Tuesday, August 30, 2011

Sheppard's story

As told by his mother Marlo.



I've always been afraid of hospitals. I hate needles. Nothing terrified me more than the idea of childbirth. My husband is the same way. But when I got pregnant in May of '09, after my first OB appointment and nifty ultrasound, we resigned ourselves to the idea that we would wind up at the hospital when the time came for me to deliver.

On my 2nd OB appointment, she asked me, "So are you interested in going all-natural? It made me feel better to think that a doctor was basically telling me that I could do it without all the scary stuff. My mom, an RN, had already scared me shitless about the whole process and I was filled with dread.

In my hormonal anxiety, I started "researching" natural childbirth. I watched the Business of Being Born with my sister-in-law and decided that it would be fine for me to go with a midwife since my doctor told me I was "healthy enough" that I should be able to "go all natural." That movie and all my internet reading suggested that home birth was a perfectly safe thing to do for healthy, low-risk women like me. My husband was on board, too.

The first group of midwives I hired were all about homeopathy, strange diet changes, and harping on people about their weight. They stressed me out tremendously, but I stayed with them because they understood the importance of all the prenatal tests, and I was able to go to the DLO (diagnostics laboratory of Oklahoma) to get all my testing done and paid for by insurance, and a local OB (who I found out later is quite quack-tastic and pretty shady) allowed these midwives' clients to come and do their ultrasounds at his office.

The midwives themselves, however, being CPMs, were not covered by insurance. They offered me a "discount" for paying in full before 35 weeks. The total fee after discount was about $2000. And in the end, I decided to change to a different midwifery practice because these CPMs were just too intense and I was having doubts... but of course, I wasn't refunded any money.



So long about 34 weeks, I hired my final set of midwives. I was in love with them-- every time I went, they told me I was beautiful. They seemed so knowledgeable, and had a huge library of books on natural birth, spirituality, and other topics which seemed interesting to me at the time. I was comforted by knowing that the lead CPM (her assistant was a DEM) had been in business for over 20 years. I figured she must have seen it all. They told me that they only had to transfer 5 or 6 women a year, so surely I wouldn't need to transfer, and the hospital they transport to was nearby and they claimed that they had a "good relationship" with the doctors and CNMs there. I still had no idea just how different CPMs and CNMs really were, and I had no idea that they were lying about having a working relationship with this hospital.

At 40 weeks and 3 days, I went into labor. I stayed in labor-- very irregular, very painful-- for a total of 3 days. The CPM never showed up, and instead, I was stuck with the DEM, who only showed up after I'd been in labor for 24+ hours (of course they said that it's fine to labor as long as it takes, because "your body knows what to do."). My doula had come in and out my house periodically the whole time, but she wasn't giving us any advice...

The DEM thought that I needed a rest at about the 30 hour mark (my hubby's estimate-- I was living out of time as we know it at this point...). She suggested that taking a benadryl would help me nap, and a drink would relax the uterine muscles and make the contractions space farther apart and lessen in severity. My husband didn't know any better, and despite my doubts, I took a benadryl with a chaser of TGI Friday's mudslide mix.

The contractions slowed all right, but I couldn't sleep. And very soon they picked back up with a vengeance. I spent hours on our pull-out sofa bed in the living room, vomiting, retching, curled up head-down butt-up because that was the only way I had any bit of relief... I tried to meditate on the Hawaiian music that we had playing on the stereo. I tried to think of our last trip to Hawaii where I decided that this music was what I wanted to hear during labor, since it was so relaxing...

My doula finally suggested the next morning that I get into the pool of warm water because I was completely distraught and she thought that it might alleviate the pressure just long enough to make some decisions about how to proceed. It had been about 48 hours, the DEM checked me and I was only at 1cm and change, but I was 60 or so percent effaced. Something was wrong, but she dismissed it at the time. I was delirious; neither my husband or I had slept (the DEM had taken a nice nap on our couch, however!). The DEM cavalierly said, "I had a 40 hour labor with my last child. It sucked, but you just have to get through it. The only way out is through. This is what gets your baby out."

I will never forget that as long as I live, how dismissive she was about my pain, fear, and exhaustion. I sobbed as I sat in the water, wearing only a tank top. My doula rubbed my shoulders, and began to explain to me how epidurals work, giving me the courage to shout, "I NEED HELP!!!!!!!!" and giving my husband the nerve to say, "We need to GO." The DEM agreed, reluctantly, and despite her promise to drive us there herself, she decided she needed to stop at her house first and had us drive ourselves.

When we got to the ER, the attending doctor was very brusque with me, slapping me on the back in the middle of a contraction and saying, "You're not in labor-- these are pregnancy symptoms. Get used to it." The MW came in with us, but she said nothing. She handed over my "records" which of course made no sense to a real medical professional.

The resident doctors knew something was wrong, they lobbied for me to be admitted for augmentation for failure to progress, they saw I was exhausted... but since my BP and heartrate, and Sheppard's heartrate, were stable, their protests fell on deaf ears with the attending. He discharged me and gave me Ambien.

We had to go back home, I took the Ambien the doctor gave me, tried to sleep... my water broke full of meconium. Back to the hospital we raced. I got an epidural in record time and was allowed to sleep since our vital signs were stable. The resident Family Medicine doc who would later deliver Sheppard assured me that most kids with meconium just have to be observed for a few days in the NICU, and that since we were stable, he wasn't too worried. I labored for 12 more hours, but was able to sleep and regain some strength from IV hydration and electrolytes. Then it was go time...

1. Jeremy called the DEM who came back when I reached 9cm, and was there through the delivery (30 min. of pushing).

2. Sheppard came out, they laid him on my chest for a moment-- he was beautiful, and smiled up at me. Then the neonatology/pediatrics team gently picked him up and said to me, "we need to help him now..."

3. Despite my skin/muscles being in great condition, I suffered a 4th degree perineal tear and a small cervical laceration. The attending doctor, an unflappable surgeon, was flapped-- he scrubbed in fast as lightning and shoved the resident who'd delivered me aside in order to commence what would become a 2.5 hour long repair. I was in the hospital for 6 days, got infected, all kinds of stuff... then I was so weak I couldn't walk for 2 weeks, I couldn't go see Shep for a week and couldn't hold him for 2 weeks... the doctor who did my repairs later apologized for not giving me a blood transfusion b/c I had lost so much blood...

4. Sheppard was taken to the NICU, but rather than being observed for a few days, he suffered there for a month. One of his lungs collapsed, necessitating a chest tube, he went into PPHN necessitating countless heart echos to monitor the wonky valve, he had: chest tube, UAC, UVC, PICC line, IV antibiotics/antivirals/nutrition/fentanyl and sildenafil ("viagra"), oxygen and NO2, and he was on a ventilator for 2 weeks.



Still, he had the strength to roll a bit to the side whenever we came into his room-- he recognized my voice and wanted me to pat his bottom and rub his back like I did when he was in my tummy (he'd press his little bum against my belly to have it patted!). He was given a 50/50 chance.

His doctors were amazing, though, and made us feel like he was a top priority for them. His nurses were wonderful. They sent every clergy-person (from every faith!!!) to our room to pray for Sheppard and sit with us. I will never forget the words of Dr. W the neonatologist-- "These little ones can turn on a dime. They can bounce back from almost anything, so please don't give in to despair-- there is every reason to hope. None of them blamed us at all for what happened.

We had Sheppard baptised and he had the Annointing of the Sick.

5. my parents blamed us for the whole thing, causing another layer of pain and drama... it didn't help that the ER doc that saw me on the first trip there was skulking around my room and telling them things like, "if these girls wouldn't try this homebirth stuff and work with midwives, these things just wouldn't happen... they bring it on themselves..."

6. The midwives didn't check on us



7. Sheppard had to take Viagra for 4 months, visits to the cardiologist, ended up back in the hospital for observation, had chest retractions for 3 months from breathing trouble, and now has a nebulizer and has to take Synagis shots during RSV season...

8. I realized more and more that the cascade of catastrophe began with the failure of the midwives to recognize that something wasn't right in labor, failure to consider the estimated size of my son from the ultrasound I had at 34 weeks, failure to get me help sooner... the DEM had the nerve to say to me, when I went to them a few months later to talk about what all happened, she said, "Hopefully next time you'll trust birth more, and it will go easier." UGH!

9. Recently I wrote a FB email to the CPM who never showed up, and she wrote me back an ugly series of notes accusing me of slander, harassment, of being crazy and "changing the story in your mind," and saying she would take legal action against me if I "continued to slander" because she would "defend" her "reputation of safety."

10. I was diagnosed with PTSD over everything that happened (flashbacks, physically feeling baby kicks and labor pains, random unexplained anger, paranoia, nightmares, intrusive thoughts of the labor & birth & mistreatment from my parents...)

11. I'm pretty sure that my husband became clinically depressed, although he refused treatment

12. I'm SO GRATEFUL to our amazing medical team, to my husband who stood by me, to Dr. Amy and all of you for giving me the permission to embrace what really happened and stop blaming myself for everything when I really had no control over it once it started and the mw's dropped the ball. Had I stayed with an OB the whole time instead of hiring a CPM (and then getting stuck with a DEM), all this might very well have been avoided entirely, or at least rendered not-as-bad. I trusted those midwives to act in my best interest, to recognize any problems before they went critical, to be there for me... but they don't have the knowledge or training to do that. I know that now.

36 comments:

  1. Oh Marlo, your story is so heartbreaking :( The midwives were so heartless and negligent and I am so relieved your beautiful family made it through this ordeal!! I hope that last line of your story helps someone else avoid this terrible tragedy.

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  2. marlo- thank you for sharing your story- i shudder to think what would have happened had you not gone into the hospital. thank God baby Sheppard made it.

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  3. Thank you for sharing. Little Sheppard is absolutely beautiful.

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  4. I love the pictures of your son. I live in OK, so your story particularly interests me. Are you willing to share any more information, mostly location? I'm wondering what part of the state you live in (I'm in Tulsa).

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  5. Thank you for sharing your story, Marlo. I am glad that your doula at least had the sense to discuss pain relief with you, but your "midwives" were obviously horrid incompetents. I'm so, so sorry that this happened to you, Shep, and your husband. I hope that you can let go of any remaining self-blame. You thought that you were doing what was best for your son, and I will continue to fight against the hucksters who are selling women the fraud that is NCB and homebirth. I am also sorry that the attending ER doc was an idiot, and I hope that he was reprimanded for this behavior. If he really wants to improve things, he should be lobbying against lay midwives, not blaming their clients.

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  6. Oh Marlo...this is heartbreaking! (Accept for the fact that you both survived- that alone is a blessing!) Thank you for being brave enough to tell your story. I am so so so sorry you had to endure that.

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  7. I am so glad you and Shep lived to tell his tale! Those MWs sounded both ignorant and mean. I'm sorry you had to go through such a bad experience.

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  8. Thank you Marlo for sharing, and just being your rockstar self. I am so sorry that you guys were dismissed by those you should have been able to count on. Thankfully, because of you other women can hopefully see the light before they are in your shoes. Hopefully, some good can come from the lesson you took for the rest of us.

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  9. Marlo, I remember reading your story long ago and trying to get you to submit it here. At the time you didn't seem to think that your pain and hurt was worth as much as the rest of the women on this site. I am so glad that your son is ok and they you can begin the process of learning not to blame yourself for thier actions.

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  10. Your story has me in tears. Thank you for sharing. I'm so sorry that you had to go through that. I hope it opens the eyes of just one mom who might be thinking about having a home birth.

    I also have to say that you have a beautiful family.

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  11. looking at the photos of your son after he was born really reminded me of how fragile life is, and because of this, how incredible it is that women will so easily forget this... it isn't your fault, it was the faulty swaying and information you were given, it was wrong. from a woman who had 2 children die, 3 years apart, i can say that when you can use medical help to take some of that fragility away, use it. even doctors and hospitals lose babies sometimes, but to not even give the baby a fighting chance, to assume that "trusting birth" is enough, it really blows my mind. i am sure you were under the impression that they knew enough to see your son thru to a healthy arrival, but the real truth is that there are many un- and under-trained midwives out there not prepared for the worst but hoping for the best anyway. to see your son make it thru this ordeal was inspiring. so many times there is a different ending. i am so glad he made it thru, and that you can see clearly the truth that this was not your fault.

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  12. Marlo, thank you for sharing your story. I had a hospital birth and failure to progress as well, but at least I had pain relief, a baby heart rate monitor, and professionals who recognize what failure to progress might mean (eg. something is wrong!) My baby was malpositioned, so my c-section was medically indicated, not emergency - and I'll take that and a healthy baby any day of the week. So glad you and Shep made it! Wish the ER doc hadn't been such a jerk - and unfortunately I didn't expect much from your midwives.

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  13. My husband said, "You can only make decisions based on the information you have. The information we had was wrong." It's very insidious the way that the Natural Childbirth (and "all things natural" in general) has permeated our culture. I have no quarrel with nature. It's just fine. But the problem is that it's not all lovely and compassionate or totally perfectly functional like these people lead you to believe. To the layperson (which let's face it, most of us are! Most people are not scientists or doctors!) the claims of the lay midwives and the natural childbirth educators (and even the MDs who subscribe to parts of the philosophy) seem totally plausible and it's easy to be seduced into it. So that's why I'm glad this blog and other sites are starting to gain visibility. We really need to speak up louder than the Natural Childbirth and Pro-CPM folks, otherwise too many other families will base their decisions on the information they have-- the wrong information, from the wrong people. ~Marlo

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  14. Im so sorry you went through so much pain and worry, thank goodness your little man is safe and sound. Im sorry you were so let down by your care providers both the homebirth people who didn't know enough and the doctors who failed to notice that something was wrong the first time you went in. I can't believe they sent you home when there was so much obviously not right. So glad your safe and well now.

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  15. Thanks, Marlo, you are right. And there are a growing number of blogs out there countering the misinformation, which I think it is and will help. There are also a growing number of skeptical blogs, countering the "all things natural is better" mantra. I wonder, if you would be willing to discuss why you were so scared of hospitals? I feel this is one of the worse things NCB does, start by scaring women away from hospitals, then go from there.

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  16. Good question Amy(T). I have been scared of hospitals as long as I can remember. They smelled... funny. People went there when they were very sick, and sometimes didn't come out. This was when I was a kid. As I got older, I had the classic "white coat" syndrome, where my BP would go up whenever I went to the doctor's office-- they had to take it twice (once at the beginning and once at the end LOL). So fast forward to my honeymoon, and all my fears came true when I landed in the ER with a ragin' campylobacter infection and a truly epic case of colitis and septic shock... yeah, it was great. They left me on a cot in the hallway for 13 hours, and said that I shouldn't drink anything "in case it's appendicitis, and we have to do surgery." A few years later, my husband ended up in the ER with a similar food-poisoning situation, and had similarly crummy treatment. So we both were pretty sure that the hospitals sucked and were "out to get us." What go the NCB ball rolling was when my first OB seemed to give me the go-ahead to try it. Problem is, I didn't know (and didn't know to ask) that there were two types of midwives. So after watching BOBB, we became even more convinced that the hospital was not where we wanted to be. If it was crappy for us, then how awful would it be for our baby? So that was how that all evolved. It was easy for us to buy into the "hospitals are scary" mantra because we were already distrustful of them and had bad memories. I know it is added bother to place on doctors, but I REALLY REALLY wish that OBs would have a detailed talk with patients about NCB. Don't just ask them if they "want to go all natural" or recommend some reading. Really explain how it works, point people toward credible info sources, explain that the epidural and stuff does NOT reach the baby so they shouldn't feel guilty or be pressured by anyone over that... present the FACTS that are most commonly misrepresented or lied-about by the NCBers. And one piece of information that will save so, so many lives is: CNMs are the ONLY midwives qualified to attend childbirth. Home birth is not worth the risk, no matter who attends it. The end. ~Marlo

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  17. Thanks, Marlo; I know it is fairly common for peopl to have aversions to hospitals, and since most of us are in because something is wrong, it's often associated with bad experiences. Hope all goes well, and glad you posted the story.

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  18. One thing, among many in your story, was how the staff sent clergy to visit you. When my daughter was in the NICU, I was so mad at the world, I was striking at everyone. One of the nurses sent in Sister Stephanie to visit with me and my daughter. I am not Catholic, but her calming presence helped my soul calm down. Often times we would sit in silence, me holding my daughter, her silently praying the rosary for us. (she asked permission to do so). Had my mother not taught me to respect people of all faiths, I likely would have lashed out at her too, but as it was, she was the one person who could reach me,

    I am so glad that Sheppard lived through this. Healing can take years, but it is possible.

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  19. Thank God you went to the hospital when you did! I'm so glad your beautiful son is doing so well after such a rough start. He's adorable.

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  20. I have preemie twins, one of which had a 9.5 month stay in the hospital. Two weeks of ventilation and all the interventions you described (sildenafil, no2!!) are some serious shit for a full term baby. I'm glad all is (mostly?) well now.

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  21. Thank you for telling your story. I am so glad your son is doing well. I think it is so important that women who have had dangerous homebirths speak out. I suspect most hide. I also was appalled by the ER attending who sent
    you away. ER docs are great most of the time but often are not good at pregnancy...better to triage anything to do with pregnancy ( except maybe first trimester)

    I was sickened by the maybe next time you will trust birth comment. That was meant to be nasty in my opinion. A person like that has no business working with pregnant women

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  22. *hugs* As much as I respect natural child birth, home births, and midwives. Sometimes there is a need for medical intervention. I can't believe how you were treated! I'm glad your son is okay. None of this was your fault. It was the malpractice of these so called "midwives"

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  23. Thanks for sharing your story. My son Julian also suffered from meconium aspiration. He's a healthy 2.5 year old now, but we really did not know if he would survive at the beginning. Like Sheppard, my son was in the hospital for a month, and we went home with a nebulizer and lots of fear.

    The doctors were amazing, though. I'm ashamed, every day, of my decision to have a homebirth with Julian. And I am amazed, every day, that we were so fortunate that he not only survived, but now seems to carry no ill effects.

    Funny. At the beginning of the ordeal, before we realized the seriousness of the problem, our "midwife" warned us that while we were welcome to take Julian to the hospital, he would spend an "unnecessary" week in the NICU. We wished it had been a week! In the end, it was a month.

    I don't know yet how to forgive myself. But I read your story, Marlo, and I realize it's a perfectly human thing, to be pregnant and hormonal and scared and make the wrong decision.

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  24. I'm so glad both you and your little guy are okay :)

    Quick question: what is a DEM?

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  25. Direct Entry Midwife - basically any midwife who is "certified" through any path that does not require a degree in nursing.

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  26. What a beautiful boy. I'm so glad this story had a happy ending.

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  27. I too gave birth via midwives in Oklahoma. I had previously had a placental abruption with #3 and after an amnio with #4 got very ill with the symptoms of an abruption again so the women's center induced quickly and watched closely so everything turned out fine. In an attempt to keep it from happening again with #5 they induced early and all went well.
    With #6 I had enough of hospitals and chose a midwifery center which I fell in love with but it closed early in my pregnancy. Having a water birth in mind I found the midwives. I told them about the previous problems and they said it wouldn't happen again that abruptions were a one time fluke and that it was not possible to happen. Luckily it didn't happen but not having any prenatal testing so to speak and not doing a glucose test I had no idea that I had diabetes. I had an ultrasound a couple of days before I had him that estimated the weight at 10 pounds. My daughter at the time of the amnio had been estimated at 7.5 and I had her 2 days later weighing 8.8 so I was obviously concerned that this baby would weigh 11 pounds.
    I went through the labor on my bed and did well until it was time to push. I had vaginally birthed 5 children before the last of which at 8-10 shot out before the Dr could get there so when I couldn't get him to budge I knew something was wrong. I begged and pleaded with the midwife something was wrong I can't get him out. My husband was hysterical knowing I was really having trouble and called 9-11. I instictivly hung around my husbands neck and let my body fall forcing all I had into pushing the head out. It worked and I finally got his head out. The midwife started yelling and snapping to push him out now, but I couldn't so she yelled at me to lay down and gave it all she had and pulled him out. Meconium had been coming out during the labor and his heart rate had dropped to the 80's and stayed there. The EMT's arrived right after he was born and asked if everything was ok, did we need anything and the midwife acting very possesive snarked No, we have everything we need. They asked if the baby was too big for the birth canal and she snapped back "No, it was ineffective pushing"
    Time to weigh the baby.....11-2
    Thinking everything would be ok now, I went about my life with my baby, but he cried and cried everytime I touched him. Feeling like the worlds worst mother I called my midwife and told her I think my baby hates me he cries everytime I pick him up. She replied with "Maybe its a personality conflict"
    I took him to the Dr every other day because he lost over a pound and was dx failure to thrive. Finally one visit the Dr was checking him and he started crying and raising only one arm. She asked if he always did that. Yes, come to think of it he doesn't ever move that arm. She said "I think his shoulder is broken." An xray later and sure enough his shoulder was broken and had already started to heal.
    Thinking back on it makes me mad now, but going through it I thought they knew best, especially when they threw around all these statistics on how safe homebirth was and dangerous hospital births are.

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    1. Yep. They prey on our fears of the hospital and distaste for medical stuff. They paint themselves as ultimate experts and comfort us with what sound like perfectly legit statistics, and cite seemingly-scientific "studies." Then it all goes to hell in a bucket, and they say that *we* "should have educated yourself." Well,I hired the professionals so I could rely on THEIR "education." Too bad they didn't have any and it nearly cost us our lives. Between all they DIDN'T know, and all the horrid ER doctors DIDN'T do, it was a trainwreck of epic proportions.

      I'm sorry for what you and your little one went through. Personality conflict... UGH. I can't believe it took so long for the pediatricians to figure out what was up, too. What a nightmare. I've heard of two other local moms who've lost babies to homebirth midwives and who've been bullied into silence. It's got to stop. Anyway, I'm glad you're okay now.

      --Marlo

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    2. I am definatly glad that I read you comment. There are many people o have talked to while trying to further my education that said there is no such thing as too big of a baby for vaginal birthing. But the proof is in the pudding so to speak.

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  28. So happy he pulled through despite the negligence of the midwives! Love your writing style, too.

    I admit I LOL'ed at: "Shepard had to take Viagra for 4 months..." Good dead pan humor there.

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    1. How is that deadpan humor? Viagra is a vaso-dialator. It was originally given to heart patients to help with their circulation and its other effects were only discovered after the researchers in the study asked their test patients why they didn't want to return the samples.

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    2. They probably dont know the history of Viagra...

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  29. What a beautiful little boy, so glad he got the care he needed at the hospital, and I'm so sorry for the trauma you had to go through.

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  30. Can you please identify which midwives you were seen by? Are they independent? Are they affiliated with a specific practice? Can you please mention which hospital you went to? My husband and I are researching the possibility of a homebirth, and specific names would be helpful. Thank you.

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    1. Well I am just now seeing this. I hope you didn't do a home birth, and that you didn't use a CPM or other lay midwife. There are CNMs in OK for people who want a midwife. The hospital was OU, and.the wretched doctor was Carlos Madrid. As far as the CPM and her partner, I will not divulge their names because I don't want to be attacked by.them anymore.

      Marlo

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  31. This is why proper education and years of understudy is important. I am wanting to become a midwife and these types of situations is what I wish to avoid the most. Being blind to something going wrong. Health of the mother and child should always come first even if that means that I dont catch the child. That is what alot of people are baulking up against with many naturalists. Some go beyond what is healthy for families and that DEM had no right to say anything about your birth. Some many people say birth is safe and interventions are risky. That is true for healthy births but for those that have any kind of issues the benefits of interventions greatly overcome any of the risks associated with them. I am sorry you got stuck with such hack jobs.

    -Midwife in training

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