Why I’d never recommend using a midwife | I don't blog, but if I did...

Why I’d never recommend using a midwife

** TRIGGER WARNING This post is about miscarriage, babyloss, stillbirth, and the fallout from it. It is about negligent care from midwives, and more. Please do not read this if these topics may cause you emotional stress, that is never my aim. **

I can’t remember what the weather was like that day. I can’t remember what I was wearing, or what I ate for breakfast. I do remember, in great detail, the searing pain of loss I felt, though, when I heard those words

There is no heartbeat, your baby has passed away.

Marshmallow

Marshmallow

I have written about my experience with late-term miscarriage a number of times. Here, on my own blog, I recounted my story. I talked about how my daughter named her dead sibling Marshmallow, and how we still remember that baby many years later. I even shared my experience with the readers over at Yummy Mummy Club. I talk openly about my experience, the feelings and the aftermath because I think that we need to discuss these things. We need to know there are others out there who suffer these losses, too, and that we can lean on one another for support.

What I have not discussed (only alluded to) was my experience with the midwives I had placed my trust in during that pregnancy.

My first pregnancy was uneventful. Though Story was 13 days “overdue” and I was induced to deliver her, nothing was very remarkable. I was under the care of an absolutely incredible OB/GYN, but we moved out to the ‘burbs and seeing her in downtown Toronto was no longer reasonable with my second pregnancy. I decided to take the advice of some friends and use the local midwifery practice. They came with rave reviews about how warm and inviting their practice was, and how natural and supportive the entire process of growing my baby and birthing it would be. I was pretty excited.

I’m a fairly crunchy sort, and practiced extended breastfeeding and many attachment parenting practices. I felt like midwives fit into my belief structure about how pregnancy and birth should be. I wasn’t really on board with them pushing home birth so hard, and I didn’t love that the secondary midwife was very anti-Western medicine in general, but I’m a confident patient able to speak up for myself, and I drew my lines where I felt comfortable.

At approximately 16 weeks, the secondary midwife tried to find my baby’s heartbeat but was unable. She tried different angles, had me roll to different positions, and was still unable to detect anything. When I questioned this, she said it was normal, and that it was “rare” to hear a heartbeat at that stage of pregnancy. I don’t carry much belly fat to cushion the sound, and I had an anterior placenta with Story and had still heard her heartbeat at 13 weeks, so I found that comment suspicious.

When I said I was planning to have the 18 week ultrasound done, the secondary midwife was extremely unhappy. She told me it wasn’t necessary, and pushed me to not have it done. But I wanted those tests done, and we also wanted to see if we could find out the sex of our baby. The midwife was adamant that it was a bad idea. I told her I wasn’t comfortable with her not being able to find the heartbeat, and that I wanted confirmation that everything was ok. She was very indignant, and I felt like a child being tsk-tsked for ill judgment.

At just over 19 weeks, I had the ultrasound done, and you know how it ended up. My baby was dead. For almost a month, I had carried a dead fetus in my womb, because a midwife made a bad choice and was so against Western medicine that she allowed it to cloud her judgment.

Lying on that ultrasound table was torture. I knew something was terribly wrong, but had no confirmation until my primary midwife returned the call of the lab tech. They sent her an emergency page, and she responded 45 minutes later. They made me wait in a gown, on a table, for 45 minutes. Alone. Cold. Afraid. She was kind enough to break the news to me over the phone, though we still had to drive to her office to speak with her in person.

When we walked into her office, I couldn’t feel anything. I was hugely pregnant, and scared to death of what I was going to hear. I told her that the secondary midwife hadn’t detected a heartbeat weeks ago, and she merely shrugged. There was nothing they could do. She explained that because my baby died before the half-way point (20 weeks) of my pregnancy, I was automatically passed onto the OB/GYN on duty at the hospital where they would decide if I should have a D&C or if I’d have to deliver. She wouldn’t be coming with me. This was good-bye.

Since my ultrasound clearly showed a fetus at approximately 16 weeks gestation, she should have known there was no choice but to deliver. There was no way a fetus of that size could be removed via D&C yet she either didn’t know this fact, or chose not to tell me. Negligence.

When I went to the hospital, I was in the care of a kind OB who stayed with me during my labour and delivery. My husband and daughter were there, too, although not in the room when I was ready to deliver. They ran into my primary care midwife in the halls of the hospital. Note that she never once popped in to say hello despite being just down the hall from me. She never offered to hold my hand or see how I was doing. She said to my husband, “How’s Alexandria?” and he replied, “Well, not good, obviously” and she said, “Well, give her my best.”

Her best. That was her best? Where was the compassionate care? The over-and-above concern and warmth? People talk about the cold care of OBs but my midwives were like ice. The OB who had just met me that day looked at me with tears in her eyes and hugged me tight, but my midwife couldn’t look me in the eye, and wouldn’t visit me while I laboured because she wasn’t getting paid anymore for my care.

In the weeks to follow, I received an email from that primary care midwife, asking if they could drop some books off to me about grief. I said sure. I declined a visit from her, while she defended the choices of her second-in-command. Later, in an official letter, I was notified that never again would an undetectable heartbeat go without further investigation so at least my experience was not in vain.

I still have the letters I wrote the week after my miscarriage. I wrote one to the Head of Obstetrics at the hospital, and one to the midwifery practice, but sent neither. It made me sick to my stomach to have to open the wounds again, when I was (and am) so desperate to let them heal.

But whenever I read about people bashing obstetricians, or offering blanket praise to midwives, I want to scream about my horrible experience. The doctors in the hospital were shocked at how long I had been carrying the deceased baby, because generally, the mother’s body would either reject the fetus, or go into septic shock from infection as a result of carrying something deceased inside the womb. I could have died. I could have died because this woman made a decision against Western medicine.

There are good midwives and bad. There are good obstetricians and bad. This is my experience. This is why I would never recommend the midwifery practice of which I was a patient, and why I would probably never recommend midwives, either. There are always other sides to the stories, nothing is quite as clear-cut as we may wish it were.

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21 Responses to “Why I’d never recommend using a midwife”

  1. Louise

    Oh my stomach just rolled over with the pain of reading this experience you’ve had, Alex. I’m deeply sorry that your profound loss was met with such indifference. When I lost a pregnancy while in the care of midwives, I was met with deep compassion that I desperately needed, and met with cold indifference from GPs and ER doctors. You’re right, there will be good and bad in both areas of practice. I wish you didn’t have to know that firsthand. My love to you and baby Marshmallow. xo

  2. SLFarnam

    This is so awful. I had no idea this was the way everything went. 🙁 Gut wrenching, Alex.

    I am so sorry.

    I am glad you wrote this. You are destined to help people with your words. You made a Story and a Mason. Both creative things, really. : )

    Keep writing.

  3. Robin Elise Weiss

    I’m sorry this happened for all sorts of reasons, but mostly because it made a painful experience more so. As you said, no profession is all positive or negative.

    • alex durrell

      Thank you for reading, and commenting.

      I am certain there are amazing midwives out there, just as certain as I am that there are wretched OBs. I wish there was a better balance.

  4. Leanne Palmerston

    When I miscarried, my midwife was wonderfully supportive and kind. Not nearly as outgoing in their aftercare support as yours, however. I think it’s really tremendous that the practice dealt with the fact that there was a poor care decision made and reached out to assure you they were dealing with it. That’s actually pretty incredible of them. I doubt there is an OB anywhere in Ontario that would send you letters admitting to anything hinting at malpractice, send you grief support books and offer to meet with you.

    While I was in the process of miscarrying my child whom I had carried 5 weeks longer than they’d lived, I treated extremely poorly by the ER triage nurse (I was told to go to ER if my bleeding was soaking a pad in less than an hour and/or the pain was too much and both were applicable – and, as an aside, my miscarriage was far more painful than either of my unmedicated births) and left nearly hysterical from pain lying in a huge expanding pool of blood by the ER doctors. The triage nurse yelled at me for making noise – in front of my family and a room full of strangers. It was humiliating and demoralising. Eventually I was given a scrip for strong painkillers and sent home. I had to pee first. In the bathroom I passed the body of my child where the automatic toilets flushed when I stood to turn and verify what had happened. So awful and sad. I was numb and ruined for a long time.

    It never occurred to me, however, to warn people away from ER doctors and nurses. Not even from the ones at the particular hospital I went to. I understand that there are good practitioners and bad practitioners in all fields of medicine.

    I wish healing for you. I never thought to name the child I never gave birth to. I think Marshmallow is a lovely name for your lost little one.

    • alex durrell

      I am so sorry for your loss, and how utterly traumatic and scarring the entire thing was for you. That is just gutting.

      The letter I received was actually a legal formality, releasing their practice from any misdoing, but I paraphrased. In addition, the books and outreach were in response to my husband expressing disgust with their care. But that’s neither here nor there.

      I’m careful to say that there are (obviously) some wonderful midwives out there, and that the system as a whole is very broken. There needs to be a balance between these seemingly opposing practices, I think. That said, just as people who had terrible experiences with OBs, I had a terrible midwifery one, and just ask that people heed my story, as well as the positive ones.

      I didn’t think to name our baby, either. In fact, I chose not to look at it. It was all my daughter’s idea.

      Again, I’m just so sorry for your awful experience, too.

  5. Karina Taño Gigante

    Oh A, I remember hearing this story the first time and I am still so angry and upset for you. Thank you for telling the other side of the story. I find the interwebs way too pro-midwife.

    • alex durrell

      I just wish there was a balance, you know? It’s so taboo to say anything negative about midwives because they are supposed to be so nurturing and positive. I am absolutely certain there are those kinds out there, but that’s exactly the kind of OBs I had, too. Thankfully.

  6. Cynthia Hill

    Even though I knew about your loss, I had no idea of the “care” you received from your midwives. That’s so heartbreaking. As you say, though, we can’t make blanket statements about any medical caregiver. I’ve certainly found that out in spades recently. And my first OB was horrid, and made me cry, but then I had a midwifery practice I was happy with, generally. And yet I chose to stick with an OB for my other 3 kids, so… you have to find the person/practice where you’re comfortable, which isn’t so easy in a time when most practices are so overbooked 🙁

    • alex durrell

      Nope, I can’t recommend them, but others can. I also wouldn’t recommend my GP, though I see him all the time.

  7. Reinie

    Though I’m very sorry for your loss and the way you were treated, this has NOTHING to do with MIDWIVES vs OBs. This is your trauma with the blame placed on an entire profession. Seek some mental health counseling and stop placing the blame for the accidental death of an extremely unviable baby on an entire group of people, of which, you only interacted with two.

    • Anj Fabian

      Well!
      Defensive much? The least you could have done was to confirm that this midwife made unacceptable choices.

    • coffeewithjulie

      What is your problem?? And what post did you read??

    • alex durrell

      Nowhere do I place blame for the baby’s death. Nothing would have prevented that from happening, regardless of the care. But competence would have had me in an ultrasound lab as soon as a heartbeat wasn’t detected, and compassion would have had someone at my delivery to support me.

      I bet if my experience with the midwives had been positive, you would feel it was fine to recommend using midwives in general, right? But because my experience was negative, it isn’t acceptable. That’s a very common attitude online, but it doesn’t make me any less likely to share my story.

    • Mad-as-Hooligan

      Whaaa? Are you HIGH or just incredibly rude and stupid? She didn’t blame anyone. Blame for the death? That didn’t happen and makes no sense. She was angry and rightfully so, at the gross incompetence of the 2nd midwife who didn’t have sense enough to send her for an US when the heartbeat was not detectable. Don’t be an ASSHAT, these midwives screwed up and could have cost this woman her uterus or even her LIFE.

  8. coffeewithjulie

    I am so sorry for everything you had to experience, Alex. It would be hard enough to go through it all while receiving compassionate care, let alone how you were treated.

  9. Krista House

    What a heartbreaking experience. Alex, I am so sorry. You have every right to share your experience and opinion about the midwifery practice that you were a patient. The more we share, the more we benefit from each other — all the good AND all the bad. Your post was well thought-out, eloquent and crystal clear.

    Thank you for sharing such a difficult and traumatic experience with us. xo

    • alex durrell

      Thanks for reading, Krista. I know there are probably amazing midwives out there. But I felt I had to share my experience.

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