A home birth midwife is facing scrutiny over the death of a newborn child - as it is revealed she previously spent time in jail after another baby died in her care.
Karen Carr has reportedly been investigated by authorities three times since 2010 following three different babies' deaths. In 2010, she was jailed in Virginia for child endangerment after a baby in her care died. An investigation by the Washington Post found she is still licensed to practise in two states.
Carr has also been fined $30,000 for practising without a licence in Maryland. In DC, she was investigated but eventually cleared. The investigation by the Post said Carr's long and ongoing career shows there are massive holes with the regulation system of home birth midwives, and it is difficult for parents to find out if someone is properly licensed and safe.
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There are just 36 states that have licensing laws for midwives but the rules across those states differ dramatically. Only around 1.4% of babies born in the US are through home births, but analysis by the Post found that a baby born at full-term is twice as likely to die during a home birth with a midwife than if it were delivered in a hospital.
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According to the DailyMail, Carr once told an investigator: "I don’t want a licence, I don’t like the rules of a licence, you know. I suppose I could get a licence but they’d probably take it away from me five minutes after I got it." Carr's former lawyer told the paper that The Post's report is a "gross mischaracterization of Karen’s performance as a midwife and her care and aversion to risk. She has an excellent reputation and an excellent history of success in her work."
She was questioned on bodycam footage when paramedics attended a birth where a baby died (Calvert County Sheriff Office)A local hospital first became concerned about Carr in May 2010. The then chief of staff at St Mary's Hospital in Leonardtown reportedly wrote to the state board of physicians: "That none of her patients have died after she’s dumped them at our hospital is plain dumb luck. I hope action can be taken before she kills a mother or baby in our community."
She was reportedly approached by a couple whose baby was in the breech position. Babies in this position often require delivery by c-section in hospital due to the high risk of complications. The couple however reportedly hoped to have a home birth. It is alleged that Carr told this couple she had delivered more than 40 babies in the breech position. Carr was not licensed in Virginia, and told the couple this, however they reportedly went ahead.
During the birth, the baby's head got stuck in the birth canal and when he was finally delivered he was not breathing. He was taken to hospital in a comatose state and the parents decided to remove his life support. His death was investigated by the Virginia Department of Health Professions and Carr was interviewed as a part of this.
She is the subject to an investigation by the Washington Post (Calvert County Sheriff Office)Just a few days later paramedics were called to attend another home birth that Carr was present at in Maryland. One of two babies born was reportedly having trouble breathing but Carr is said to have insisted it was fine. The baby later died in hospital. It was around this time that staff at the Children's National Hospital noticed that they had treated three babies who had been under Carr's care who eventually died.
A grand jury in Alexandria indicted Carr on six felony counts in 2011. This included involuntary manslaughter and child abuse in relation to the baby that died in Virginia. She accepted a plea deal and pleaded guilty to child endangerment and performing an invasive procedure without a licence. She was jailed for five days and made to pay a $3,200 fine. She also agreed never to practise midwifery in Virginia again.
A 'cease and desist' from delivering babies was also sent to Carr in Maryland alleging she was practising without a licence but she claimed midwifery was not medicine and she did not need one. The judge disagreed and she was fined $30,000. In 2017 The Post said she applied for a midwifery licence in Delaware, Wisconsin and Maryland.
She once spent five days in prison (Alexandria Sheriff's Office)Her licence was approved in Delaware but denied in Wisconsin with officials reportedly responding with saying she "posed an unreasonable risk of harm to the public." In 2020, she was licensed in Maryland, with the board who approved the licence having said: "Since her conviction, the applicant has demonstrated a strong commitment to the profession of midwifery and the safety of mothers and babies." A year later a couple accused her of negligence after a baby died during childbirth while under Carr's care. Her licence was suspended after a complaint was made.
Her former lawyer, Micah Salb, told the Mail: "It is useful to recognize that the Maryland claim against Karen began when several physicians began stridently claiming that Karen Carr posed a grave danger to Maryland families. The facts were irrelevant — in fact, Karen Carr has safely aided in the delivery of over a thousand healthy babies.
"The Board of Physicians quickly recognized that it could not prevail in a case about the quality of Ms. Carr’s midwifery services, so it explicitly conceded at the start of the case that this case was not about standards of care. This is important because it contradicts the Post’s version that Karen’s work was deficient. It is easy to attack the caregiver—whether a doctor, nurse, or midwife—when a baby dies. It is harder to prove that the baby’s death was actually caused by the caregiver."
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