Tuesday, August 2, 2011

Homebirth in Oregon

Since the beginning of the year, I have heard about around a dozen homebirth losses in that state. So, I'm going to explore the ins and outs of midwifery in Oregon.

1. What is the legal standing of midwives in Oregon?? 
 According to CFMDirect entry midwifery is legal in Oregon as a completely unregulated practice. There is also a voluntary licensure for those who want to recieve medicaid reimbursement Oregon Medical Assistance program (OMAP) and maximize the opportunity for insurance reimbursement; however, in reality access to medicaid payments for fee-for-service maternity care in the home is very limited due to the administrative rules set up by ). Licensure requires successful completion of the North American Registry of Midwives written and skills exam. 

In other words: CPM's can bill medicaid so they can try to make more money and if you want to call yourself a midwife, have fun practicing. 

2. Who tracks the data for this state??

 The answer to this is pretty much nobody. I found on Oregon PublicHealth that in 2006, 269 infants died. Oddly enough, only 33 babies show up on the CDC Wonder Database. I also managed to find this. We know that Melissa Cheney has also insisted all midwives submit their data to MANA, but we also know she is on the board for both places and making good money doing it, and we also know MANA doesn't share data. All in all, nobody tracks outcomes! 

3. How many Licensed Midwives are there??
   Thee are 74 Licensed Midwives. However, the number of unlicensed midwives practicing is unknown as nobody tracks them nor are they held accountable for negative outcomes. 

I did find that there are 36 practices that employ CNM's!




In 2010, Andaluz Birth Center filed a class action suit against Oregon Health and Science University. 

Midwives say doctors and nurses at OHSU have filed baseless complaints to the licensing agency meant to thwart competition.

According to this article , there were 6 complaints lodged against that cente when patients an into trouble and were transported. It states the Oregon homebirth numbers at 877 in 2009. Of course no neonatal or perinatal mortality numbers are mentioned, but, it says fetal deaths are .1% for Licensed Midwives and .5% for Physicians. Oh wait, it does share numbers. According to a 2009 BC Homebirth study, the risk of a baby dying in a midwife attended homebirth is 1.7% versus .6% in the hospital. This study included breech, twins, and vbac (which we know increase risks, but their moms and midwives don't really seem to care about that one). That is a 2.8 times higher risk of death, yikes!


 It's scary to look at this state while people think they are something to be idolized and emulated. It's also sad to think that the only people who seem to care about the dead babies are doctors and nurses who tried standing up against the broken corrupt midwifery system in that state.

5 comments:

Liz said...

i am probably moving there in a few months. all i can say is watch out Oregon- Liz Paparella eats crappy midwives for breakfast!!

~Brett~Stephanie~Augustine~ said...

*sigh* I'm from Oregon and have had to watch so many friends go through homebirths with CPMs and intentionally unlicensed DEMs. (They don't like any restrictions). It makes me nervous every time.

Liz, your presence in Oregon would be fantastic! They need your voice!

The Sensible Midwife said...

Shout it from the mountaintops Bambi!!!

Branwen said...

This is a huge issue for me. All three of my children are alive THANK GOD, but no thanks to the incompetent, nasty, hateful midwife who changed all of our lives for the scarier, and who cannot be stopped by the impotent state of OR.

On top of all you said, here's something I posted on Dr. Amy's site that will shock readers further: The State of Oregon also doesn't care if a midwife has had to stop practicing in another state due to malpractice and licensing problems. In 2009, I contacted them about multiple acts of gross malpractice by Portland midwife Laura Erickson. In preparing my complaint for state officials, I discovered that Erickson had been investigated by the Minnesota atty general in 1999. She was basically forced to stop practicing in MN, but months later she showed up in Oregon and got licensed without so much as a hiccup. In fact, when I spoke to licensing board investigators, it was news to them that Erickson had ever had problems in another state! One of the sites I found has been taken down since then but you can still see it on the Wayback Machine:

http://web.archive.org/web/20080517171435/http://www.minnesotanaturalhealth.org/newsletters/midwives.html

Another site:

http://www.paynesvillearea.com/news/headlinesarticles/archives/032598/Localmidwifestopspractice.html

And yet, despite this, despite Erickson having failed to mention these legal troubles to Oregon officials, and despite her ongoing negligence and malpractice in the state of Oregon, despite her refusing at first to turn over relevant records when requested by investigators...not only is she still practicing, as far as public record shows the case was closed without even so much as a reprimand. In fact, as her bio on her current practice's site shows, she was even an instructor and director at the big midwifery school in Portland:

http://www.almamidwifery.com/midwives/laura.html

I know of two losses that happened under her care and how do I know of them? Because she BLABBED about them to me! She has no regard for patient privacy, and if a mother rubs her the wrong way she will mishandle her care or abandon her with no referral and, because of Oregon's insane midwifery laws, no recourse.

There are NO consequences. It is nuts and absolutely disgraceful to my state.

Becca Sue Congdon said...

I'm interested in more information about the OR losses you're referring to. I live in Portland and just had a home VBAC in April. Things went fine. I have a handful of friends who are considering homebirth and I want them to have access to information about the losses, and not just my positive story, as they consider homebirth.

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