Doula Pleads Guilty Following Baby Death in ‘Unassisted’ Birth

Doula Pleads Guilty Following Baby Death in ‘Unassisted’ Birth January 25, 2019
Megan Herzog Facebook

A doula in Illinois pled guilty to practicing as a nurse without a license following the death of an infant at a homebirth she attended. Megan Reed participated in the birth of client as a doula in 2017. The baby died hours after her birth as a result of aspirating on meconium. The story of baby Junia was broken wide open when Certified Nurse Midwife Rita Ledbetter shared the news of Reed’s guilty plea on social media.

In a Facebook post shared by Rita Ledbetter, she outlined the court proceedings and the case against Reed. Ledbetter worked with the county coroner and provided expert commentary for Reed’s prosecution. Reed clapped back and joined the discussion to share her side of the story.

Ledbetter says that in 2017, Reed befriended a woman at a local chiropractor office. The woman, who was pregnant, confided in Reed that she was in a physically abusive relationship. Reed counseled the woman on domestic abuse and offered her services as a doula for her birth.

Shortly after meeting the expectant mother, Reed says that the mother hired her as a doula. The mother planned to have a homebirth. Because she was not a licensed provider, Reed says she provided names 0f midwives to the woman.

After interviewing several midwives, Reed says the mother opted for an unassisted home birth. Reed agreed to stay on as her doula even though a trained birth provider would not supervise her.

Ledbetter told me in an interview that Reed did provide the mother with multiple names of midwives. However, she disputes Reed’s claims that the mother decided not to use the midwives on her own.

According to multiple people in the birth community, Reed told the mother the midwives were not good people. Because of their established relationship, the mother believed Reed. By Reed’s influence, the mother decided not to hire a midwife.

Instead, Reed presented herself as a certified birth coach, doula, and trained to manage emergencies. She bragged to many that she helped deliver her sister’s child. Additionally, her website Fearless Doulas says she’s a certified Bradley instructor.

Reed offers doula services to mothers that choose a hospital and both assisted and unassisted homebirth. Her choice to help mothers birth unassisted is ultimately what landed her in legal hot water.

In 2017, Reed updated many social media groups, including a local doula group. Reed told the other doulas that she was currently helping a woman through 4-days of labor.

Other doulas within the group grew concerned that Reed was practicing outside her scope of expertise. Reed shared with the group she got into the birth tub with the mother. When the baby was born, Reed moved the umbilical cord off the baby’s neck and shoulder. She admitted to placing the baby on the mother’s chest.

Doulas are not trained to deliver babies nor can they legally help deliver a child. However, Reed admitted to the group that she assisted the mother.

Following the birth, Reed said the baby appeared healthy. She told the parents the baby seemed normal. However, within hours the baby struggled to breathe. In an interview with investigators, Reed told them the baby appeared to inhale but not exhale.

Noticing the baby might be struggling, Reed instructed the father to run to the pharmacy to buy a thermometer. By the time he returned, Reed had said the baby’s breathing had become more labored.

Reed admitted to grabbing a suction bulb and attempted to suction out the baby’s mouth and throat. She said the mucus she pulled out appeared brown and thick. After suctioning the baby, Reed attempted CPR and asked the father to call 911.

After the baby transferred to the hospital, she was pronounced dead. While Reed insists the doctors could not provide a reason for her death, the coroner report lists the baby’s cause of death as meconium aspiration.

Shortly after the baby’s death, the doula group notified Ledbetter about Reed’s involvement in the baby’s death. Ledbetter, a Certified Nurse Midwife, works closely with the doula community to foster a healthy relationship between doulas and obstetric midwives and doctors.

As Ledbetter started to dig into Reed’s past and read through the screenshots, she believed that Reed misrepresented herself to the couple. When Reed met the woman at the chiropractor office, the woman was new to the area. The woman belonged to a conservative religious community and was naive about birth.

Through their relationship, Reed influenced the mother not to have a midwife. She misled the woman about her certifications. Reed does not hold any active certifications to instruct the Bradley Method nor is she certified as a doula.

The woman trusted Reed to help her through her labor and delivery. After the birth, Reed stayed much longer than the standard 3 hours listed on her website. During that time she gave medical directions, suctioned the baby, and instructed the dad to go to the pharmacy and buy a thermometer.

After an investigation, Rock Island County prosecutors charged Reed with six counts of Practicing as an advanced practice registered nurse without a license. In May 2018, authorities arrested Reed on the charges. She denied the allegations and any involvement in the death of the baby.

For months, the case inched through the court system. Ledbetter said she attended every hearing and brought a photo of the infant to court. Finally, on Wednesday, January 23rd, Reed agreed to a plea deal. She decided to plead guilty to one charge of practicing as an advanced practice nurse without a license.

As a part of the plea, the court sentenced her to 24 months of supervised probation, a $300 fine, and court fees.  During her period of probation, she is not allowed to work as a doula nor market herself as a birth professional.

Despite the guilty plea, Reed’s website remains online and offers coaching and doula services. She continues to minimize her involvement. In a post to Ledbetter, she said she only pled guilty to suctioning the baby not practicing without a license. The baby would have survived had the baby been seen by medical providers immediately following the birth.

The birth community in the small Rock Island Community feels mixed emotions about the verdict. Many think that Reed got a slap on the wrist for contributing to the death of the baby. However, they remain hopeful the guilty plea will stop Reed from influencing and harming other expectant mothers in the area.

Read Ledbetter’s full post:

 

 

*Katie Joy is a columnist and hosts Without A Crystal Ball on Patheos Non-Religious Channel. She writes articles on parenting, disability advocacy, debunking pseudoscience, atheism, and crimes against women and children.

She co-hosts the YouTube show, “The Smoking Nun,” with Kyle Curtis. The show airs weekly and tackles pseudoscience, current events, and crime stories.

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What Are Your Thoughts?leave a comment
  • andrea

    Since the husband was a DV perpetrator, I wonder what role he played in the “decision” to stay home. Maybe there is a warrant for his arrest or he knows OBGYN staff are supposed to ask if you feel safe in your relationship. It is also possible that church friends pressured her to stay home.

  • from what I gathered in the discussion – there wasn’t much evidence he was ever violent.

  • andrea

    I would be very interested to know how her church friends gave birth.

  • Ardent

    I would love to use the “buy you a coffee” link but it says your account can’t make charges at this time. Thank you for writing about these horrible tragedies.

  • Eh, it’s not like a CPM has really any more training than this doula. She absolutely practiced medicine without a license and deserves any legal penalties coming to her, but a homebirth with a CPM doesn’t have a more qualified attendant either. Only CNMs are actual midwives/nurses.

  • andrea

    You have a point. Sigh (not you, CPM training).

  • persephone

    My ex abused me and our kids for years, but most of it was emotional, which means getting an arrest was almost impossible.

    I do know, from my own interactions with medical staff, is that one of the first things they ask any woman in a relationship is if she is safe at home, and any bruises or injuries are noted and questioned.

    It’s unfortunate that this woman was a member of a patriarchal cult. The men do have final say on everything, including medical care. They may not have had insurance or the money to cover a hospital birth, or the husband simply didn’t want to pay for it. They often view pregnancy as NBD, because that’s what women are for: to breed the next generation of believers. They also often won’t let male medical personnel near their women.

  • persephone

    I also have tried the coffee link, and after I put my info in, it gives a checkmark, which I assumed meant it went through, then an error message pops up that the site can’t accept “live charges.”

  • Hmm, let me check! You can always become a patron!

  • Let me see what is going on! Otherwise you can become a patron. you can donate as little as. $5 a month 🙂 http://www.patreon.com/withoutacrystalball2

  • Ok I just set up a brand new link! Please try!

  • Ardent

    Thanks it works now! I would use Patreon but they don’t have a one time option, and I am forgetful about subscriptions!

  • thank you so much!

  • The Bofa on the Sofa

    Late to the discussion, I know, but two things:

    1)

    Doulas are not trained to deliver babies nor can they legally help deliver a child. However, Reed admitted to the group that she assisted the mother.

    Keep in mind, the place where she got in trouble was not in delivering the baby or assisting. You don’t have to be licensed in anything to “help deliver a child” (heck, cab drivers do it, right?). Her problem was accepting money for such services. You want to help someone deliver their baby at home, you do it as a friend/relative/acquaintance, and not as a professional, unless you are one.

    2)

    Noticing the baby might be struggling, Reed instructed the father to run to the pharmacy to buy a thermometer.

    And THIS is where my head hit the desk.

    So prepared they were for this homebirth, that they didn’t even have a friggin thermometer. And when the baby is struggling, her response is, “Go to CVS and get a thermometer”

    Bam! Bam! Bam!

  • Christina

    That is COMPLETELY false. CPMs have rigourous training requirements, sit a board exam, and have continual education requirements after certifying. Doulas don’t. Having known good CNMs and good CPMs I would honestly trust more CPMs with my own child’s birth. The main difference is WHERE each may attend births (varies by state). In most states CNMs must always be under an MD’s supervision, whereas a CPM is free to assist births on her own (usually with other CPMs).

  • No, they really don’t. I looked into what it would take to be a CPM. You need a high school degree, to pass a test so very easy that I could study for about 2 weeks and pass it, and attend 100 births with another midwife. That’s it. It’s a joke.

  • Christina

    I hve no idea where you are getting that idea but your information is faulty. Those are not the requirements according to NARM. (and even if they were, that is a heck of a lot of training). There are several pathways to a CPM certification, all of them require specific clinical skills, the test you say is easy (tho I don’t know how you would know that) but most student midwives study long & hard for, and a specific number of births, prenatal exams, newborn exams and postpartum visits in various capacities.

    Here is the info from NARM:
    https://narm.org/entry-level-applicants/

    Some student midwives also go the route of midwifery schools which offer Bachelor degrees in midwifery science (still CPMs).

  • I got my information from NARM. I was unimpressed by the requirements. The fact that you are defending a certification that requires only a high school education, for people who will be overseeing medical scenarios that can involve “she will entirely exsanguinate in less than 10 minutes” and “the baby isn’t breathing” and “the baby is stuck; we have less than 5 minutes before permanent brain damage occurs” and “she just tore from her vagina to her anus, this needs surgery to fix” and “she has been laboring for 24+ hours, is there an infection, is there uterine atony, does she need a c-section”, is beyond absurd.

    The clinical skills aren’t assessed by anyone competent (another CPM). The test I saw a sample question set from the NARM website; it was a joke. The number of births is 100, which is a very tiny number and will not prepare anyone for being the primary solo practitioner at a birth. The other functions are postpartum and not relevant in a discussion of birth attendants. CPMs are tragically, grossly unqualified to be medical attendants; if someone wants to be a midwife, she can be a CNM and have an actual medical background.

  • Christina

    You’re just simply wrong. Look at the requirements.

    The truth is that the best midwives are trained to avoid those emergencies, to head them off if possible & treat them when it’s not. CPMs often have a wider knowledge that allows them to better avoid emergencies. Technology is not associated w better birth outcomes.

    And the truth is that midwives of all kinds are equated with equal or better birth outcomes for low risk women compared to OBs. For centuries the norm was to gain knowledge primarily through experience not books. Don’t automatically assume that a program that depends on experience is inferior than one that uses more written tests. When it comes to bleeding or a stuck baby, I want someone who has watched someone else handle it and has helped actually solve it… not someone who’s just read about it.

  • Christina

    You’d be surprised at how few births OBs have seen before they begin practicing. Most have never seen a physiologically normal birth and many have never seen a substantial amount of labor. I’ve been at births attended by OB residents, by experienced OBs, by family docs w OBs, CNMs, CPMs, and state-licensed midwives… the ones I have been most impressed with are those who are used to attending technologically-simple births— ie CPMs & LMs, and some CNMs (but not all).

  • Bullshit. OBGYNs have a residency in a hospital, like all other doctors, and most births are “physiologically normal” if by that you mean a vaginal birth. They see thousands of births before they finish their training, ranging from fast and easy to medical emergencies.

    CPMs and LMs are unqualified birth attendants. They might be nice and friendly and all that, but their medical skills range from non-existent to subpar, and in an emergency their lack of training and equipment can kill you and/or your baby. Are there incompetent OBYGNS? Of course. OBGYNs are people, and some people suck. But given that LMs and CPMs haven’t even bothered to try to learn how to help women give birth safely because nursing school/medical school is too hard, why would you ever trust them to be even minimally competent? I sure don’t.

    Remember- high school education. 100 births. Super easy test. That’s it. Those things combined add up to “not qualified”.

  • Technology is absolutely associated with better birth outcomes. Do you really think that the US and Afghanistan have equal maternal and neonatal mortality and morbidity rates? What do you think makes the difference between them? Hint: it’s the technology. There is a reason that poor women in India will move Heaven and Earth to get to a hospital to give birth- it’s that much safer. Even when CPMs are supposed to risk out anyone who is not having a singleton vertex birth without other complications, so literally the least complicated pregnancies and lowest risk patients, they still manage to kill 3x the number of babies that their OBGYN counterparts lose, and the OBGYNs deal with all the complicated, risky pregnancies as well as the standard ones.

    OBGYNs get far more experience prior to finishing their residency than a CPM basically ever will get. Tests and experience both matter, and OBGYNs have more of both. When it comes to bleeding or a stuck baby, I want someone who has helped actually solve it … in a manner that is consistent with modern medical science, not “let me breathe cinnamon breath over a bleeding woman, that’ll surely stop the bleeding”.* I want someone who understands that a shoulder dystocia is an emergency, and that if they can’t resolve it in 5 minutes to surgery we will go because time is brain, and brain damage sucks. I don’t want someone who will fuck around for 20 minutes with increasing awkward positions before calling an ambulance, which will take the mom to a hospital, where she still has to be sent to emergency surgery if there is an available OBGYN and OR … you’re looking at a good hour without oxygen for the baby at that point, and you’ve got a situation ranging from dire to catastrophic on your hands. Babies and women die, do you understand that?

    *Source: Midwifery Today Facebook page, where CPMs in good standing suggested the following to deal with a hemorrhage: chlorophyll, homeopathic phosphorus, chewing cinnamon candy and breathing across the woman, and rubbing cypress oil across her abdomen. Needless to say, those will all do exactly jack, diddly, and squat to stop blood coming out.

  • Christina

    Oh my gosh… the level of misunderstanding you have… No, a vaginal birth is not by definition “physiologically normal”— birth is an amazing interplay of dozens of hormones and processes that are disrupted in the vast majority of hospital births. Once you’ve restricted a mom’s eating and drinking you are no longer looking at a normal birth— once a mom’s around strangers and her movement is restricted, the birth is already being affected. (Think of how all mammals labor.). once you start adding in artificial hormones (pitocin) and altering neurological input (epidual anasthesia, laughing gas…)… yeah it’s not a physiologically normal birth anymore. Left to follow their own bodies most women will choose to move in rhythms during birth and deliver standing, squatting or on all fours, NOT their backs. They will push spontaneously and they will not often tear. Most residents have never seen a birth progressing at a woman’s own pace followed by her pushing & delivering as she desires, in whatever position is most comfortable to her. (Honestly most have never even witnessed much labor at all— they leave that to the nurses.)

    As for dystocia— it usually is simply resolved with the Gaskin maneuver (essentially turning mom onto hands and knees) and possibly sweeping to help guide shoulders to a better position to be delivered one at a time. Other changes of position can resolve the dystocia but are not usually needed. But so many emergencies that arise have multiple red flags before they develop. Skilled birth workers watch for these— and often catch them before a machine would in a hospital (where moms labor alone on monitors). By far the majority of transfers from birth centers or home births are for non-emergencies. But when moms do need to transfer for emergencies, then they need to transfer! And good midwives will recognize when and make sure mom gets to help.

    Birth in and of itself is not a medical emergency. Medical emergencies can arise, just as they can in any physically demanding event— a marathon, weight lifting, etc. But it’s not in and of itself an emergency. We don’t need it to be attended by surgeons or even someone with hospital-based medical training. Midwives don’t need to be able to start IVs in most of the US (bc they can access IVs easily should a mom need fluids) though that surely can be helpful— they don’t need to handle prescriptions beyond 2-3 ocassionally needed in after-birth emergencies. They do need to know how to monitor vitals for mom and baby, how to handle dystocia, to know when to transfer (ie call for a different skill set), to have first aid skills and how to handle common labor obstructions like a malpositioned baby or tired mom. And those are the skills the CPM programs teach. Most CNMs know all of those skills— and they also know hospital policies, which are NOT in any way evidence based (they are usually about 17 years behind current research). They know hospital politics and limitations. Those don’t make a midwife better. Like CPMs they don’t handle IVs or epidurals or most prescriptions— those all are referred to other hospital personnel. (They have to know how to work with moms using epidurals and pitocin and other drugs, a skill CPMs don’t need working in an environment where those are not an option). But primarily, the extra hours of classes are related to working in hospitals … they aren’t spent learning how to better do birth! I would argue— how could they be better spent than what CPMs are required primarily to do: be at births!?

    And no, technology is not associated with better outcomes. The US has the most technology used in births, we spend the most money per birth…we have more highly trained surgeons attending moms vs midwives and yet we rank 30th among developed nations when it comes to maternal & fetal morbidity.

    I’m not trying to convince you, for whatever reason your mind is made up- I’m saying these things for others who may be reading. Maybe some of you will be motivated to become CPMs, because we need more skilled out-of-hospital birth providers… and in many states CNMs are not allowed to attend home births unless an OB also attends… which defeats the point and is redundant. (I also hope those states change those laws, and I work towards that in my own state!)

  • Oh, so you’re working towards letting more babies die. Well, that’s horrific. I’m trying to convince both you and the general audience. And I think it’s rather telling that you keep moving on from arguments you are losing- you have conceded that CPMs have inadequate training, you have conceded that it’s easy to become a CPM, you have conceded that hospitals have better outcomes, and you have conceded that OBGYNs see more births and more situations in residency alone than most CPMs will see over their whole career. You have conceded that women without access to technology, the ones who have actually seen the damage that homebirth with a CPM-equivalent can do, will do amazing things- walking miles, crossing a river in flood, being carried piggy back- to get to a hospital because they know that it is safer to have access to the technology.

    Many emergencies do have red flags … which are also often ignored by CPMs. They are never censured when they screw up. They are supported by NARM when they are sued for obvious medical malpractice- see Sisters in Chains, which supports CPMs who have been involved in multiple births that led to dead or brain-damaged babies (and sometimes dead mothers). Deaths never lead to inquests or investigations into why; instead you get pious exclamations of “some babies just weren’t meant to live”, which ignores that in a hospital they would have lived. And some emergencies don’t have red flags- if an amniotic fluid embolism occurs at home, the mother will die. Period. End of story. Even in hospital it’s got a death rate of ~61%, but that goes up to 100% at home. And that’s just one of the things that can go horribly wrong with no warning.

    The Gaskin maneuver (which she did not develop, but stole from indigenous societies and renamed) does resolve SOME dystocias, but not all. And if it doesn’t work, then what? You transfer the mother, with her baby’s head hanging out of her vagina, possibly bleeding badly, in an ambulance ride from hell? That is really not a good situation at all. Yet that’s your solution- let everything go to hell, then transfer and hope that the hospital can fix your mistakes (and yes, I say your, because I get the feeling you are a CPM). You know that technology makes birth safer, because you rely on it as your backstop for your recklessness in trying to do without. P.S.: hospitals know the various positions to try to resolve dystocias too, and they try two of them before moving to surgery. Why only two? Because you have 5 minutes to get the baby unstuck before brain damage starts occurring, and then you had better either have it resolved or be heading to surgery. CPM transfers cannot happen that fast.

    Your naturalistic fallacies are noted, and discarded as the logical fallacies that they are. Oxytocin and pitocin are quite literally the same chemical- we provide pitocin when the mother’s body isn’t producing enough oxytocin for labor to proceed apace. Being around strangers doesn’t matter at all; different cultures around the world have done births in all sorts of ways, some alone, some with strangers, some with only family. They all killed lots of women and babies before modern technology, but they also all did well enough that those civilizations continued to exist. And most women labor around family and/or friends in the US. They may or may not be seen by their familiar doctor, but they usually aren’t alone.

    Hospitals do not restrict movement anymore. Women have generally not eaten during labor- they might have drunk water, honeyed watered wine, or other clear liquids so they don’t get dehydrated, but they can still do that today. Immense pain and nausea don’t leave most laboring women interested in eating, and if they need emergency surgery with general anesthesia, it’s safer not to have eaten.

    US maternal mortality is driven by lack of access to technology. Women with the most access to technology- wealthy white women in urban areas- also have the best maternal mortality statistics. Women with the worst access- poor women of color, women in rural areas- also have the worst maternal outcomes. Our outcomes are so bad because our health care system is so bad that women who need technology are not getting it. If technology was bad, you’d see worse outcomes among people who used it, and that’s not what we see at all.

  • I type medical reports for a living. I’d probably be a better birth coach because I know enough about real medicine to be familiar with classic red flags like pre-eclampsia and gestational diabetes.

    My one child was born without anesthetics, episiotomy or other interventions — but in a birthing room at a major hospital. (What’s the big deal about home birth, anyway? You get to go back there after your child is born. Endangering a child and her mother for the sake of ego or some silly woo-woo is unconscionable, IMO.)