Child Protective Services (CPS) in Illinois has removed a child from the home for endangerment.
Specifically, CPS alleges the parents endangered their newborn’s life (medical neglect) by choosing a home birth for a baby in a breech presentation.
The Facebook group to Bring Ruth Home! describes this horrible story:
Ruth Abigail Light was born at home on July 21st at 7:38PM. She weighed 7 lbs. 10 oz. and was 20 inches long. During the birth, her shoulders were stuck momentarily (Shoulder Dystocia) but once they were free, she came right out. Ruth was doing well but a few hours later she seemed to be fussier than usual and we decided to take her in to get her checked out just to be sure. We took her to the ER in the middle of the night. Over the next few days, they told us that her arms had nerve damage from her shoulders getting stuck and a couple of days later, someone filed a complaint against us citing medical neglect for having her at home vs. the recommended C-section since she was breech. Since that time, Ruth has had every test possible run and so far, she seems to be doing very well. Her arms are recovering and she is a very content baby.
Unfortunately, the State of Illinois took her into custody as a result of the complaint and she has been in foster care for over a week. During that time, we were only allowed to see her twice for a couple of hours. Thankfully, as of Aug. 9th, she was placed with Melissa’s parents and we are now allowed to see her for a few hours each day.
Shoulder dystocia is a relatively infrequent complication in birth, but it is one that all midwives and doctors will eventually face, and is covered in every maternity book parents-to-be read. The American Academy of Family Physicians (AAFP) explains:
Shoulder dystocia is one of the most anxiety-provoking emergencies encountered by physicians practicing maternity care. Typically defined as a delivery in which additional maneuvers are required to deliver the fetus after normal gentle downward traction has failed, shoulder dystocia occurs when the fetal anterior shoulder impacts against the maternal symphysis following delivery of the vertex.
America’s most famous midwife Ina May Gaskin even has a shoulder dystocia maneuver named after her involving women moving into an all fours position during labor. The Journal of Reproductive Medicine reports:
The conclusion of the study is that the all-fours maneuver appears to be a rapid, safe, and effective technique that is applicable in a delivery room or other birth setting, for attendants with a range of levels of training. “Future studies should focus on ways to incorporate this technique into the practice of all midwives and physicians.”
Ina May’s success with shoulder dystocia has proven that a home birth is just as safe as a hospital birth when it comes to this complication. In fact, it is recommended that physicians learn her maneuver. Unfortunately, child protective services authorities in Illinois disagree about the safety of home births, as this birth also involved a breech presentation.
Many midwives won’t attempt breech deliveries, but many will. It is true that a breech delivery with shoulder dystocia poses a higher risk than a normal presentation in which shoulder dystocia occurs, but should such an unpredicted complication be cause for loss of custody? Had the same nerve damage occurred in the hospital, would the family still be subjected to the same harsh treatment?
Was this family irresponsible to attempt a breech birth at home or would more appropriate blame fall with the midwife, if blame must fall?
I do not believe this is a situation in which CPS should have removed a child from the home. In my years in education, I have seen serious instances of neglect (including medical), but only once instance of removal. I do not feel that choosing a home birth falls into this category, breech position or not. I hope that Ruth is returned to her parents soon, and I am happy to report she is doing well despite this rough start.