Baltimore Midwife Indicted For Involuntary Manslaughter

BALTIMORE (WJZ) — A Baltimore midwife has been indicted on involuntary manslaughter charges after a baby died during a home delivery.

Jessica Kartalija reports the mother was warned that a home delivery could be risky.

Karen Carr, a Baltimore midwife who’s delivered more than 1,200 babies, is facing manslaughter and child abuse charges after a baby she was delivering inside a Virginia home died.

“Her main purpose was to help this woman get what she wanted.  Her history shows she was qualified,” said attorney John Kenneth Zwerling.

Carr’s attorney says the baby’s body was out, but his head became caught.  He was declared dead at a local hospital.

“I’m flabbergasted by the story and it didn’t have to happen,” said OB/GYN Dr. Glenna Andersen.

Andersen says home births are a risk that shouldn’t be taken.  She also says gynecologists rarely deliver breech babies because of the risk and that C-sections are much safer.

“I would prefer, if things are going well, to deliver a baby vaginally.  I don’t want to do C-sections; their risk is higher, but there are times when C-sections are the right thing to do,” Andersen said.

Carr is licensed to practice here in Maryland—not Virginia.

Morgan Hanslick delivered her son at home and knows Carr.  She believes the midwife did nothing wrong.

“Karen did everything in her power to make sure that baby came into the world and was not at fault for her medical practices as a midwife,” Hanslick said.

An Alexandria grand jury also indicted Carr on charges of neglect and acting without a license.

The baby’s mother–who isn’t commenting–is 43.  She had been told by an Alexandria midwife practice that delivering a breech baby at home could present complications.  Carr’s attorney said this was her ninth breech delivery last year.

More from Jessica Kartalija
  • Bullfrog

    What a tragic situation for everyone. The baby is an angel now, but the suffering for that mother and the midwife will last a lifetime. That should be punishment enough. That mother made a choice and it turned out to be the wrong one, so I do not understand why she is being prosecuted for the decision of the mother. May the jury and the judge have mercy on this mid wife for doing her job, she is not GOD, she is a woman who has a special expertise for delivering babies at home at the request of the pregnant mothers.

    • sjl

      i totally agree, i also feel at 43 yrs of age, the mother w/want to be in a hospital, i know women are having babies when they are older, but common sense w/tell me be in a hospital-i was 21-28 and both times a c-section was a welcomed relief…….sjl joppa md

    • m soto

      I agree. but they’ll still get her for practicing without a license (she’s licensed in MD not VA).

    • suzie

      why would you say the baby is an angel now??? an angel is a total separate creation. babies die and go to heaven they don’t turn into angels???

      • James

        Seriously, as a father, I’m with Erin on this one. Suzie & Dottie, some level of sensitivity must be maintained with regards to nature of this subject. Debating the place or lack thereof for a child amongst the celestial choir of the heavenly host is likely commentary best reserved for another forum. Your comments are not only unkind and insensitive, but entirely misplaced. Please take some time to reflect on yourselves, your faith, and whether or not you have any business assigning such judgement to a comment made clearly to express sympathy for the loss of a child.

      • dottie

        I agree Suzie.

      • Erin

        Sorry suzie but I don’t understand why you would post something like that. If it gives parents whose babies have died comfort to think of them as angels in heaven, why nitpick? Other people may hold different beliefs. This article is about a dead baby. Whether you believe that baby is now an angel is irrelevant, and it seems downright unkind to try to correct someone — no, sorry, that baby isn’t an angel. Really? People are free to express their opinions always, but when it comes to parents losing children, I believe that some discretion should be exercised. “Angel baby” is a common term used by parents who have lost children. Go to a social networking site for parents, many of the profiles will list names and ages of children, as well as “angel babies” that were lost. Are you going to go correct all of these, too?

  • Owings Mills

    I don’t understand how this woman can be held criminally responsible for a choice the mother made against doctors orders? Anyone else feeling the same?

    • Deneen

      Because she was not licensed in VA and should not have been “practicing” there.

    • Susan

      When the midwife tells the mother she can deliver a breech baby and avoid the c section, when the midwife community scares expectant mothers away from doctors with horror stories…when the midwife practices outside her license and profits by doing so, the MIDWIFE should be charged.


      exactly i think the mother should be held responsible she was told the baby was breech which was her 9th breeched baby 43 yrs old that midwife was in the wrong for practicing in va and va is a common wealth state there super strict on there laws but that is something that thier gonna have to live w/for the rest of there lives and trust me i no wat that feels like i lost a 2mo 18 day old bbaby n theres not a day that goes by i dont think of him itll tear your heart out more n more every day she should b stuck w/a fine but if anyone should b held responsible it should b the mother!!!

      • slinky

        please read the article again. it was not the mother’s 9th breech birth. it was the 9th breech birth the midwife had delivered last year. if you don’t understand what you are reading, please do not comment.

    • Lamouth phd

      Yes I do…Any way especially knowing that your child was breech and not taking the medical precautions to arrange another method of delivery. The mother should have not had the home delivery. And any way she was told by the practice of the complications…there should have been a liability signed.

  • Dee

    Owings Mills: Yes, she should be held criminally responsible. She wasn’t licensed in Virginia where she attempted the delivery. It is likely that since the Virginia midwife practice warned the mother against delivering a breech baby at home, the mother looked elsewhere. Ms. Carr may be a fantastic midwife, but she is only licensed in Maryland.

  • JMD

    practicing without a license certainly does not equal manslaughter and child abuse

    • Deneen

      First Do No Harm!

  • Bud

    Sure it does. Had she not been practicing where she wasn’t licensed, this would not have happened. If the virginia midwife practice said they wouldn’t go for the breech delivery, and this lady didn’t go down for this delivery, I bet that mother ends up delivering in a hospital, with tenfold the resources that a midwife has. She should be held responsible. Both of them.

  • John

    wow, went all the way to Virginia just to commit manslaughter? HMM? Sounds like she went to help someone who wouldn’t go to a hospital because they were…say it…an illegal immigrant! Now this woman/Midwife who has delivered MANY babies is going to pay for what the mother chose to do. Giving birth at 43 at home? Sounds like there is more to this!

    • antoinette shorter

      what an assumption… an illegal immigrant….really? And you obtained your information from where exactly? My mother gave birth to me at home by a midwife at the age of 42 and she wasn”t an illegal immigrant. What an ignorant, ignorant perspective to take. Plenty of women choose this way of birthing their children EVEN today. Hope it all makes sense to you when you find out “what the more to this is.”

      • mike

        @antoinette shorter It prob was an illegal alien one that came into this country on a shoe box, or found a hole in the fence for their families. Your mom just never told you that her green card was fake.

    • Deneen

      It doesn’t even say the woman’s name. How do you know it was an illegal? And Yes, woman at 43 or whatever age can deliver safely at home. This particular woman was told not to and chose to do it anyway. The only one that should be felt sorry for is the baby who suffocated to death.

      • James

        @ John & Mike: Seriously, gentlemen? And I should note here that I use the term “gentlemen” loosely in its assignment to you both. Your assumptions are not only ignorant and insulting to anyone who truly understands anything about the argument you attempt to present, they are completely counterproductive and demonstrate a profound lack of education as to the facts. More to the point, they detract from the intent of this commentary, which when I last checked was in regard to a midwife being charged with involuntary manslaughter for the death of a child she was attempting to deliver. Whether or not the mother was here legally does not change the context of the argument. The charges would be levied just the same in either case. That is, unless you presume that a mother here illegally and the child lost would not be worthy of justice given that mother’s immigration status, but I will not make that assumption, I will simply allow your own words to be your testimonial.

  • Charity Ponton

    I do not think she should be charged with anything. If you give birth at home without any help and the baby dies, should you be charged with manslaughter? What about if your own mother or sister is helping you with your choice of a home birth and the baby dies? Should they be charged for practicing medicine without a license and then charged with manslaughter? Women have been birthing babies for thousands of years without hospitals and outside help. The midwife told her it would be risky, but nobody is to blame. Not even the mother

    • Deneen

      Really!?! The OB/GYN told her it would be risky. The midwife went to VA knowing full well she was not licensed to practice there. She had the knowledge to say no. This midwife did not tell her it would be risky. The mother should also be held accountable. She hired an unlicensed midwife (in VA), she knew she was breach, and was told by a licensed OB not to do it. That poor baby suffocated.

      • Charity Ponton

        I think you missed my point completely. But we are all entitled to our opinions :)

  • bmoregyrl

    No one knows the whole story, I believe that she should not be charged at all. The woman knew what she was getting into when she decided to have the baby at home. People judge to quickly and not knowing the whole story you should not be judging. So I hope that this woman walks away with no guilty.

  • whatnow

    The midwife should only be charged with practicing without a license. The mother should be charged with manslaughter. If you are having your first baby at 43, you are mature enough to now what a miracle it is and if the doctors and other midwives have told you it is breech and should be delivered in the hospital, your selfishness to want to have the baby at home, is what killed the baby. God bless this little angel that didn’t have a chance with this idiot as a mother.

    • Susan

      Why is the mother an idiot when midwives are out there selling the idea that doctors are bad, that c-sections leave the mother unable to bond with the baby, and that they, as women, understand more and have delivered lots of breech babies safely??? This is a money making industry set up to scare women away from medical professionals.

    • lynn d

      i agree totally!!!!! this is the smartest comment i have heard all day!!! Let me say if i was 43 i wouldnt of given it a second thought about giving birth in a hospital. Now because of the moms selfishness she wants to put the blame on someone else and yet ruin anothers life…..

    • j

      I totally agree with you. Mothers who refuse doctors’ advice and withhold medicine from their sick child are charges with manslaughter, so why shouldn’t she be? And yes the midwife should have her license revoked for practicing where she wasn’t supposed to, but not manslaughter. But then that’s why OB’s malpractice insurance are so high-they get the blame despite poor decisions of the mother(And they’re doctors not midwives)

    • Shauna

      i totally agree

  • PAT


    • Lain

      Yeah. Like the hospital Jesus was born in? Give me a break.
      I delivered 4 healthy babies at home with the help of an educated, qualified midwife. I PAID MORE to do this out of my own pocket that I would have if they were born in a hospital and insurance covered some of the cost. This isn’t about cost in many cases. It is a quality of experience choice. Please educate yourself.
      If I had complications during pregnancy my midwife would have referred me to an OBGYN for hospital delivery. In many states that is the law. Breech baby? No home delivery. Twins? No home delivery. Why? Because those laws keep mothers and babies safe. Hate to say it, because midwifes help many women have a positive experience during birth at home, but if the caregiver wasn’t observing the law punishment to the full extent of the law is reasonable. She should have said no.

  • SW

    Women who choose this way of birthing when they are at risk are VERY selfish. Just to have the “experience” she wants, she ignores the professionals advice. Both the mother and the midwife SHOULD be held accountable.The midwife is knowledgeable enough to know that the situation was very risky – the BirthCare Center strongly advised the woman having the baby against homebirth. Whether people like it or not, lifesaving equipment is in the hospital, and that is where the attending helpers in this case called to save the baby when the birthing went wrong. People can always heal from a Caesarean, but they will never heal from losing a baby. Maybe this midwife will think twice before trying to fulfill a selfish expectant mother’s desires when there is high risk involved.

    • alyssab

      I had a hospital birth with my daughter and hated it because i wasnt progressing quickly enough for the doctor he made me get a c-section, my daughter was in no danger, her heartbeat, vitals etc were just fine. So i decided to have a home-birth with my son and it was the best experince ever!! Its not about being selfish, its about being natural…. Doctors push drugs, unnessary c-sections etc. They see birth as a “medical process” not the natural process it is. My son was 9lbs 4 oz and sideways… Every ob i have seen since then says i should have had another csection because he was big and crooked. My amazing midwife had no problems getting him out safely without any trama to me or him. And i hate to break it to you, almost all midwives deliver breech babies at some point. Some home-birthers chose not to get ultrasounds, testing etc…. Yes this woman in question knew it was risky but she made her decision, the midwife and the mother should not be held accountable for a MISTAKE. Why arent nurses or doctors charged when they give a newborn the wrong kind of meds at a hospital and kill them, what about if a baby is born and it dies, should the doctors be held accountable…

  • SmartMom

    She should absolutely be charged. She chose to assist in a complicated breech birth after other medical professionals warned against it, and without a license. True, the mother opted for a midwife assisted home-birth after being told of the risks, but as the professional, the onus of the situation falls squarely on the midwife. She should have known better, and because of her decisions, an innocent baby died. Break the rules = punishment.

  • Buffy

    OMG a bad decison was made. No one should be charged. It was the mother right to have her child at home, no matter what ANYONE says,and no one has the right to tell her she couldn’t.

  • Williejoe

    Unlicensed?…Bad decision period. I wouldn’t want this person delivering my child. Why in the hell didn’t she take action & call 911.

  • Common Sense

    This is what you get for using a moronic midwife with no medical license. What do people expect (when using an unqualified individual to bring a human life into this world?) People need to pay the consequences for their stupidity. This quack deserves everything coming to her.

    • j

      She was qualified and had a license-just not licensed in VA>She was wrong but lets get the facts straight.

      • Common Sense

        Apparently you didn’t read my comment correctly. I said no “MEDICAL LICENSE”, thus my facts are certainly “straight” ; A midwife is not a Physician, therefore cannot have a medical license. A Midwife license is NOT the same as a medical license! My point was that I’d never, ever allow a non-Physician anywhere near me during childbirth, as they do not have the same education, expertise, or resources as a doctor in a hospital.

  • Belinda

    Can anyone guarantee that the complications of hospital interventions outweighed the risk of a birth with minimal intervention? Yes, it’s common medical lore in this country, but is there research to back this up? I’ve looked for it, and I’ve yet to find any research that shows that our modern obstetrical model is best for mothers or babies. Once we understand that our standard operating procedures are not based on research, we see that there is no clear answer. Babies sometimes die during birth, and so do mothers. Nothing in life is without risk.

    • Erin

      My son would have died, and probably me too, if I hadn’t been at a hospital. Everything seemed to be going fine until it came time to push… things went down hill from there. There wasn’t any way that he was going to be born that way, he was stuck. I really wanted to do natural birth, but the safety of my son was way more important, and thankfully he was born healthy beacuse of careful monitoring by the doctors and nurses at the hospital. It isn’t ALWAYS necessary, perhaps, but as you say, nothing is without risk — and having a home birth or a natural birth wasn’t worth either of our lives. That’s just my experience, but there are thousands like me out there. Modern medicine may not be best in a case where the birth COULD occur naturally, but they can’t necessarily know that beforehand. It doesn’t hurt to at least be in a place where they can provide emergency care if it’s needed.

  • sta

    Well she will surely lose whatever license she has left. Both parties are at fault here. A mother who clearly knew the risks and a Midwife who got a little over confident in her abilities. Sadly now an innocent life is lost.

  • JustSaying

    The mother and the midwife made mistake. Just because the OBGYN siad that it could be risky doesnt mean they should be charged. Any childbirth has risk, When I went into labor the nurses or the doc never seen the complications i had and it almost cost me my life. If it wasn’nt for my mom screaming and yelling at the doctors they would not noticed until it was to late.

  • the facts...

    The facts are this article isn’t accurate. The birth center (midwives) told her she had options to birth at home and even recommended this home birth midwife but also told the mother she could deliver her breech baby vaginally in a hospital. And of course there is always c-section. No one should be charged. The mother made the best decision at the time based on information from everyone involved. The midwife is only guilty of practicing without a license. The birth center should not be at fault either because they properly gave this woman her options and she picked one. Whether she delivered vaginally in the hospital or not, the baby would have gotten stuck at the head. The baby would have been very brain damaged or died. There are risks in all deliveries. We do not arrest OBs for the babies who die after an early c-section or a forceps delivery or vacuum delivery gone awry. Its considered a tragic accident. There is no difference here. And the OB in this article is wrong. C-section isn’t safest for all breech babies. Only in hindsight do we see that now for this baby although there is no guarantee the mother wouldn’t have died from surgical complications or infection. However did mankind make it to 2011 without C-section? Fact is, c-section causes our infant and maternal deaths more than vaginal birth. This mother knew she had an increased risk doing a breech birth but also knew that she and her baby had a 3 times greater chance of dying during a C-section than a vaginal birth. Everyone should learn the facts before judging.

    • NatureFreak1978

      the facts….You made a vaild statement regarding the OB’s statement about C-sections being the safest delivery method for breech babies. The OB was wrong for saying that but like any other doctor they are paid the big bucks to make those sort of statements. Our society is built around the belief that physicians know what’s best when the fact of the matter is there is always a risk with anything. Death is inevitable and that baby may have died even if it were delivered in the hospital. To make this woman go to prison for manslaughter is absolutely uncalled for. The charge for practicing without the appropriate credntials is understandable but manslaught and abuse, that’s a bit much. I mean seriously, we got women out here who can’t even get a restraining order against a psycho ex and then ending up dead in the end.

  • NatureFreak1978

    I don’t think the midwife should be held liable at all. The baby could have died in a hospital just as the baby died at home. The mother new the risks and made a choice. It is tiresome to hear how common folk get held accountable for so much when our society is more willing to bailout companies for financial misfortune rather than having mercy on a woman who was performing a duty she has done thousands of times. Humans die, it is inevitable. The fact of the matter is that this child could have died regardless of where the birth took place. Just because physicians receive years of education does not make them gods of humanity. Most of them study medicine for the money. I mean who would spend thousands of dollars on education jsut to make minimum wage. Seriouslly. The focus should be on the mother loosing her child and praying for her strength to endure that loss.

  • ShannonF

    I am the mother of three children. I could go on about my experience with homebirth, but that is not the point here… Instead my heart and prayers go out to this mother and to this midwife and to their whole families that grieve with them. Death is a part of life and one we choose to ignore in our modern society. Death happens, it is a risk we take in living. It does not lessen the pain we feel with loss, but rather acknowledges the value that losses add to our life. I do not believe that either the mother or the midwife should be charged with a crime. I think that’s ridiculous. Are the hospitals and doctors charged when patients die? Unless there is a case of serious negligence, no, and often then they just pay monetary fines. Babies are born healthy at home, breech and otherwise. Never in our history has EVERY baby made it, in the hospital or otherwise. Currently the United States has the WORST survival rates for the delivery of babies in the industrial world. The reason, delivery at home is often safer, and is the tried and true method of just about every country with better birth survival rates than ours. That’s why stories like this one are so rare, but babies die in deliveries at the hospital every day… God bless their families!

  • AY

    One’s birth is a matter of choice…home, hospital, birth center, office…it’s the choice a family makes. Everything has risks and one must decide what benefits, risks, alternatives they are willing to do. Breech birth is a lost art. Yes, there was a time when breech births were preferred, taught and safely done. Because of the medicalization of birth much of the art of birth has been lost.
    rom: January 2006 issue Vol. 194, No.1

    The American Journal of Obstetrics and Gynecology (2006) 194, 20-5

    “Results: most cases of neonatal death and morbidity in the term breech trial cannot be attributed to the mode of delivery. Moreover, analysis of outcome after 2 years has shown no difference between vaginal and abdominal deliveries of breech babies.”

    This article January 2006 questions the Objective, Study design and Results of the study frequently quoted for making every breech an automatic cesarean. The Conclusion is that previous recommendations should be withdrawn.

    In most cases a vaginal term breech is at no more risk than a cesarean term breech.

    Also, another point that is left out was that this was NOT the first breech she had done. She has done hundreds! I am one of her clients. I support her, I support womens choices for birth.

  • WandaM

    In this country obstetricians and midwives have been cowed by the legal system, and thus most are inexperienced. Other countries do it (breech births and VBAC’s) better. They do it more safely. They do it with MIDWIVES and many at home or birth centers. They also have a WORKING RELATIONSHIP with their midwives and have a system set up to SUPPORT homebirth transports of women and babies. THAT IS WHAT KEEPS BIRTH AND BABIES AND MAMAS SAFE!!

    The actual research evidence shows that homebirth IS safe and that homebirth with a Certified Professional Midwife who may or may not hold a Bachelor’s or Master’s degree in midwifery and certainly does not hold a medical degree or nursing degree IS A SAFE BIRTH ATTENDANT. CPMs are not inadequately trained. They are much better experts at natural, normal birth than any OB wishes they could be! They do not interfere with birth and do not unnecessarily use drugs or interventions all of which makes birth unsafe for mom and baby – ask those women and babies who’ve suffered or died after forceps, vacuum, drugs, Cytotec, Pitocin, infection in the hospital, cesarean section, blod clots, hemorrhaging from surgical errors and other interventions gone awry. Many more babies die in-hospital and it will always be that way. Less babies die in birth centers and at home – these attendants are trained to see signs of distress and if the signs are acted on promptly, it is very unlikely the baby will die. It is nearly unheard of for mothers to die in childbirth at home or in the birth center. Yet our country has a higher maternal mortality rate than most of Europe and other developed countries – embarrassing!! It happens mostly to those women having cesareans – surgery increases the risk of maternal death 3 to 4 times that of vaginal birth ESPECIALLY after 3 or 4 cesareans. VBACing is much safer! VBACing after one cesarean or three cesareans is safer than cesarean birth for the mother.

    What is the real problem here? The real problem is that doctors in hospitals and midwives in hospitals DO NOT offer VBACs (some say they do but in the end – look at their actual VBAC #s), VBAMCs (vaginal birth after multiple cesareans), breech births or vaginal births to hypertensive moms. Because the woman cannot birth at the birth center either (another ACOG doing) nor can they birth in the above situations in the hospital, they look to homebirth by default. Some only want homebirth even if they did have the choice but some do want a choice but it is not there!!

    Another HUGE problem is that doctors and hospitals remain hostile to many midwives and women who transport in pregnancy, labor or postpartum from a homebirth. It’s unacceptable!! When women or midwives fear judgment, persecution in any form or poor treatment of mom/baby to “punish” for their original choice, then birth will continue to remain unsafe.

    – ACOG start following their own guidelines and offer VBAC and VBA2C and EVEN VBA3C as proposed by the NIH as being JUST AS SAFE AS VBA1C.

    – ACOG reverse their position on breeches like Canada’s OB/GYN college (SOGC) and start offering vaginal breech birth in the hospital – that would mean having OBs and CNMs trained by CPMs/some CNMs who still actually do breech birth.

    – ACOG stops coercing women into unnecessary, premature inductions and cesareans because they are VBACing, having twins, Breech, Hypertensive, Diabetic, etc… Many of these women can SAFELY birth naturally and vaginally if each case is considered individually and protocols for a “group” are not applied to every woman.

    – ACOG reaches out to MANA and builds a relationship with CPMs and CNMs, especially those practicing in the home or birthing centers.

    – ACOG and hospitals set up a system of transfer for homebirth by ANY attendant much in the same way they do with area birth centers to keep pregnancy, birth and postpartum/postnatal care SAFE!

    – ACOG only produces and promotes solid evidence-based research to back up all of their statements and admits that Dr. Wax’s study is heavily flawed and withdraws it immediately.

    – Lastly, the ACOG should write letters with their true name on the letterhead – they are now the Americal Congress of Obstetricians & Gynecologists. They switched their nonprofit status so they could back the campagin of OBs running for office and counter any lobbying efforts against homebirth and midwifery by being able to spend more than 15% of their budget on lobbying fees, etc…

    Why aren’t we ALL working together for women and babies? Other countries have a system that works together and their statistics are sadly better than ours. Lower c/s rates, lower maternal mortality rates and lower neonatal mortality rates. Until we work together, unnecessary lives will continue to be lost.

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