for women’s right to homebirth in this country. I wish you all the best with this fight.

    1. Andrew Pesce

      This is my first post on this thread.
      It has been assumed that the “AP” who posted early on was me. It wasn’t.
      The post from “CB” is a mystery to me. I have reviewed my files and none of the patients with those initials I have cared for had a birth corresponding to the post. Perhaps the initials are an alias. I perform very few vacuum assisted deliveries and don’t believe I have ever given a time limit to a patient as related in the post. However, if CB was a patient of mine, perhaps we could both learn from talking about what happened. I presume CB would know how to contact me.
      Andrew Pesce

  35. Scott

    Hi Lisa,

    You and the homebirth movement are going to try and be demonised and pilloried by the institutions that control our lives. We have had two unassisted home births and would do it again.

    Anyone with the ability for analytical research understand the dangers associated with many standard medical practices that are just accepted that is never put in the spotlight.

    I have no advice for you except don’t allow the bastards to grind you down and don’t let their lackeys get inside your head or your heart.

    Scott

  36. Frances McCann

    Lisa,

    My heart goes out to you.

    I live in Scotland, UK and was made aware of your fight by a mom friend of mine from Australia. I just cannot believe what I am reading. It is clear to me that the Coroner has gone outside of exising laws in order to have an inquest basically because he wants to!

    I find it astonishing that the media are not even properly reporting this. What is going on?

    I had an emergency c-section for my first child and recently had an elective c-section with my second. I was given the facts around my first birth and made an informed decision that felt right for me and my second child. The crucial thing here is that i had a choice! Just as it should be. Just as every single woman should have the right to do. Home Birthing was unfortunately not for me, but I support HB and more importantly, support freedom of choice.

    If it were not for people like you, I fear women would be strapped down to hospital beds and made to give birth! The arrogance of these people is unbelievable. Women have been giving birth since the beginning of time, the way nature intended. Medical interventions can be fantastic and have probably saved millions of lives. But how dare they believe that they are better than nature itself!

    I wish you luck and will be watching with interest from accross the world!

  37. Tam Stewart

    My youngest son was born 5 years ago today by a planned c section at Maitland hospital. During the birth, his arm was broken and his testicles bruised. Their reply was “accidents happen”, and they are right. These things happen through no fault of anyone. Best of luck with what you are going through at this time. xx

  38. AimeeM

    My uncle was stillborn in hospital due to severe shoulder dystocia. He was so badly stuck that he could not be brought from the birth canal whole. I’m not sure why homebirth is being made a scapegoat.

    This IS off-track – but I do wonder if shoulder dystocia is more prevalent amongst hospital births due to constant EFM and maternal stress. I believe my babies turned from posterior to anterior after a spell of rocking on all fours, something which felt comfortable to me.

  39. Leonie Crosse

    I am only just learning about homebirth fully now. I admit I am wuss and being a nurse I have chosen a hospital each time. Now I am aware of homebirth I am deemed to high risk for it after three births with complications. I still support a woman’s right to choose and thank my friends who are fighting for this with policy. I have been a nurse for quarter century and in ER for half of that … I sure hope PEA does not become a definition of life. The implications for any nursing/medicine are monumental. All those elderly that die peacefully in their sleep without a NFR or so many other patients. What a nightmare for practitioners.

  40. meena

    No you dont post comments good and bad, I have left many very relevant comments under different names and if the question or the point I make is too hard, too technical or too close to the bone you dont print or you alter the comments to your own pleasing, especially if you dont know the answer and dont want to look ignorant on medical nursing midwifery and legal issues. Shame on you
    In effect you only have a very basic understanding of the entire birth process, its all about the same level as a first year student really but you wont print anything you cant answer so women get the idea you know what you are talking about when in fact you know very little, or only enough to make you dangerous.