Kristin (7:13)

Think you know me, you don't know me well. They can know me. You don't know me well. You make you know me. You don't know me well. You think you know me. You don't know me well. You don't know anybody until you talk to someone. My name is Kristin. Me and my husband became pregnant in 2021. At the time, I wasn't one way or the other when it came to choosing a provider for my pregnancy. And honestly, when I was first looking for a provider, I wasn't really thinking about midwifery at all. I assumed that I would give birth in a hospital with an obstetrician. I didn't really even know that there was another option. However, I was talking to a co worker who spoke about his wife's experience with a home birth midwife and how it was just a great experience, very easy. His wife recovered very quickly. And I was like, okay, that's interesting. And then I was kind of looking into more how I wanted a birth, how I wanted to labor and deliver, and what I wanted my pregnancy to look like. And I stumbled across what's coined now as natural birth or physiological birth. Ideally, I wanted to try to give birth without any pain management things of that nature, just to give it a shot on my own. And when you begin to look into natural birth or physiological birth, you come across a lot of different types of content. You come across bloggers, birth gurus and doulas and midwives and all these different types of accounts that talk about you don't need to give birth in a hospital. Historically speaking, women were built to birth. And so I started looking into more of how to quote, unquote, train for natural birth and delivery. You know, when you look on Instagram and you see all these pictures and videos of these women, like, having these beautiful, transcendent births in bathtubs filled with flowers in their home, that victory face after a woman's just given birth unmedicated on her own, you look at that and you think, I can do that, too. And you're further convinced by these people on these platforms that you were built to birth. When you're consuming these types of platforms that tell you that physiological birth and natural birth is the best way to go. There's also some other stigmas that come with it where if you walk into a hospital to birth, you better be prepared to advocate for yourself. You better be prepared to know more than the doctor about certain procedures and statistics. More or less, you're going to experience obstetric violence, trauma and a cascade of interventions which leads to higher rates of cesarean sections and whatnot. And above all else, I just did not want to be traumatized. It didn't matter to me whether or not I was with an obstetrician or with a midwife. I was raised by a nurse, so I had a very neutral feeling and a good respect and understanding for the medical field. This concept that my providers wouldn't be for me or wouldn't make the best decisions for me was kind of a foreign concept to me. I started spreading my feelers and looking for other options. I'd heard about birth centers. I know in a lot of other countries similar to the United States economically primarily use midwives in their maternity wards. For example, New Zealand, they have some of the lowest mortality rates in the world. Texas had lots of obstetric deserts. 46% of our counties are considered obstetric deserts where women do not have access to a hospital or a maternity ward over a 30 mile radius. That is almost half of our counties. And there are more and more and more people flooding into Texas in the last few years. Obstetricians are fleeing our state because of strict abortion bans and bars on their practice. We are in a lose lose situation right now. If we are looking at direct entry midwives as the answer to our lack of prenatal care and access into the state of Texas, we are in bad shape. Indeed. There is such a lack of foundational regulation in educational standards here. There's not a lot of unification or standardization inside of the profession itself across the United States.

Unknown Midwife (12:40)

I really do love midwifery and there are going to be a lot of people who listen to this and go, does she really? But it's true. I was enamored by the belief in physiological birth, in a woman's ability, in the miracle to produce life. I do believe there is room for less hands on intervention and to allow what is normally considered a natural process to happen under expert guidance and supervision to be safe keepers if things do go wrong. And I think America as a whole needs more of that in their awards. We need more respect for women's autonomy. We need to allow women to make choices for themselves by giving them the safest options available to them and talking to them in ways to help them understand the situations that they're in. Because oftentimes I see women who have gone through birth trauma, which it occurs to more than you would think. And it was through an intervention that was necessary, but no one explained what was happening. No one was holding her hand while these things were happening and telling her, this is what we need to do to keep you safe. This is how we're going to do it. Can we do this? The way that we talk to women inside of hospital rooms when they're giving birth can be at times dehumanizing. We forget about the woman and focus solely on the safety of the baby, which more or less, this is what this is about. But it is about the whole. It is about mother and the baby and how they begin to come apart. And how we treat her in this process is going to affect everything about the mother that she is. And that is kind of the key point of what drives me to tell my story. Because this misunderstanding and this mistreatment of women is not just happening in hospitals. It happens in out of hospital births. And I think that there is a lack of discussion with inside of the midwifery community about what can we be doing to bridge the gap. Closing the parameters of risk. That is what I'm hoping to incite here is that I believe in this process, I really do. But I believe in it when it's done safely, when it's done ethically, and when it's done in a way that gives the woman that is taking these services in a way that allows her to see the full picture, that isn't swaying her one direction or another, is laying out the risks and really letting her understand and decide those things for herself. So that's really what I'm hoping to get here. In no way am I trying to discriminate against the midwifery community or signal that there needs to be an end of midwifery in the United States. What I'm trying to wave here is a red flag that says, we need help. This field needs help. There's a quote out there that says at some point we need to stop pulling people out of the river and travel upstream and discover why they're falling in the first place. And I think that's what we need to do as a community, as a whole, as consumers and as midwives is we need to start looking at why people are falling in the river in the first place and not just writing it off. We cannot write off these instances. For the most part, the community tries to focus on the good, because mostly good happens, mostly pregnancy and delivery go normally, but that means people like me are not truly safe when complications arise and you are in the presence of people with varying degrees of education. Texas has multiple pathways to licensure for midwifery through apprenticeship model or a state approved course, or you can go to an accredited college, but it's not required.

Kristin (16:43)

I did not know this. This is what I learned later.

Unknown Midwife (16:47)

When you're hiring a midwife, one, you don't know to ask. Two, you don't know what kind of education they received. You don't know what kind of education their preceptor received and what they believe in and how that was passed on and how that's going to affect your care. Abnormalities and complications can happen to anybody. And that is the thing you don't realize as you're walking into care, you think it's, it's not going to be you. I was a healthy 20 something year old, no prior complications or medical conditions. There was no reason for me really not to have a normal, uneventful pregnancy. But it happened to me. We cannot write off death, we cannot write off morbidity and extreme trauma, because I know this personally. You affect a whole generation. Let's be honest, what happened to me affected the mother that I am today in a lot of ways. I felt like the mother that I was supposed to be was stolen from me because of what had happened to me. And I've had to work really, really, really hard to get back to who I thought she would be. I think that I probably would have been a lot less anxious. And I don't mean like the typical run of the mill anxiety of are they safe? The kind of anxiety I'm talking about is gripping. It is a direct fear of death. It is all encompassing. It is an entire visceral feeling of my child is going to die at any moment. And that is something that is not normal. It is something that was done to me, how my body responds because of what happened to us and what happened to us was preventable. Several points within my care, my providers could have said, oh, hey, something is not right here. We want to make sure you're getting the best care that you can receive. And we want to refer you to an OB GYN to get checked out for more testing because the signs that you're presenting to us is outside of our scope. There would have been nothing wrong with them saying that to me and I would have had so much love and respect for them if that is what.

Kristin (18:56)

They chose to do.

Unknown Midwife (18:56)

But they didn't. For whatever reasons, maybe they thought they could handle it. We could speculate all day long about the why, but reality is they didn't. No matter what the reason, they didn't. Choices like that cost people everything.

Kristin (19:13)

Licensed or direct entry midwives, they are regulated by completely different systems than certified nurse midwives or even certified midwives, which certified midwives don't practice in the state of Texas. But either of those groups are regulated by vastly different foundations with vastly different ethical and clinical standards. Direct entry midwives are nationally overseen by the North American Registry of Midwives, which is an institute or foundation for certified professional midwives. They suggest that direct entry midwives should decide on their own standards for care. So what that means to me is that let's say I'm a midwife and I won't take on anyone who has preeclampsia because preeclampsia is high risk. So if I suspect that my client has preeclampsia, I will refer them out to an obgyn. That doesn't stop midwife Jane over here from taking on that client. So it's left up to the individual to decide what is safe, what is not, what is acceptable and what is not. When you look at these medical systems that certified nurse midwives and certified midwives are involved in, their foundational institute is going to be the American College of Nurse Midwives. They all have to abide by these same exact standards. They specialize in low risk birth and pregnancy and delivery as well. So not only is there a huge variance in what standards are for care and what is acceptable for midwifery care, there is a huge difference in educational standards. Certified nurse midwives having to get a master's degree in nurse midwifery, Certified midwives going through a three year collegiate level program to become a midwife, direct entry midwives or licensed midwives or certified professional midwives, these are all within the same kind of group and there's a lot more variation there. In the state of Texas, there are many ways to become a midwife. You can go through what is called the PEP portfolio ran by narm, which is an apprenticeship model where a candidate for midwifery goes through a self study method and is in an internship or apprenticeship with a preceptor for 13, 50 out of hospital clinical hours. So she does not have to take any kind of accredited education. She self studies and she does these clinical hours, the preceptor, and then she passes the CPM examination, which I don't know what that entails I've never seen the exam before. So that is one way to become a licensed midwife in the state of Texas. And if you become a CPM through narm, then your next step is to take the Texas licensure exam. And then they assign you your licensure based on whether or not you pass that exam. Another way to become a midwife is through going through a Meek accreditation course. It is basically direct entry midwives accredited colleges and it accredits certain programs for midwifery. They're all held to the same standard. And from what I understand, to become accredited by Meek is actually a pretty difficult task. Some of these programs within MEEK are 18 months long certification programs and some of them are three to four year collegiate level degrees and there are some that are in between. And then the last route is through a Texas approved course, which the minimum requirement to become a Texas approved course for midwifery here is 250 curriculum hours. And then once upon completion of the programs and your preceptorship, you take that same state exam, you pass it, you become licensed. So there are very many different ways to become a licensed direct entry midwife. For me it screams red flags within the profession. It is very scary because you don't know what you're getting, you don't know who you are hiring. So how are you as a consumer supposed to differentiate and then understand the ramifications of those differences, understand how it correlates to your care, how it affects that professional's ability to be able to clinically judge what's happening to you during your pregnancy. I was looking for the best birth center in Dallas. I wanted something that was close enough to a hospital that if I needed or if my son needed medical attention, we could get it pretty easily. That is where I stumbled across Origins, Birth and Wellness. I had read many, many stellar five star reviews, not only on their Google page, but also by magazines and I believe DFW Child all recommending Origins being one of the best birth centers in the Dallas area. They are located on Swiss Avenue and kind of like a historical district of Dallas. Literally a stone throw away from one of the best hospitals in Texas, Baylor University Medical Center. You could actually run to Baylor from Origins, Birth and Wellness if you wanted to for context. My husband and I, we both work in the restaurant industry. At the time he was a chef at a restaurant in Dallas. If you're familiar with service industry, you'll know that we work a lot of hours and odd hours at that. So he worked a lot of the time he was like, you know, you pick out some places, we'll talk about it. This is your body, this is your pregnancy, and I'm here to support you through that. So, you know, we can make these decisions together. But ultimately, I want you to choose where you're comfortable.

Thomas (25:17)

Hi, I'm Thomas. I'm Kristen's husband. We met in 2018. We actually worked together. 2019 is when things kind of switched from co worker to dating. And our relationship moved really quickly after that. We moved states a couple times. We went through the pandemic together in 2020, living together, and then got pregnant in 2021 with our son. We had talked about wanting to have a kid, so I was very excited when she really started diving into natural birth. I really didn't have any clue exactly what that meant. She was very happy to educate me in that. So we started reading things, we started listening to stuff. She started looking into birthing centers, and all this was as foreign as a calculus class would be. Once I really started to understand that it was more than just not getting an epidural, I started to kind of maybe be a little bit skeptical. Once I started really diving into, like, the information that she was reading, I saw really just how, like, empowered she felt about doing this and how much she was excited about it. I got on board. I saw that she was taking this seriously. We looked through numerous different birth centers online and read the reviews and planned some visits. And then that led us right into finding Origins.

Kristin (26:33)

So I went to do a tour at the Dallas location. They did have open houses every Thursday. The facility is beautiful. Imagine Victorian style house across the street being a beautiful park with a gazebo. It had a first and a second story. The rooms were absolutely beautiful. Huge porcelain tubs and large beds. I mean, all the amenities you can imagine. So it was very comfortable, very homelike setting. Very different than what you typically see in a hospital room, right? Like, no beeping, no weird things sticking out of walls, no monitors. It almost felt like you were at home in your own room in a lot of ways. And that's how it was meant to be set up. It was meant to be as comfortable as possible and to help pregnant women feel like they were in their element at the birth center. If I recall correctly, I met Amy Tate, Jennifer Crawford, and I believe there was one or two other midwives there. None of them were Gina Thompson and Caitlin Wages. As the owners of Origins Birth and Wellness, I spoke to those midwives, and I felt really good about what I was being sold. I was told that they only hire experienced professionals and they specialize in preventative care basically. So they keep an eye out on anything that would go wrong before it does go wrong. If anything is abnormal, we would be sent to an obgyn, which they had backup OB gyns and they had a great relationship with Baylor. I was told that if something was wrong with a baby during delivery or birth, that, you know, the NICU team would come literally running down from the hospital if the ambulance couldn't get here fast enough, which was very reassuring to me. My mother had worked for Baylor for 20 years, so I knew that Baylor was a great hospital and if I wasn't going to be at that birth center, I was going to birth at Baylor. It's not only all over origins birth and wellness like webpage and interviews with the owners, but I was told that they had the same standard of care. Care is any hospital and any obgyn. They did all the same testing standards and whatnot. Not only that, but they followed ACOG protocols and clinical guidelines. So this for me stuck out. I didn't want an overly medicalized birth. But for me this was very validating. I have a lot of respect for the medical field doctors and medical staff. So to me, for them to hold themselves to this same very stringent standard of care to me was a green flag. It was like, okay, great, I'm safe with these people. They're professionals. If anything was to go wrong, they would recognize it as it was happening or before it was happening.

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Kristin (32:38)

Once you decide whether or not you're going to use Origins for your care, they went through a self pay or insurance method. At the time I had Blue Cross Blue Shield of Illinois through my husband's work, so at the time they were not taking out of state insurance, but I was told that there could be an in network exception and I would just need to apply for it. Most direct entry midwives do not take insurance, but Origins did. Origins build globally under their aprn, who was their nurse practitioner. They would all have a CNM hired. So you can bill underneath an aprn. You can bill underneath a cnm. When I was billed, I was billed under their nurse practitioner. She was listed as my provider even though in the state of Texas nurse practitioners don't perform prenatal care. It was another loophole that they got around to get more clientele to get more money. In my opinion. This was after I'd started to begin care and before I went to my first prenatal visit. I was given a series of paperwork and contracts to sign. One of them was kind of like their orientation packet. What Origins was about what kind of services they Delivered what they believed in, things of that nature. And then I was given an informed consent document that listed all of the midwives that would be attending me in my care when their neonatal resuscitation certificate was, how many births they had attended, and whether or not they were licensed under the regulatory body for midwives in the state of Texas, tdlr. I signed it acknowledging that the midwives that would be taking care of me were on there and that they all had the certifications they needed to be licensed by the state of Texas. Then I was given another consent document. It's basically a liability waiver. I would also like to state that while I was overviewing this paperwork, I was sitting in their waiting room. The front desk gave me this packet and said, just go through and sign. None of these documents were explained to me. There was no one there really to answer any questions for me, if I had any. So I was looking at this consent document, and this was the first icky feeling I had about this place, was looking at this liability document. It basically stated that me, my husband, and nobody who is related to us, no third party would sue Origins even in the event of neglect and death. I'm sure that there are going to be people who hear that and go, why would you ever sign anything like that? At the time, I had been told and was convinced that they abided by these high standards. Well, they were in a hospital, so I guess this is just to cover themselves. This is just a formality. But me and my husband looked at that document and that was our first real. I'm not so sure about this, but we came to the decision, we signed it. We're like, well, it Justice Sue. And I'm sure that nothing like this would happen to us anyway. And so we signed the document and continued in care. My OB gyn, she printed out all of my paperwork that Origins sent over to her, and she said, kristin, never sign anything like this ever again. She said, no physician would ever ask you to sign anything like this ever. This is unethical at best. Looking back, what I know now versus what we knew then. And I say this in the kindest way to like the people we were then. We were very naive to a lot of that stuff. We assumed that these people were professionals that were being regulated by the state of Texas. They claimed to be upheld to these really high standards of care. So to us, certified midwife or licensed midwife was the equivalent of a nurse or a doctor. We trusted them because of the titles that they carry. I wish, looking back then that we had consulted with an attorney to give this document a once over. This put a bad taste in our mouths, and that's something that we thought about periodically throughout our care there. But when things like in my first trimester were going well and everything, we thought it would be fine. And all these people who had all these great experiences were like, well, surely this is just a formality.

Tiffany Reiss (37:13)

As you started going in for your visits and your checkups, who were you being seen by, and what was that process like?

Kristin (37:22)

Origins, Birth and Wellness used several different midwives in one practice. The idea was you would see all of these midwives, so by the time your birth and labor and delivery came along, you'd be familiar with whoever walked in the door. So I saw very many different people at first. I saw a woman named Rachel. I believe I saw someone else named Danielle. I saw Jennifer Crawford several times. I even believe I saw Amy Tate once. I was always seen by one person at a time. This is also a really important context for kind of the era that I entered into. Origins was originally owned by three people. Amy Tate, Katelyn Wages, and Gina Thompson. From what I understand, amy Tate owned 49% of the business. Gina and Caitlin owned the rest. The majority have. During my first and second trimester, there was some sort of split in ownership. Amy Tate left to have her own practice in Gina, and Caitlin kept Origins. I got an email about it. Everything seemed fine and dandy. Gina and Caitlin wished Amy the best. During this split, most of the midwives at Origins left. There was a time for several, several weeks where the only midwife in clinic was Jennifer Crawford. Jennifer was a student under Amy Tate. Amy Tate was supposed to be her preceptor. Jennifer Crawford, one of my midwives, was practicing without a license. She practiced medicine, but she was a student. She was an unlicensed student who presented herself to me as a midwife. Jennifer was performing clinic by herself, and she was also attending births without any kind of preceptor present. Now, from what I understand, Gina and Caitlin kind of didn't care whether or not you were licensed. And they would put you on call and push you to go to births regardless if your preceptor was there or not. Jennifer Crawford was practicing without a license. She was running labs. She was interpreting those labs. She was interpreting my health and my son's health. She made diagnoses, recommended supplements to me, all of those things. And she's the one that I saw most consistently. I saw her six or seven times.

Tiffany Reiss (39:53)

Only her Amy wasn't there supervising her no, only her. So then who was teaching her?

Kristin (39:58)

Gina Thompson and Caitlin Wages, which neither one of them I've met a day in my life. Wrote on my medical records that they were her preceptors, but they were never present, ever. I only had 14 prenatal visits. She saw me for almost half of my prenatal visits and she was also one of the midwives on call while I was laboring at home. When you're only seeing someone a handful of times and you're the most consistent person that they see, you're responsible for a majority of their care. I did sign a form that stated that I was okay with students being present during my care. I just assumed that they would let me know who the students were.

Tiffany Reiss (40:39)

And it doesn't matter what your impression was. She's not allowed to practice medicine, whether you know it or not.

Kristin (40:45)

Whether I know it or not. Right. And so there's no safeguarding of my health or my son's health.

Tiffany Reiss (40:50)

Was your care at all high risk? How did your pregnancy go in general? Would you say?

Kristin (40:56)

This is the real meat and potatoes of the story. I started care. My first prenatal visit was 712 of 21. I started at, I believe, 118 pounds. I was a normal, healthy 22 year old woman. Things went fine for the most part in the beginning. Coming around to my second trimester, I started having symptoms of preeclampsia.

Tiffany Reiss (41:23)

The Mayo Clinic states that along with high blood pressure, preeclampsia signs and symptoms may include excess protein in urine or other signs of kidney problems decreased levels of platelets in blood increased liver enzymes that indicate liver problems severe headaches changes in vision including temporary loss of vision, blurred vision or light sensitivity shortness of breath caused by fluid in the lungs pain in the upper belly, usually under the ribs on the right side nausea or vomiting sudden weight gain or sudden appearance of edema, particularly in the face and hands. Some complications of preeclampsia may include female fetal growth restriction or preterm birth. Preeclampsia may lead to an unplanned preterm birth or delivery before 37 weeks. A baby born prematurely has increased risk of breathing and feeding difficulties, vision or hearing problems, developmental delays and cerebral palsy. Preeclampsia increases risk of placental abruption. With this condition, the placenta separates from the inner wall of the uterus before delivery. Severe abruption can cause heavy bleeding, which can be life threatening for both the mother and baby. Preeclampsia may also result in damage to the kidneys Liver, lungs, heart, or eyes, and may cause a stroke or other brain injury. The amount of injury to the other organs depends on how severe the preeclampsia is. Having preeclampsia may also increase your risk of future cardiovascular disease.

Kristin (43:11)

I was having spots in my vision. I was also having high blood pressure rates in office. I remember looking down at my wrist cuff that one of the midwives was taking my blood pressure on, and it read 140. And she said, hmm, I don't like that number. And so she retook my blood pressure until it came down to a number that she liked. But that was never recorded in my chart, even though I verbally said that I had spots in my vision and things of that nature. Jennifer told me, that's nothing to be worried about. Your blood volume is just doubling. I said, okay, that's fine. As a patient, like, I do my due diligence to tell my provider everything, even if it seems little or minuscule to me. And I knew that preeclampsia, one of the hallmark signs, was spots in one's vision. That's why I told her. And it was never recorded anywhere in my charts. I'm pulling out some of my medical paperwork now from Origins. I have my flow chart sitting out in front of me, which is the chart that has, like, my weight, my blood pressure readings, my fundle height, all of those things. And then I also do have some labs and along with the appointment notes that they make during your visits. Most of my notes in my charts are kind of copy and pasted from my first prenatal visit. Thomas is her spouse. Da da da da da da da. Like, pretty generic stuff. There's no additions to signify my health or anything that's changing in my life. At one point, I believe at 22 weeks, I started to feel like I had BV bacterial vaginosis. It's not like a yeast infection, but it can be as common as a yeast infection. I felt that I might have had that, and so I reached out to my midwives, and they recommended that I use garlic clove suppositories to cure this infection. This infection that is historically known to be cured with a round of antibiotic treatment. I kind of had to argue with them back and forth to get to be able to see their nurse practitioner, Chrissy, to be able to get any antibiotics for that. They had me come in several times to perform my own vaginal swab to be submitted for testing, and several times it came back not as a suitable specimen. I'm pregnant and I'm doing my own swabs. How am I supposed to know how to swab myself for bacterial vaginosis testing? Well, eventually I was just sent over to their nurse practitioner and she just prescribed me the treatment for it and said, here you go. I'm sorry it's taken so long to get this done.

Tiffany Reiss (45:55)

They were essentially saying to not to be tmi, but insert the garlic inside of yourself.

Kristin (46:03)

Yes, that was Thomas's. My husband's first or like, really second red flag, right? Because the first was the consent forms. The second one was, okay, we're treating possible infections with garlic in 2021. I don't understand.

Thomas (46:22)

When she told me that, I was like, wait a sec. That's. That's. I don't know. I'm around garlic a lot. I can't imagine that I doubted that that was gonna work.

Tiffany Reiss (46:33)

Did your husband attend some of these visits with you?

Kristin (46:36)

Yes, he did. He didn't attend all of them, but the important ones like the anatomy scan, my gestational diabetes scan, and some of my pre. He absolutely did. It didn't matter to me that he couldn't come to all the appointments he came to, the ones that I felt like mattered. He was always able to work out when I needed him to be there.

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Kristin (48:28)

Everything'S mostly normal other than having these spots in my vision occasionally. And then I had that one BP reading and office about 27 weeks I had labs collected for gestational diabetes.

Tiffany Reiss (48:43)

Gestational diabetes is defined by the Mayo Clinic as diabetes diagnosed for the first time during pregnancy. Like other types of diabetes, gestational diabetes affects how your cells use sugar. Gestational diabetes causes high blood sugar that can affect your pregnancy and your baby's health during pregnancy. You can help control gestational diabetes by eating healthy foods, exercising, and if necessary, taking medication. Gestational diabetes that's not carefully managed can lead to high blood sugar levels. High blood sugar can cause problems for the mother and baby, including increased likelihood of needing surgery to deliver via C section. High blood sugar may also increase the risk of early labor and delivery before the due date or early delivery may be recommended because the baby is large. Babies born early may experience respiratory distress syndrome, a condition that makes breathing difficult.

Kristin (49:45)

Jennifer entered these labs. This is what the note on my flowchart says. It says, hi Kristen, you passed your glucose tolerance test and your other labs look great. Lots of love your Origins midwives. So that was something that Jennifer often did. She would either sign off on MyChart as Jen or your Origins midwives. They also all had the same login, so they would use one singular login to insert chart information. The values that were documented on my chart by Jennifer read as diabetes screen 1 hour 1002 hour 96 fasting 61 now I'm going to read you the results that actually came out of Quest Labs. My glucose fasting was 100, which was a high value. The reference range listed right next to this reading is 65 to 91. My glucose 1 hour was 96, which read as normal. My glucose 2 hour was 61, which was very low. So even though I didn't have testing results that screamed you have gestational diabetes, my gestational diabetes test results were abnormal and then they were inserted into my charts to look normal. I found this out later when I had another professional review my charts and they came across my labs and put 2 and 2 together. Gestational diabetes can cause all kinds of issues. I'm not a doctor, but your body's lack of being able to regulate and control your insulin during pregnancy can cause large babies. Or it can also cause a restriction of growth, which is called iugr, intrauterine growth restriction. That is more of a rarity. And this is important to note for what I will begin to tell you later. So I go through thinking, my gestational diabetes results went great. My lab work revealed that something was not right, but the chart did not. My lab work revealed that at the very least, I needed to redo my gestational diabetes screening.

Tiffany Reiss (51:57)

So now you have your high blood pressure reading that wasn't in the chart at all. And you have them putting your numbers down, not matching the actual numbers.

Kristin (52:08)

Right. And also another note attached to my glucose testing. Jennifer stated that my labs were normal during this testing. So they ran a CBC as well, which is a pretty basic blood panel screening. And my red blood count was low, the range being 3.75, which the normal range is 3.8. I'm almost anemic at this point, but that is the only abnormal lab result that is on my glucose test. About 30, 32 weeks, I experienced a big bleed. I was at work, I was managing at the end of shift. I was outside with a co worker and he was locking up the back door for me. While we were doing that, I felt this gush. I looked down my leg and my legs are streaming blood. I just very calmly look at my co worker and I say, you need to call an ambulance. And he's still chitter, chattering. And I say, again, you need to call an ambulance. And he looks at me and looks at my leg and kind of freaks out and runs inside. I sit down and at this point, I am doing my very best to keep calm. I was born through a full placental abruption and I knew from my own story from my mother birthing me that during a placental abruption, it is extremely important to remain calm so your heart doesn't pump faster so you don't lose more blood. I assume because of how much blood was pouring out of me, that I was having a placental abruption.

Tiffany Reiss (53:48)

The Mayo Clinic states that a placental abruption is an uncommon yet serious complication of pregnancy. The placenta develops in the uterus during pregnancy. It attaches to the wall of the uterus and supplies the baby with nutrients and oxygen. A placental abruption occurs when the placenta partly or completely separates from the inner wall of the uterus before delivery. This can decrease or block the baby's supply of oxygen and nutrients and cause heavy bleeding in the mother. Placental abruption often happens suddenly if left Untreated, it endangers both the mother and baby.

Kristin (54:29)

I text my husband, Thomas, and I'm sitting in this chair. One of my other managers comes out and she's sitting with me, and we're waiting for this ambulance to come and get me. My husband and I were only driving one car at the time, and so I had the vehicle. He was skateboarding to work. We lived in downtown, where we worked wasn't very far. My husband ran from his job, which was probably about a mile away, ran from his job down to my restaurant and got there just as the ambulance was pulling up. So ambulance takes me to Baylor L and D, and I'm kept overnight for observation. I bleed through most of the night. When I speak with the doctors that come in, I ask them what is worst case scenario here. They say, worst case scenario is that we're performing an emergency C section tonight. And they said, we're going to continue to monitor, see if things get worse. We hope that that's not the case. It was a very scary moment for us.

Tiffany Reiss (55:30)

So scary. Were they able to tell if you had the placental abruption or not through ultrasound?

Kristin (55:37)

They were not able to tell. The doctors that were on my case, they came in and they said, we do think that this was a placental abruption, but a very small one, like the size of a nickel or something. That wasn't detectable via ultrasound. And they said, if you have experienced any cramping, any more bleeding, you need to come back straight away. And I was released the next morning after the bleeding had dissipated and was, you know, I stayed in bed for the rest of the day. The midwives knew what was going on. We had called them when we had gone to the hospital. I go back to work a few days later, and I start experiencing cramping. And it feels like period cramping. No bleeding, but just cramping. I call the midwife line, and Jennifer answers and I tell her what's going on. She doesn't have me go to the hospital. She does have me come into office, though. So I leave work a little early and go to an appointment to see Jennifer. I tell her what happened at the hospital. She said that she thought that what happened to me was a subchorionic hemorrhage. Subchorionic hemorrhage is a pocket of blood that is essentially trapped between the uterus and the. I believe it's like the amniotic sac. And sometimes when that's trapped there, the amount of blood is released and it produces a bleed. She was going to treat my cramping with a supplement called Eutrophin. She essentially said that it would calm an agitated uterus.

Tiffany Reiss (57:09)

This is Jennifer the student. Is there a midwife overseeing this visit?

Kristin (57:14)

No, it was just me and Jennifer in the room. I felt like I had a good relationship with Jennifer. She was the one I saw the most. So when Jennifer said that this was just a subchorionic hemorrhage, nothing to worry about, I believed her. After I have this abruption, things really start to snowball downhill for me. My mom had bought me a BP monitor because at this point, I was gaining weight. I was beginning to puff up and swell, and my mother was worried. She was like, you know, I'm really worried about your blood pressure, Kristen. I'm worried about you having preeclampsia. Here is a BP monitor. It was a cuff and everything. You buy it at cvs. Just keep an eye on your blood pressure for me. And so I did that. I had a reading at home that was 138 over 90. I was pretty stressed at that time because I was supposed to have this big meeting with the owner of the restaurant I was working for. I figured that it wasn't a big deal, but I went to another visit with Elizabeth. Elizabeth is one of the midwives who came on in my third trimester after there was a split in ownership. So Jennifer went from running clinic by herself to having Elizabeth Fuel and a CNM working with her. So there are three midwives at the time. Elizabeth said, if you can't work less than what you're working, get off your feet as much as you are, then you're going to have to go on bed rest. So from what we understand, direct entry midwives specialize in low risk normal pregnancy. I've gotten to a point thus far where I have out of range labs. I have several instances of high blood pressure and symptoms of spots in my vision. I have this big bleed. I continue to cramp and have problems after this bleed. I'm not sent to an ob gyn and I'm threatened to be put on bed rest. But you're still continuing to keep me in care. If I was having a normal pregnancy, there was no reason why I would need to be put on bed rest.

Tiffany Reiss (59:20)

Did they know about the edema too, the swelling?

Kristin (59:23)

They never said anything. But looking at my flow chart from 30 weeks to 32 weeks, I'm 136 pounds. From 32.3 to 34.3, I'm 143 pounds. I almost gained 10 pounds in two weeks. And then at 36.4 weeks, I go from 144 pounds and then to 38 weeks, 151 pounds. So in less than two weeks, I almost gained another 10 pounds. There is severe fluid retention there. It was never addressed. My weight was never concerned. I looked into this because I was like, how did I have preeclampsia and not know that weight gain? At the end, there was a big sign for preeclampsia. I'm being threatened to be put on bed rest because of this bleeding episode that I have that the doctors at Baylor considered a placental abruption. My pregnancy is not normal at this point. Things continue to get worse.

Tiffany Reiss (60:23)

Obviously now you've learned so much about this and you're coming to it from that hindsight perspective, but at the time when all this stuff is going on and you are in their care, was your anxiety increasing? Like, were you stressed or did you feel like at that time you were in good care?

Kristin (60:42)

At that time, I was still feeling confident in my team. I was always told that this was a variation of normal and that I had no reason to worry. I was never referred to an OBGYN to be tested for preeclampsia, ever. Or any kind of further testing for my glucose readings. I was invested in my team. I believed that they cared about me. I liked Jennifer. I cared about Jennifer. I thought she was looking out for me. I thought I was in good care. I really did.

Unknown Midwife (61:12)

After 34 weeks, you sign in your financial contract that you will not receive any refund for services rendered, even if you transfer care. That being said, it was definitely frowned upon for people to transfer out of care because when you transferred out of care, it just didn't look good.

Tiffany Reiss (61:32)

And this is one of the things that their website was boasting. Even when I looked at it, it's like, we have low transfer rates, etc. And so that's their way of convincing people this is as safe as a hospital.

Kristin (61:43)

Exactly.

Unknown Midwife (61:44)

And also too, even though you pay your cost for care up front, there are many other things that they're pushing for you to buy, such as their chiropractic packages, their placental encapsulation, their supplements, massages, IV therapy. At one point they were even doing Botox. They offered a wide range of services so they can't crank out any more money from you. If they transfer you out of care.

Kristin (62:11)

Early in your pregnancy at 36.4 weeks, we're looking at January 12th of 2022 at this point, it is discovered that my son is breach. It's recorded, but on my flowchart, they record that I was breach at 32 weeks. But 32 weeks was around the time that I had gone into Baylor for that placental abruption.

Tiffany Reiss (62:39)

And they had never mentioned this to you if that was the case?

Kristin (62:43)

No, they never mentioned. Well, they wouldn't have known. So my scan wasn't done until 36 weeks, and I don't know why they would record it that way because my son was discovered to be breach at 36 weeks, not at 32, but it was recorded as such in my chart. At 36 weeks, I see a brand new midwife. She's a CNM, I think I saw this midwife once, maybe twice. And upon seeing her, I was 36 weeks, but I was measuring at 31 centimeters, funnel height. So that means my baby was not growing normally anymore. She sends up red flags. I was like, what does this mean? She says, honestly, it can mean that there's something wrong with your placenta, that your placenta is not doing what it's supposed to, and your son's not growing normally anymore. Those are along the lines of what she said to me. It was very upsetting. And she wasn't being rude or anything of that nature. That's not what I mean. But she was the one that was like, something's not right. She says, you need to get an ultrasound. They had a guy that came in every Wednesday that did ultrasounds. So it is Wednesday on the day that I have this visit. I go to the front desk and they say, we'll get you scheduled for an ultrasound next week. I'm sorry, you just told me that my son is weeks behind in growth and you're telling me that you're not going to get me in for an ultrasound until next week. I went out to the car and I was crying, and my husband was like, you know what? No. We're going to go in there and we're going to demand to get an ultrasound that day. And so we went back in, we talked to the front desk, and we were basically like, we need to get this done today. If there are issues or if there are signs that our son's not growing normally, we need to know now. We get this ultrasound done by Moody Diagnostics. Dr. Brunson, my son is breech positioned. There are many different types of breech positioning for babies. My son is breaching what was called transverse breach. So that's like when your baby is laying like a banana in your uterus so he's laying across side to side in my belly instead of up and down. Looking at this ultrasound, my son, who had been developing normally my entire pregnancy, suddenly was almost two weeks behind in growth. This is also another major red flag that my provider shows should have recognized as being abnormal. I'd had multiple high BP readings. I had started to swell pretty severely. At this point, I had abnormal lab results. At 36 weeks, my hemoglobin was low. My hemacrit was abnormal as well. So all of these things were suggesting that there was something more going on than just a normal, normal pregnancy. When you have preeclampsia, your body is beginning to deteriorate. Your kidneys are not functioning normally, your liver is not functioning normally, and worst case scenario, you have seizure like episodes. Looking back at my records, I don't understand why I wasn't referred. Even at 36 weeks and four days, I was not referred to an OB GYN because my son was breech. They did refer me for what is called an ecv, which is a medical procedure that moves the baby. So I'm scheduled for this, but also at the same time I'm told to perform like a spinning babies exercise. Spinning babies is like a natural program or philosophy that if you do these exercises, sometimes you can naturally turn your baby over. There's one night where I feel like my son is like jumping up and down in my womb. So I call the midwives the next day and I say, hey, I think my son turned over. Can I come in and have my baby looked at? I think it was Elizabeth who felt around for my baby. She proclaimed after doing a manual examination, pressing down on my abdomen and things like that, that my son had turned over, that he was no longer breech and he was in the right position. No ultrasound was done to confirm that my son had flipped over at 36 weeks. And this is important to note because of how my labor and delivery will go.

Tiffany Reiss (67:18)

Coming up this season on Something was wrong.

Kristin (67:25)

Great. I'm safe with these people. They're professionals. If anything was to go wrong, they would recognize it as it was happening or before it was happening.

Unknown Survivor (67:35)

I believe my body will do what it's supposed to do. That's why I chose midwifery over the route of choosing an obgyn doctor.

Kristin (67:49)

I thought the birth center would be a happy medium between the hospital setting and the home birth setting. We assumed that these people were professionals that were being regulated by the state of Texas. They claimed to be upheld to these really high standards of care.

Tiffany Reiss (68:07)

I did A lot of research and found a birth center in Dallas. Little did we know it would turn out to be a total nightmare.

Kristin (68:19)

I had spots in my vision. Jennifer told me that, oh, that's nothing to be worried about.

Tiffany Reiss (68:25)

It's not in my chart. But I was leaking meconium all night.

Kristin (68:30)

I said, is it illegal? And they nodded like, yeah, it's illegal. Then when I was taking the screenshots, that's when I realized, oh my gosh, they changed something. To have a student taking care of someone without their preceptor there, to me is below the standard of care that is putting your client at a huge risk. And this is when all hell breaks loose. This is a life threatening emergency. If we don't deliver this baby in the next few minutes, you are risking serious, serious harm and death. Yes, the death was a homicide, but no, the midwife was not prosecuted in any way and as far as I know, continues to practice with no repercussions.

Unknown Survivor (69:26)

They had to do cpr. He didn't have oxygen for so long that he didn't have any brain activity. So my healthy 7 pound baby that was healthy throughout my entire pregnancy is now born with no brain activity, ends in an icu.

Unknown Midwife (69:47)

Too many American women die in pregnancy. There's no question that in the United States there's a maternal health crisis.

Thomas (69:58)

How could you do that? As another woman pray upon someone's desire to take their autonomy and their body back from this patriarchal system that we live in.

Unknown Midwife (70:09)

There's a quote that says at some point we need to stop pulling people out of the river and travel upstream and discover why they're falling in the first place.

Tiffany Reiss (70:22)

They didn't have a certificate of occupancy for the clinic endowed. We knew that they were changing birth records. We started reporting those things.

Unknown Survivor (70:32)

I knew what had happened should not have happened. I knew that if this had happened to me, it probably happened to other people. And I had already made up my mind that I was going to try to do whatever I can to help other people from this tragic and horrific event that has happened happened to me.

Tiffany Reiss (71:09)

Something was Wrong is a broken cycle Media production created and produced by Executive producer Tiffany Reese Associate producers Amy B. Chesler and Lily Rowe with audio editing and music design by Becca High. Thank you to our extended team, Lauren Barkman, our social media Marketing manager and Sarah Stewart, our graphic artist. Thank you to Marissa Travis and our team at WME Wondry, Jason and Jennifer, our cybersecurity team, Darkbox Security and my lawyer Allen. Thank you. Thank you endlessly. To every Survivor who has ever trusted us with their stories and thank you each and every listener for making our show possible with your support and listenership. Special Shout out to Emily Wolf for covering gladrag's original song you Think youk for us this season. For more music by Emily Wolf, check out the Episode Notes or your favorite music streaming app. Speaking of episodes, there every week you'll find episode specific content, warnings, sources and resources. Until next time, stay safe friends. If you like something was wrong, you can listen early and ad free right now by joining Wondery plus in the Wondery app or on Apple Podcasts. Prime members can listen ad free on Amazon Music. Before you go, tell us about yourself by filling out a short survey@wondery.com survey.

Unknown Narrator (72:43)

A few miles from the glass spires of Midtown Atlanta lies the south river forest. In 2021 and 2022, the woods became a home to activists from all over the country who gathered to stop the nearby construction of a massive new police training facility, nicknamed COPS.

Kristin (73:03)

At approximately 9:00 this morning, as law enforcement was moving through various sectors of the property, an individual without warning shot a Georgia State Patrol trooper.

Unknown Narrator (73:14)

This is We Came to the Forest, a story about resistance.

Kristin (73:18)

The abolitionist mission isn't done until every prison is empty and shut down.

Unknown Narrator (73:22)

Love and fellowship.

Tiffany Reiss (73:24)

It was probably the happiest I've ever.

Unknown Narrator (73:25)

Been in my life and the lengths we'll go to protect the things we hold closest to our hearts. Follow We Came to the Forest on the Wondery app or wherever you get your podcasts. You can binge all episodes of We Came to the Forest early and ad free right now by joining Wondery Plus.