Celebrity Midwife Cara Muhlhahn Sued for Negligence Resulting in Stillbirth

Midwife Cara Muhlhahn, the star of The Business of Being Born, Ricki Lake’s documentary about home births, is being sued by a Manhattan couple who are claiming that it’s her fault that their baby was stillborn.  The couple, Catherine and Ricardo McKenzie, decided to have Muhlhahn deliver their child after seeing the documentary.  “Initially, they considered using a physician and they went to a different midwife for home birth,” said Richard Reich, a lawyer for the couple. “When they heard about Cara Muhlhahn and all of her expertise and they saw the movie, they decided to have her deliver their baby at home.”

But now Muhlhahn and her aides are being accused of “gross negligence” for failing to refer Catherine McKenzie to a doctor during her three days of labor, despite the fact that the McKenzies’ apartment was less than two blocks from a hospital.  Reich claims that Muhlhahn violated state law by “failing to have a written practice agreement with a hospital where a licensed doctor could provide care.”

This is not the first time that Muhlhahn, a self-described “outlaw” midwife, has been accused of negligence, incompetence, or disregard for the health of the mother and child.  A New York Magazine profile of Muhlhahn by Andrew Goldman, published last March, showcased Muhlhahn’s disturbing, daredevil tendencies.  And although The Business of Being Born, which has done much to legitimize and glamorize the home birth movement, makes Muhlhahn’s care seem infinitely preferable to a sanitized, impersonal, drug-filled hospital birth, Goldman’s profile is much darker.

He recounts the horror stories that didn’t quite make it into the movie’s final cut – like the time Muhlhahn left a woman in labor for 72 hours while she went off to deliver another baby. When Muhlhahn returned, the father (understandably worried about his wife’s health) asked, “How long is too long for a woman to be in labor?” “Never,” Muhlhahn replied. The woman was taken to the hospital and the baby was delivered by C-section. She remembers her reaction to entering the hospital, which surprised her – “It was a feeling of, ‘Oh my God. Here are people in their white lab coats who know what they’re doing, and there’s equipment and medicine here.’ Then I looked over at Cara with her crazy hair and ragtag clothes and I said to myself, ‘What was I thinking?’”

From the limited information available right now (Muhlhahn did not return calls to her office, and so was not quoted in the article), it sounds like Muhlhahn made a serious mistake.  And indeed, the NY Mag profile pointed out that in 2003, settled a $950,000 lawsuit over a home birth that left a baby partially paralyzed.  Although Muhlhahn’s glamorous “outlaw” midwifery has helped to make the home birth movement more mainstream, something that I think is ultimately very good for birthing generally, she is careless too often, and unwilling to admit that sometimes a hospital is necessary.  Her stated goal, to “render birth more poetic than clinical,” sometimes blinds her to the necessity of medical care that she is personally unqualified to provide.  And this blindness has resulted several times in tragedy.

It’s important to remember that nightmarish experiences can happen in hospitals too, and that birthing sometimes is a dangerous process – but many hospitals and birthing centers are helping to bridge the divide.  Some midwives (Muhlhahn is not one of them) have hospital privileges, allowing them to move their patients to hospitals if the birth is not going smoothly.  Muhlhahn also does not have a protocol under which women “risk out” of home birth because of complications like vaginal birth after cesarean section, breech births, diabetes, and twins.

Obstetrician Jacques Moritz, who is an unabashed proponent of the home birth movement, still has reservations about some of Muhlhahn’s practices.  “I like her, but there’s some protocols that she has that I just can’t sign off on,” he says. Like the breech babies and vaginal births after Cesarean (VBACs) she says she’s performed at home? “That’s like bragging,” he says. “There’s a lot of stuff I’ve done, too, and said afterward, ‘Wow, I didn’t know I could do that.’ But I wouldn’t want to do it again.”

This particular case was highlighted on a Today show segment last month titled “The Perils of Midwifery”, which resulted in outcry from the home birth movement.  The petition against the segment, which you can see (or sign) here, claimed that the show presented a “gross misrepresentation” of midwife-attended home birth.  Citing the United States’ high infant mortality rates, the sponsoring organization, Choices in Childbirth, chastisted NBC producers for failing to recognize “an opportunity to discuss the reasons why highly educated, thoughtful and responsible women are choosing a home birth with a qualified midwife as an alternative to a hospital birth- an option that other countries have proven again and again costs less money, necessitates fewer c-sections, and provides better outcomes for mothers and babies than our system.”

So where does this leave us?  Certainly one thing we can take away from this is that even though Cara Muhlhahn has made some questionable, and even dangerous decisions, she is not representative of all midwives, and although her presence as a “celebrity midwife” has popularized home birth, her apparent daredevil qualities are now making her something of a liability for less radical home birth proponents.  Muhlhahn has had dramatic victories, and tragic defeats.  But the spectacle that she has created is distracting from the most central tenets of the home birth movement: that women have a right to give birth how they choose, without drugs if they don’t want them, without a cesarean section if it’s not necessary, and, if it’s safe, in their own homes.  There are many other midwives who are trying to provide this, in much safer and less dramatic ways, and they are being hurt by hyperbolic media characterizations, in part brought on by cases like Muhlhahn’s.

What are your birth stories?  Have you had experiences with home births or hospital births?  And if you haven’t yet had children, how do you want them to be born?

Photo courtesy of The Business of Being Born.  Photo by Paulo Netto.


Yana W.
Yana W.7 years ago

I had two babies at home with Cara. I felt that my babies and I were very well cared for throughout the pregnancies and birthing process. And I hope to have a 3rd with her.

I did read the NY Times Magazine article and this one. What's never mentioned is how many healthy births Cara has attended at home, how few transfers to hospitals she has had to do over the many, many years she has been practicing. There is a reason that she is a midwife to celebrities and has had the opportunity to attend so many births. I think that might put some things in a more balanced perspective.

If I had doubts about my health, I would not consider homebirth. Homebirth has to make sense to you on an individual, personal level. I am by no means a rebel, to the contrary, I read up on all the issues to be absolutely certain of my feelings about it, but homebirth is normal to me. I was born at home in the early 70s, as were my 3 siblings and the 4 children from my father's first marriage in the 60s, these were attended by "lay midwives", were family only (!), not even a Certified Nurse Midwife (like Cara). No problems. In my family, it was thought to be important to have excellent prenatal nutrition, to be in best possible health for the optimal birthing experience and healthiest mom and baby. Hospitals, because of the shear numbers of people, have to assume the worst about a woman's health. I understand that. I feel very privileged to have had such great birthing experiences.

Virginia R.
Virginia Rallis7 years ago

Both of my sons were born @ home with Cara Muhlhahn. I would not have it any other way. We were going to tranfer with my 2nd birth to a hospital because the labor was not progressing but ended up delivering at home. It just started happening. It is a shame that Cara is facing these charges. Birth in hospitals are not without fault,complications or unsuccesful births & I would think in some circumstances way more risky then home.Cara is incredibly competent. Things do go wrong with home birth too. Cara's record is pretty good. I support home birth & Cara

Yvonne C.
Yvonne C.8 years ago

I had a stillbirth in a hospital after having state of the art care at a teaching hospital with obstetricians and nurses and technology and I nearly died from infection following it. I chose to have my babies at home because, for me, it was safer and more humane. Babies die in hospitals everyday. Technology can't save everyone.

Marilyn C.
Marilyn C.8 years ago

Significant research supports the safety of home birth. As a labor nurse with nearly 40 years of experience in a hospital setting only I have no reservations about recommending home birth with a midwife. In the current health care environment, home birth is likely to be safer actually. To those who want to know why midwives don't have hospital privileges, please be aware that physicians control who is permitted to admit / attend births in hospitals and they have refused in many places to even consider allowing midwives into the "club". Women have been cheated out of a safe, spiritual birth by a system that is driven by greed and control.

Carol L.
Carol L.8 years ago

For a beautiful and powerful midwife's memoir, please read LADY'S HANDS, LION'S HEART, A MIDWIFE'S SAGA by Carol Leonard, Bad Beaver Publishing, 2008.
Ina May Gaskin,author of Spiritual Midwifery, calls it, "Inspiring, often hilarious, always touching and full of beans, Carol Leonard's memoir overflows with her gifts as a storyteller as well as intuitive midwife. This is a story of love, loss and deep dedication to birthing women."
Available from Amazon as well as www.badbeaverpublishing.com

Manuela Bortolussi
Manuela B8 years ago

Why would any woman risk herself and child by having a homebirth is beyond me. Do people not remember the death rate in pre hospital days. I like to think that we have progressed to an age where we have experts and qualified doctors and nurses to moniter and rectify any problems that may arise. and that is something NO ONE is able to determine - because a birth can go wrong at any time. Not to say a hospital birth is guarranteed to go smoothly without any problems, but I think the risk is lessened and why would you not take advantage of that.

Victoria B.
Victoria B8 years ago

No, though I won't use her for sure!

Ch Hardy
Past Member 8 years ago

I have had a baby and was lucky I was in the hospital...I wanted the drugs to help with the pain I was having and I had to have an emergency c - section. It saved my daughters life. Births go both ways & to those women who gave birth without drugs and at home - I give praise and hugs to you...Its not for me.

I dont know all the facts in this case to really say if Cara murdered this baby and would have to see more facts about the case before making that decision but I am sure Law & Order will do an episode based off this in the upcoming year.

Amanda M.
Amanda M8 years ago

Both my children were delivered by midwives, and both were hospital births. The first one was supposed to be delivered in the CNM's freestanding birth center, but she was on vacation the week I went into labor. The backup midwife who was on call was from a different state (we're in the section of Maryland between West Virginia and Pennsylvania-birth center was in PA, the backup midwife was in WV) and was not licensed to work in the state where the birth center was, so we found out at that point that we'd have to go to the hospital (which is what I was trying to avoid in the first place because the hospital here has very little in the way of amenities for natural birth!). My daughter arrived less than an hour after we got to the hospital (including an ambulance ride due to a fast labor).

My second daughter was also born at the same hospital nearly five years later. The CNM I'd gone to had closed down her practice due to the skyrocketing malpractice rates, but there was another group of CNMs in practice here. Unfortunately, they only do hospital births, so once again my hopes for an out-of-hospital birth were dashed. At least this time we knew what to expect at the hospital and they knew we wanted the birth to be as free of interference as possible! It'll still never be my idea of an ideal place for a homelike delivery, though. Women should have all birthing options available to them if they desire!

Kati S.
Kati S.8 years ago

I had both of my sons in the hospital. 26 and 24 years ago, our insurance didn't cover and we couldn't afford out-of-pocket to pay for at-home birthing. I had absolutely No medications, Only IV fluids. In my eyes, I had two completely "Natural" childbirths. I simply was not at Home when I gave birth. It would have been nice, but as it turned out... with my first son, I hemorrhaged (I have a bleeding disorder). So, for my sake, it was a Good thing to be in the hospital. They immediately handed me my son so he could begin breastfeeding - this helps the uterus begin contracting and helped to get the bleeding under control. I had no problems with my second son except that he was in a hurry and was born 15 minutes after we got there! My children are precious to me. I'm simply content that they are Here and Healthy!

God bless All mothers - Wherever they give birth - and especially those who don't get to see those precious ones grow older......