the STATISTICS, HIGHLIGHTS + TRAGEDIES of Kim’s PRACTICE
These are Kim’s statistics as of 31 December 2024. Most of the births described below occurred in Michigan and Colorado, while a handful occurred in Haiti.
Kim’s conducted 6,492 prenatal appointments and 2,740 postpartum appointments, caring for the mothers of more than 1,000 babies.
Kim’s attended 761 of those babies’ births.
Kim’s spent well over 20,000 hours serving childbearing families through the last 31 years.
Kim’s been in service to some of the families those babies represent for all of those years. Many of the mothers she served through her training are the grandmothers of the babies who came later. One of those mothers became a grandmother as she and Kim knelt together between the feet of her birthing daughter—the very daughter she pressed into Kim’s hands eighteen years earlier—to receive the newest child in her line to life. Two of the babies included in this review of Kim’s work are her nephews and three are her nieces. Still seven others are her own beloved grandchildren.
Kim did not attend the births of the 400-some other babies mentioned above for a great variety of reasons. Many of their mothers suffered miscarriages. Many of their mothers were the clients of other midwives. A few of their mothers changed their minds about having homebirths. Kim felt three of their mothers would be better served by other providers. Some of the babies were born while Kim was away or ill or having one of her twelve throat surgeries, some were born after Kim moved from Michigan to Colorado, and seven babies were born at exactly the same time as seven other babies.
The mothers of eighteen of those babies were referred out of care prior to birth for serious medical conditions, but Kim was unable to accompany them to the hospital for their births. An accounting of those babies and their mothers may be found at the end of this section with a desire both to acknowledge them, as well as to highlight how infrequently serious medical conditions arise in pregnancy.
Kim’s attended the births of 758 living babies.
Three, or fewer than 0.004, of the full-term babies in Kim’s care died either just before, during, or soon after their births.
Of those priceless little ones, one baby died prior to his labor, one baby died during his labor, and one baby died soon after her birth. Kim gives an accounting of all three of these babies at the end of this section. Kim’s also attended the births of three preterm babies who died within their mothers’ wombs—a little boy who made it nearly to 31 weeks, a little girl who made it almost to 20 weeks, and another little boy who also almost made it to 20 weeks. Kim’s been part of the pregnancies and birthings of three others so very tragically tiny as well.
All of the mothers in Kim’s care have lived.
687, or 90% of the births occurred at home. Kim missed 38, or fewer than 6% of those births by heart-pounding seconds.
73, or just under 10% of the births occurred at the hospital. Kim missed 14 of those births.
54, or 7% of the births were in-labor transports. Kim received one of those babies in an ambulance.
12, or just under 2% of the births occurring at the hospital were planned hospital births—planned through the entire pregnancy, that is.
32, or just over 4% of the babies were born by cesarean section.
One baby was born assisted by forceps and two babies were born assisted by vacuum.
14, or just over 2% of the living babies born in Kim’s care were born prematurely, including two sets of twins. 12 were born in in the hospital, eight vaginally and four by cesarean section. Three babies were born at home. One baby was born at home because the birth was so fast-occurring we were unable to manage a transport, the other two babies were born at home because the parents refused to transport. One of those latter babies was transported post-birth. All three of the babies born prematurely at home occurred during Kim’s apprenticeship in Michigan.
11, or just under 2% of mothers birthing in Kim’s care were transported to the hospital after their births.
Kim’s called emergency services 11 times, or just under 2% of the time she’s been in attendance at homebirths. Two of those times resulted in the tragedies described at the close of this section. Five times Kim traveled with her clients to the hospital in the ambulance with them. Twice the ambulances were sent away.
Five, or 0.007 of babies born within Kim’s care, were transported to the hospital very soon after their births. A more in-depth accounting of those babies may be found a few paragraphs below.
41 of the women birthing in Kim’s care had birthed previously by cesarean section. 35, or 85% of those women were able to birth vaginally. Two of these women birthed twice by cesarean section prior to giving birth vaginally, with both of those initial vaginal births occurring in hospitals. One woman who’d birthed her first baby by cesarean section birthed her fifth baby by elective cesarean.
174, or 23% of the mothers Kim’s served were first-time birthers and 48, or 6% of the mothers were giving birth for the seventh, eighth, ninth, tenth, or eleventh times. One woman in Kim’s care has been pregnant eighteen times, and another sixteen. Neither of those mothers gave birth to nearly so many full-term, living babies.
A handful of babies in Kim’s care have been posteriorly positioned through labor and/or at the time of birth, and twelve babies in Kim’s care have manifested brow or military presentations. Nine of the brow or military presentations finally flexed, but three were actually born brow first. Kim transported one first-time mother laboring to birth such baby to the hospital. She labored a total of 71 hours, and was completely dilated and pushing for eight hours before her baby flexed her head at last and was born.
19 babies in Kim’s care have presented breech. Seven were born by cesarean section in the hospital, one was born vaginally in the hospital, and 11 were born vaginally at home. The baby born vaginally in the hospital was an incomplete breech, presenting with a foot and a knee. One of the homeborn babies was an actual footling breech—that is, the second baby of a set of twins—she presented at the start of labor as a complete breech, but with the birth of her brother swept one of her legs to standing. Three of the other homeborn babies were complete breeches, and the 10 remaining homeborn babies presented frank breech. One of the babies presenting frank breech died before she drew breath. A more detailed accounting of her death may be found in a section below.
Three babies in Kim’s care have presented face first. One was born at home to a first-time mother, one was born vaginally in the hospital, and one was born by cesarean section.
18 babies born in Kim’s care were twins. Four of those babies were born in the hospital—two babies were born prematurely, but vaginally in an operating room (the second baby in that set presented breech, but the doctor got him turned head down after the birth of his sister), and two babies were born by cesarean section at 31 weeks after their mama developed HELLP syndrome. 13 twin babies were born at home, but one baby was born by cesarean after the birth of her brother destabilized her lie. One of those sets of homeborn twins wound up with separate birthdays, though they’re the homeborn twins born closest together with only thirty-nine minutes between them. Two of the mothers Kim served have birthed twins twice!
Kim’s been part of resolving 26 shoulder dystocias. All of the dystocias were satisfactorily resolved, though two of the babies suffered broken clavicles and one suffered a broken humerus.
Kim’s been part of the resuscitative efforts for 57 babies. Several mothers participated in their baby’s resuscitations. Two of Kim’s efforts to resuscitate a baby were unsuccessful, although retrospectively one of those babies was clearly born a few hours after his death. Again, the stories of those babies are told more fully a few paragraphs down.
Kim’s been part of resolving 66 postpartum hemorrhages. Three of those times Kim arranged for a transport to the hospital to occur by ambulance. The source of two of those hemorrhages were, surprisingly, cervical lacerations. Both of the mothers sustaining cervical lacerations required blood transfusions.
Kim’s personally repaired 63 lacerations—mostly second-degree lacerations. Though Kim hasn’t counted, certainly more than sixty-three of the women she’s served have sustained lacerations. Some of the lacerations were repaired by other practitioners, while others were so slight they didn’t require repair. Kim transferred five women who sustained second-degree lacerations to hospitals for repairs as she considered the lacerations beyond the level of her skill. Two women Kim’s served sustained third-degree lacerations which were repaired by other practitioners, but yet in the homes of those women. None of the women Kim’s served have sustained fourth-degree lacerations.
Kim transferred two mothers to the hospital during their labors for maternal cardiac concerns. She was part of transferring one laboring mother to the hospital for a prolapsed cord by ambulance, and two other laboring mothers with prolapsed cords to the hospital by car. One of those mothers was able to birth vaginally upon her arrival to the hospital. Kim transferred one mother to the hospital by ambulance for a partially abrupted placenta. She, too, was able to birth vaginally upon her arrival to the hospital.
Three mothers Kim transferred to the hospital in labor were able to return home! Two of them then birthed their babies at home, but one mother Kim returned to the hospital a day later. That mother still managed to have a very lovely vaginal birth. One woman Kim transferred to the hospital gave birth to her baby in her car just as the car pulled up to the hospital doors. The birth resolved the issues occurring with the baby’s heart tones prior to birth, so Kim just shut the doors and the group returned home.
Most of the other in-labor transfers were for malpresentations and/or malpositions of babies carried by first-time mothers, or for maternal blood pressure elevations or for non-reassuring fetal heart tones–again, those transferred were primarily first-time mothers—though two transfers were for mildly flattened pubic arches (one birthed vaginally with the assistance of a vacuum and one birthed by cesarean section), and one transfer was for a baby who’d become dramatically tangled up in its cord.
Kim transferred one mother to the hospital when she arrived at her 42nd week of pregnancy without having given birth, per the state of Colorado dictates. Kim transferred another two mothers to the hospital per prolonged rupture of membranes and signs infections were brewing. One of those mothers birthed vaginally, while the other, a first-time mother, birthed by cesarean section.
Kim’s transferred several first-time moms to the hospital who just really needed an epidural and a nap. Most of those mothers snoozed, woke, and birthed their babies without incident, although one of those mothers was—for the first time in my entire career—literally bullied into a cesarean section per unbelievable disrespect coupled with lurid descriptions of damage and death. The doctor who’d performed the bullying glibly admitted twice after the cesarean—unprompted—she thought the mama could actually have birthed her baby vaginally after all.
Besides the three mothers Kim transferred after birth for hemorrhages (see above), she transferred three mothers to the hospital post-birth by car for retained placentas. Three other women Kim’s served have required manual removals of their placentas two she’d already transferred to the hospital, so the births occurred there. One of those births occurred at home, and Kim accomplished the removal herself.
Kim transferred one mother to the hospital after birth for elevated blood pressure.
Kim referred one mother out of care for postpartum infection at a week after her baby’s birth. Kim referred three mothers out of care in the weeks after birth for retained placental fragments—one incident failed to manifest until after the six-week visit! Kim referred one mother out of care for deep vein thrombosis around two weeks after her baby’s birth.
Three mothers in Kim’s care have required medical treatment for severe postpartum depression. One of the women Kim’s served experienced psychosis through the first trimester of her pregnancy, also requiring treatment.
11, or less than 2% of the births Kim’s attended concluded with babies admitted to the NICU. Of those births, Kim’s served as primary midwife at nine. Though that feels like a lot of babies to Kim, but she’s reassured to know it’s actually a lot less than the national average. According to The Health Care Cost Institute, “In 2021, 18% of newborn admissions involved some NICU care, an 8% increase since 2017.” The article this quote was taken from may be viewed at healthcostinstitute.org/hcci-originals-dropdown/all-hcci-reports/nicu-use-and-spending-1
One of those babies who spent time in the NICU was born eleven hours after our arrival at the hospital, and required a full-scale resuscitation. Another baby was born at home with his placenta at his heels. He required a full-scale, 75-minute resuscitation and airlift to the hospital. Both of those babies underwent a 72-hour cooling protocol and both, thankfully, made complete recoveries. They were home eight and nine days after their births.
Kim transferred one 37-week baby boy to the hospital for respiratory support, and watched in horror as the baby’s little lungs were wildly over-inflated by a nurse in the emergency room. He was diagnosed some hours later with a pneumothorax, and was in the NICU for a little better than a week. To be clear, this baby breathed well immediately upon his birth—no breaths were provided him at home—he just began to grunt a bit around one-hour post-birth, letting us know he needed some extra assistance.
One baby was admitted to the NICU seven days after his birth for a serious case of neonatal jaundice. Another baby was admitted to a NICU seven days after his birth by an over-zealous hospital staff suspicious all manner of horrid things were happening in the baby per his birth at home, although it turned out he simply needed some supplemental oxygen—not too uncommon a thing out here in Colorado Springs. He was, at last, provided that and sent home. Ten of the babies Kim’s been called upon to tend here in the Springs have required supplemental oxygen for a few weeks after their births—almost all of those babies were actually born in the hospital, and were therefore subject to immediate cord severance.
Two babies were born in the hospital with serious malformations—one without an anus and one with his bladder positioned outside of his body. These issues were addressed surgically.
One of the babies born into Kim’s care was born with a nasal malformation called choanal atresia this issue was surgically corrected soon after birth.
Kim referred two babies out of care post-birth for serious cardiopulmonary malformations. One baby required open-heart surgery to correct a transposition of the great arteries of the heart, while the other required laparoscopic surgery to correct a case of pulmonary stenosis.
Kim discovered one case of ventral-septal defect by fetoscope at around 30 weeks gestation. The diagnosis was provided by a maternal-fetal medicine doctor who indicated the plan to welcome the baby at home was still viable. He was born in excellent condition and is now under the surveillance of a pediatric cardiologist.
Kim detected another baby’s heart issues pre-birth and referred him and his mama out of care. He was administered a prescription at home for half a year for an issue which somehow remains obscure to this day. He’s fine now.
Kim referred yet another mother out of care for diminished fluid volume, or oligohydramnios. That baby was initially diagnosed with pleural effusion and arrangements were made to induce her labor, but a secondary examination of the baby revealed no issues at all, so mom was able to return home to birth. The fluid volume issue resolved and the baby made her appearance about four weeks later.
Kim’s referred tens of additional babies out of care in the days following their births for a number of less severe abnormalities. Several babies manifested benign heart murmurs, a few have sustained cephalohematomas, one had a sizeable inguinal hernia which did require surgery, one had a huge hydrocele, one had a cleft lip, one had an oral hemangioma, one had a malformed ear, one had a club foot, four babies suffered severe jaundice (one of those babies is mentioned in a previous paragraph, and another wound up permanently damaged. A fuller accounting of that baby’s experience may be found below), one baby had one undescended teste, and one baby had a set of undescended testes.
Kim referred two babies out of care for broken clavicles and one baby out of care for a broken humerus, all of these bones were broken during the resolution of the babies’ shoulder dystocias, described above.
Kim’s attended the births of three babies diagnosed with disorders via the newborn screen—two minor and one very serious.
The births of twenty-plus babies initially in Kim’s care occurred in the hospital and, for a variety of reasons, Kim wasn’t able to attend them. Seven of those births were for pregnancy-induced hypertension or preeclampsia, three were for truly postdates pregnancies, one was for severe polyhydramnios with lethal fetal anomalies, two were for unstable lies, one was for placenta previa, three were for breech presentations, one was for an abrupted placenta, and three were for preterm labor. Of these babies, fifteen were born by cesarean section. One of these babies has Down Syndrome. At three of the births, Kim was barred from attending per COVID-19 hospital policies.
Excluding the preterm babies, the babies have ranged in size from 4lbs, 3oz to 12lb, 3oz, with 31 babies weighing more than ten pounds. Three of those babies weighed more than eleven pounds. Then, of course, there was the twelve-pounder. He slipped from his forty-year-old mother in less than two and a half hours, slick as a stick of butter. All but one of those hefty babies were born vaginally.
The youngest mother Kim’s served was seventeen and the oldest was forty-six. Kim’s served a great many women over the age of thirty-five, and a great many at or over the age of forty.
The longest labor among Kim’s clients lasted 71-hours, though one of the women Kim referred out for preeclampsia (and wasn’t able to attend) had a 108-hour labor! Both moms were first-timers and both managed to birth vaginally.
The longest Kim’s stayed with a birthing mother so far is just over 66 hours (that was through the 71-hour labor mentioned above), and her shortest stays have been between three and four hours. On average, Kim spends ten hours with a birthing family.
Once, Kim attended three homebirths in a twenty-four-hour period while in Michigan, and she attended five births in twelve hours at a birth center in Haiti. The three homebirths included 200 miles in the car, two states, and one transfer.
The shortest labor among Kim’s clients was forty-seven minutes. Of course, Kim missed that birth. The next shortest labors were one hour flat, one hour and one minute, and one hour and five minutes. Kim also missed those births. The next shortest labor was one hour and nine minutes, and somehow to that birth Kim managed to arrive with 29 minutes to spare.
The longest a woman who’s birthed at home with Kim has gone on with released waters is 91 hours. The woman’s actual labor lasted 38 hours. Both the mother and the baby remained healthy for the duration of their labor, birth, and postpartum period. Two other women in Kim’s care experienced the release of their waters at 25 weeks. One of those women birthed by cesarean section at 32 weeks, and another birthed vaginally at the hospital at 35 weeks.
Kim’s attended the births of two babies with both little hands on their heads and one baby with both fists jammed beneath its chin.
Kim’s attended the births of two babies with single artery cords, eight babies with knots in their cords, three babies whose cords were damaged during their births, and twenty-two babies who were born fully enclosed within their water sacs.
Kim served one woman with a bicornate uterus. She served another woman multiple times who appeared to have two cervices and whom Kim suspects has two uteri. Three mothers Kim’s served have suffered mild degrees of uterine prolapse as they birthed. Three other mothers experienced uterine prolapse some while after their births.
Kim served a woman with six fingers on each hand who gave birth to a baby with six fingers on each hand, and she served a woman who gave birth to a baby with two tiny teeth in its mouth.
Kim is a passionate advocate of optimal cord severance. Most of the babies and umbilical cords in her care remain undisturbed for two hours or longer. Thrice the connections have remained intact for two to three days. Dozens of umbilical cords have been severed by burning.
Kim’s seen a great many interesting placentas through the years! A handful of velamentous cord insertions, another handful of placenta circumvallate and placenta marginate, two succenturiate-lobed placentas, and one battledore placenta. Many of the women Kim serves consume their placentas raw or by encapsulation, and many have their placentas processed into homeopathics, or matridonal remedies.
the tragedies
Each of the following stories is shared with the permission of the bereaved families.
One full-term baby born into Kim’s care suffered brain damage prior to being diagnosed with a condition called Criglar Nijjar, a rare inherited disorder affecting the metabolism of bilirubin, a chemical formed from the breakdown of the heme in red blood cells. The disorder results in a form of nonhemolytic jaundice, which results in high levels of unconjugated bilirubin, and often leads to brain damage in infants. The baby became moderately jaundiced in the week following his birth and remained mildly jaundiced through six weeks post-birth. His parents declined medical evaluation as their three older sons and several nieces, nephews, and cousins had also experienced prolonged periods of mild to moderate jaundice post-birth minus harm. The baby became severely jaundiced shortly after his six-week visit and was taken to the hospital, he survived, but the damage was fast-occurring and permanent.
The baby was diagnosed with the condition about two weeks later. One of his two younger sisters also has the condition, but she was diagnosed very soon after birth (a homebirth in Kim’s care) and in-home light therapy was secured immediately. The child is fine today, though she required nighttime light therapy treatments until she was finally able to receive a liver transplant in 2019. The child who suffered permanent brain damage is his mother’s fourth child.
A second full-term baby in Kim’s care was born after passing away in the womb a week prior to his birth due to an umbilical cord accident. The mother reported absence of movement on a Tuesday. Kim went to her immediately and, when she was unable to auscultate heart tones, took her to the hospital to confirm the baby had died. The couple still wanted to have their son at home, and he was born the next Sunday. At birth his cord appeared wrapped in amnion constriction bands an inch or so from the baby’s navel. He was his mother’s first baby.
A third full-term baby in Kim’s care was born in a state of severe depression after a cessation of her mother’s contractions during the expulsive phase of her breech birth. She was born just to the line of her nipples, and then her mother’s uterus refused to provide another contraction until after the baby was born. Kim performed the Louwen maneuver to release the baby’s arms and the Mauriceau-Smellie-Viet maneuver to flex the head and complete the birth. It took fully sixteen minutes to free the child. Kim immediately initiated resuscitation, but was unable to inflate the baby’s lungs. Emergency services was summoned. EMS facilitated a monitoring system between the family’s home and the hospital while Kim continued to attempt resuscitation. After fifty-nine minutes of effort, a doctor providing remote oversight ordered Kim’s efforts be discontinued. Kim then wrapped the baby in a soft blanket and laid her away in her mother’s arms. She was her mother’s first baby.
At two of the three peer reviews Kim submitted this case to, the idea the baby may have suffered a respiratory tract anomaly was raised. A doctor Kim consulted with later suggested the same. Naturally, Kim would like to think an anomaly was behind her inability to inflate the baby’s lungs, but an autopsy wasn’t performed, so that simply can’t be known. It does remain the only time Kim’s experienced such an issue.
And finally, one of Kim’s clients, a first-time mama, started her labor early one Thursday morning in January, 2024—around three o’clock—with some cramping and a smear of pink show.
By ten o’clock or so in the morning her rushes were coming every four to five minutes, lasting a minute each.
She called Kim around eleven o’clock to tell her so, and Kim began the process of heading her way.
Her labor intensified immensely over the next thirty minutes, so Kim spent the entirety of her drive with the mother on the telephone.
Kim arrived around noon to find the baby at the point of his birth!
But she also found him without a heartbeat.
In hopes he was only very recently compromised, Kim’s team dialed emergency services while trying to encourage his mama to just quickly press him into the daylight.
Emergency services arrived soon after they were called, and soon after they arrived, it became apparent he wasn’t going to very rapidly spiral earthward, so Kim climbed into the ambulance with the mother, and they started for the hospital.
A few minutes before their arrived at the hospital the wee baby boy and his placenta slipped into Kim’s hands.
He was utterly still.
Kim immediately began efforts to resuscitate him, and the hospital’s NICU team took over the moment they pulled to the door.
And he was unable to be revived.
And everyone was shattered.
Then, in the midst of the shock and the sorrow, before Kim’s client had been observed more than an hour or so, and before Kim even had the chance to provide the hospital staff her records, someone from the hospital filed an anonymous complaint against her license.
Kim’s records and the hospital records debunk the points of the complaint, but the complaint is nonetheless under investigation.
The cause of the baby’s death remains unclear to this day, though there are a number of variables likely to have made contribution.
For Kim, it was a reminder to mind all the little signs which, though any single one of those signs presenting alone may not prove especially significant, a number of them clustering together may very well be.
Through the years since these heartbreaking losses, three of the four families have enjoyed the beautifully uneventful births of happy, healthy babies—four with Kim before she moved to Colorado—and four after. So far.
