these are the happy customers?

I decided to look at the stories better birth links to on its website as examples of happy, satisfied customers. I expected idyllic experiences that were undoubtedly within the scope of practice outlined in utah state code. The stories posted make such an assumption questionable. Some of these stories make me wonder why Better Birth linked to them at all?

Story # 1 has a familiar feature:

At the birthing center they checked me. Now let me say something right here. I did not want to be checked throughout the pregnancy and labor unless it was necessary. I think they wanted to see how far I had progressed although numbers don’t mean a whole lot to me. But I think they just didn’t think I was ready to come in to the birthing center.

There aren’t any details about how they went about checking her dilation without her wanting it to happen. I don’t know how it went down, but it is another example of the “you are in control” selling point being total bullshit. When I asked not to be checked I was denied food and entry into the birth center unless I submitted. There is no way for me to know if that is the experience of the author of the birth story.
This is another bit from the same story:

. I had no IV’s or anything constricting me throughout this all so this felt like my world was closing in around me. Apparently her heart rate had started to drop and they were wanting to make sure she was getting enough oxygen. I started to black out and hyperventilate. TOO MUCH OXYGEN. They took it off after about two minutes. I truly and honestly thought I was going to die in those moments. I was pushing, there was soo much pressure and I was blacking out. And I thought there was an emergency because they put oxygen on me. I am sure they told me what was going on but I was too out of it to remember.

Its the best experience she can’t really remember! We don’t know how low the heart rate dropped, so it isn’t possible to say if better birth followed the state’s scope of practice guidelines or not. If it was scary enough to start interventions like oxygen, it would seem like it would be scary enough to start a transfer. Unfortunately the state guidelines are not clear enough on this matter to make a determination one way or the other.

and more:

Suddenly her head came out! I looked down and saw a blue head. The chord was wrapped around her neck twice. I thought to myself that she was dead. I literally thought that my perfectly wonderful baby was dead. Tanner knew immediately what I was thinking and grabbed my face and told me she was fine. He told me she was alive, healthy and wonderful and that I could do this. The midwives told me to flip on my hands and knees and by some magic, I flipped over. It felt like angel literally flipped my body over.
I pushed twice and her little body flopped out.

Tanner is her significant other, not a midwife. Flipping onto hands and knees is usually refered to as the gaskin maneuver by midwives. It is something that they typically recommend for shoulder dystocia (a potentially fatal problem where a baby’s shoulder gets stuck behind the pubic bone, and if not freed they can suffer from hypoxic brain injury or death).  The mom does not say if that was what she experienced, but its pretty consistent with other stories of shoulder dystocia. This story is eerily similar to many stories of deaths or brain injuries caused by midwives that I have read in the past, except that they were not lucky enough to resolve the dystocia before death or disability was caused by lack of oxygen. This was a seriously close call. Why are they advertising this?

To summarize: an unwanted vaginal exam, a dropping heart rate, a stuck blue baby, and blacking out during labor. This is example #1 on better births website that they are professionals who do a great job. ????? I am genuinely puzzled that they linked to this birth story.

Story # 2:

The morning of Saturday April 28th, 37 weeks along, I woke up around 7am with my underwear a little damp.

It ended up being ruptured membranes. The fact that she woke up with it means that there was no real idea about when the rupture actually took place, so it would be very difficult to properly assess risk in this situation.  She (fortunately) delivered the next morning, before the risk of infection would increase.

There is no information on how they judged the gestation of the baby either, but there is no mention of an ultrasound to verify that the baby was mature enough for birth. A gestational age of less than 37 weeks requires a mandatory referral to another care provider. I was worried when I read this sentence about the newborn:

She was making grunting sounds, probably from her lungs being a little underdeveloped so they had me hold an oxygen tube up next to her mouth.

I immediately thought of wren’s story:

His parents did not realize it at the time, but Wren is grunting, a sign of respiratory distress. He was already very sick.

Wren ultimately passed away because direct entry midwives are inadequately trained to deal with pediatric health concerns. They didn’t recognize the grunting as an abnormal sign of respiratory distress and Wren passed away. Looks like better  births example #2 of how awesome they are is another situation where luck played a large role in the positive outcome of the birth. I am extremely grateful that this baby did not die like Wren did.

I have seen more than one story where a woman thanked the ‘awesome’ midwives who were responsible for the death of the baby. They generally do not know that their midwives acted negligently- how could they? Most people are not birth professionals and do not have the level of knowledge needed to assess such things. Positive experiences are great, but they don’t mean much in terms of proving that care was appropriate. They are promoting stories where everyone lucked out and things turned out okay, and then take credit for the outcome as evidence of how great they must be. The real test of quality is how a business reacts when things go poorly. There is ample evidence that Better Birth sweeps complaints under the rug, either by minimizing them or denigrating the people who spoke up. Its easy to take credit when things go well.

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