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Baby's Death Brings Investigation; Midwife May Have Practiced Medicine Without a License, Court Documents Say

Posted on: Saturday, 10 December 2005, 15:00 CST

By DAVID DOEGE, DAN BENSON and DON BEHM

A midwife present during the delivery of a newborn who died in a Town of Vernon home last month is suspected of practicing medicine without a license, according to documents filed in Waukesha County Circuit Court on Friday after authorities seized evidence from her Milwaukee home.

The midwife, who told the expectant couple she has been performing midwife services for 22 years, dissuaded them from going to a hospital when the delivery process started, advising that all expectant mothers worry and assuring them that everything was proceeding "smooth as butter," according to one of the documents.

The midwife went on to perform a medical procedure several times in an attempt to aid the birthing process, the documents show, but when investigators later described the conditions of the mother and child to a physician, the doctor equated them with "a very serious emergency situation."

"In hospitals, doctors actually perform emergency drills for this so that it can be dealt with quickly by trained physicians," according to one of the documents, an affidavit investigators filed as the basis for a search warrant.

The affidavit also says that the couple, Bridget and Brian Stoiber, had been videotaping the birth with the permission of the midwife. But after an ambulance was summoned and efforts to save the baby were begun, the midwife left the home and the camcorder was found hidden beneath a bathroom sink without the videocassette, according to the affidavit.

Bridget Stoiber declined to comment when a reporter contacted her by telephone Friday afternoon.

The Journal Sentinel is not naming the midwife because she has not been arrested or charged with a crime.

Investigators from the Waukesha County Sheriff's Department went to the midwife's home on the south side of Milwaukee on Wednesday night, seizing a variety of items including "medications," an appointment book, videotapes, "alcohol prep pads,""supplies for home birth," a home birth certificate and a variety of books concerning pregnancy, birth and related topics.

Sheriff's Detective Steve Pederson said Friday that no arrests had been made and that the investigation is continuing. Pederson said the investigation is focusing on all of the circumstances surrounding the birth at the home on Nov. 28 and is expected to be lengthy.

The affidavit filed by investigators Friday gives the following account:

Two other women were with the midwife at the couple's home, including one who referred to herself as a "care and comforter." At 2:30 p.m., the mother told the midwife to call 911 and "get me to a hospital." The 51-year-old midwife assured her, however, that all would be well.

Six times in the hours that followed, the midwife performed an episiotomy using scissors, a procedure aimed at widening the birth canal. At 6:22 p.m., a 911 call was placed from the home with the caller reporting that a newborn was not breathing. When emergency personnel arrived, they attempted unsuccessfully to revive the child.

Injection was witnessed

While they were still on the scene, one of the emergency medical technicians noticed the midwife inject a substance into the mother's thigh. When she was questioned about the injection, the midwife replied that she had administered Pitocin, a medication normally used to start or improve uterine contractions.

Questioned later by investigators, Brian Stoiber, the child's father, said that before the birth process began, they had been assured by the midwife that they could videotape the event. She warned them, however, "that if anything tragic" occurred, she would not go to the hospital with them and they were not to use her name.

She added that in such circumstances, "she would be taking the tape."

One of the two women who accompanied the midwife told a member of the ambulance crew that the baby's head emerged from the birthing canal about 20 minutes before help was summoned, but the midwife "could not manipulate the shoulders or the rest of the body to allow delivery of the baby."

An autopsy was performed on the baby's body, but the Waukesha County medical examiner's office had not determined Friday whether the baby was stillborn or died after birth.

The woman under investigation, who declined to comment Friday, is listed as a member of the CARE Network on the organization's Web site. The group is a referral service to help expectant parents in the Milwaukee metropolitan area contact childbirth educators and midwives, said Coral Slavin, the organization's chairwoman.

A listing on the group's Web site is not an endorsement of a person's abilities or experience, Slavin added.

Delivery called risky

Katie Prown of the Wisconsin Guild of Midwives said Friday that a certified professional midwife from the Milwaukee area turned the couple down earlier because Bridget Stoiber's maternity history was considered "too high risk" for a home birth. She declined to specify the risks identified by that midwife.

Lisa Hanson, a professor in Marquette University's College of Nursing and chairwoman of the Wisconsin chapter of the American College of Nurse-Midwives, said there are three midwife classifications: certified nurse-midwife, certified professional midwife and lay, or direct-entry, midwife. Only nurse-midwives are recognized by the State of Wisconsin, and they are licensed by the state Department of Regulation and Licensing.

A nurse-midwife has earned a master's degree, can write prescriptions and administer medications, can perform certain surgical procedures such as episiotomies, can collaborate with physicians, and is allowed to deliver babies in hospitals and birthing centers, Hanson said.

Certified professional midwives are recognized by the North American Registry of Midwives after completing skills and knowledge exams and undergoing a training regimen. The woman who assisted at the birth is not certified by the North American Registry of Midwives.

Lay midwives, such as the one in this case, typically follow an apprenticeship program, Hanson said.

Bill would clarify status

The status of certified professional midwives and lay midwives exists in a legal gray area in Wisconsin, said Hanson and Gina Dennik-Champion, chief executive officer of the Wisconsin Nurses Association.

"They really aren't addressed" by state law, Dennik-Champion said.

That could change under legislation proposed by Rep. Gregg Underheim (R-Oshkosh). If enacted, Underheim's measure would license certified professional midwives, who are not nurses, and allow them to administer certain medications and obtain medical malpractice insurance.

The bill was recommended by the Assembly Committee on Health on Nov. 22, days before the incident. There is a companion bill in the state Senate.

"This legislation could have prevented a tragedy like this," said Prown of the Wisconsin Guild of Midwives. "It is a perfect example of why we need this legislation."

Hanson said there are fewer than 10 certified professional midwives in Wisconsin.

Copyright 2005, Journal Sentinel Inc. All rights reserved. (Note: This notice does not apply to those news items already copyrighted and received through wire services or other media.)

Source: Milwaukee Journal Sentinel

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