In Oklahoma, midwives who deliver babies outside the hospital operate in the Wild West of legal landscapes. They are unregulated, untracked and largely unaccountable. As out-of-hospital births have gained popularity in the state, problems have continued unabated. Non-nurse midwives who oversee deliveries that result in babies’ deaths are not investigated or disciplined by any state agency. They continue to practice unmonitored and unchecked, putting mothers and babies in the state at risk.
Reporter Lucille Sherman did something the state of Oklahoma would not: She counted each baby that died from a midwife-assisted, out-of-hospital birth for an entire year. By scouring obituaries, fetal and infant mortality review projects, medical examiners’ reports, state records and public social media posts, Sherman found that, in 2018 alone, seven babies died in Oklahoma during or after midwife-assisted out-of-hospital deliveries. Medical experts consulted by GateHouse Media (now Gannett) said most of those deaths could have been prevented.
If seven deaths seem like a small number, consider this: Fewer than 30 of the 41,825 full-term, hospital-born babies in Oklahoma died within a week of delivery in 2017, according to the latest data available from the CDC. That’s less than 0.07%. The CDC does not publish data for death counts under 10 due to confidentiality constraints. As such, it does not show Oklahoma’s midwife-assisted, out-of-hospital mortality rate among full-term babies that year. But based on the seven full-term fetal and infant deaths we was able to confirm divided by the CDC’s count of 510 such births in 2018, it could be around 1.4%. That’s 20 times higher than the hospital mortality rate for newborns.
Among the investigations other findings were that: Oklahoma midwifery groups claim to collect this data themselves, but they undercounted the number of out-of-hospital deaths between 2012-2016 in a report provided to a lawmaker attempting to regulate the profession in 2017. That legislative attempt failed amid strong opposition by midwives, some of whom belonged to those same groups and had overseen fatal deliveries just one year later.
The investigation also uncovered the fact that midwives are routinely obtaining prescription drugs online and administering them to clients, as well as performing medical procedures like episiotomies, despite lacking the required medical license to do so. The state, which until recently has taken no action against these providers, charged midwife Debra Disch in September with a felony for administering drugs and performing an episiotomy. The move came just weeks after a story Sherman wrote detailing Disch’s handling of a botched out-of-hospital birth earlier that year.
But other midwives have openly done the same thing for decades, even bragging about it to the reporter. We detail these practices in our investigative series. Finally, we provided a deep-dive narrative into one Oklahoma mother’s story of how she lost her infant son in an attempted out-of-hospital birth. The mother, Lecye Doolen, reached out to us last year after learning from one of our prior stories that her son’s death was preventable despite what her midwife had told her. Lecye is now fighting for justice on behalf of the son she never got to meet.